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Factors Contributing to Delay in Diagnosis and Start of Treatment of Leprosy: Analysis of Help-seeking Narratives from a Community Study in Dang District 麻风病诊断和治疗延迟的因素分析——来自党区社区研究的求助叙述
Pub Date : 2018-12-31 DOI: 10.3126/DSAJ.V12I0.22175
M. Subedi, Ulla-Britt Engelbrektsson
Prolonged delays between first symptoms and diagnosis easily result in more impairment in newly detected leprosy patients, and aggregate negative consequences for individuals and their families. In cases of infectious leprosy, longer delays increase the risk for the spread of the disease. Limited studies have been carried out to explore the causes for delays in Nepal. This is a community level qualitative study conducted in Dang district. The information was obtained through in-depth interviews with 8 leprosy affected persons, 8 contacts, 8 community members and 5 service providers in Dang district. Skin patches were regarded as a simple skin disease, in particular of paucibacillary patients who had a limited number of skin lesions and no nerve damage. A local medical shop was the first choice for medicine to treat skin conditions. Delays in diagnosis of leprosy occurred at many stages from the development of the symptoms to consultation of health care services. The use of traditional medicine, a belief in self-cure and visit to traditional healers, and misdiagnosis (a disease other than leprosy by the health worker) and inadequate knowledge about the disease and its early symptoms were the main factors that influenced the delayed diagnosis. Delays accumulated as the result of series of help-seeking actions that reflected local socio-cultural beliefs and practices. Misdiagnoses could be reduced if adequate information on leprosy is given to community people and health service providers. Specific interventions are needed to promote knowledge and a good attitude among contacts and community members. To reduce patient delay, public health promotion is needed to increase the awareness of leprosy, and the health service delay should be reduced by improving diagnostic skills in public and private sectors. Addressing both components of delays will decrease the time to diagnosis and ultimately the extent of transmission of the disease and reduce the risk of nerve function impairments.
首次症状和诊断之间的长期延迟很容易导致新发现的麻风病患者出现更多的损伤,并对个人及其家人产生负面影响。在传染性麻风病病例中,延迟时间越长,疾病传播的风险就越大。为探讨尼泊尔延误的原因,进行了有限的研究。这是在当区进行的一项社区层面的定性研究。该信息是通过对当区8名麻风病患者、8名接触者、8名社区成员和5名服务提供者的深入访谈获得的。皮肤贴剂被认为是一种简单的皮肤病,尤其是对皮肤损伤数量有限且没有神经损伤的少杆菌病患者。当地一家医药店是治疗皮肤病的首选药物。麻风病的诊断延误发生在从症状发展到咨询卫生保健服务的许多阶段。传统医学的使用、对自我治疗和拜访传统治疗师的信念、误诊(卫生工作者对麻风病以外的一种疾病)以及对该疾病及其早期症状的了解不足是影响延迟诊断的主要因素。由于一系列反映当地社会文化信仰和做法的求助行动,延误不断累积。如果向社区人民和卫生服务提供者提供足够的麻风病信息,就可以减少误诊。需要采取具体干预措施,在接触者和社区成员中促进知识和良好态度。为了减少患者延误,需要促进公共卫生以提高对麻风病的认识,并应通过提高公共和私营部门的诊断技能来减少医疗服务延误。解决延迟的两个组成部分将缩短诊断时间,最终缩短疾病的传播程度,并降低神经功能受损的风险。
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引用次数: 7
Addressing Linguistic Diversity with Three Language Formula: A Case Study of Newa Schools in Newa Settlements 用三种语言公式解决语言多样性:以纽瓦聚居区纽瓦学校为例
Pub Date : 2018-12-31 DOI: 10.3126/DSAJ.V12I0.22183
T. Bhattarai
Nepal, as a multilingual nation, has constitutionally adopted mother tongue based multilingual education (MTB-MLE) policy in 1990. However, implementation of this policy into practice has been taking considerably a long time. This study, primarily focused on Newa Schools in Newa Settlement Campaign (NSNSC), looks into the efforts made by Nepalbhasa communities to implement the MTB-M LE policy by adopting a practical strategy of three language formula to facilitate students’ learning through mother tongue, official language Nepali and international language English, thus, addressing the demands of socially and culturally diverse parents as well. This study has been carried out with ethnographic methods including participant observation, interviews, electronic recording, taking notes while recording and also using local language as suggested by Duranti (2000, pp.99-118 ). The data have shown that as a new experiment the three language formula has been a success story and a raiser of hope for future endeavors to implement MTB-MLE policy in the context of Nepal’s linguistic diversity. What is still required is to chart a ‘plan of action’ supported by ‘political will’ of the government (central as well as local) and an active support of respective linguistic communities.
尼泊尔作为一个多语言国家,在1990年宪法上采用了以母语为基础的多语言教育(MTB-MLE)政策。然而,这一政策的实施已经花了相当长的时间。本研究主要聚焦于Newa Settlement Campaign (NSNSC)的Newa学校,研究尼泊尔语社区为实施MTB-M LE政策所做的努力,通过采用三种语言公式的实用策略来促进学生通过母语,官方语言尼泊尔语和国际语言英语进行学习,从而满足社会和文化多样化的父母的需求。本研究采用民族志方法进行,包括参与观察、访谈、电子记录、记录时记笔记以及使用Duranti (2000, pp.99-118)建议的当地语言。数据表明,作为一项新的实验,三种语言公式是一个成功的故事,并为未来在尼泊尔语言多样性的背景下实施MTB-MLE政策带来了希望。仍然需要的是制定一个“行动计划”,得到政府(中央和地方)“政治意愿”的支持,以及各自语言社区的积极支持。
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引用次数: 1
A Review of Simarongarh’s History on Its Nexus Areas with References of Archaeological Evidences 从考古证据看西玛荣格尔及其周边地区的历史
Pub Date : 2018-12-31 DOI: 10.3126/DSAJ.V12I0.22176
Prakash Darnal
After the Lichachhavi period, Nepal was bounded within the Kathmandu valley only. Sinja emerged as a powerful state in the west of Nepal. Likewise, Karnata dynasty became strong and powerful to the south of Nepal in the beginning of 10th and 11th century A. D. They were so strong and powerful that they attacked Kathmandu valley several times and plundered for the sake of wealth. So Simraongarh was once an important medieval kingdom of Nepal. It was established by Karnata dynasty Nanyadev in 1097 A. D. After capturing Mithila, Nanyadev began to rule it from Simraongarh. He has been credited in the records for the unification of Tirhut. Under the Karnatas Tirhut had developed on economic, social and cultural which was also known as golden age. They ruled over Mithila for about 227 years and after that Gayasuddin Tuglak conquered. Muslims ruled about three hundred years, and then it came under Sens of Makawanpur. Lohang Sen had extended his territories up to Vijayapur. When Prithivi Narayan Shah conquered Makawanpur in 1762 A. D. all part of eastern Terai including Tirhut or Mithila became integral part of Nepal. After the Anglo Nepal war in 1814 - 16 A.D., Nepal lost some parts of eastern Terai, it came again under its jurisdiction in Sugauli Treaty of 1816 A.D. But now people seem to forget Simarongarh which was once so rich and highly developed. Therefore, the objective of this article is not only to remind of its glorious past history but also to prove how important this area through archaeological findings.
在利查查维时期之后,尼泊尔仅以加德满都谷地为界。辛加在尼泊尔西部成为一个强大的国家。同样,在公元10世纪和11世纪初,尼泊尔南部的卡纳塔王朝变得强大起来,他们非常强大,多次袭击加德满都山谷,为了财富而掠夺。Simraongarh曾经是尼泊尔一个重要的中世纪王国。它由卡纳塔王朝南亚德夫于公元1097年建立。在占领米蒂拉之后,南亚德夫开始从西姆拉恩加尔统治它。在史料中,他被认为是提尔胡特统一的功臣。在卡纳塔斯的统治下,提尔胡特的经济、社会和文化都得到了发展,这也被称为黄金时代。他们统治米提拉大约227年,之后加亚苏丁·图格拉克征服了米提拉。穆斯林统治了大约三百年,然后是马卡万普尔的Sens。罗hang Sen将他的领土扩展到了维贾雅普尔。当Prithivi Narayan Shah在1762年征服Makawanpur时。东台莱的所有部分,包括提尔胡特和米蒂拉,都成为尼泊尔不可分割的一部分。在1814 - 16年的英尼战争之后,尼泊尔失去了东寺莱的部分地区,在1816年的《苏高利条约》中,尼泊尔重新回到了它的管辖之下。但是现在人们似乎忘记了曾经如此富裕和高度发达的锡马龙格尔。因此,这篇文章的目的不仅是要提醒它辉煌的过去,而且要通过考古发现来证明这个地区的重要性。
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引用次数: 0
Teacher: An Important but Less Recognized Actor of School Curriculum Development in Nepal 教师:尼泊尔学校课程发展中一个重要但不被认可的角色
Pub Date : 2018-12-31 DOI: 10.3126/dsaj.v12i0.22181
Kalpana Rimal
Curriculum development is considered as a key factor in the process of educational transformation. In this process, teachers can play multiple roles such as translator of learning objectives into outcome, mediator between curriculum and students and so on. On the other hand, curriculum experts contribute to making a need assessment and contents development on the basis of educational theories and principles. But, contemporary literatures point gaps in exchange of knowledge and expertise between these two important actors of school curriculum development. On this backdrop, this study aims to explore what rolesteachers can perform and how their rolesare acknowledged in the curriculum development. Following social constructivist worldview, this study adopted qualitative approach with the scientific tool of in-depth interviewsand purposive sampling design. This study reveals teacher’s contribution inidentification of practical educational needsin the context of changing overall societal needs.Moreover, the teacherscan bridge existing gaps between national educational goals, social needs and the interest of people. But the current school curriculum development process takes place at the top where curriculum experts play decisive role. These experts seek school teacher’s contribution only at the review phase of curriculum development process which is not enough to incorporate teacher’s expertise. In this respect, teachers will be able to view curriculum not in terms of content to be covered, but as a transformative process. Rather, this looks like just maintaining a formality. The attitudinal and procedural process constrain in recognition and involvement of teacher in curriculum development process. Thus, school curriculum has missed opportunity to reflect local need and increase ownership of the teachers. This paper argues for the recognition of teacher’s role as a critical practitioner and change agent, and urges to provide sufficient space to incorporate their real-life experiences in school curriculum.
课程开发被认为是教育转型过程中的关键因素。在这一过程中,教师可以扮演多种角色,如学习目标转化为结果的翻译者、课程与学生之间的中介者等。另一方面,课程专家在教育理论和原则的基础上进行需求评估和内容开发。但是,当代文献指出,这两个学校课程开发的重要角色之间的知识和专业知识交流存在差距。在此背景下,本研究旨在探讨教师在课程发展中可以扮演什么角色,以及他们的角色如何得到承认。本研究遵循社会建构主义世界观,采用定性研究方法,采用深度访谈和目的性抽样设计的科学工具。本研究揭示了教师在社会整体需求变化的背景下,在识别实际教育需求方面的贡献。此外,教师可以弥合国家教育目标、社会需求和人民利益之间存在的差距。但当前学校课程开发过程发生在顶层,课程专家起着决定性的作用。这些专家只在课程发展过程的审查阶段寻求学校教师的贡献,这不足以纳入教师的专业知识。在这方面,教师将不再从内容的角度来看待课程,而是将其视为一个变革的过程。相反,这看起来只是保持一种形式。态度过程和程序过程制约着教师对课程开发过程的认识和参与。因此,学校课程错过了反映当地需求和增加教师自主权的机会。本文主张承认教师作为批判性实践者和变革推动者的角色,并敦促提供足够的空间将他们的现实经验纳入学校课程。
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引用次数: 3
Kinship as a Social Capital in Rural Development: An Anthropological Perspective 亲属关系作为农村发展中的社会资本:一个人类学视角
Pub Date : 2018-12-31 DOI: 10.3126/dsaj.v12i0.22184
R. Aryal
This paper is the study of institutional and organizational aspects of the management system of a community based micro hydropower. It mainly focuses on the role of kinship as well as social capital for the sustainability of micro hydropower management. However, social capital has been analyzed as one of the fundamental sources of kinship organization. This study also emphasizes on the social transformation that is only possible with an effective social mobilization and reliable institutional sources. An organized form of management system for micro hydro is functioning continuously due to the consistent engagement of community, proper mobilization of groups/institutions and institutional guidance, where social and cultural substances are primarily embedded. Ethnographic fieldwork was the principal data collection method. Both direct and indirect participant observations were used to garner the substantial amount of data. In-depth nature of semistructured interviews on various social, structural and cultural aspects was used to conduct the key interviews. To make the representative units inclusive, twenty people were purposively selected for key informant interviews including male, female and from the various occupation status. The related structural issues as well as regarding the entire management system of micro hydropower were probed through the informal interviews and group discussions to enhance the ethnographic data.
本文是对社区微型水电管理系统的制度和组织方面的研究。它主要关注亲属关系以及社会资本对微型水电管理可持续性的作用。然而,社会资本被分析为亲属组织的基本来源之一。本研究还强调了只有有效的社会动员和可靠的制度来源才能实现的社会转型。由于社区的持续参与、团体/机构的适当动员以及主要嵌入社会和文化物质的机构指导,有组织的微型水电管理系统正在持续运作。民族志实地调查是主要的数据收集方法。参与者的直接和间接观察都被用来收集大量的数据。采用社会、结构和文化方面的半结构访谈的深度性质进行关键访谈。为了使代表单位具有包容性,有目的地选择了20人进行关键线人访谈,其中包括男性、女性和不同职业状况的人。通过非正式访谈和小组讨论,探讨了相关的结构问题以及微型水电的整个管理系统,以增强民族志数据。
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引用次数: 4
When the Needs of Multicultural Classroom are Ignored: An Ethnographic Study in Nepal 当多元文化课堂的需求被忽视:尼泊尔的民族志研究
Pub Date : 2018-12-31 DOI: 10.3126/dsaj.v12i0.22180
M. Dahal
The teaching-learning process begins with the interaction between the teachers and the children. Without two-way interaction between student and teachers the process is incomplete. Using ethnographic research methods, this paper aims to analyze the role of teachers in a multicultural classroom. Attempt is made to do so by exploring and understanding the school culture and its impact on children’s learning as well as the perception of the teachers in its processes. It is found that the teachers’ cultural understandings and the children’s cultural background is not adequately addressed in the teaching-learning process.
教与学的过程始于老师和孩子之间的互动。没有师生之间的双向互动,这个过程是不完整的。本文运用民族志研究方法,旨在分析教师在多元文化课堂中的角色。试图通过探索和理解学校文化及其对儿童学习的影响以及教师在其过程中的感知来做到这一点。研究发现,教师的文化理解和儿童的文化背景在教学过程中没有得到充分的重视。
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引用次数: 0
Local Governance Restructuring in Nepal: From Government to Governmentality 尼泊尔地方治理重组:从政府到治理
Pub Date : 2018-12-31 DOI: 10.3126/DSAJ.V12I0.22178
K. Acharya
Local governments are the closest unit of the grassroots communities as they are not only undertaking to institutionalize the governance system and create enabling environment to promote the democratic values and public participation mainly from marginal section in decision making process, but also accelerate the economic development so that they enhance the peoples' capacity and enable them to influence the local governments representatives for responsive governance. However, Nepali society remains frustration and dissatisfaction at the citizen level, and dishonrization and dishonesty in the political and bureaucratic domain as these attributes have created the extreme risk to capacity development of the local governments. Against this perspective, the study aims to address a major research question: to what extent local governments are able to implement the constitutional granted exclusive and concurrent rights to transform the local communities, which is a consequence of governance shift from government to governmentality. Findings indicate that more capacity is required to institutionalize the restructuring process of local governance, increase citizen engagement in local governance system, build new partnerships in changing context, enhance technical, administrative, and fiscal capacity for effective service delivery, and formulate the essential laws, acts, and regulations. Nonetheless, some major arguments such effectiveness of local autonomy, political differences mainly identity based issues, productive role of outsiders, and democratization of bureaucratic assertiveness have been remained to be answered.
地方政府是基层社区最亲密的单位,因为它们不仅致力于将治理体系制度化,创造有利的环境,以促进民主价值观和公众参与,主要来自决策过程中的边缘阶层,而且还加快了经济发展,从而提高了人民的能力,使他们能够影响地方政府代表进行响应式治理。然而,尼泊尔社会仍然在公民层面感到沮丧和不满,在政治和官僚领域感到不诚实和不诚实,因为这些特点给地方政府的能力发展带来了极大的风险。基于这一观点,本研究旨在解决一个重大的研究问题:地方政府在多大程度上能够实施宪法赋予的排他性和并行性权利来改造地方社区,这是治理从政府转向治理的结果。调查结果表明,需要更多的能力来将地方治理的重组进程制度化,增加公民对地方治理系统的参与,在不断变化的背景下建立新的伙伴关系,增强有效提供服务的技术、行政和财政能力,并制定基本的法律、法令和条例。尽管如此,一些主要论点,如地方自治的有效性、主要基于身份的政治分歧、外来者的生产性作用以及官僚自信的民主化,仍有待回答。
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引用次数: 33
Case Study Research, Philosophical Position and Theory Building: A Methodological Discussion 案例研究、哲学定位与理论建构——方法论探讨
Pub Date : 2018-12-31 DOI: 10.3126/DSAJ.V12I0.22182
Thakur Prasad Bhatta
Case study research though increasingly popular in social sciences for positivist and intrepretivist research, a kind of confusion is prevalent when it is used ignoring its philosophical position. Arguably, the case study research is considered more appropriate for qualitative research because of its foremost strength ˗ the in-depth study of complex issues. This paper, drawing from the literature, discusses the philosophical position of case study research and argues that qualitative case study research is appropriate for theory building. For theory building, this paper follows the inductive approach guided by qualitative research paradigm and argues that it is not appropriate to assess theory building from the perspective of quantitative research. Very similar to other research methods, it is natural that the case study research has certain challenges; however, most of the challenges and misunderstandings overlap causing difficulty to understand the role of case study research. Hence, this paper aims to contribute to the understandings of the challenges and misunderstandings associated with the theory building from case study research. This paper argues that most of the challenges associated with theory building from case study can be addressed employing appropriate research strategies particularly clear understanding of philosophical stance and selection of appropriate case. The misunderstandings, on the other hand, are arisen due to the differences in the researcher’s perspectives particularly positivistic thinking of them rather than the shortcomings inherent in the qualitative case study research design.
案例研究虽然在社会科学中越来越受实证主义和实证主义研究的欢迎,但在使用时却普遍存在一种忽视其哲学地位的混乱。可以说,案例研究被认为更适合定性研究,因为它最重要的优势是对复杂问题的深入研究。本文从文献资料入手,论述了案例研究的哲学立场,认为定性的案例研究适合于理论建设。在理论建设方面,本文遵循定性研究范式指导下的归纳法,认为从定量研究的角度评估理论建设是不合适的。与其他研究方法非常相似,案例研究自然存在一定的挑战;然而,大多数挑战和误解重叠,导致难以理解案例研究的作用。因此,本文旨在通过案例研究来帮助理解与理论构建相关的挑战和误解。本文认为,案例研究中与理论构建相关的大多数挑战都可以通过适当的研究策略来解决,特别是对哲学立场的清晰理解和适当案例的选择。另一方面,这些误解的产生是由于研究者视角的差异,特别是对他们的实证主义思维,而不是定性案例研究设计中固有的缺陷。
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引用次数: 17
Ethnographic Fieldnote Writing: Methodological Challenges in the 21st Century 民族志田野调查写作:21世纪的方法论挑战
Pub Date : 2018-12-31 DOI: 10.3126/DSAJ.V12I0.22185
D. Adhikari
This paper focuses on the methodological challenges in the 21st century of ethnographic field note writing using pen and pencil amidst the increasing use of modern gadgets. Many ethnographers have been using modern electronic devices to collect field texts. Thus, the ethnographers are in a dilemma whether to use the traditional field note writing method or the modern method using gadgets. To address the research problem I conducted in-depth interview with 23 participants focusing on Communist Party of Nepal Maoist female ex-combatants and observed their activities for a prolonged period in the natural setting. Fieldnote is considered the most important field text collection method in ethnographic research. Ethnographic research requires more descriptive and interpretive field text analysis with cultural aspects. This article considers the creation of ethnographic fieldnote in the act of seeing and writing through emerging insight and understanding. The challenges related to the method of writing ethnographic fieldnote have received less attention in methodological discussions. This indicates that while writing ethnographic fieldnote in the field may have some benefits looking at the field practicalities but is equally challenging. There are certain methodological aspects involved in every fieldnote writing mission. My personal experiences of writing ethnographic fieldnote about the experiences of the excombatants fail to exclude the researcher in terms of methodological aspects rather it is more multifaceted and inspiring.
本文重点讨论了21世纪在现代小工具使用日益增多的情况下,使用钢笔和铅笔进行民族志实地笔记写作的方法学挑战。许多民族志学者一直在使用现代电子设备来收集田野文本。因此,民族志学者在使用传统的田野笔记书写方法还是使用小工具的现代方法方面陷入了进退两难的境地。为了解决研究问题,我对23名参与者进行了深入采访,重点关注尼泊尔共产党毛派女性前战斗人员,并观察了她们在自然环境中的长期活动。田野调查被认为是民族志研究中最重要的田野文本收集方法。民族志研究需要更多的描述性和解释性的田野文本分析与文化层面。本文通过新兴的洞察力和理解来思考民族志田野笔记在观看和写作行为中的创造。在方法论讨论中,与民族志田野调查的写作方法有关的挑战较少受到关注。这表明,虽然在该领域撰写民族志实地考察可能有一些好处,但同样具有挑战性。每一次撰写实地考察报告的任务都涉及到某些方法方面。我个人撰写关于战斗人员经历的民族志田野笔记的经历并没有在方法论方面排除研究者,而是更具多面性和启发性。
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引用次数: 2
Critical Reflective Practice as an Approach to Developing Transformative Living-theory 批判性反思实践:发展变革生活理论的途径
Pub Date : 2018-12-31 DOI: 10.3126/DSAJ.V12I0.22186
Sadruddin Bahadur Qutoshi
This reflective paper aims to provide an opportunity to the readership in the field of transformative education in order to engage them with reflective practices as professional development approach. In academia, writing reflective papers, using multi-paradigmatic research design, for readers believing in post/positivist views is a challenging task. However, innovative editors of journals encourage to create new knowledge through un/conventional approaches. I used Jack Whitehead’s paper (i.e., the review of my doctoral study- Creating living-educational-theory: A journey towards transformative teacher education in Pakistan) and my own reflections as lived experiences to carry out this study. Moreover, I employed reflexivity as an approach to meaning making to serve the purpose of data analysis in this paper. The key findings of this study show that Jack Whitehead skillfully captures key learning outcomes of the doctoral study and synthesized some deep insights very precisely. He created a space for future researchers especially action researches and self-study practitioners to think about how to engage with multi-epistemic approaches in order to experience transformative learning. It is recommended to encourage reflective writings on un/conventional studies to develop a clear understanding of the existing state of teacher education and nature of the journey of transformative teacher education in the academia.
这篇反思性的论文旨在为变革教育领域的读者提供一个机会,以便他们参与作为专业发展方法的反思性实践。在学术界,为相信后/实证主义观点的读者撰写反思性论文,使用多范式研究设计是一项具有挑战性的任务。然而,创新的期刊编辑鼓励通过非常规的方法创造新的知识。我使用了Jack Whitehead的论文(即我的博士研究综述- Creating living-education -theory: A journey towards transformative teacher education in Pakistan)和我自己作为生活经验的反思来进行这项研究。此外,在本文中,我将反身性作为一种意义制造的方法来服务于数据分析的目的。本研究的主要发现表明,Jack Whitehead巧妙地抓住了博士研究的关键学习成果,并非常精确地合成了一些深刻的见解。他为未来的研究人员,特别是行动研究人员和自学实践者创造了一个空间,让他们思考如何利用多认知方法来体验变革性学习。建议鼓励非传统研究的反思性写作,以清晰地了解教师教育的现状和学术界变革教师教育之旅的性质。
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引用次数: 4
期刊
Dhaulagiri Journal of Sociology and Anthropology
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