Search results for: clinical skills

Authors: Klara Królewiak-Detsi, Anna Orylska, Anna Gorgolewska, Marta Boczkowska, Agata Graczykowska

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This study investigates the communication between students and teachers in inclusive education in Poland. Specifically, we examine the communication and interaction of students with special educational needs during online learning compared to traditional face-to-face instruction. Our research questions are (1) how children with special educational needs communicate with their teachers and peers during online learning, and (2) what strategies can improve their communication skills. We conducted five focus groups with: (1) 55 children with special educational needs, (2) 65 typically developing pupils, (3) 28 professionals (psychologists and special education therapists), (4) 16 teachers, and (5) 16 parents of children with special educational needs. Our analysis focused on primary schools and used thematic analysis according to the 6-step procedure of Braun and Clarke. Our findings reveal that children with disabilities faced more difficulties communicating and interacting with others online than in face-to-face lessons. The online tools used for education were not adapted to the needs of children with disabilities, and schools lacked clear guidelines on how to pursue inclusive education online. Based on the results, we offer recommendations for online communication training and tools that are dedicated to children with special educational needs. Additionally, our results demonstrate that typically developing pupils are better in interpersonal relations and more often and effectively use social support. Children with special educational needs had similar emotional and communication challenges compared to their typically developing peers. In conclusion, our study highlights the importance of providing adequate support for the online education of children with special educational needs in inclusive classrooms.

Keywords: Inclusive education, Special educational needs, Social skills development, Online communication

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Authors: Tharwat N. Hijjawi

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Learning oral skills in an Arabic speaking environment is challenging. A blended course (material, activities, and individual/ group work tasks …) was implemented in a module of level B1 for undergraduate students of French as a foreign language in order to increase their opportunities to practice listening and speaking skills. This research investigates the influence of this modality on enhancing active learning and examines the effectiveness of provided strategies. Moreover, it aims at discovering how it allows teacher to flip the traditional classroom and create a learner-centered framework. Which approaches were integrated to motivate students and urge them to search, analyze, criticize, create and accomplish projects? What was the perception of students? This paper is based on the qualitative findings of a questionnaire and a focus group interview with learners. Despite the doubled time and effort both “teacher” and “student” needed, results revealed that the NTIC allowed a shift into a learning paradigm where learners were the “chiefs” of the process. Tasks and collaborative projects required higher intellectual capacities from them. Learners appreciated this experience and developed new life-long learning competencies at many levels: social, affective, ethical and cognitive. To conclude, they defined themselves as motivated young researchers, motivators and critical thinkers.

Keywords: active learning, critical thinking, inverted classroom, learning paradigm, problem-based

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Authors: Claire Xu, Welton Wang, Manasvi Pinnaka, Anqi Pan, Michael Han

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Hospitalizations account for one-third of the total health care spending in the US. Early risk detection and intervention can reduce this high cost and increase the satisfaction of both patients and physicians. Due to the lack of awareness of the potential arising risks in home environment, the opportunities for patients to seek early actions of clinical visits are dramatically reduced. This research aims to offer a highly personalized remote patients monitoring and risk assessment AI framework to identify the potentially preventable hospitalization for both acute as well as chronic diseases. A hybrid-AI framework is trained with data from clinical setting, patients surveys, as well as online databases. 20+ risk factors are analyzed ranging from activities, biometric info, demographic info, socio-economic info, hospitalization history, medication info, lifestyle info, etc. The AI model yields high performance of 87% accuracy and 88 sensitivity with 20+ features. This hybrid-AI framework is proven to be effective in identifying the potentially preventable hospitalization. Further, the high indicative features are identified by the models which guide us to a healthy lifestyle and early intervention suggestions.

Keywords: hospitalization prevention, machine learning, remote patient monitoring, risk prediction

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Authors: Maaly Jarrah

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Oral fluency in the target language is what many second language learners hope to achieve by living abroad. Research in the past has demonstrated the role informal environments play in improving L2 learners' oral fluency. However, living in the target country and being part of its community does not ensure the development of oral fluency skills. L2 learners' desire to communicate and access to speaking opportunities in the host community are key in achieving oral fluency in the target language. This study attempts to identify differences in oral fluency, specifically speech rate, between learners who communicate in the L2 outside the classroom and those who do not. In addition, as the desire to communicate is a crucial factor in developing oral fluency, this study investigates whether or not learners' desire to speak the L2 outside the classroom plays a role in their frequency of L2 use outside the classroom. Finally, given the importance of the availability of speaking opportunities for L2 learners in order to practice their speaking skills, this study reports on the participants' perceptions of the speaking opportunities accessible to them in the target community while probing whether or not their perceptions differed based on their oral fluency level and their desire to communicate. The results suggest that exposure to the target language and daily communication with the native speakers is strongly related to the development of learners' oral fluency. Moreover, the findings suggest that learners' desire to communicate affects their frequency of communication in their L2 outside the classroom. At the same time, all participants, regardless of their oral fluency level and their desire to communicate, asserted that speaking opportunities beyond the classroom are very limited. Finally, the study finds there are marked differences in the perceptions learners have regarding opportunities for learning offered by the same language program. After reporting these results, the study concludes with recommendations for ESL programs that serve international students.

Keywords: ESL programs, L2 Learners, oral fluency, second language

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Authors: A. Sewell

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The paper reports a research project which investigated the social interactions of nine to ten-year-olds in a mainstream primary school. The project implemented an adaption of a whole class, behavioural intervention known as 'The Good Behaviour Game (TGBG)'. TGBG is an evidence-based intervention traditionally used to reduce low-level disruptive behaviours in a classroom setting. TGBG was adapted to encourage pupil’s engagement in pro-social behaviour during lessons. A mixed methods research design was employed to evaluate intervention effects and pupil’s perceptions of their social interactions and relationships with others. Single-case research design was used to evaluate behaviour change, and Personal Construct Psychology (PCP) repertory grids were used to explore pupil’s perceptions. The findings demonstrated that TGBG could be successfully adapted to positively influence pupil’s engagement in pro-social behaviours. The findings from the PCP repertory grid interviews revealed the complexities of how children construct their social interactions and relationships with others, and how an understanding of these could be used to design better social skills interventions. It is concluded that TGBG is a cost-effective, simple to implement intervention for promoting positive social interactions and relationships at the whole class level. The paper presents the aims, design, findings, and conclusions of the study in further detail and relates limitations and potential future extensions of the research. The outcomes have direct application and relevance for practitioners interested in children’s social development and how to promote positive outcomes in this critical aspect of childhood.

Keywords: social skills, social development, social competency, the good behaviour game

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Authors: Pamela Ventola, Laurel Bales, Sara Florczyk

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Background: Fully remote or hybrid administration of clinical outcome measures in rare neurodevelopmental disorders trials is increasing due to the ongoing pandemic and recognition that remote assessments reduce the burden on families. Many assessments in rare neurodevelopmental disorders trials are complex; however, remote/hybrid trials readily allow for the use of centralized raters to administer and score the scales. The use of centralized raters has many benefits, including reducing site burden; however, a specific impact on data quality has not yet been determined. Purpose: The current study has two aims: a) evaluate differences in data quality between administration of a standardized clinical interview completed by centralized raters compared to those completed by site raters and b) evaluate improvement in accuracy of scoring standardized developmental assessments when scored centrally compared to when scored by site raters. Methods: For aim 1, the Vineland-3, a widely used measure of adaptive functioning, was administered by site raters (n= 52) participating in one of four rare disease trials. The measure was also administered as part of two additional trials that utilized central raters (n=7). Each rater completed a comprehensive training program on the assessment. Following completion of the training, each clinician completed a Vineland-3 with a mock caregiver. Administrations were recorded and reviewed by a neuropsychologist for administration and scoring accuracy. Raters were able to certify for the trials after demonstrating an accurate administration of the scale. For site raters, 25% of each rater’s in-study administrations were reviewed by a neuropsychologist for accuracy of administration and scoring. For central raters, the first two administrations and every 10th administration were reviewed. Aim 2 evaluated the added benefit of centralized scoring on the accuracy of scoring of the Bayley-3, a comprehensive developmental assessment widely used in rare neurodevelopmental disorders trials. Bayley-3 administrations across four rare disease trials were centrally scored. For all administrations, the site rater who administered the Bayley-3 scored the scale, and a centralized rater reviewed the video recordings of the administrations and also scored the scales to confirm accuracy. Results: For aim 1, site raters completed 138 Vineland-3 administrations. Of the138 administrations, 53 administrations were reviewed by a neuropsychologist. Four of the administrations had errors that compromised the validity of the assessment. The central raters completed 180 Vineland-3 administrations, 38 administrations were reviewed, and none had significant errors. For aim 2, 68 administrations of the Bayley-3 were reviewed and scored by both a site rater and a centralized rater. Of these administrations, 25 had errors in scoring that were corrected by the central rater. Conclusion: In rare neurodevelopmental disorders trials, sample sizes are often small, so data quality is critical. The use of central raters inherently decreases site burden, but it also decreases rater variance, as illustrated by the small team of central raters (n=7) needed to conduct all of the assessments (n=180) in these trials compared to the number of site raters (n=53) required for even fewer assessments (n=138). In addition, the use of central raters dramatically improves the quality of scoring the assessments.

Keywords: neurodevelopmental disorders, clinical trials, rare disease, central raters, remote trials, decentralized trials

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Authors: Yeaji Seok, Myung Kyung Lee

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Background: Even if patients survive after a stroke, stroke patients may experience disability in mobility, sensation, cognition, and speech and language. Stroke patients require rehabilitation for functional recovery and daily life for a considerable time. During rehabilitation, the role of caregivers is important. However, the stroke patients’ quality of life may deteriorate due to family caregivers’ non-preparedness and increased role burden. Purpose: To investigate the prediction of caregivers' preparedness and role burden on stroke patients’ quality of life. Methods: The target population was stroke patients who were hospitalized for rehabilitation and their family care providers. A total of 153 patient-family caregiver dyads were recruited from June to August 2021. Data were collected from self-reported questionnaires and analyzed using descriptive statistics, t-tests, chi-squared test, one-way analysis of variance, Pearson’s correlation coefficients, and multiple regression with SPSS statistics 28 programs. Results: Family caregivers’ preparedness affected stroke patients’ mobility (β = .20, p < 0.05) and character (β = -.084, p < 0.05) and production activities (β = -.197, p < 0.05) in quality of life. The role burden of family caregivers affected language skills (β = .310, p<0.05), visual functions (β=-.357, p < 0.05), thinking skills (β = 0.443, p = 0.05), mood conditions (β = 0.565, p < 0.001), family roles (β = -0.361, p < 0.001), and social roles (β = -0.304, p < 0.001), while the caregivers’ burden of performing self-protection negatively affected patients’ social roles (β = .180, p=.048). In addition, caregivers’ role burden of personal life sacrifice affected patients’ mobility (β = .311, p < 0.05), self-care (β =.232, p < 0.05) and energy (β = .239, p < 0.05). Conclusion: This study indicated that family caregivers' preparedness and role burden affected stroke patients’ quality of life. The results of this study suggested that intervention to improve family caregivers’ preparedness and to reduce role burden should be required for quality of life in stroke patients.

Keywords: quality of life, preparedness, role burden, caregivers, stroke

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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: Ellen Patricia, Marilou Hyson

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Coaching has been showing great potential to strengthen the impact of brief group trainings and help early childhood teachers solve specific problems at work with the goal of raising the quality of early childhood services. However, there have been some doubts about the benefits that village teachers can receive from coaching. It is perceived that village teachers may struggle with the thinking skills needed to make coaching beneficial. Furthermore, there are reservations about whether principals and supervisors in villages are open to coaching’s facilitative approach, as opposed to the directive approach they have been using. As such, the use of coaching to develop the professionalism of early childhood teachers in the villages needs to be examined. The Coaching Pilot for early childhood teachers in Indonesia villages provides insights for the above issues. The Coaching Pilot is part of the ECED Frontline Pilot, which is a collaboration project between the Government of Indonesia and the World Bank with the support from the Australian Government (DFAT). The Pilot started with coordinated efforts with the local government in two districts to select principals and supervisors who have been equipped with basic knowledge about early childhood education to take part in 2-days coaching training. Afterwards, the participants were asked to collect 25 hours of coaching early childhood teachers who have participated in the Enhanced Basic Training for village teachers. The participants who completed this requirement were then invited to come for an assessment of their coaching skills. Following that, a qualitative evaluation was conducted using in-depth interviews and Focus Group Discussion techniques. The evaluation focuses on the impact of the coaching pilot in helping the village teachers to develop in their professionalism, as well as on the sustainability of the intervention. Results from the evaluation indicated that although their low education may limit their thinking skills, village teachers benefited from the coaching that they received. Moreover, the evaluation results also suggested that with enough training and support, principals and supervisors in the villages were able to provide an adequate coaching service for the teachers. On top of that, beyond this small start, interest is growing, both within the pilot districts and even beyond, due to word of mouth of the benefits that the Coaching Pilot has created. The districts where coaching was piloted have planned to continue the coaching program, since a number of early childhood teachers have requested to be coached, and a number of principals and supervisors have also requested to be trained as a coach. Furthermore, the Association for Early Childhood Educators in Indonesia has started to adopt coaching into their program. Although further research is needed, the Coaching Pilot suggests that coaching can positively impact early childhood teachers in villages, and village principals and supervisors can become a promising source of future coaches. As such, coaching has a significant potential to become a sustainable model for a continuous professional development program for early childhood teachers in villages.

Keywords: coaching, coaching pilot, early childhood teachers, principals and supervisors, village teachers

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Authors: Abu S. Mustafa, Mohammad W. Khan, Faraz Shaheed Khan, Nazima Habibi

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Brucellosis is a zoonotic disease of worldwide prevalence. There are at least four species and several strains of Brucella that cause human disease. Brucella genomes have very limited variation across strains, which hinder strain identification using classical molecular techniques, including PCR and 16 S rDNA sequencing. The aim of this study was to perform whole genome sequencing of clinical isolates of Brucella and perform bioinformatics and comparative genomics analyses to determine the existence of genetic differences across the isolates of a single Brucella species and strain. The draft sequence data were generated from 15 clinical isolates of Brucella melitensis (biovar 2 strain 63/9) using MiSeq next generation sequencing platform. The generated reads were used for further assembly and analysis. All the analysis was performed using Bioinformatics work station (8 core i7 processor, 8GB RAM with Bio-Linux operating system). FastQC was used to determine the quality of reads and low quality reads were trimmed or eliminated using Fastx_trimmer. Assembly was done by using Velvet and ABySS softwares. The ordering of assembled contigs was performed by Mauve. An online server RAST was employed to annotate the contigs assembly. Annotated genomes were compared using Mauve and ACT tools. The QC score for DNA sequence data, generated by MiSeq, was higher than 30 for 80% of reads with more than 100x coverage, which suggested that data could be utilized for further analysis. However when analyzed by FastQC, quality of four reads was not good enough for creating a complete genome draft so remaining 11 samples were used for further analysis. The comparative genome analyses showed that despite sharing same gene sets, single nucleotide polymorphisms and insertions/deletions existed across different genomes, which provided a variable extent of diversity to these bacteria. In conclusion, the next generation sequencing, bioinformatics, and comparative genome analysis can be utilized to find variations (point mutations, insertions and deletions) across different genomes of Brucella within a single strain. This information could be useful in surveillance and epidemiological studies supported by Kuwait University Research Sector grants MI04/15 and SRUL02/13.

Keywords: brucella, bioinformatics, comparative genomics, whole genome sequencing

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Authors: Sedigheh Samimian, Sadra Ashrafi, Tahereh Khaleghdoost Mohammadi, Mohammad Reza Yeganeh, Ali Ashraf, Hamideh Hakimi, Maryam Dehghani

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Introduction: The recommended position for measuring Intra-Abdominal Pressure (IAP) is the supine position. However, patients put in this position are prone to Ventilator-associated pneumonia. This study was done to evaluate the relationship between bed head angle and IAP measurements of intubated patients in the intensive care unit. Methods: In this clinical trial, seventy-six critically ill patients under mechanical ventilation were enrolled. IAP measurement was performed every 8 hours for 24 hours using the KORN method in three different degrees of the head of bed (HOB) elevation (0°, 15°, and 30°). Bland-Altman analysis was performed to identify the bias and limits of agreement among the three HOBs. According to World Society of the Abdominal Compartment Syndrome (WSACS), we can consider two IAP techniques equivalent if a bias of <1 mmHg and limits of agreement of - 4 to +4 were found between them. Data were analyzed using SPSS statistical software (v. 19), and the significance level was considered as 0.05. Results: The prevalence of intra-abdominal hypertension was 18.42%. Mean ± standard deviation (SD) of IAP were 8.44 ± 4.02 mmHg for HOB angle 0°, 9.58 ± 4.52 for HOB angle 15°, and 11.10 ± 4.73 for HOB angle 30o (p = 0.0001). The IAP measurement bias between HOB angle 0◦ and HOB angle 15° was 1.13 mmHg. This bias was 2.66 mmHg between HOB angle 0° and HOB angle 30°. Conclusion: Elevation of HOB angle from 0 to 30 degree significantly increases IAP. It seems that the measurement of IAP at HOB angle 15° was more reliable than 30°.

Keywords: pressure, intra-abdominal hypertension, head of bed, critical care, compartment syndrome, supine position

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Authors: Itsuo Yokoyama, Rika Kikuti, Naoko Watabe

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Introduction: It has been known that chronic kidney disease (CKD) patients can benefit from physical exercise during dialysis therapy improving aerobic capacity, muscle function, cardiovascular function, and overall health-related quality of life. This study aimed to evaluate the effectiveness of dialysis rehabilitation. Materials and Methods: A total of 55 patients underwent two-hour resistance exercise training during each hemodialysis session for three consecutive months. Various routine clinical data were collected, including the calculation of the planar dimension of the muscle area in both upper legs at the level of the ischial bone. This area calculation was possible in 26 patients who had yearly plain abdominal computed tomography (CT) scans. DICOM files from the CT scans were used with 3D Slicer software for area calculation. An age and sex-matched group of 26 patients without dialysis rehabilitation also had yearly CT scans during the study period for comparison. Clinical data were compared between the two groups: Group A (rehabilitation) and Group B (non-rehabilitation). Results: There were no differences in basic laboratory data between the two groups. The average muscle area before and after rehabilitation in Group A was 212 cm² and 216 cm², respectively. In Group B, the average areas were 230.0 cm² and 225.8 cm². While there was no significant difference in absolute values, the average percentage increase in muscle area was +1.2% (ranging from -7.6% to 6.54%) for Group A and -2.0% (ranging from -12.1% to 4.9%) for Group B, which was statistically significant. In Group A, 9 of 26 were diabetic (DM), and 13 of 26 in Group B were non-DM. The increase in muscle area for DM patients was 4.9% compared to -0.7% for non-DM patients, which was significantly different. There were no significant differences between the two groups in terms of nutritional assessment, Kt/V, or incidence of clinical complications such as cardiovascular events. Considerations: Dialysis rehabilitation has been reported to prevent muscle atrophy by increasing muscle fibers and capillaries. This study demonstrated that muscle volume increased after dialysis exercise, as evidenced by the increased muscle area in the thighs. Notably, diabetic patients seemed to benefit more from dialysis exercise than non-diabetics. Although this study is preliminary due to its relatively small sample size, it suggests that intradialytic physical training may improve insulin utilization in muscle fiber cells, particularly in type II diabetic patients where insulin receptor function and signaling are altered. Further studies are needed to investigate the detailed mechanisms underlying the muscle hypertrophic effects of dialysis exercise.

Keywords: dialysis, excercise, muscle, hypertrophy, diabetes, insulin

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Authors: Ryotaro Ishikawa

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INTRODUCTION: Post-traumatic stress disorder (PTSD) is a psychiatric label for a collection of psychological symptoms following a traumatic event. PTSD is as a result of a traumatic experience such as rape or sexual assault. A victim may have PTSD if she/he has experienced the following symptoms for at least a month: a) Stressor, b) Intrusion symptoms, c) Avoidance, d) Negative alterations in cognitions and mood, e) Alterations in arousal and reactivity. Studies on the cognitive theory of PTSD emphasized the roles of (a) negative appraisals of trauma memories in maintaining the symptomatology of PTSD, and (b) disorganized trauma memories in the development of PTSD. Mental contamination is primarily caused by experiences involving humans (e.g. violators or perpetrators) as opposed to substances (e.g. dirt or bodily fluids). Feelings of mental contamination may evoke following experiences of ill-treatment, sexual assault, domination, degradation, manipulation, betrayal, or humiliation. Some studies have demonstrated that traumatic thoughts related to sexual assault are particularly strong predictors of mental contamination. Treatment protocols based on cognitive-behavioral therapy appear to be beneficial in reducing the severity of PTSD and mental contamination. Studies on the cognitive theory of PTSD emphasized the roles of (A) negative appraisals of trauma memories in maintaining the symptomatology of PTSD, and (B) disorganized trauma memories in the development of PTSD. We will demonstrate a feasibility study of individual CBT for PTSD and mental contamination in Japanese clinical settings. METHOD: The single-arm trial is a group setting CBT intervention. The primary outcome is the self-rated Posttraumatic Stress Diagnostic Scale, with secondary measurements of depressive severity and mental pollution questionnaire. Assessments are conducted at baseline, after a waiting period before CBT, during CBT, and after CBT. RESULTS: Participants are eligible for the study and complete the outcome measures at all assessment points. In our hypothesis, receiving CBT would lead to improvements in primary and secondary PTSD severity. CONCLUSION: We will demonstrate a feasibility study of individual CBT for PTSD and mental contamination in Japanese clinical settings. Our treatment would achieve favorable treatment outcomes for PTSD with mental contamination in Japanese clinical settings.

Keywords: CBT, cognitive theory, PTSD, mental pollution

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Authors: Fatema Salman, Ridha Hammam, Fatima Khairallah, Fatima Aradi, Nafeesa Abdulla, Mohammed Alsafar

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Purpose: This study aims at measuring the extent of nurses’ knowledge and attitudes toward the use of physical restraints in different hospital wards at Salmaniya Medical Complex (SMC). Background: The habitual use of physical restraint is a widespread practice among nurses working in the clinical settings. Restraints inflict many deleterious consequences on patients physically and psychologically which in turn increases their morbidity and mortality risk and jeopardizes care quality. Nurses’ knowledge and attitudes toward physical restraints are crucial determinants of the persistence of this practice. Literature review: the evidence of lack of knowledge among nurses regarding the use of physical restraints is overwhelming in various clinical settings, especially in two main areas which are the negative consequences and the available alternatives to physical restraints. Studies explored nurses’ attitudes toward physical restraints yielded inconsistent findings. Equally comparable, some studies found that nurses hold positive attitudes toward the use of physical restraints while some others reported just the opposite. Methods: Self-administered knowledge and attitudes scales to 106 nurses working in the SMC. Findings: nurses hold the moderate level of knowledge about restraints (M=58%) with weak negative attitudes (M = -20%) toward using it. Significant moderately-strong negative correlation (r= -0.57, r2= 0.32, p= 0.000) was uncovered between nurses knowledge and their attitudes which provided an empirical explanation of this phenomenon (use of physical restraints). Recommendations: Induction of awareness program that especially focuses on the negative consequences and encourages the use of alternatives is an evident need. This effort necessarily should be adjoined with policy and procedure adjustments.

Keywords: attitudes, knowledge, nurses, restraints

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Authors: Anna Hadamus, Patryk Wasowski, Anna Mosiolek, Zbigniew Wronski, Sebastian Wojtowicz, Dariusz Bialoszewski

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Introduction: Kinesiology Taping is a very popular physiotherapy method, often used for healthy people, especially athletes, in order to stimulate the muscles and improve their performance. The aim of this study was to determine the effect of the muscle application of Kinesiology Taping on the joint position sense in active motion. Material and Methods: The study involved 50 healthy people - 30 men and 20 women, mean age was 23.2 years (range 18-30 years). The exclusion criteria were injuries and operations of the knee, which could affect the test results. The participants were divided randomly into two equal groups. The first group consisted of individuals with the applied Kinesiology Taping muscle application (KT group), whereas in the rest of the individuals placebo application from red adhesive tape was used (placebo group). Both applications were to enhance the effects of quadriceps muscle activity. Joint position sense (JPS) was evaluated in this study. Error of Active Reproduction of the Joint Position (EARJP) of the knee was measured in 45° flexion. The test was performed prior to applying the patch, with the applied application, then 24 hours after wearing, and after removing the tape. The interval between trials was not less than 30 minutes. Statistical analysis was performed using Statistica 12.0. We calculated distribution characteristics, Wilcoxon test, Friedman‘s ANOVA and Mann-Whitney U test. Results. In the KT group and the placebo group average test score of JPS before applying application KT were 3.48° and 5.16° respectively, after its application it was 4.84° and 4.88°, then after 24 hours of experiment JPS was 5.12° and 4.96°, and after application removal we measured 3.84° and 5.12° respectively. Differences over time in any of the groups were not statistically significant. There were also no significant differences between the groups. Conclusions: 1. Applying Kinesiology Taping to quadriceps muscle had no significant effect on the knee joint proprioception. Its use in order to improve sensorimitor skills seems therefore to be unreasonable. 2. No differences between applications of KT and placebo indicates that the clinical effect of stretch tape is minimal or absent. 3. The results are the basis for the continuation of prospective, randomized trials of numerous study groups.

Keywords: joint position sense, kinesiology taping, kinesiotaping, knee

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Authors: Paula Lazarim

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As global mobility thrives, researchers emphasize the urgency of global literacy through training qualified counselors to serve internationally in a culturally competent manner. However, the focus thus far has been on how counselors’ preparation to approach international populations fuses with study abroad experiential learning short-term immersions. Looking for better solutions for cultural competency and skills learning related to international counseling, the author of this manuscript examines international counseling's current status, learning scope and goals, and educational opportunities. A guiding framework grounded on relational pedagogy (Reeves & Le Mare, 2017), relational cultural theory (Jordan, 2017), and intercultural education (Nastasi et al., 2020) is applied with four long-term educational modality projects designed to benefit cultural competence, attitude, relational skills development, and learning an intercultural counseling approach. Suggestions that encourage innovative instruction in counselor education and counseling programs at master and doctoral levels, stimulate self-learning, and educate in intercultural relational competence are linked to strategies for engaging in international counseling based on findings of a literature review and training-projects implementation. Ultimately, the author highlights theoretical and practical implications of suitable training to improve counselors' performance and discusses long-term teaching-learning opportunities that positively impact the international counseling community by sending out internationally culturally competent counselors.

Keywords: international counseling, counselor education, counseling, relational pedagogy, intercultural education, counselors’ training

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Authors: Niveen Hassan-Abbas, Tammie Ronen-Rosenbaum

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Background and purpose: 'Flourishing in marriage' is a concept refers to married individuals’ high positivity ratio regarding their marriage, namely greater reported positive than negative emotions. The study proposes a different approach to marriage which emphasizes the place of the individual himself as largely responsible for his personal flourishing within marriage. Accordingly, the individual's desire to preserve and strengthen his marriage largely determines the marital behavior in a way that will contribute to his marriage success (Actor Effect), regardless the contribution of his or her partner to his marriage success (Partner Effect). Another assumption was that flourishing in marriage could be achieved by two separate processes, where capitalization support increases the positive marriage's evaluations and accommodation decreases the negative one. A theoretical model was constructed, whereby individuals who were committed to their marriage were hypothesized as employing self-control skills by way of two dynamic processes. First, individual’s higher degree of 'capitalization supportive responses' - supportive responses to the partner's sharing of positive personal experiences - was hypothesized as increasing one’s positive evaluations of marriage and thereby one’s positivity ratio. Second, individual’s higher degree of 'accommodation' responses - the ability during conflict situations to control the impulse to respond destructively and instead to respond constructively - was hypothesized as decreasing one’s negative evaluations of marriage and thereby increasing one’s positivity ratio. Methods: Participants were 156 heterosexual Arab couples from different regions of Israel. The mean period of marriage was 10.19 (SD=7.83), ages were 31.53 years for women (SD=8.12) and 36.80 years for men (SD=8.07). Years of education were 13.87 for women (SD=2.84) and 13.23 years for men (SD=3.45). Each participant completed seven questionnaires: socio-demographic, self-control skills, commitment, capitalization support, accommodation, marital quality, positive and negative affect. Using statistical analyses adapted to dyadic research design, firstly descriptive statistics were calculated and preliminary tests were performed. Next, dyadic model based on the Actor-Partner Interdependence Model (APIM) were tested using structural equation modeling (SEM). Results: The assumption according to which flourishing in marriage can be achieved by two processes was confirmed. All of the Actor Effect hypotheses were confirmed. Participants with higher self-control used more capitalization support and accommodation responses. Among husbands, unlike wives, these correlations were stronger when the individual's commitment level was higher. More capitalization supportive responses were found to increase positive evaluations of marriage, and greater spousal accommodation was found to decrease negative evaluations of marriage. High positive evaluations and low negative evaluations were found to increase positivity ratio. Not according to expectation, four partner effect paths were found significant. Conclusions and Implications: The present findings coincide with the positive psychology approach that emphasizes human strengths. The uniqueness of this study is its proposal that individuals are largely responsible for their personal flourishing in marriage. This study demonstrated that marital flourishing can be achieved by two processes, where capitalization increases the positive and accommodation decreases the negative. Practical implications include the need to construct interventions that enhance self-control skills for employment of capitalizing responsiveness and accommodation processes.

Keywords: accommodation, capitalization support, commitment, flourishing in marriage, positivity ratio, self-control skills

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Authors: Caio E. G. Reis, Sara Wassell, Adriana L. Porto, Angélica A. Amato, Leslie J. C. Bluck, Teresa H. M. da Costa

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Background: Multiple epidemiologic studies have consistently reported association between increased coffee consumption and a lowered risk of Type 2 Diabetes Mellitus. However, the mechanisms behind this finding have not been fully elucidated. Objective: We investigate the effect of coffee (caffeinated and decaffeinated) on glucose effectiveness and insulin sensitivity using the stable isotope minimal model protocol with oral glucose administration in healthy men. Design: Fifteen healthy men underwent 5 arms randomized crossover single-blinding (researchers) clinical trial. They consumed decaffeinated coffee, caffeinated coffee (with and without sugar), and controls – water (with and without sugar) followed 1 hour by an oral glucose tolerance test (75 g of available carbohydrate) with intravenous labeled dosing interpreted by the two compartment minimal model (225 minutes). One-way ANOVA with Bonferroni adjustment were used to compare the effects of the tested beverages on glucose metabolism parameters. Results: Decaffeinated coffee resulted in 29% and 85% higher insulin sensitivity compared with caffeinated coffee and water, respectively, and the caffeinated coffee showed 15% and 60% higher glucose effectiveness compared with decaffeinated coffee and water, respectively. However, these differences were not significant (p > 0.10). In overall analyze (0 – 225 min) there were no significant differences on glucose effectiveness, insulin sensitivity, and glucose and insulin area under the curve between the groups. The beneficial effects of coffee did not seem to act in the short-term (hours) on glucose metabolism parameters mainly on insulin sensitivity indices. The benefits of coffee consumption occur in the long-term (years) as has been shown in the reduction of Type 2 Diabetes Mellitus risk in epidemiological studies. The clinical relevance of the present findings is that there is no need to avoid coffee as the drink choice for healthy people. Conclusions: The findings of this study demonstrate that the consumption of caffeinated and decaffeinated coffee with or without sugar has no acute effects on glucose metabolism in healthy men. Further researches, including long-term interventional studies, are needed to fully elucidate the mechanisms behind the coffee effects on reduced risk for Type 2 Diabetes Mellitus.

Keywords: coffee, diabetes mellitus type 2, glucose, insulin

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Authors: Reni Francis

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Learning has transcended the classroom boundaries to create a learner centric, interactive, and integrative teaching learning environment. This study analysed the impact of iLearn on the teaching, learning, and evaluation among 100 teacher trainees. The objectives were to cater to the different learning styles of the teacher trainees, to incorporate innovative teaching learning activities, to assist in peer tutoring, to implement different evaluation processes. i: Identifying the learning styles among the teacher trainees through VARK Learning style checklist was followed by planning the teaching-learning process to meet the learning styles of the teacher trainees. L: Leveraging innovations in teaching- learning by planning and creating modules incorporating innovative teaching learning and hence the concept based year plan was prepared. E: Engage learning through constructivism using different teaching methodology to engage the teacher trainees in the learning process through Workshop, Round Robin, Gallery walk, Co-Operative learning, Think-Pair-Share, EDMODO, Course Networking, Concept Map, Brainstorming Sessions, Video Clippings. A: Assessing the learning through an Open Book assignment, Closed book assignment, and Multiple Choice Questions and Seminar presentation. R: Remediation through peer tutoring through Mentor-mentee approach in the tutorial groups, Group work, Library Hours. N: Norming new standards. This was done in the form of extended remediation and tutorials to understand the need of the teacher trainee and support them for further achievements in learning through Face to face interaction, Supervised Study Circle, Mobile (Device) learning. The findings of the study revealed the positive impact of iLearn towards student achievement and enhanced social skills.

Keywords: academic achievement, innovative strategy, learning styles, social skills

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Authors: Selina Doncevic, Lisa Perla, Angela Kindvall

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The Global War on Terror which began after September 11, 2011, increased survivability of severe injuries requiring varying trajectories of rehabilitation and recovery. The costs encompass physiologic, functional, social, emotional, psychological, vocational and scholastic domains of life. The purpose of this poster is to inform private sector health care practitioners and clinicians at various levels of the unique and long term dynamics of healthcare recovery for polytrauma, and traumatic brain injured service members and veterans in the United States of America. Challenges include care delivery between the private sector, the department of defense, and veterans affairs healthcare systems while simultaneously supporting the dynamics of acute as well as latent complications associated with severe injury and illness. Clinical relevance, subtleties of protracted recovery, and overwhelmed systems of care are discussed in the context of lessons learned and in reflection on previous wars. Additional concerns for consideration and discussion include: the cost of protracted healthcare, various U.S. healthcare payer systems, lingering community reintegration challenges, ongoing care giver support, the rise of veterans support groups and the development of private sector clinical partnerships.

Keywords: brain injury, future, polytrauma, rehabilitation

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Authors: Horesh Reinman Netta

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Objectives: To examine the relationship between stressful life events and recurrent major depressive disorders Methods: Three groups of 50 subjects were assessed. One group had a recurrent major depressive disorder with melancholic features; the second group met the criteria for borderline personality disorder, and the third consisted of healthy controls. The Structured Clinical Interview for AXIS I DSM-IV Disorders sand the Structured Clinical Interview for AXIS II DSM-IV Disorders were used for diagnosis. The Israel Psychiatric Epidemiology Research Interview (IPERI) Life Event Scale and the Coddington Life Events Schedule (CLES) were used to measure life events which were confirmed with a confirmatory semi-structured interview. The Beck Depression Inventory and the Satisfaction from Life scales were also administered. Results : The total number of loss-related events in childhood and in the year preceding the first episode was significantly higher in the affective disorder group than in the two control groups. Total number of LE, uncontrolled and independent events were also more common in the depressed patients in the year preceding the first episode. No category of SLE was differentiated among any of the three groups during any period of time following the first depressive episode. Conclusions: SLE play an important role in the onset of affective disorders. There appear to be specific kinds of SLE occurring in childhood and in the year preceding a first episode that have particular significance. SLE may have a lesser role in the maintenance of this illness.

Keywords: modd dosorders, recurrent depression, stress, life events

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Authors: Jihene Bettaieb, Ghassen kharroubi, Rym mallekh, Ines Cherif, Taoufik Atawa, Kaouther Harrabech

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Brucellosis is a major worldwide zoonosis. It is a reportable condition in Tunisia where the disease remains endemic, especially in rural areas. The aim of this study was to describe the epidemiological, clinical, and bacteriological profile of human brucellosis cases notified in the district of Tunis. It was a retrospective descriptive study of cases reported in the district of Tunis through the national surveillance system between the 1st January and 31th December 2017. During the study period, 133 brucellosis confirmed cases were notified. The mean age was 37.5 ± 18.0 years, and 54.9% of cases were males. More than four-fifths (82.7%) of cases were reported in spring and summer with a peak in the month of May (36 cases). Fever and sweats were the most common symptoms; they occurred in 95% and 72% of cases, respectively. Osteoarticular complications occurred in 10 cases, meningitis in one case and endocarditis in one other case. Wright agglutination test and Rose Bengale test were positive in 100% and 91% of cases, respectively. While blood culture was positive in 9 cases and PCR in 2 cases. Brucella melitensis was the only identified specie (9 cases). Almost all cases (99.2%) reported the habit of consuming raw dairy products. Only 5 cases had a suspect contact with animals; among them, 3 persons were livestock breeders. The transmission was essentially due to raw dairy product consumption. It is important to enhance preventive measures to control animal Brucellosis and to educate the population regarding the risk factors of the disease.

Keywords: brucellosis, risk factors, surveillance system, Tunisia

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Authors: Sanjeev Sharma, Suman Lata

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With the availability of diverse printed, electronic literature and web sites on medical and health related information, it is impossible for the medical professional to get the information he seeks in the shortest possible time. For all these problems information literacy is the only solution. Thus, information literacy is recognized as an important aspect of medical education. In the present study, an attempt has been made to know the information literacy skills of the faculty and students at medical colleges of Haryana, Punjab and Chandigarh. The scope of the study was confined to the 12 selected medical colleges of three States (Haryana, Punjab, and Chandigarh). The findings of the study were based on the data collected through 1018 questionnaires filled by the respondents of the medical colleges. It was found that Online Medical Websites (such as WebMD, eMedicine and Mayo Clinic etc.) were frequently used by 63.43% of the respondents of Chandigarh which is slightly more than Haryana (61%) and Punjab (55.65%). As well, 30.86% of the respondents of Chandigarh, 27.41% of Haryana and 27.05% of Punjab were familiar with the controlled vocabulary tool; 25.14% respondents of Chandigarh, 23.80% of Punjab, 23.17% of Haryana were familiar with the Boolean operators; 33.05% of the respondents of Punjab, 28.19% of Haryana and 25.14% of Chandigarh were familiar with the use and importance of the keywords while searching an electronic database; and 51.43% of the respondents of Chandigarh, 44.52% of Punjab and 36.29% of Haryana were able to make effective use of the retrieved information. For accessing information in electronic format, 47.74% of the respondents rated their skills high, while the majority of respondents (76.13%) were unfamiliar with the basic search technique i.e. Boolean operator used for searching information in an online database. On the basis of the findings, it was suggested that a comprehensive training program based on medical professionals information needs should be organized frequently. Furthermore, it was also suggested that information literacy may be included as a subject in the health science curriculum so as to make the medical professionals information literate and independent lifelong learners.

Keywords: information, information literacy, medical professionals, medical colleges

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Authors: Yuri Melis, Mattia Resteghini, Emanuela Apicella, Eugenia Dozio, Leonardo Mendolicchio

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Aim: This retrospective study was created to analyze the psychometric, anthropometric and body composition values in patients at the beginning and the discharge of their of hospitalization in the residential care clinic for eating and feeding disorders (EFD’s). Method: The sample was composed by (N=59) patients with mean age N= 33,50, divided in subgroups: Anorexia Nervosa (AN) (N=28), Bulimia Nervosa (BN) (N=13) and Binge Eating Disorders (BED) (N=14) recruited from a residential care clinic for eating and feeding disorders. The psychometrics level was measured with self-report questionnaires: Eating Disorders Inventory-3 (EDI-3) The Body Uneasiness Test (BUT), Minnesota Multiphasic Personality Inventory (MMPI – 2). The anthropometric and nutritional values was collected by Body Impedance Assessment (B.I.A), Body mass index (B.M.I.). Measurements were made at the beginning and at the end of hospitalization, with an average time of recovery of about 8,6 months. Results: The all data analysis showed a statistical significance (p-value >0,05 | power size N=0,950) in variation from T0 (start of recovery) to T1 (end of recovery) in the clinical scales of MMPI-2, AN group (Hypocondria T0 64,14 – T1 56,39) (Depression T0 72,93 – T1 59,50) (Hysteria T0 61,29 – T1 56,17) (Psychopathic deviation T0 64,00 – T1 60,82) (Paranoia T0 63,82 – T1 56,14) (Psychasthenia T0 63,82 – T1 57,86) (Schizophrenia T0 64,68 – T1 60,43) (Obsessive T0 60,36 – T1 55,68); BN group (Hypocondria T0 64,08 – T1 47,54) (Depression T0 67,46 – T1 52,46) (Hysteria T0 60,62 – T1 47,84) (Psychopathic deviation T0 65,69 – T1 58,92) (Paranoia T0 67,46 – T1 55,23) (Psychasthenia T0 60,77 – T1 53,77) (Schizophrenia T0 64,68 – T1 60,43) (Obsessive T0 62,92 – T1 54,08); B.E.D groups (Hypocondria T0 59,43 – T1 53,14) (Depression T0 66,71 – T1 54,57) (Hysteria T0 59,86 – T1 53,82) (Psychopathic deviation T0 67,39 – T1 59,03) (Paranoia T0 58,57 – T1 53,21) (Psychasthenia T0 61,43 – T1 53,00) (Schizophrenia T0 62,29 – T1 56,36) (Obsessive T0 58,57 – T1 48,64). EDI-3 report mean value is higher than clinical cut-off at T0, in T1, there is a significant reduction of the general mean of value. The same result is present in the B.U.T. test in the difference between T0 to T1. B.M.I mean value in AN group is (T0 14,83 – T1 18,41) BN group (T0 20 – T1 21,33) BED group (T0 42,32 – T1 34,97) Phase Angle results: AN group (T0 4,78 – T1 5,64) BN (T0 6 – T1 6,53) BED group (T0 6 – T1 6,72). Discussion and conclusion: The evident presence that on the whole sample, we have an altered serious psychiatric and clinic conditions at the beginning of recovery. The interesting conclusions that we can draw from this analysis are that a multidisciplinary approach that includes the entire care of the subject: from the pharmacological treatment, analytical psychotherapy, Psychomotricity, nutritional rehabilitation, and rehabilitative, educational activities. Thus, this Multidisciplinary treatment allows subjects in our sample to be able to restore psychopathological and metabolic values to below the clinical cut-off.

Keywords: feeding and eating disorders, anorexia nervosa, care clinic treatment, multidisciplinary treatment

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Authors: Zahra Shokrolahi, Mohammad Reza Atashzar

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The goals of treating patients with breast cancer are to cure the disease, prolong survival, and improve quality of life. Immune cells in the tumor microenvironment have an important role in regulating tumor progression. The term of cellular immunotherapy refers to the administration of living cells to a patient; this type of immunotherapy can be active, such as a dendritic cell (DC) vaccine, in that the cells can stimulate an anti-tumour response in the patient, or the therapy can be passive, whereby the cells have intrinsic anti-tumour activity; this is known as adoptive cell transfer (ACT) and includes the use of autologous or allogeneic lymphocytes that may, or may not, be modified. The most important breast cancer cellular immunotherapies involving the use of T cells and natural killer (NK) cells in adoptive cell transfer, as well as dendritic cells vaccines. T cell-based therapies including tumour-infiltrating lymphocytes (TILs), engineered TCR-T cells, chimeric antigen receptor (CAR T cell), Gamma-delta (γδ) T cells, natural killer T (NKT) cells. NK cell-based therapies including lymphokine-activated killers (LAK), cytokine-induced killer (CIK) cells, CAR-NK cells. Adoptive cell therapy has some advantages and disadvantages some. TILs cell strictly directed against tumor-specific antigens but are inactive against tumor changes due to immunoediting. CIK cell have MHC-independent cytotoxic effect and also need concurrent high dose IL-2 administration. CAR T cell are MHC-independent; overcome tumor MHC molecule downregulation; potent in recognizing any cell surface antigen (protein, carbohydrate or glycolipid); applicable to a broad range of patients and T cell populations; production of large numbers of tumor-specific cells in a moderately short period of time. Meanwhile CAR T cells capable of targeting only cell surface antigens; lethal toxicity due to cytokine storm reported. Here we present the most popular cancer cellular immunotherapy approaches and discuss their clinical relevance referring to data acquired from clinical trials .To date, clinical experience and efficacy suggest that combining more than one immunotherapy interventions, in conjunction with other treatment options like chemotherapy, radiotherapy and targeted or epigenetic therapy, should guide the way to cancer cure.

Keywords: breast cancer , cell therapy , CAR T cell , CIK cells

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Authors: A. Bruce Janati, Muhammad Umair Khan, Naif Alghassab, Ibrahim Alzeir, Assem Mahmoud, M. Sammour

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Rationale: Lennox-Gastaut syndrome(LGS) is an electro-clinical syndrome composed of the triad of mental retardation, multiple seizure types, and the characteristic generalized slow spike-wave complexes in the EEG. In this article, we report on two patients with LGS whose brain MRI showed dysgenesis of corpus callosum(CC). We review the literature and stress the role of CC in the genesis of secondary bilateral synchrony(SBS). Method: This was a clinical study conducted at King Khalid Hospital. Results: The EEG was consistent with LGS in patient 1 and unilateral slow spike-wave complexes in patient 2. The MRI showed hypoplasia of the splenium of CC in patient 1, and global hypoplasia of CC combined with Joubert syndrome in patient 2. Conclusion: Based on the data, we proffer the following hypotheses: 1-Hypoplasia of CC interferes with functional integrity of this structure. 2-The genu of CC plays a pivotal role in the genesis of secondary bilateral synchrony. 3-Electrodecremental seizures in LGS emanate from pacemakers generated in the brain stem, in particular the mesencephalon projecting abnormal signals to the cortex via thalamic nuclei. 4-Unilateral slow spike-wave complexes in the context of mental retardation and multiple seizure types may represent a variant of LGS, justifying neuroimaging studies.

Keywords: EEG, Lennox-Gastaut syndrome, corpus callosum , MRI

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Authors: Laura Mion

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The implementation of quality management systems in higher education in different countries is determined by national regulatory choices and supranational indications (such as the European Standard Guidelines for Quality Assurance). The effective functioning and transformative capacity of these quality management systems largely depend on the organizational context in which they are applied and, more specifically, on the culture of quality developed in single universities or in single countries. The University's concept of quality culture integrates the structural dimension of QA (quality management manuals, process definitions, tools) with the value dimension of an organization (principles, skills, and attitudes). Within the EHEA (European Higher Education Area), countries such as Portugal, the Netherlands, the UK, and Norway demonstrate a greater integration of QA principles in the various organizational levels and areas of competence of university institutions or have greater experience in implementation or scientific and political debate on the matter. Therefore, the study, through an integrative literature review, of the quality management systems of these countries is aimed at determining a framework of the culture of quality, helpful in defining the elements which, both in structural-organizational terms and in terms of values and skills and attitudes, have proved to be factors of success in the effective implementation of quality assurance systems in universities and in the countries considered in the research. In order for a QA system to effectively aim for continuous improvement in a complex and dynamic context such as the university one, it must embrace a holistic vision of quality from an integrative perspective, focusing on the objective of transforming the reality being evaluated.

Keywords: higher education, quality assurance, quality culture, Portugal, Norway, Netherlands, United Kingdom

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Authors: Majda El Moufarej

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Higher education plays a central role in socio-economic development. However, with the wave of change mainly due to the extensive use of technology in the workplace, the rate of unemployment among graduates rises because they lack the appropriate competencies and skills currently required in professional life. This situation has led higher education institutions worldwide to reconsider their missions, strategic planning, and curricula, among other elements to redress the image of the university as expected. When it comes to practice, there are many obstacles that hinder the achievement of the expected objectives, especially in public universities with free access, as in the case of Morocco. Nevertheless, huge efforts have been made by educational managers to improve the quality of education by focusing on the issue of pedagogical approaches, where university teachers assume more responsibility to save the situation. In this paper, the focus will be placed on the issue of pedagogical approaches to be adopted, depending on the nature of the subject, the size of the class, the available equipment, the students’ level and degree of motivation. Before elaborating on this idea, it may be more insightful to begin by addressing another variable, which concerns the new role of university teachers and their qualification in pedagogical competence. Then, the discussion will revolve around five pedagogical approaches currently adopted in western universities and the focus will be exclusively placed on the one which is called “the Systematic Approach to course Design”, due to its crucial relevance in the teaching of subjects in the schools of humanities, as it can guide the teacher in the development of an explicit program for purposeful teaching and learning. The study is based on a qualitative method, and the findings will be analyzed and followed by some recommendations about how to overcome difficulties in teaching large groups, while transmitting the relevant knowledge and skills on demand in the workplace.

Keywords: higher education, public universities, pedagogical approaches, pedagogical competence

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Authors: Suwarno, D. Jongudomkarn

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Family Health Assessment (FHA) is a key process to identify the family health needs, family health problems, and family health history. Assessing the family health is not only from the assessment tool but also from health care provider especially Nurse. Nurses’ have duties to assess the family as holistic view and they have to increase their capacities (knowledge, skills and experiences) in FHA. Thus, the continuing nursing education-training program on using the KKU FHA Tool was aimed to enhance the participant nurses’ capacities in (FHA) based on such tool. The aim of this study was to evaluate the KKU FHA Tool training program on PCU nurses’ capacity before and after training program in Primary Care Unit Bantul, Yogyakarta. The Quasi-Experiment with one group pre-, post-test design as a research design with convenient sampling technique and one group pre- post test formula for Nurses who work in Six PCU Bantul, Yogyakarta as much as fourteen respondents. The research processes were used training program with module, video and handbook KKU FHA Tool, KKU FHA tool form and capacities questionnaires. It was analyzed by descriptive data, Kolmogorov-Smirnov and Paired Sample t-test. The overall comparing analysis of paired sample t-test revealed that the mean values of pre-test were 3.35 with SD 0.417, post-test was 3.86 with SD 0.154 and post-test in later two weeks was 4.00 with SD 0.243. It was found that the p value of among the pre-test, the intermediate post-test and the post–test in later two weeks were 0.000. The p value of the intermediate post-test and post-test in later two weeks was 0.053. KKU FHA Tool training program in PCU Bantul Yogyakarta was enhanced the participant nurses’ capacities significantly. In conclusion, we are recommending KKU FHA Tool forms have to develop and implement with qualitative research as complementary data in PCU Bantul Yogyakarta by Focus Group Discussion.

Keywords: family health assessment, KKU FHA tool, training program, nurses capacities

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Authors: Robert Jedrys, Zdzislaw Kobos, Justyna Skrzynska, Zbigniew Wochynski

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Professions connected to aviation require an assessment of the suitability of health, psychological and psychomotor skills and overall physical fitness of the organism, who applies. Assessment of the physical condition is conducted by the committees consisting of aero-medical specialists in clinical medicine and aviation. In addition, psychological predispositions should be evaluated by specialized psychologists familiar with the specifics of the tasks and requirements for the various positions in aviation. Both, physical abilities and general physical fitness of candidates for aviation shall be assessed during the selection exams, which also test the ability to deal with stress what is very important in aviation. Hence, the mentioned exams in physical education not only help to judge on the ranking in candidates in terms of their efficiency and performance, but also allows to evaluate the functioning under stress measured using psychological tests. Moreover, before-test stress is a predictors of successfulness in the next stages of education and practical training in the aviation. The aim of the study was to evaluate the influence of temperamental traits on strategies used for coping with stress during selection exams in physical education, deciding on admission to aviation school. The study involved 30 candidates for fighter pilot training in aviation school . To evaluate the temperament 'The Formal Characteristics of Behavior-Temperament Inventory' (FCB-TI) by B. Zawadzki and J.Strelau was used. To determine the pattern of coping with stress 'The Coping Inventory for Stressful Situations' (CISS) to N. S. Endler and J. D. A. Parker were engaged. Study of temperament and styles of coping with stress was conducted directly before the exam selection of physical education. The results were analyzed with 'Statistica 9' program. The studies showed that:-There is a negative correlation between such a temperament feature as 'perseverance' and preferred style of coping with stress concentrated on the task (r = -0.590; p < 0.004); -There is a positive correlation between such a feature of temperament as 'emotional reactivity,' and preference to deal with a stressful situation with ‘style centered on emotions’ (r = 0.520; p <0.011); -There is a negative correlation between such a feature of temperament as ‘strength’ and ‘style of coping with stress concentrated on emotions’ (r = -0.580; p < 0.004). Studies indicate that temperament traits determine the perception of stress and preferred coping styles used during the selection, as during the exams in physical education.

Keywords: aviation, physical education, stress, temperamental traits

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