Search results for: care skills

Authors: Elin Mordal, Meseret Tsegaye, Hirut Gemeda, Ingeborg Ulvund

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Background: Even the rural-urban gap in the provision of skilled care during childbirth has narrowed, developing countries have the highest percentage of maternal deaths. More important than uncovering deficiencies during pregnancy, is preventing situations of risk during childbirth. The aim of this study was to identify factors women in the rural area consider before they decide where to give birth. Methods: This study utilizes a qualitative descriptive design based on individual interviews with 25 women of childbearing age who has given birth at least once, where women who delivered both at home and a health centre were included. Data collection took place in rural areas around Hawassa Zuriya Worda in Ethiopia February 2015. To identify conditions associated to where women prefer to give birth a thematic analysis was carried out. Result: Experienced risks regarding child birth were the most common reason for women and their families to seek help from skilled birth attendants. Decision-making and planning were identified as a major factor contributing to where women give birth. The women’s position and responsibilities pointed to the fact that women's role is mainly to take care of children and manage the household, while husbands, mother in laws and the elderly are the family members who take most of the decisions. This includes decision about where women give birth. The infrastructure also influences where women choose to give birth. Conclusion: To further improve childbirth care in Hawassa Zuriya Worda it’s important that women get positive experiences, and are met in a safe and supportive way at Health Centers. Challenges appear to women’s autonomy, quality aspects, and infrastructure.

Keywords: childbirth, women, health care utilization, Hawassa Zuriya Worda, Ethiopia, rural area

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Authors: Olivera Lupescu, Taina Elena Avramescu, Mihail Nagea, Alexandru Dimitriu

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Acetabular fractures represent a real challenge due to their impact upon the long term function of the hip joint, and due to the risk of intra- and peri-operative complications especially that they affect young, active people. That is why treating these fractures require certain skills which must be exercised, regarding the pre-operative planning, as well as the execution of surgery.The authors retrospectively analyse 38 cases with acetabular fractures operated using the posterior approach in our hospital between 01.01.2013- 01.01.2015 for which complete medical records ensure a follow-up of 24 months, in order to establish the main causes of potential errors and to underline the methods for preventing them. This target is included in the Erasmus + project ‘Collaborative learning for enhancing practical skills for patient-focused interventions in gait rehabilitation after orthopedic surgery COR-skills’. This paper analyses the pitfalls revealed by these cases, as well as the measures necessary to enhance the practical skills of the surgeons who perform acetabular surgery. Pre-op planning matched the intra and post-operative outcome in 88% of the analyzed points, from 72% at the beginning to 94% in the last case, meaning that experience is very important in treating this injury. The main problems detected for the posterior approach were: nervous complications - 3 cases, 1 of them a complete paralysis of the sciatic nerve, which recovered 6 months after surgery, and in other 2 cases intra-articular position of the screws was demonstrated by post-operative CT scans, so secondary screw removal was necessary in these cases. We analysed this incident, too, due to lack of information about the relationship between the screws and the joint secondary to this approach. Septic complications appeared in 3 cases, 2 superficial and 1 profound (requiring implant removal). The most important problems were the reduction of the fractures and the positioning of the screws so as not to interfere with the the articular space. In posterior acetabular fractures, pre-op complex planning is important in order to achieve maximum treatment efficacy with minimum of risk; an optimal training of the surgeons insisting on the main points of potential mistakes ensure the success of the procedure, as well as a favorable outcome for the patient.

Keywords: acetabular fractures, articular congruency, surgical skills, vocational training

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Authors: Kyung Min Kwom, Young Joo Lee

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Purpose: Up to 90% of pancreatic cancer patient suffer from neuropathic pain. In palliative care setting, pain control in a pancreatic cancer patient is one of the major goals. Ketamine is a NMDA receptor antagonist effective in neuropathic pain. Also, there have been studies about opioid sparing effect of ketamine. This study was held in palliative care unit among pancreatic cancer patients to find out the factors related to ketamine use and the opioid sparing effect. Methods: Medical records of pancreatic cancer patients admitted to St. Mary’s hospital palliative care unit from 2013.1 to 2014.12 were reviewed. Patients were divided into two categories according to ketamine use. Also, opioid use before and after ketamine use was compared in ketamine group. Results: Compared to non ketamine use group, patients in ketamine group required a higher dose of opioid. Total opioid dose, daily opioid dose, number of daily rescue medication, daily average rescue dose were statistically significantly higher in ketamine group. Opioid requirement was increased after ketamine administration. Conclusion: In this study, ketamine group required more opioid. Ketamine is frequently considered in patients with severe pain, requiring high amount of opioid. Also, ketamine did not have an opioid sparing effect. Future studies about palliative use of ketamine in a larger number of patients are required.

Keywords: ketamine, opioid sparing, palliative care, pancreatic cancer

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Authors: Asma Inge-Hanif, Ayyub Ansari Hanif

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The impact of conflicts, the subsequent refugee migration to America and their attempted use of societal resources implicate the lack of further humanitarian aid as a consequence of the abrupt decrease in services and policy changes stemming from new governmental mandates and Executive Orders. Statistical research data indicates a substantial decline in access to standardized health services by refugee women creating a significant alteration in the management of their maternal health care in America, previously shown to result in decreased mortality and morbidity. Studying nursing at Howard University in Washington, D.C., observed doctors were not always sensitive to the needs and modesty concerns of immigrant Muslim women - often unintentionally. Among health care professionals, the prevailing belief should be that every man, woman and child has the right to quality care in a dignified manner and the achievement of optimal health and well-being, regardless of race, creed, socio-economic level or status. In 1987 Muslimat Al Nisaa Health and Social Services Center was established to care for underserved and uninsured women and children. This Center, plus the subsequent shelter, provided direct access to those homeless, refugees, human trafficking and women victims of domestic violence was established and provides the data for this study. Understanding specific culture, social, economic and religious nuances respects their diversity and addressing their basic human needs that they achieve optimal success. The ultimate goal being to facilitate the rescue and housing of those whom escaped from a country/communities where girls are devalued, brought, sold and abused.

Keywords: women, refugee, domestic violence, health care

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Authors: Deirdre Mc Grath, Joanne Reid

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Background: Ovarian cancer is the leading cause of mortality among gynaecologic cancers in developed countries and the seventh most common cancer worldwide with nearly 240,000 women diagnosed each year. Although it is recognized engaging in exercise results in positive health care outcomes, women with ovarian cancer are reluctant to participate. No evidence currently exists focusing on how to successfully implement an exercise intervention program for patients with ovarian cancer, using a realist approach. There is a requirement for the implementation of exercise programmes within the oncology health care setting as engagement in such interventions has positive health care outcomes for women with ovarian cancer both during and following treatment. Aim: To co-design the implementation of an exercise intervention for women following treatment for ovarian cancer. Methods: This study is a realist evaluation using quantitative and qualitative methods of data collection and analysis. Realist evaluation is well-established within the health and social care setting and has in relation to this study enabled a flexible approach to investigate how to optimise implementation of an exercise intervention for this patient population. This single centre study incorporates three stages in order to identify the underlying contexts and mechanisms which lead to the successful implementation of an exercise intervention for women who have had treatment for ovarian cancer. Stage 1 - A realist literature review. Stage 2 -Co-design of the implementation of an exercise intervention with women following treatment for ovarian cancer, their carer’s, and health care professionals. Stage 3 –Implementation of an exercise intervention with women following treatment for ovarian cancer. Evaluation of the implementation of the intervention from the perspectives of the women who participated in the intervention, their informal carers, and health care professionals. The underlying program theory initially conceptualised before and during the realist review was developed further during the co-design stage. The evolving program theory in relation to how to successfully implement an exercise for these women is currently been refined and tested during the final stage of this realist evaluation which is the implementation and evaluation stage. Results: This realist evaluation highlights key issues in relation to the implementation of an exercise intervention within this patient population. The underlying contexts and mechanisms which influence recruitment, adherence, and retention rates of participants are identified. Conclusions: This study will inform future research on the implementation of exercise interventions for this patient population. It is anticipated that this intervention will be implemented into practice as part of standard care for this group of patients.

Keywords: ovarian cancer, exercise intervention, implementation, Co-design

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Authors: Nursuhaila Ibrahim, Noor Hanim Rahmat, Nurul Ain Hasni, Nursyuhada Zakaria

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Past studies have shown that class discussions in the ESL classrooms not only helped students exchange ideas with their peers. Students also learn turn taking skills throughout the discussion. Through interacting with their peers, learners learn to use turn-taking strategies. They learn to wait for their turn, to listen to the ideas of others, to disagree, or to agree, and to add on more points in the conversation. This quantitative research explores students’ perception on class discussions and how the discussions influence their choice of turn-taking strategies. Findings of this research will have interesting implications towards the use of class discussions in the ESL classrooms.

Keywords: ESL, class discussions, turn-taking skills, peers

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Authors: Wilailuk Meepracha

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The results of the study on the project evaluation to develop the competencies, capabilities, and skills in repairing computers of people in Jompluak Local Municipality, Bang Khonthi District, Samut Songkram Province showed that the overall result was good (4.33). When considering on each aspect, it was found that the highest one was on process evaluation (4.60) followed by product evaluation (4.50) and the least one was on feeding factor (3.97). When considering in details, it was found that: 1) the context aspect was high (4.23) with the highest item on the arrangement of the training situation (4.67) followed by the appropriateness of the target (4.30) and the least aspect was on the project cooperation (3.73). 2) The evaluation of average overall primary factor or feeding factor showed high value (4.23) while the highest aspect was on the capability of the trainers (4.47) followed by the suitable venue (4.33) while the least aspect was on the insufficient budget (3.47). 3) The average result of process evaluation was very high (4.60). The highest aspect was on the follow-op supervision (4.70) followed by responsibility of each project staffs (4.50) while the least aspect was on the present situation and the problems of the community (4.40). 4) The overall result of the product evaluation was very high (4.50). The highest aspect was on the diversity of the activities and the community integration (4.67) followed by project target achievement (4.63) while the least aspect was on continuation and regularity of the activities (4.33). The trainees reported high satisfaction on the project management at very high level (43.33%) while 40% reported high level and 16.67% reported moderate level. Suggestions for the project were on the additional number of the computer sets (37.78%) followed by longer training period especially on computer skills (43.48%).

Keywords: project evaluation, competency development, the capability on computer repairing and computer skills

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Authors: Auni Idi Muhire

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Background: Prior to April 2012, resuscitations were often ineffective resulting in poor patient outcomes. An initiative was implemented at Rwanda Military Hospital (RMH) to review root causes and plan strategies to improve patient outcomes. An interdisciplinary committee was developed to review this problem. Purpose: Analyze the frequency, obstacles, and outcome of patient resuscitation following cardiac and/or respiratory arrest. Methods: A form was developed to allow recording of all actions taken during resuscitation including response times, staff present, and equipment and medications used. Results:-The patient population requiring the most resuscitation effort are the intensive care patients, most frequently the neonatal the intensive care patients (42.8%) -Despite having trained staff representatives, not all resuscitations follow protocol -Lack of compliance with drug administration guidelines was noted, particularly in initiating use of drugs despite the drug being available (59%). Lesson Learned: Basic Life Support training for interdisciplinary staff resulted in more effective response to cardiac and/or respiratory arrest at RMH. Obstacles to effective resuscitation included number of staff, knowledge and skill level of staff, availability of appropriate equipment and medications, staff communication, and patient Do not Attempt Resuscitation (DNR) status.

Keywords: resuscitation, case analysis of knowledge versus practice, intensive care, critical care

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Authors: Siziwe Monica Zuma

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The Expanded Public Works Program (EPWP) is an instrument that the South African Government uses to reduce unemployment and poverty and also stimulate economic growth. However, due to the limited budget and programs in the EPWP, the program has had challenges in reducing unemployment, poverty and stimulating economic growth. The EPWP Vuk’uphile program had positive outcomes in developing Black emerging contractors, in order for them to participate in the main stream economy far better than when the EPWP program was not introduced. The Skills component of the program particularly the EPWP Infrastructure, which is the most funded program under EPWP has had limited success in transferring appropriate skills to ensure labour participants can penetrate the labour market after participating in the EPWP. Education and skills are important attributes that can contribute to labour absorption, however, the EPWP particularly the infrastructure program needs to strengthen skills development over a longer period of time suggested a year with multi skills relevant to the labour market. Longer and more sustained employment provides a safety net and reduces poverty better that short term employment. The EPWP program can be expanded in the infrastructure sector, focusing on rural infrastructure, agricultural infrastructure, infrastructure related components like property, ownership, management, and other services. These can stimulate the Economic sector Infrastructure of EPWP, offer longer term and more sustained employment and rural enterprise development and further employment. The Expanded Public Works Program (EPWP) is an instrument that the South African Government uses to reduce unemployment and poverty and also stimulate economic growth. However, due to the limited budget and programs in the EPWP, the program has had challenges in reducing unemployment, poverty and stimulating economic growth. The EPWP Vuk’uphile program has had positive outcomes in developing Black emerging contractors, in order for them to participate in the main stream economy far better than when the EPWP program was not introduced. The Skills component of the program particularly the EPWP Infrastructure, which is the most funded program under EPWP has had limited success in transferring appropriate skills to ensure labour participants are able to penetrate the labour market after participating in the EPWP. Education and skills are important attributes that can contribute to labour absorption, however, the EPWP particularly the infrastructure program needs to strengthen skills development over a longer period of time suggested a year with multi skills relevant to the labour market. Longer and more sustained employment provides a safety net and reduces poverty better that short term employment. The EPWP program can be expanded in the infrastructure sector, focusing on rural infrastructure, agricultural infrastructure, infrastructure related components like property, ownership, management, and other services. These can stimulate the Economic sector Infrastructure of EPWP, offer longer term and more sustained employment and rural enterprise development and further employment.

Keywords: Expanded Public Works Program (EPWP), VUKÚPHILE, youth, Public Works Programs (PWP), Infrastructure Sector of EPWP (EPWP Infrastructure)

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Authors: Poojitha Vemula

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Understanding how we use image manipulation to communicate through an audience’s perceptions and conceive visual intelligence. With the use of many software and high-end skills, designers have developed a third eye to combine two different visuals and create the desired image by using photoshop and other software skills. The purpose of visual intelligence is to convey a message to the targeted audience. For instance, the images of models are retouched on their skin to make it more convincing and draw attention from the audience. There are many ways of manipulating an image, such as double exposure, retouching photography inks or paint airbrushing and piecing photos together, or enhancing the brightness and contrast. To understand visual intelligence, a questionnaire survey as well as research was conducted on how image manipulation is used by both the audience and the designers. This depends on the message that needs to be conveyed by the brands. For instance, Fair & Lovely, a brightening cream for ladies use a lot of retouching and effects to show the dramatic change the cream takes effect on dark or dusky faces. Thus the designer’s role is to use their third eye to incorporate the message into visuals. The research and questionnaire survey concludes the perceptions and manipulations used in visual communication. However this is all to make an effortless communication between the designer and the audience by using the skills of the designer and the features provided by the software. The objective of visual intelligence is to covet the message of the brands that advertise their products or services by using visuals through softwares. Conveying a message through visual intelligence requires an audiences perceptions and understanding from the visuals created by the artists or designers. Visual intelligence determines how we use our technical skills to retouch and manipulate an image for a better understanding to convey the message to the targeted audience. This also bridges the communication between the brand and the audience.

Keywords: graphic design, visual communication, convey messages, photoshop, image manipulation

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Authors: Somruedee Pongsena

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The purpose of this study is to follow up on the graduated students of Bachelor of Science in Applied Statistics from Suan Sunandha Rajabhat University (SSRU) during the 1999 – 2012 academic years and to provide the fundamental guideline for developing the current curriculum according to Thai Qualifications Framework for Higher Education (TQF: HEd). The sample was collected from 75 graduates by interview and online questionnaire. The content covered 5 subjects: ethics and moral, knowledge, cognitive skills, interpersonal skills and responsibility, numerical analysis as well as communication and information technology skills. Data were analyzed by using statistical methods as percentiles, means, standard deviation, t-tests, and F-tests. The findings showed that samples were mostly females younger than 26 years old. The majority of graduates had income in the range of 10,001-20,000 Baht and their experience range was 2-5 years. In addition, overall opinions from receiving knowledge to apply to work were at agree; mean score was 3.97 and standard deviation was 0.40. In terms of opinion difference, the hypothesis' testing results indicate gender only had different opinion at a significant level of 0.05.

Keywords: follow-up, graduates, knowledge, opinion, work performance.

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Authors: Yasir Naseem

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In this fast-growing and evolving world, usage and adoption of technology have displayed an essential component of the learning process, both in and out of the class, which converges and incorporates every domain of the learning aspects. It aids in learning distinct entities irrespective of their levels of challenge. It also incorporates both viewpoints of learning, i.e., competence as well as the performances of the learner. In today's learning scenario, nearly every language class ordinarily uses some form of technology. It integrates with various teaching methodologies and transforms in a way that now it grew as an integral part of the language learning courses. It has been employed to facilitate, promote, and enhances language learning. It facilitates educators in numerous ways and enhances their methodologies by equipping them to modify classroom activities, which covers every aspect of language learning.

Keywords: communication, methodology, technology, skills

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Authors: Katie Jerram, Jacqui Nevols, Rebecca Howes, Hayley Richardson, Debbie Suso, Thomas Batten, Reny Mathai

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Pyomyositis is an uncommon acute purulent skeletal muscle infection, usually caused by Staphylococcus aureus, occurring either spontaneously or following local trauma. Immunocompromise is a risk factor. It presents with pyrexia, pain, and tenderness of the affected muscle, which may have a firm ‘woody’ feel. Management usually involves surgery and prolonged courses of antibiotics, but alongside these active treatments, palliation of symptoms such as pain is also a priority. A short case series of diabetic inpatients under the care of the Renal Medicine team with pyomyositis is presented, demonstrating that Hospital Palliative Care Teams may be well placed to provide symptom management advice by working jointly with the patient’s medical or surgical team. A review of the literature on the management of pain in pyomyositis is also presented, and there was no clear consensus on the best strategy. It may be that a combination of analgesics and adjuncts is the most effective strategy, perhaps combined with the holistic approach used within palliative care.

Keywords: pyomyositis, pain, palliation, analgesia

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Authors: Hsin-Yi Lo, Huang-Ju Jiun, Yu-Chiao Chu

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Hemodynamic monitoring is an important in the intensive care unit. Advances in medical technology in recent years, more diversification of intensive care equipment, there are many kinds of instruments available for monitoring of hemodynamics, Edwards Lifesciences Hemodynamic Monitoring (FloTrac) is one of them. The recent medical safety incidents in parameters were changed, nurses have not to notify doctor in time, therefore, it is hoped to analyze the current problems and find effective improvement strategies. In August 2021, the survey found that only 74.0% of FloTrac correctness of operation, reasons include lack of education, the operation manual is difficulty read, lack of audit mechanism, nurse doesn't know those numerical changes need to notify doctor, work busy omission, unfamiliar with operation and have many nursing records then omissions. Improvement methods include planning professional nurse education, formulate the secret arts of FloTrac, enacting an audit mechanism, establish FloTrac action learning, make「follow the sun」care map, hold simulated training and establish monitoring data automatically upload nursing records. After improvement, FloTrac correctness of operation increased to 98.8%. The results are good, implement to the ICU of the hospital.

Keywords: hemodynamic monitoring, edwards lifesciences hemodynamic monitoring, multiple strategies, intensive care

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Authors: Bismark Agbemble

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This paper talks about how project-based learning (PBL) is being infused or implemented in the educational sphere of Africa. The paper navigates through the liminal aspects of PBL as a pedagogical approach to bridge the divide between theoretical knowledge and its application within school curriculums. Given that contextualized learning can be embodied, the abstract vehemently discusses that PBL creates an opportunity for students to work on projects that are of academic relevance in their local settings. It presents PBL’s growth of critical thinking, problem-solving, cooperation, and communications, which is vital in getting young citizens to prepare for the 21st-century revolution. In addition, the abstract stresses the possibility that PBL could become a stimulus to creativity and innovation wherein learning becomes motivated from within by intrinsic motivations. The paper advocates for a holistic approach that is based on teacher’s professional development with the provision of adequate infrastructural facilities and resource allocation, thus ensuring the success and sustainability of PBLs in African education systems. In the end, the paper positions this as a transformative educational methodology that has great potential in helping to shape an African generation that is prepared for a great future.

Keywords: student centered pedagogy, constructivist learning theory, self-directed learning, active exploration, real world challenges, STEM, 21st century skills, curriculum design, classroom management, project base learning curriculum, global intelligence, social and communication skills, transferable skills, critical thinking, investigatable learning, life skills

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Authors: D. Kokt, T. F. Dreyer

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The main objective of the study was to design a mentoring programme aimed at developing the soft skills of mentors. The mentors are all employed by a multinational corporation. The company had a mentoring plan in place that did not yield the required results, especially related to the development of soft skills. This prompted the researchers to conduct an extensive literature review followed by a mixed methods approach to ascertain the best practices in developing the soft skills of mentors. The outcomes of the study led to the development of a structured mentoring programme using 25 modules to be completed by mentors. The design incorporated a blended modular approach using both face-to-face teaching and teaching supported by Information Communication Technology (ICT). Blended learning was ideal as the ICT component helped to minimise instructor-mentor physical contact as part of the health measures during the Covid-19 pandemic. The blended learning approach also allowed instructors and mentors an online or offline mode, so that mentors could have more time for creative and cooperative exercises. A range of delivery methodologies were spread out across the different modules to ensure mentor engagement and accelerate mentor development. This included concept development through in-person instructor-led training sessions, concept development through virtual instructor-led training sessions, simulations, case studies, e-learning, role plays, interactive learning using mentoring toolkits, and experiential learning through application. The mentor development journey included formal modular competency assessments. All modules contained post-competency assessment consisting of 10 questions (comprising of a combination of explanatory questions and multiple-choice questions) to ensure understanding and deal with identified competency gaps. The minimum pass mark for all modular competency assessments was 80%. Mentors were allowed to retake the assessment if they scored less than 80% until they demonstrated understanding at the required level.

Keywords: mentor, mentee, soft skills, mentor development, blended learning, modular approach

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Authors: Vera Lúcia Raposo

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The right to health care – usually known as the right to health – is recognized in many national laws and Constitutions, as well as in international human rights documents. The kind of health care that citizens are entitled to receive, especially in the framework of the National Health Service, is usually identified with conventional medicine. However, since ancient times that a different form of medicine – alternative, traditional or nonconventional medicine – exists. In recent times it is attracting increasing interest, as it is demonstrated by the use of its specific knowledge either by pharmaceutical companies either by modern health technologies. Alternative medicine refers to a holistic approach to body and mind using herbal products, animal parts and minerals instead of technology and pharmaceutical drugs. These notes contributed to a sense of distrust towards it, accusing alternative medicine of being based on superstition and ignorance. However, and without denying that some particular practices lack indeed any kind of evidence or scientific grounds, the fact is that a substantial part of alternative medicine can actually produce satisfactory results. The paper will not advocate the substitution of conventional medicine by alternative medicine, but the complementation between the two and their specific knowledge. In terms of the right to health, as a fundamental right and a human right, this thesis leads to the implementation of a wider range of therapeutic choices for patients, who should be entitled to receive different forms of health care that complement one another, both in public and private health facilities. This scenario would demand a proper regulation for alternative medicine, which nowadays does not exist in most countries, but it is essential to protect patients and public health in general and to reinforce confidence in alternative medicine.

Keywords: alternative medicine, conventional medicine, patient’s rights, right to health

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Authors: Susanne Shunnaq

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During the past decade, an increasing number of higher education institutions in Oman have sought accreditation in an attempt to assure the quality of their programs. Sultan Qaboos University (SQU), the only public university in the country, has also been seeking accreditation. Hence, the university administration has been encouraging departments to evaluate their programs for development purposes. The Department of English, where 100% of the students are learners of English as a foreign language, already produced a self-study report that outlined the strength and weaknesses of the current program. The department came to the realization that due to a changing local and regional job market, transferrable communication skills are high in demand among stakeholders in the public and private sectors. Failure to equip English literature students, for example, with excellent verbal communicative skills in English may have detrimental effects for undergraduate job-seekers who have to compete for jobs in employment sectors with a predominantly English-speaking workforce. Ongoing extensive discussions about restructuring the current literature program by means of partially replacing literature courses with skills courses, hoping to produce higher quality graduates who are equipped with effective communication skills for local and regional markets, have sparked the idea for this research. The researcher, who is an American Literature specialist at SQU, has set out to investigate to what extent senior American literature students have been able to apply transferable communication skills in an advanced literature course. The study also attempts to unearth performance inhibitors and causes for communication breakdown. The primary data source for the study were audio-recordings of 6 in-class peer-group discussions in an advanced contemporary American literature course during the academic year 2016/2017. The significance of this research lies in the rarity of studies focusing on verbal communication skills in Omani higher education literature classrooms at a time when English programs are in the process of being re-visited and revamped both for accreditation purposes and for meeting job-market demands. The results showed a considerable variation in Omani students' verbal communicative abilities and English proficiency levels. The study also raises crucial questions and provides important recommendations for administrators and teachers alike who are in the process of restructuring English programs in the region and in non-English speaking countries worldwide.

Keywords: job-market, literature, Oman, tertiary education, oral communication skills

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Authors: Hsin-Yi Lo, Chia-Yu Hsu

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This article is the nursing experience of a multiple trauma case using Swanson's theory of caring, the nursing period is from May 31 to June 4, 2021, collect data through observation, written talks, interviews, listening, direct care and physical assessment, established cases with health problems such as acute pain, impaired tissue integrity, and anxiety. Nursing process including, evaluate the pain index with the pain assessment scale, assist in acupoint massage, use a corset to fix the wound, and give the patient listening to favorite radio programs to divert attention and relieve pain problems; promote wound healing and avoid infection by assessing wound condition and exudation, changing dressings with aseptic technique, and providing appropriate dressings; encourage patients to express their feelings, provide companionship, and assist in self-care and participation in treatment plans, to enable the case to overcome the anxiety caused by being admitted to the intensive care unit for the first time and not knowing about the disease, and assist the case to overcome the injury caused by the accident and return to normal life. There is no video equipment in the intensive care unit during the nursing period. In response to the problem that family visits cannot be opened during the epidemic, it is a limitation this time. It is recommended that the hospital take this into consideration in the future. In the post-epidemic era, it can reduce the risk of various infections for patients and family members. Traveling between home and hospital, improving the quality of high-quality and technological care.

Keywords: swanson's theory of caring, multiple trauma, anxiety, nursing experience

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Authors: Emily Saurman, David Lyle

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In Australia, a well serviced rural town might have a psychiatrist visit once-a-month with more frequent visits from a psychiatric nurse, but many have no resident access to mental health specialists. Access to specialist care, would not only reduce patient distress and benefit outcomes, but facilitate the effective use of limited resources. The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) was developed to improve access to specialist emergency mental health care in rural and remote communities using telehealth technologies. However, there has been no current benchmark to gauge program efficiency or capacity; to determine whether the program activity is justifiably sufficient. The evaluation of MHEC-RAP used multiple methods and applied a modified theory of access to assess the program and its aim of improved access to emergency mental health care. This was the first evaluation of a telepsychiatry service to include a time and motion study design examining program time expenditure, efficiency, and capacity. The time and motion study analysis was combined with an observational study of the program structure and function to assess the balance between program responsiveness and efficiency. Previous program studies have demonstrated that MHEC-RAP has improved access and is used and effective. The findings from the time and motion study suggest that MHEC-RAP has the capacity to manage increased activity within the current model structure without loss to responsiveness or efficiency in the provision of care. Enhancing program responsiveness and efficiency will also support a claim of the program’s value for money. MHEC-RAP is a practical telehealth solution for improving access to specialist emergency mental health care. The findings from this evaluation have already attracted the attention of other regions in Australia interested in implementing emergency telepsychiatry programs and are now informing the progressive establishment of mental health resource centres in rural New South Wales. Like MHEC-RAP, these centres will provide rapid, safe, and contextually relevant assessments and advice to support local health professionals to manage mental health emergencies in the smaller rural emergency departments. Sharing the application of this methodology and research activity may help to improve access to and future evaluations of telehealth and telepsychiatry services for others around the globe.

Keywords: access, emergency, mental health, rural, time and motion

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Authors: S. Mantzoukis, M. Gerasimou, P. Christodoulou, N. Varsamis, G. Kolliopoulou, N. Zotos

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Purpose: Patients in Intensive Care Units (ICU) are exposed to a different spectrum of microorganisms relative to the hospital. Due to the fact that the majority of these patients are intubated, bronchial secretions should be examined. Material and Method: Bronchial secretions should be taken with care so as not to be mixed with sputum or saliva. The bronchial secretions are placed in a sterile container and then inoculated into blood, Mac Conkey No2, Chocolate, Mueller Hinton, Chapman and Saboureaud agar. After this period, if any number of microbial colonies are detected, gram staining is performed and then the isolated organisms are identified by biochemical techniques in the automated Microscan system (Siemens) followed by a sensitivity test in the same system using the minimum inhibitory concentration MIC technique. The sensitivity test is verified by a Kirby Bauer test. Results: In 2017 the Laboratory of Microbiology received 365 samples of bronchial secretions from the Intensive Care Unit. 237 were found positive. S. epidermidis was identified in 1 specimen, A. baumannii in 60, K. pneumoniae in 42, P. aeruginosa in 50, C. albicans in 40, P. mirabilis in 4, E. coli in 4, S. maltophilia in 6, S. marcescens in 6, S. aureus in 12, S. pneumoniae in 1, S. haemolyticus in 4, P. fluorescens in 1, E. aerogenes in 1, E. cloacae in 5. Conclusions: The majority of ICU patients appear to be a fertile ground for the development of infections. The nature of the findings suggests that a significant part of the bacteria found comes from the unit (nosocomial infection).

Keywords: bronchial secretions, cultures, infections, intensive care units

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Authors: Sipho Mbatha, Anne Mastament-Mason

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The Multi-Fibre Arrangement (MFA) which regulated all trade in the Apparel Manufacturing Industries (AMI) for four decades was dissolved in 2005. Since 2005, the Apparel Manufacturing Industry of South Africa (AMISA) has been battling to adjust to an environment of liberalised trade, mainly due to strategic, infrastructural and skills factors. In developing competitive advantage strategy for the AMISA, the study aimed to do the following (1) to apply Porter’s diamond model’s determinant “Factor Condition” as framework to develop competitive advantage strategies. (2) Examine the effectiveness of government policy Industrial Policy Action Plan (IPAP 2007) in supporting AMISA. (3) Examine chance events that could be used as bases for competitive advantage strategies for the AMISA. This study found that the lack of advanced skills and poor infrastructure are affecting the competitive advantage of AMISA. The then Clothing, Textiles, Leather and Footwear Sector Education and Training Authority (CTLF-SETA) has also fallen short of addressing the skills gap within the apparel manufacturing industries. The only time that AMISA have shown signs of competitive advantage was when they made use of government grants and incentives available to only compliant AMISA. The findings have shown that the apparel retail groups have shown support for the AMISA by shouldering raw material costs, making it easier to manufacture the required apparel at acceptable lead times. AMISA can compete in low end apparel, provided quick response is intensified, the development of local textiles and raw materials is expedited.

Keywords: compliance rule, apparel manufacturing idustry, factor conditions, advance skills, industrial policy action plan of South Africa

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Authors: Takamitsu Kodama, Eiji Kawamoto

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Introduction: Ultrasound in emergency room has advantages of safer, faster, repeatable and noninvasive. Especially focused Point-Of-Care Ultrasound (POCUS) is used daily for prompt and accurate diagnoses, for quickly identifying critical and life-threatening conditions. That is why ultrasound has demonstrated its usefulness in emergency medicine. The true value of ultrasound has been once again recognized in recent years. It is thought that all resident physicians working at emergency room should perform an ultrasound scan to interpret signs and symptoms of deteriorating patients in the emergency room. However, a practical education on ultrasound is still in development. To resolve this issue, we established a new educational program using high-fidelity simulators and evaluated the efficacy of this course. Methods: Educational program includes didactic lectures and skill stations in half-day course. Instructor gives a lecture on POCUS such as Rapid Ultrasound in Shock (RUSH) and/or Focused Assessment Transthoracic Echo (FATE) protocol at the beginning of the course. Then, attendees are provided for training of scanning with cooperation of normal simulated patients. In the end, attendees learn how to apply focused POCUS skills at clinical situation using high-fidelity simulators such as SonoSim® (SonoSim, Inc) and SimMan® 3G (Laerdal Medical). Evaluation was conducted through surveillance questionnaires to 19 attendees after two pilot courses. The questionnaires were focused on understanding course concept and satisfaction. Results: All attendees answered the questionnaires. With respect to the degree of understanding, 12 attendees (number of valid responses: 13) scored four or more points out of five points. High-fidelity simulators, especially SonoSim® was highly appreciated to enhance learning how to handle ultrasound at an actual practice site by 11 attendees (number of valid responses: 12). All attendees encouraged colleagues to take this course because the high level of satisfaction was achieved. Discussion: Newly introduced educational course using high-fidelity simulators realizes the circle of learning to deepen the understanding on focused POCUS by gradual stages. SonoSim® can faithfully reproduce scan images with pathologic findings of ultrasound and provide experimental learning for a growth number of beginners such as resident physicians. In addition, valuable education can be provided if it is used combined with SimMan® 3G. Conclusions: Newly introduced educational course using high-fidelity simulators is supposed to be effective and helps in providing better education compared with conventional courses for emergency physicians.

Keywords: point-of-care ultrasound, high-fidelity simulators, education, circle of learning

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Authors: Netalie Shloim, Brian Brown, Siobhan Hugh-Jones, Jane Plastow, Diana Setiyawati, Anna Madill

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In June 2021, the World Health Organization launched its guidance and technical packages on community mental health services, stressing a human rights-based approach to care. This initiative stems from an increasing acknowledgment of the role mental health plays in achieving the Sustainable Development Goals. Nevertheless, mental health remains a relatively neglected research area and the estimates for untreated mental disorders in low-and-middle-income countries (LMICs) are as high as 78% for adults. Moreover, the development sector and research programs too often side-line mental health as a privilege in the face of often immediate threats to life and livelihood. As a way of addressing this problem, this study aimed to examine past or ongoing GCRF projects to see if there were opportunities where mental health impact could have been achieved without compromising a study's main aim and without overburdening a project. Projects funded by the UKRI Global Challenges Research Fund (GCRF) were analyzed. This program was initiated in 2015 to support cutting-edge research that addresses the challenges faced by developing countries. By the end of May 2020, a total of 15,279 projects were funded of which only 3% had an explicit mental health focus. A sample of 36 non-mental-health-focused projects was then sampled for diversity across research council, challenge portfolio and world region. Each of these 36 projects was coded by two coders for opportunities to embed mental health impact. To facilitate coding, the literature was inspected for dimensions relevant to LMIC settings. Three main psychological and three main social dimensions were identified: promote a positive sense of self; promote positive emotions, safe expression and regulation of challenging emotions, coping strategies, and help-seeking; facilitate skills development; and facilitate community-building; preserve sociocultural identity; support community mobilization. Coding agreement was strong on missed opportunities for mental health impact on the three social dimensions: support community mobilization (92%), facilitate community building (83%), preserve socio-cultural identity (70%). Coding agreement was reasonably strong on missed opportunities for mental health impact on the three psychological dimensions: promote positive emotions (67%), facilitate skills development (61%), positive sense of self (58%). In order of frequency, the agreed perceived opportunities from the highest to lowest are: support community mobilization, facilitate community building, facilitate skills development, promote a positive sense of self, promote positive emotions, preserve sociocultural identity. All projects were considered to have an opportunity to support community mobilization and to facilitate skills development by at least one coder. Findings provided support that there were opportunities to embed mental health impact in research across the range of development sectors and identifies what kind of missed opportunities are most frequent. Hence, mainstreaming mental health has huge potential to tackle the lack of priority and funding it has attracted traditionally. The next steps are to understand the barriers to mainstreaming mental health and to work together to overcome them.

Keywords: GCRF, mental health, psychosocial wellbeing, LMIC

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Authors: Diane Ghanem, Whitney Kagabo, Rebecca Engels, Uma Srikumaran, Babar Shafiq

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Hospitalist co-management of orthopaedic surgery patients is a growing trend across the country. It was created as a collaborative effort to provide overarching care to patients with the goal of improving their postoperative care and decreasing in-hospital medical complications. The aim of this project is to provide a guide for implementing and optimizing a hospitalist co-management service in orthopaedic surgery. Key leaders from the hospitalist team, orthopaedic team and quality, safety and service team were identified. Multiple meetings were convened to discuss the comanagement service and determine the necessary building blocks behind an efficient and well-designed co-management framework. After meticulous deliberation, a consensus was reached on the final service agreement and a written guide was drafted. Fundamental features of the service include the identification of service stakeholders and leaders, frequent consensus meetings, a well-defined framework, with goals, program metrics and unified commands, and a regular satisfaction assessment to update and improve the program. Identified pearls for co-managing orthopaedic surgery patients are standardization, timing, adequate patient selection, and two-way feedback between hospitalists and orthopaedic surgeons to optimize the protocols. Developing a service agreement is a constant work in progress, with meetings, discussions, revisions, and multiple piloting attempts before implementation. It is a partnership created to provide hospitals with a streamlined admission process where at-risk patients are identified early, and patient care is optimized regardless of the number or nature of medical comorbidities. A wellestablished hospitalist co-management service can increase patient care quality and safety, as well as health care value.

Keywords: co-management, hospitalist co-management, implementation, orthopaedic surgery, quality improvement

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Authors: Maria Hopkins, Sarah Koch, Fred Biasini

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Autism is lifelong disorder that affects one out of every 110 Americans. The deficits that accompany Autism Spectrum Disorders (ASD), such as abnormal behaviors and social incompetence, often make it extremely difficult for these individuals to gain functional independence from caregivers. These long-term implications necessitate an immediate effort to improve social skills among children with an ASD. Any technology that could teach individuals with ASD necessary social skills would not only be invaluable for the individuals affected, but could also effect a massive saving to society in treatment programs. The overall purpose of the first study was to develop, implement, and evaluate an avatar tutor for social skills training in children with ASD. “Face Say” was developed as a colorful computer program that contains several different activities designed to teach children specific social skills, such as eye gaze, joint attention, and facial recognition. The children with ASD were asked to attend to FaceSay or a control painting computer game for six weeks. Children with ASD who received the training had an increase in emotion recognition, F(1, 48) = 23.04, p < 0.001 (adjusted Ms 8.70 and 6.79, respectively) compared to the control group. In addition, children who received the FaceSay training had higher post-test scored in facial recognition, F(1, 48) = 5.09, p < 0.05 (adjusted Ms: 38.11 and 33.37, respectively) compared to controls. The findings provide information about the benefits of computer-based training for children with ASD. Recent research suggests the value of also using socially assistive robots with children who have an ASD. Researchers investigating robots as tools for therapy in ASD have reported increased engagement, increased levels of attention, and novel social behaviors when robots are part of the social interaction. The overall goal of the second study was to develop a social robot designed to teach children specific social skills such as emotion recognition. The robot is approachable, with both an animal-like appearance and features of a human face (i.e., eyes, eyebrows, mouth). The feasibility of the robot is being investigated in children ages 7-12 to explore whether the social robot is capable of forming different facial expressions to accurately display emotions similar to those observed in the human face. The findings of this study will be used to create a potentially effective and cost efficient therapy for improving the cognitive-emotional skills of children with autism. Implications and study findings using the robot as an intervention tool will be discussed.

Keywords: autism, intervention, technology, emotions

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Authors: Mostafa Fanaei, Shahram R. Sistani, Athare Nazri-Panjaki

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Introduction: Critical thinking skills are increasingly recognized as vital for academic success, particularly in higher education. This study examines the influence of critical thinking on learning achievement among undergraduate and master's students enrolled in foreign language programs. By investigating this correlation, educators can gain valuable insights into optimizing teaching methodologies and enhancing academic outcomes. Methods: This cross-sectional study involved 150 students from the Shahid Bahonar University of Kerman, recruited via random sampling. Participants completed the Critical Thinking Questionnaire (CThQ), assessing dimensions such as analysis, evaluation, creation, remembering, understanding, and application. Academic performance was measured using the students' GPA (0-20). Results: The participants' mean age was 21.46 ± 5.2 years, with 62.15% being female. The mean scores for critical thinking subscales were as follows: Analyzing (13.2 ± 3.5), Evaluating (12.8 ± 3.4), Creating (18.6 ± 4.8), Remembering (9.4 ± 2.1), Understanding (12.9 ± 3.3), and Applying (12.5 ± 3.2). The overall critical thinking score was 79.4 ± 18.1, and the average GPA was 15.7 ± 2.4. Significant positive correlations were found between GPA and several critical thinking subscales: Analyzing (r = 0.45, p = 0.013), Creating (r = 0.52, p < 0.001), Remembering (r = 0.29, p = 0.021), Understanding (r = 0.41, p = 0.002), and the overall CThQ score (r = 0.54, p = 0.043). Conclusion: The study demonstrates a significant positive relationship between critical thinking skills and learning achievement in foreign language programs. Enhancing critical thinking skills through educational interventions could potentially improve academic performance. Further research is recommended to explore the underlying mechanisms and long-term impacts of critical thinking on academic success.

Keywords: critical thinking, learning achievement, higher education, foreign language programs, student success

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Authors: A. Zurraini, Syed Alwi Sar, H. Helmy, H. Nazeefah

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Early Dementia Questionnaire (EDQ) was developed as a screening tool to detect patients with early dementia in primary care. It was developed based on 20 symptoms of dementia. From a preliminary study, EDQ had been shown to be a promising alternative for screening of early dementia. This study was done to further test on EDQ’s reliability and validity. Using a systematic random sampling, 200 elderly patients attending primary health care centers in Kuching, Sarawak had consented to participate in the study and were administered the EDQ. Geriatric Depression Scale (GDS) was used to exclude patients with depression. Those who scored >21 MMSE, were retested using the EDQ. Reliability was determined by Cronbach’s alpha for internal consistency and construct validity was assessed using confirmatory factor analysis (principle component with varimax rotation). The result showed that the overall Cronbach’s alpha coefficient was good which was 0.874. Confirmatory factor analysis on 4 factors indicated that the Cronbach’s alpha for each domain were acceptable with memory (0.741), concentration (0.764), emotional and physical symptoms (0.754) and lastly sleep and environment (0.720). Pearson correlation coefficient between the first EDQ score and the retest EDQ score among those with MMSE of >21 showed a very strong, positive correlation between the two variables, r = 0.992, N=160, P <0.001. The results of the validation study showed that Early Dementia Questionnaire (EDQ) is a valid and reliable tool to be used as a screening tool to detect early dementia in primary care.

Keywords: Early Dementia Questionnaire (EDQ), screening, primary care, construct validity

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Authors: Deirdre Mc Grath, Joanne Reid

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Background: Ovarian cancer is the leading cause of mortality among gynaecologic cancers in developed countries and the seventh most common cancer worldwide, with nearly 240,000 women diagnosed each year. Although it is recognized engaging in exercise results in positive health care outcomes, women with ovarian cancer are reluctant to participate. No evidence currently exists focusing on how to successfully implement an exercise intervention program for patients with ovarian cancer, using a realist approach. There is a requirement for the implementation of exercise programmes within the oncology health care setting as engagement in such interventions has positive health care outcomes for women with ovarian cancer both during and following treatment. Aim: To co-design the implementation of an exercise intervention for women following treatment for ovarian cancer. Methods: This study is a realist evaluation using quantitative and qualitative methods of data collection and analysis. Realist evaluation is well-established within the health and social care setting and has, in relation to this study, enabled a flexible approach to investigate how to optimise implementation of an exercise intervention for this patient population. This single centre study incorporates three stages in order to identify the underlying contexts and mechanisms which lead to the successful implementation of an exercise intervention for women who have had treatment for ovarian cancer. Stage 1 - A realist literature review. Stage 2 -Co-design of the implementation of an exercise intervention with women following treatment for ovarian cancer, their carer’s, and health care professionals. Stage 3 –Implementation of an exercise intervention with women following treatment for ovarian cancer. Evaluation of the implementation of the intervention from the perspectives of the women who participated in the intervention, their informal carers, and health care professionals. The underlying programme theory initially conceptualised before and during the realist review was developed further during the co-design stage. The evolving programme theory in relation to how to successfully implement an exercise for these women is currently been refined and tested during the final stage of this realist evaluation which is the implementation and evaluation stage. Results: This realist evaluation highlights key issues in relation to the implementation of an exercise intervention within this patient population. The underlying contexts and mechanisms which influence recruitment, adherence, and retention rates of participants are identified. Conclusions: This study will inform future research on the implementation of exercise interventions for this patient population. It is anticipated that this intervention will be implemented into practice as part of standard care for this group of patients.

Keywords: exercise, ovarian cancer, co-design, implementation

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Authors: Nazym Alykpashova

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This article is based on the results of the action research at Nazarbayev Intellectual School in Pavlodar, Kazakhstan. The participants of this research were high school students who study Global Perspectives and Project Work course. Intellectual schools are designed to become an experimental site that develops, monitors, studies, analyzes, approves, implements modern models of educational programs. Subjects in NIS aimed to develop skills that will be useful for students in their life. Students learn how to do projects, research credible information, solve different issues. Many subjects cover complex topics, and most teachers feel that they often have to deliver a lot of information within one hour. Many educators recognize Conceptual Teaching, as well as Conceptual Learning, has a lot of benefits for students in terms of developing their perception of the subject topics. This qualitative paper presents findings of two research questions which explored high school students’ perception of conceptual teaching and its impact on their academic performance. Individual semi-structured interviews and observations were conducted with Global Perspectives teachers and students. The results of this action research assist teachers reflect on their professional practice.

Keywords: concept-based teaching, students’ research skills, teacher’s professional development, kazakhstan

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