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The growth of sensory evaluation as a product information resource has been significant over the past four decades. With increased competition, companies look for sensory information that can be obtained quickly without compromising the quality of results. This author describes the basic principles and how they are best used to advantage. Particular attention is given to the subject selecting and qualifying process and its effect on test time and the quality of the results. Additional attention is given to descriptive analysis, a methodology that is used in almost every sensory program but in different ways, reflecting how researchers understand the process. The author describes the process by which the quantitative descriptive analysis (QDA) method was developed, taking into account the time requirements in the context of a rapid method.

The Ideal Profile Method (IPM) is a descriptive analysis in which consumers are asked to rate products on both their perceived and ideal intensities against a list of attributes. In addition, overall liking is rated. The information gathered from the IPM is rich, and directly actionable for product development. However, these data need special attention, since they are provided by consumers who are rating a fictive product. In order to fully appreciate the data, the Ideal Profile Analysis (IPA) has been set up. This methodology helps in (1) evaluating the consistency of the ideal data, (2) assessing homogeneous groups of consumers/products, (3) defining the sensory profile of the ideal product of reference, and (4) optimizing the products according to that reference.

Can (sorted) Napping be considered a rapid method? Can it be considered as an alternative to descriptive analysis? The main objective of this chapter is to shed new light on Napping and sorted Napping in order to provide some clues for answering these two questions. In particular, we will stress the intrinsic nature of the data collected when using Napping, and on the link between Napping and sorted Napping. We will see how the information provided by Napping is unique, and how different it can be from that provided by descriptive analysis. We will see that, at a subject level, Napping is certainly a rapid method, but in order to be used as an alternative to descriptive analysis, a relatively high number of subjects need to be considered.

Background and objectives: Neuropathic pain is common in the general population worldwide and Brazil. The painDETECT questionnaire is a notable instrument for screening on neuropathic pain. A Brazilian version of the painDETECT is necessary to broaden the possibilities of identification of neuropathic pain in the Brazilian population for the proper diagnosis and treatment. The current study aimed to perform the translation and cross-cultural adaptation of the painDETECT into the Portuguese language of Brazil. Methods: A cross-cultural adaptation study was conducted in 11 stages according to standard procedures. Descriptive statistics were performed. The internal consistency of the questionnaire was assessed using Cronbach’s Alpha test (α). Results: Four translators, 10 experts, and 30 patients participated in the study. The expert committee adapted five out of nine items (item 2, 3, 6, 8, and 10) to the Brazilian context. The pretesting phase showed good internal consistency (α = 0.74) for the nine items, including the pain pattern and the body chart domains. The Cronbach’s α of the instrument with seven descriptor items of pain was 0.83. Conclusions: The painDETECT was cross-culturally adapted into a Brazilian context and can be used to identify neuropathic components in pain of Brazilian patients. Clinical implications: PainDETECT is available for Brazilians to identify neuropathic components in pain.

Purpose The objective of this study was to explore the ambience of professionalism related to academic integrity among undergraduate dental students. Methodology “Dundee Polyprofessionalism Inventory I: Academic Integrity” was used to collect responses from first-year to fifth-year dental students of the College of Dentistry, King Saud University (Response rate = 78%). The participants’ responses (for 34 professionalism lapses) were recorded by using the Dundee Polyprofessionalism Inventory. Statistical analysis included descriptive statistics, Chi-square, and T-tests (P Results The “Ignore” sanction was not opted for any of the 34 professionalism behaviors, and there was unanimous agreement between the participants in considering all 34 behavior statements to be “wrong”. Male and female participants were found to opt for a similar sanction as the median for 16 statements (47%), whereas, for 18 statements (53%), their responses differed with a range of levels 0.5 to 1.5. Preclinical- and clinical-year student responses also showed similarities in their 11 statements (32.3%), and they did differ for 20 statements (58.8%). Interestingly, clinical year respondents were overall on the stricter side of recommending sanctions. Conclusions For the majority of the dental students tested, there was a good understanding of the significance of some lapses of professionalism associated with academic integrity. Some of the disclosures in this study were substantially appreciable because none of the students selected “ignore” sanction for any of the survey statements. We found that using the Dundee Polyprofessionalism Inventory for learning and understanding academic professionalism among dental students is useful.

Objective This study aimed to assess the factors associated with tooth loss in an adult population in Guanajuato, Mexico. Methods This cross-sectional study included individuals enrolled in a community program (2014-2016). Data were gathered through closed-ended questions about sociodemographic characteristics such as sex, age, and schooling. Oral hygiene practices, self-perceived oral health, dental visits during the last 12 months, smoking habits, and diabetes status of the participants were also recorded. A clinical evaluation was performed for each person to register decayed, missing, and filled teeth (DMF-t). Descriptive statistics, bivariate analysis, and negative binomial models were used to identify variables associated with the number of missing teeth. Results A total of 1640 persons were included in the study. The mean age was 41.6 (±15.4) years; 63.6% were female; and 52.7% had at least 1 missing tooth, with a mean of 2.9 (+4.6) missing teeth. The mean number of missing teeth increased by 5% per year relative to age. Females (relative ratio [RR] = 1.40), smokers (RR = 1.56), people with diabetes who smoke (RR = 3.62), and people who rated their oral health as fair or poor (RR = 1.2) had higher mean values of missing teeth. In contrast, individuals who achieved a high school degree (or above) (RR = 0.81), practiced daily toothbrushing (RR = 0.63), or practiced regular toothbrushing and flossing (RR = 0.65) had fewer missing teeth. Conclusions More than half of the population has at least 1 missing tooth. The number of missing teeth is higher in individuals with diabetes and unhealthy habits such as smoking. Good oral hygiene practices play an essential role in preventing tooth loss.

Objectives Identify risk factors associated with increased hospital admission and mortality due to dengue fever (DF), and estimate the risk magnitude associated with each individual variable. Methods Records of patients diagnosed with dengue were obtained from the Mexican National Epidemiological Surveillance System. Descriptive statistics were performed in all variables. Demographic characteristics and comorbidities were compared between patients based on type of care and mortality. Multivariable analysis was done with a logistic regression model, using two different outcomes: hospitalization and mortality. Results A total of 24,495 patients were included in the analysis, with a DF case fatality rate of 0.58%. Patients younger than 10 and older than 60, were found to have a greater risk of both hospitalization and mortality due to DF. Comorbidities associated with a higher risk for hospital admission include cirrhosis, CKD, immunosuppression, diabetes, and hypertension. For mortality, CKD, diabetes, and hypertension were identified as risk factors, along with pregnancy. Conclusion Identification of risk factors associated with increased hospitalization and mortality due to DF can help categorize patients that require close monitoring and inpatient care. Early identification of warning signs and patients at increased risk is key to avoiding delay of supportive care.

This study attempts to take a close look on corporate governance, board practices and performance of shipping firms in Bangladesh. The study has conducted a survey on 24- shipping firms operated in Bangladesh and collected perceptional data from top tier executives and factual data from firms balance sheet and income statement. The results of descriptive statistics show that most of the firms’ managers are not aware about the corporate governance and board practices of the firm. Moreover, there is significant lack of transparency in the board practices documented among the shipping firms in this study. The results of regression analysis confirm that board ownership, board leadership, board size, and firm size have significant impact on firm performance. Moreover, factual analysis results show that board leadership has significant impact on firm performance. However, this study also confirmed that board composition has no significant impact on firm performance in the context of Bangladeshi shipping firms. Thus, this is of the essence to spotlight on corporate governance policies in the shipping firms to make legal aspects of board practices to escalate the growth of shipping industry in Bangladesh.

Objective To evaluate the clinical and financial impact of clinical pharmacists’ interventions (CPIs) on antimicrobial use at a 500-bed multidisciplinary tertiary care hospital in Oman. Methods A retrospective analysis of CPIs related to antimicrobials use at Sultan Qaboos University Hospital (SQUH) from January to December 2018. Interventions were recorded using an electronic CPI form and were reviewed by two independent CPs. Data on the type and clinical significance of the interventions were extracted. Cost analysis was done using a previously defined cost avoidance model in addition to direct cost reduction estimation. Descriptive data were used to describe the results. Results In 2018, 26% of CPIs were related to antimicrobial use, with more than 60% of these interventions done on intensive care unit patients. The most common intervention type was adjusting the dosing regimen (42% of the total interventions), followed by deletion of the antimicrobial order in 34% of the cases. The most common clinical impact of CPIs was improving efficacy in 45% of the interventions, followed by preventing unnecessary exposure to the antimicrobials in around 30% of the interventions. The interventions were of major significance in 64% of the cases. This translated into a projected net cost saving of approximately $200,000 USD/year. Conclusions CPs interventions on antimicrobial use had a positive impact on both the clinical and financial outcomes.

Objectives Globally, drug-resistant tuberculosis (DR-TB) is the leading cause of death globally related to antimicrobial resistance, affecting 500,000 emergent cases annually. In 2018, the first United Nations High-Level Meeting (UNHLM) on tuberculosis declared DR-TB a global public health priority. Bold country targets were established for 2018–2022. This study reviews the DR-TB situation in 2018, and the UNHLM target accomplishments in 10 high-burden countries (HBCs). Methods An ecological descriptive analysis of the top 10 DR-TB HBCs (Bangladesh, China, India, Indonesia, Myanmar, Nigeria, Pakistan, Philippines, Russian Federation, and South Africa), which share 70% of the global DR-TB burden, was undertaken, complemented by a cascade-of-care analysis and a survey gathering additional information on key advances and setbacks 2 years after the UNHLM declaration. Results Most countries are showing historic advances and are on track for the 2018 and 2019 targets. However, according to the cascade-of-care, none of the countries are capable of providing effective care for 50% of the estimated patients. Increasing levels of fluoroquinolone resistance and access to timely susceptibility testing can jeopardize ongoing adoption of shorter, all-oral treatment regimens. The programmatic management of DR-TB in children remains minimal. Achievements for 2020 and beyond may be affected significantly by the coronavirus disease 2019 (COVID-19) pandemic. Conclusion Triggered by the COVID-19 pandemic, there is a global risk of recoil in DR-TB care with long-term consequences in terms of deaths, suffering and wider transmission. Investment to support DR-TB services is more important now than ever to meet the aspirations of the UNHLM declaration.

Purpose To evaluate the quality and content of internet-based information available for some of the most common orthopaedic sports medicine terms. Methods A search of the PubMed, Embase, and Cochrane databases following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines was performed. All English-language literature published from 2010 to 2020 discussing information quality pertaining to orthopaedic sports medicine terms was included. Outcomes included the search engines used, number and type of websites evaluated, platform, and quality scoring metrics. Descriptive statistics are presented. Results This review includes 21 studies. Of these, 3 evaluated both the upper and lower extremity. Twelve focused on either the upper or lower extremity, most commonly rotator cuff tears (3 of 12) and/or anterior cruciate ligament pathologies (7 of 12). The most common engines were Google (18 of 21), Bing (16 of 21), Yahoo (16 of 21), YouTube (3 of 21), Ask (3 of 21), and AOL (2 of 21). The average number of media files assessed per study was 87 ± 55. Website quality was assessed with DISCERN (7 of 21), Flesch-Kincaid (9 of 21), Health on the Net (7 of 21), and/or Journal of the American Medical Association Benchmark (7 of 21) scores. YouTube was evaluated with Journal of the American Medical Association Benchmark scores (1.74 ± 1.00). Image quality was reported in 2 studies and varied with search terminology. Conclusions The results of this systematic review suggest that physicians should improve the quality of online information and encourage patients to access credible sources when conducting their own research. Clinical Relevance Doctors can and should play an active role in closing the gap between the level of health literacy of their patients and that of most common online resources.

Objectives: To describe the professional quality of life and explore its associated factors among nurses coming from other areas of China to assist with the anti-epidemic fight in Wuhan and especially examine whether the hospital ethical climate was independently associated with nurses’ professional quality of life. Methods: A cross-sectional online survey was conducted from March 2020 to April 2020. The nurses working in Wuhan from the other parts of China were the target population. The Professional Quality of Life Scale version 5, the Hospital Ethical Climate Survey, and a basic information sheet were used to collect data. Descriptive statistics, t-test, ANOVA, Pearson correlation, and multiple linear regression analysis were used to analyze the data. Results: In total, 236 nurses participated in this study, and 219 valid questionnaires were analyzed. The average age of the participants was 31.2 ± 5.0 years. Most nurses were female (176/219; 80.4%) and married (145/219; 66.2%). In term of professional quality of life, nurses reported moderate (129/219; 58.9%) to high (90/219; 41.1%) levels of compassion satisfaction, low (119/219; 54.3%) to moderate (100/219; 45.7%) levels of burnout, and low (67/219; 36.0%) to high (10/219; 4.6%) levels of secondary traumatic stress. Regarding hospital ethical climate, nurses reported moderately high hospital ethical climates with an average score of 4.46. After controlling for socio-demographic characteristics, the multiple linear regression models showed that the hospital ethical climate subscale of “relationship with physicians” was independently associated with the compassion satisfaction (β = 0.533, P

Background & Objectives One of the broadly talked about class of medications for their extravagantly expanded abuse is proton pump inhibitors (PPIs). In spite of the fact that, they are known to be profoundly useful, it is accounted for several adverse manifestations. Health care professionals can assume an essential part in controlling its irrational use. The purpose of this study was to explore the knowledge, attitude and behavior of health care professionals of Riyadh region of Saudi Arabia on the use of PPIs by a cross-sectional study design. Methods The study data was obtained through a validated self-administered questionnaire covering knowledge (20 items), attitude (8 items) and behavior (6 items). Furthermore, demographic questions were placed to decide their effect on the intended three domains. The results were analysed by descriptive analysis and affirmed by multinomial regression method using SPSS-IBM 25. Results Of 414 surveyors, 121 (31%), 182 (44%) and 103 (25%) were doctors, pharmacist and nurses, respectively. Average age of participants' was 33.96 ± 8.37 years. Both doctors and pharmacist showed better degree of information (13.17/20 and 13.25/20) and good attitude (6.66/8 and 6.9/8) towards PPI use compared to nurses. Altogether higher extent of knowledge score showed by highly educated individuals, middle age groups and those with more practicing experience. The reliance on the utilization of PPI is less among pharmacist and nurses when compared to doctors. The outcome of the regression analysis exhibited that the odds of having low knowledge is more in young and bachelor degree holders. Interpretation & Conclusion Healthcare professionals in the Riyadh area are generally positive about the use of PPIs. However, increasing their level of knowledge and reducing their reliance on PPIs must be strengthened. Frequent professional development programs and trainings for healthcare professionals are needed to minimize widespread PPI overuse.

open access article BACKGROUND There is no current research to explain the trends in vasectomy and vasectomy reversals in the United Kingdom, leaving little understanding of the social phenomena involved. OBJECTIVE This study aimed to provide an overview of vasectomy as a main method (or primary method) of contraception and vasectomy reversals among men in the United Kingdom aged >16 years. STUDY DESIGN Descriptive statistics were generated from the National Health Service's publicly accessible datasets from 2004/2005 to 2019/2020, including data from 1,621,105 men. RESULTS Although men are increasing their use of contraceptive services, the number of men having vasectomies and vasectomy reversals has decreased significantly. CONCLUSION The researchers propose that more rigorous techniques for capturing data are required to understand vasectomy in the United Kingdom. There is also an urgent need for research on vasectomy in the United Kingdom and globally, not only to explain the behavioral trends found in this study, but also to explain the global trend.

Introduction: Clinical practice guidelines on the diagnosis and treatment of acute pancreatitis (CPGDTAP) have been designed in an effort to reduce the morbidity and mortality of that severe disease. Aim: To identify the knowledge acquired from CPGDTAP in hospitals in Veracruz. Materials and methods: A descriptive, observational, multicenter study was conducted at four hospitals in Veracruz, through the application of a survey to evaluate the knowledge of attending physicians and residents that treat patients with acute pancreatitis. Descriptive statistics were employed to analyze the results. Results: A total of 74 physicians were surveyed, 55.41% of whom were attending physicians and 44.59% of whom were resident physicians. The majority of physicians (67.57%) were familiar with CPGDTAP from the Asociación Mexicana de Gastroenterología (AMG), followed by those of the General Health Council of the Mexican Department of Health (CENETEC, the Spanish acronym) (54.05%) and the American College of Gastroenterology (ACG) (48.65%). A total of 97.30% of the physicians routinely use a nasogastric tube, 79.73% considered early enteral nutrition to be very important, as did 98.65% regarding generous fluid replacement, 85.14% did not routinely use antimicrobials, 63.51% ordered a CAT scan at 72 h or later, and 87.84% answered that infected necrosis was the indication for surgery, preferably after the third week. Discussion and conclusions: In our hospital environment, the CPGDTAP issued by the AMG and CENETEC were the most well-known, but their recommended measures were given importance by under 85% of the physicians surveyed. Therefore, the diffusion of the knowledge they contain is advisable to guarantee optimal results in acute pancreatitis management. Resumen: Introducción: Las Guías de Práctica Clínica para el Diagnóstico y Tratamiento de la Pancreatitis Aguda (GPCDMPA) han sido diseñadas con la finalidad de disminuir la morbimortalidad de ésta grave enfermedad. Objetivo: Identificar el conocimiento de las GPCDMPA en hospitales de Veracruz. Material y métodos: Estudio observacional, descriptivo, multicéntrico realizado en 4 hospitales de Veracruz, aplicando encuesta para evaluar su conocimiento en médicos y residentes que atienden pacientes con pancreatitis aguda. El análisis de los resultados se realizó por estadística descriptiva. Resultados: Se aplicaron 74 encuestas: 55.4% a médicos adscritos y 44.59% a residentes. La GPCDTPA más conocida fue la de la Asociación Mexicana de Gastroenterología (AMG) (67.57%), seguida por la del Consejo de Salubridad General de la Secretaría de Salud (CENETEC) (54.05%) y la del Colegio Americano de Gastroenterología (ACG) (48.65%). El 97.30% de los médicos utilizaron rutinariamente una sonda nasogástrica, el 79.73% consideran muy importante el inicio temprano de la nutrición enteral, el 98.65% la reposición hídrica generosa, el 85.14% no emplearon antimicrobianos de rutina, el 63.51% realizan la TAC a partir de las 72 h y el 87.84% consideran que la indicación quirúrgica es la necrosis infectada, preferentemente después de la tercera semana. Discusión y conclusiones: En nuestro medio las (GPCDMPA) más conocidas fueron las de la AMG y CENETEC y su conocimiento es inferior al 85.00%, por lo que es recomendable su difusión para garantizar resultados óptimos en el manejo de la pancreatitis aguda.

Globally, the psychological health of the people is being affected due to the COVID-19 pandemic. Given the fact that numerous systematic reviews already exist on yoga and mental health, it becomes vital to undertake an overview on the same. The objective of the overview was to summarise the evidence from different systematic reviews of distinct yoga interventions used to improve mental health and recommend yoga practices for the same. The protocol was registered on PROSPERO (CRD42020185221). MEDLINE via Pubmed, Cochrane Database of Systematic Reviews and Google Scholar were searched for relevant literature. Search terms used were “Yoga practice, mental health and systematic review”. Reviews from earliest possible date till May 2020, including those examining the effects of any single or combination of yoga interventions on mental health reported on children, youth and adults were selected. The Assessment of Multiple Systematic Reviews (AMSTAR) tool was used to evaluate the evidence of the included reviews. Out of the 90 reviews found, eight unique reviews were selected for the overview. Overall, 243 studies were analyzed, with an overlap of only 6 studies across the reviews. Out of 8 reviews, only 2 were of high quality and the rest were of moderate quality. Owing to heterogeneity of the included studies, only descriptive analysis was possible. The results of the review indicate moderate to positive effects of yoga on the mental health parameters. Practicing yoga (physical postures, Bhramary Pranayam, mindfulness meditation, sahaj yoga and laughter therapy) can be beneficial to improve psychological health of the people during the COVID-19 pandemic.

Introduction Prehospital care is integral in addressing sub-Saharan Africa's (SSA) high injury and illness burden. Consequently, robust, high-quality prehospital guidance documents are needed to inform care. These guidance documents include, but are not limited to, clinical practice guidelines (CPGs), protocols and algorithms that are contextually appropriate for SSA. However, SSA prehospital guidance mostly originates from the ‘Global North,’ with limited guidance for Africa by Africans. To strengthen prehospital clinical practice in SSA, we described and appraised all prehospital SSA guidance documents informing clinical decision making. Methods We conducted a scoping review of prehospital-relevant guidance documents, including CPGs, algorithms, protocols and position statements originating from SSA. We performed a comprehensive literature search in various databases (PUBMED and SCOPUS), guideline clearing houses (Scottish Intercollegiate Guidelines Network, Trip, and Guidelines International Network), journals, various forms of grey literature and contacted experts. Guidance document screening and data extraction was done independently, in duplicate and reviewed by a third author. Guidance quality was then determined using the AGREE II tool and data were analysed using simple descriptive statistics. Results We included 51 guidance documents from 13 countries across SSA after screening 2320 potential documents. The majority of guidance documents lacked an evidence foundation, made recommendations based on expert input, and were predominantly end-user presentations such as algorithms or protocols. Overall, reporting quality was poor, specifically for critical domains such as rigour of development; however, clarity of presentation was generally strong. Guidance topics were focused around resuscitation and common diseases (both communicable and non-communicable) with major gaps identified across a variety of topics; such as mental health for example. Conclusion The majority of prehospital clinical guidance from SSA provides clinicians with excellent ready to use end-user material. Conversely, most of the guidance documents lack an appropriate evidence foundation and fail to transparently report the guidance development process, highlighting the need to strengthen and build guideline development capacity to promote the transition from eminence-based to evidence-based guidance for prehospital care in SSA. Guideline developers, professional societies and publishers need to be aware of international and local guidance document development and reporting standards in order to produce guidance we can trust.

Increasing attention was given to building information modeling (BIM) and multi-criteria decision-making (MCDM) globally due to their advantages for various stages of the life cycle of a building. The aim of this paper is to improve practitioners' understanding of the process for BIM and MCDM adoption towards sustainable construction through energy efficiency. A questionnaire survey is being conducted for construction professionals and building industry experts in Malaysia. With expert survey data, a multi-criteria decision model using analytical network process (ANP) was built to identify key factors affecting sustainable building by reducing both embodied and operational energy and carbon emissions. Data from the survey was analysed using descriptive statistics. Model developed consisted of three clusters with a total of six nodes, and the level of importance was compared pairwise with one another. Results shows that design optimisation, reduced material requirements are important factors for sustainable construction considered in the BIM application.

Background: Healthcare workers, especially the young medical students, can play a significant role in providing the recommendations to prevent or manage cervical cancer (CC) caused by human papilloma virus (HPV). However, it is often observed that the awareness about the knowledge of CC and HPV is limited in the medical students, who are part of the front-line support for managing the patients. Objective: To evaluate the knowledge, attitude, and acceptance of CC and HPV vaccine among medical students. Method: ology: In this cross-sectional study, 297 medical students of the age group >18 years were included. Their knowledge regarding cervical cancer (risk factors, screening and prevention) was explored through a questionnaire. The acceptability of HPV vaccine among girls was also assessed. Descriptive statistics, chi-square test and regression method were used to analyze the study data with p 0.0001). Proportion of subjects willing for vaccination in future was high among females (p > 0.0001). Age (p = 0.047) and education (p > 0.0001) were the only variables significant after application of logistic regression model. Conclusion: The study suggests that the overall awareness and knowledge about CC, HPV and HPV vaccination was high among college students and associated with sex, education and also family background. This study inferred that a vast majority of subjects were fairly aware of CC, but the knowledge of risk factors and prevention techniques was lacking.

Introduction: The admission of minors into adult psychiatric units is a problem due to the lack of adequate resources and epidemiology data. Objective: The aim of this study is to describe and analyse the sociodemographic and clinical characteristics of minors that were admitted into the Short-Stay Psychiatric Hospitalisation Unit of Caceres, Spain. Materials and methods: A retrospective, observational, and descriptive study was conducted on a sample of patients between 12 and 18 years-old admitted to the Psychiatric Unit. The study period was between 1 January 2014 and 31 December 2018. Results: A total of 79 patients, with a mean age of 15.72 (±1.65) years, were included. Almost all of them (93.6%) had a personal psychiatric history. The most common diagnoses at discharge in males were disruptive, impulse-control and conduct disorders, and mood disorders in females. A history of substance consumption was present in 40.6%, and was more common in males, which led to a worse prognosis. The mean stay was 5.4 (±4.7) days. Prolongation of the mean stay was associated with a history of previous psychiatric admissions, the number of diagnoses at discharge, a greater number of drugs at discharge, and those that received long-acting injectable antipsychotic drugs (P

Purpose Grit and resilience are considered non-cognitive traits associated with motivation, attitude and temperament rather than intellect and have been increasingly recognized as important skills to identify and develop in medical professionals. The purpose of this study was to investigate grit scores as well as the relationship of grit and other factors to academic success in Doctor of Physical Therapy (DPT) Students. Method Forty-four 2nd year DPT students from the US, were surveyed utilizing the 12-Item Grit Scale prior to the start of semester 4, composed of an 8-week didactic module followed by an 8-week clinical internship. Cognitive traits including Pre-admission Grade Point Average, Graduate Readiness Exam scores, age, as well as descriptive statistics were extracted from admission data. Cumulative GPA and semester GPA from the 8-week didactic portion of the semester were gathered post semester completion. Results The mean grit score for 2nd year DPT students was 3.74 (SD ± .48). Moderate correlation between grit score and cumulative GPA, r = .501, P = .001 was found. A multiple regression analysis found grit score and age as predictors of cumulative GPA, explaining 41.4% of the variance. Discussion Among 2nd year DPT students at a teaching and learning institution in the southeast United States, grit and age appear to be associated with DPT program cumulative GPA scores. Non-cognitive factors such as grit and age may assist in predicting academic success among entry-level DPT students. Grit has not been examined previously as a non-cognitive trait contributing to academic success among entry-level DPT students but may serve as a helpful addition for admission profile to assist in predicting academic success.

Objective The purpose of this study was to estimate the utilization of chiropractic in Klang Valley, Malaysia. Methods This research was a cross-sectional study conducted in 4 health care centers, namely Klinik Mediviron Sri Rampai, Queck Dental Surgery, International Medical University (IMU) Healthcare Chiropractic Centre, and Be Pharmacy Bandar Sri Permaisuri, in Klang Valley from July to November 2018, with a total of 440 respondents. The data collection was done by the self-administration method using questionnaires that were enclosed in envelopes and passed on to the participants by the center's staff. Descriptive statistics were conducted on the data collected and are presented in tables and figures. The variables were sex, age, nationality, ethnicity, marital status, education level, employment status, and health status with the utilization of chiropractic. Result There were 186 (42.3%) male and 254 (57.7%) female respondents. The youngest respondent was 18 years old, and the oldest was 81 years old. The median age was 30 years old. Most respondents (97.3%) were Malaysian from a non-Bumiputra (non-Malay) ethnic group. Almost half (47.5%) of the respondents had a bachelor's degree education level. The utilization of chiropractic was 35.9% (95% confidence interval [CI]: 31.4-40.5). Conclusion The utilization of chiropractic was 35.9%, which was slightly lower than utilization among other traditional and complementary medicine practices in Malaysia.

Objectives Antimicrobial resistance (AMR) is one of the major health issues worldwide. Clinicians should play a central role to fight AMR, and medical training is a pivotal issue to combat it; therefore, assessing levels of knowledge, attitudes and practices among young doctors is essential for future antimicrobial stewardship (AMS) programmes. Methods A nationwide, cross-sectional, multicentre survey was conducted in Italy. A descriptive analysis of knowledge and attitudes was performed, along with a univariate and multivariate analysis of their determinants. Results Overall, 1179 young doctors accessed the survey and 1055 (89.5%) completed all sections. Regarding the knowledge section of the questionnaire, almost all participants declared to know the different species of bacteria proposed, however the percentage of participants who correctly responded to clinical quizzes was 23% for the question on vancomycin-resistant enterococci (VRE), 42% on carbapenem-resistant Enterobacteriaceae (CRE), 32% on extended-spectrum β-lactamase-producing enterobacteria (ESBL) and 27% on methicillin-resistantStaphylococcus aureus (MRSA). Similarly, 81% of participants disagreed in stating that AMR was adequately addressed during their medical training and 71% disagreed that they received the right example from their tutors. Finally, a high rate of agreement with the proposed actions to combat AMR was documented; in particular, the percentage agreement was 76% for respondents who agreed to be part of an active surveillance system or AMS programme. Conclusions Tackling AMR should be a priority for politicians and for all health workers. Inclusion of competencies in antibiotic use in all specialty curricula is urgently needed.

This study investigated productivity in an offshore wind project to understand the distribution of their value-adding and non-value-adding hours. A comprehensive literature review presented results on productivity in regular mega-projects, revealing a limited knowledge of offshore wind projects. From the first quarter of 2019 to the early second quarter of 2020, 62,447 realized activities, equaling 213,786 h, were sampled from a wind farm development project in the British sector of the North Sea. This data was then analyzed and presented through a descriptive statistic. The results showed a distribution of 21.21% value-adding (VA) and 50.09% non-value-adding (NVA) hours. With 20.9% of the total hours, the weather is the dominant cause of waiting time, followed by vessels and previous tasks. The findings further show the disruptions of the COVID-19 pandemic and its effects on productivity. It supports and expands on existing knowledge of causes for waiting time in offshore wind projects, ultimately providing the industry with an understanding of areas that need development to enhance productivity. The paper contributes to current knowledge by providing an understanding of productivity in offshore wind projects.

Background: Over 1 million total joint arthroplasties (TJAs) are performed every year in the United States, creating Medicare cost concerns for policy makers. The purpose of this study is to evaluate recent trends in Medicare utilization and reimbursements to hospitals/surgeons for TJAs between 2012 and 2017. Methods: We tracked annual Medicare claims and payments to TJA surgeons using publicly available Medicare databases and aggregated data at the county level. Descriptive statistics and multivariate regression models were used to evaluate trends in procedure volume, utilization (per 10,000 Medicare beneficiaries), and reimbursement rates and to examine associations between county-specific variables and TJA utilization and reimbursements. Results: Between 2012 and 2017, there was an 18.9% increase in annual primary TJA volume (357,500 cases in 2012 to 425,028 cases in 2017) and a 2.0% increase in annual primary TJA per capita utilization (73.4 cases per 10,000 Medicare beneficiaries in 2012 to 74.8 in 2017). The Midwest and the South had higher utilization rates compared with the Northeast and West (P < .001). Utilization rates for primary TJA procedures also had a significant negative association with the poverty rate (P < .001). Medicare Part B payments to surgeons fell by 7.5%, equivalent to a 14.9% inflation-adjusted decline, whereas hospital reimbursements and charges increased by 0.3% and 18.6%, respectively, during the study period. Conclusions: Despite increasing TJA volume and utilization, surgeon reimbursements have continued to decline, whereas hospital payments and hospital charges have increased significantly more than surgeon charges. Cost containment efforts will need to address other expenditures such as hospital costs and implant costs to better align financial risks and incentives for TJA surgeons.

Objective: To assess the presence and content of policies toward posthumous assisted reproduction (PAR) using oocytes and embryos among Society for Assisted Reproductive Technology (SART) member clinics in the United States. Design: Cross-sectional questionnaire-based study. Setting: Not applicable. Patient(s): A total of 62 SART member clinics. Intervention(s): Questionnaire including multiple choice and open-ended questions. Main Outcome Measure(s): Descriptive statistics regarding presence and content of policies regarding PAR using oocytes and embryos, consent document content regarding oocyte and embryo disposition, and eligibility of minors and those with terminal illness for fertility preservation. Result(s): Of the 332 clinics contacted, 62 responded (response rate 18.7%). Respondents were distributed across the United States, and average volume of in vitro fertilization (IVF) cycles per year ranged from 1,500, but 71.2% (n = 42) reported a volume of 5 cases. Participation in cases of posthumous reproduction was not significantly associated with practice type or IVF cycle volume among those surveyed. Only 59.6% (n = 34) of clinics surveyed had written policies regarding PAR using oocytes or embryos, whereas 36.8% (n = 21) reported they did not have a policy. Practice type, IVF cycle volume, fertility preservation volume, and prior participation in cases of PAR were not significantly associated with the presence of a policy among respondent clinics. Of those with a policy, 55.9% (n = 19) reported they had used that policy, 59.1% (n = 13) without a policy reported they had considered adopting one, and 63.6% (n = 14) reported they had received a request for PAR services. Only 47.2% (n = 25) of clinics surveyed specified that patients not expected to survive to use oocytes due to terminal illness are eligible for oocyte cryopreservation, whereas 45.3% (n = 24) did not specify. Conclusion(s): Respondent clinics reported receiving an increasing number of requests for PAR services, but many also lacked PAR policies. Those with policies did not always follow ASRM recommendations. Given the low response rate, these data cannot be interpreted as representative of SART clinics overall. As PAR cases become more common, however, this study highlights poor reporting of PAR and institutional policies toward PAR, suggesting that SART clinics may not be equipped to systematically manage the complexities of PAR.

Highlights • Thailand reported the first imported case of COVID-19 outside of China • Events requiring an international response from Thailand were compiled • Thailand's ability to communicate with international stakeholders was evaluated • Duration of response times were rapid during the early phase of the emergency • There is a need to nominate official English-speaking spokespeople, Objectives This study aimed to assess the Thailand Department of Disease Control's (DDC) early responses to COVID-19 in respects to communication with the international community and to identify the manner of Thailand's response during public health emergencies. Methods Documents and international response communication from 4 to 31 January 2020 were reviewed and dates of responses were collected for descriptive analysis. A questionnaire was submitted to the DDC officers responsible for international coordination. A meeting to identify responses was held to evaluate the self-assessed capacities of the department's international communication. Results Thailand began the COVID-19 screening protocol on 3 January 2020. International correspondence subsequently occurred continually either through the ASEAN or International Health Regulations (IHR) mechanisms. The total score of communication for international response was 88.9%. For IHR reporting duties, the median duration to respond was 2.49 hours. Official news was sent within a mean of 9.18 hours and the English daily situation reports were always uploaded onto the official website within 24 hours. Conclusions This study provided a benchmark for international coordination and communication capacities and also identified areas for improvement during public health emergencies, such as the need to identify English-speaking spokespeople to communicate at the international level.

Objective As a developable ability, empathy is significantly associated with patient-centered care. The authors intended to evaluate the effect of Virtual Dementia Tour (VDT) upon nursing students’ empathy level and propose practical rationales for optimizing future dementia care. Methods A total of 45 second-year undergraduate nursing students were organized to watch a theme movie entitled Still Alice and participate in an 8-min VDT. Jefferson Scale of Empathy-Health Professional Students (JSE-HPS) was employed for evaluating the empathy level of nursing students. After VDT, all nursing students participated in a structured interview. Descriptive statistics and paired t-tests were performed using SPSS 24.0. Results Their empathy levels demonstrated significant overall improvements (106.69 ± 9.49 vs 115.51 ± 10.16, P, Highlights What is known? • Although nursing students demonstrated acceptable empathy levels, there is still much room for improvement. • Empathy is a kind of ability that can be facilitated but cannot be forced to occur. The most effective empathy education strategies in undergraduate nurses were immersive and experiential simulations that focused on vulnerable patient groups and provided opportunities for guided reflection. What is new? • Watching a movie and participate in the Virtual Dementia Tour significantly improved nursing students’ empathy, changed their attitude toward the older adults and people with dementia, and may have positive impact on their future nursing practice.

Background: Three-dimensional (3D) printing is a new technology capable of producing patient-specific 3D cardiac models. Methods: A cross-sectional survey of pediatric cardiologists was conducted. Members of the Canadian Pediatric Cardiology Association and Congenital Cardiac Interventional Study Consortium were invited to participate. A questionnaire was distributed using Research Electronic Data Capture between May and September 2019. Results were analyzed using descriptive statistics, Fisher exact test, and odds ratio. Results: A total of 71 pediatric cardiologists responded. Some 85% (60/71) agreed that patient-specific 3D printed cardiac models are a beneficial tool in treating children with congenital heart disease (CHD); 80% of those (48/60) believe 3D models facilitate communication with colleagues; 49% (35/71) of respondents had access to 3D printing technology; and 77% (27/35) of those were using models for clinical care. Access differed according to geographic location (P = 0.004). Of respondents, Americans were 5.5 times more likely (confidence interval, 1.6-19.2) than Canadians to have access to 3D printing technology. The primary reason for lack of access was financial barriers (50%, 18/36). In clinical practice, surgical planning is the primary use of models (96%, 26/27), followed by interventional catheterization planning (52%, 14/27). Double outlet right ventricle was the most commonly modelled lesion (70%, 19/27). Conclusion: 3D printing is a new technology that is beneficial in the care of children with CHD. Access to 3D printing varies by geographic location. In pediatric cardiology, 3D models are primarily used for procedural planning for CHD lesions with complex 3D spatial relationships. Résumé: Contexte: L’impression en trois dimensions (3D) est une nouvelle technologie permettant de produire des modèles cardiaques 3D sur mesure pour chaque patient. Méthodologie: Une enquête transversale a été menée auprès de cardiologues-pédiatres. Les membres de l’Association canadienne de cardiologie pédiatrique et du Congenital Cardiac Interventional Study Consortium ont été invités à y participer. À cette fin, un questionnaire a été diffusé au moyen de l’outil REDCap (Research Electronic Data Capture) de mai à septembre 2019. Les résultats ont été analysés au moyen de techniques de statistique descriptive, du test exact de Fisher et du rapport de cotes. Résultats: Au total, 71 cardiologues-pédiatres ont répondu au questionnaire. Environ 85 % (60/71) des répondants convenaient que les modèles cardiaques personnalisés à chaque patient et produits par impression 3D sont utiles pour traiter les enfants atteints d’une cardiopathie congénitale; de ce nombre, 80 % (48/60) estimaient que les modèles 3D facilitent la communication entre collègues; 49 % (35/71) avaient accès à la technologie d’impression 3D et, parmi eux, 77 % (27/35) se servaient de modèles pour prodiguer des soins cliniques. L’accès variait selon l’emplacement géographique (p = 0,004). Parmi les répondants, les médecins situés aux États-Unis étaient 5,5 fois plus susceptibles (intervalle de confiance : 1,6-19,2) que les médecins canadiens d’avoir accès à la technologie d’impression 3D. Les ressources financières constituaient le principal obstacle à l’accès à cette technologie (50 %, 18/36). Dans la pratique clinique, les modèles sont surtout utilisés pour planifier les interventions chirurgicales (96 %, 26/27) et le cathétérisme interventionnel (52 %, 14/27). Le ventricule droit à double issue était particulièrement modélisé (70 %, 19/27). Conclusion: L’impression 3D est une nouvelle technologie utile pour soigner les enfants présentant une cardiopathie congénitale. L’accès à cette technologie varie selon l’emplacement géographique. En cardiologie-pédiatrie, les modèles 3D sont surtout utilisés pour planifier les interventions relatives à des cardiopathies congénitales complexes sur le plan tridimensionnel.

Background Coronavirus disease 2019 (COVID-19) has profoundly impacted residency and fellowship training and education. However, how and to what extent the daily involvement of trainees in clinical and surgical activities was compromised by the COVID-19 pandemic is currently unknown. Materials and methods We conducted an electronic survey. An invitation was sent through the executive training administration of the Saudi Commission for Health Specialties (SCFHS) randomly to 400 residents and fellows over two weeks period from April 23, 2020 until May 6, 2020. Descriptive statistics were presented using counts and proportions (%). The comparison between the trainees among the socio-demographic and the characteristics of trainees toward the impact of COVID-19 pandemic on their training had been conducted using the Chi-square test. A p-value cut off point of 0.05 at 95% Confidence Interval (CI) used to determine statistical significance. Results Out of the 400 questionnaires distributed, 240 trainees responded, resulting in a response rate of 60%. The most frequently cited specialty was surgical (41.3%) and medical (38.3%). Approximately 43% of them had direct contact with patients with COVID-19, and 43.8% had enough training regarding the proper use of Personal Protective Equipment (PPE). There were seven responders (2.9%) who had been infected by the disease. Among them, 6 (2.5%) members of their family had also been infected. Approximately 84.6% reported a reduction in training activities due to the current pandemic. Of those with surgical specialties, almost all (97%) reported that their surgical exposure reduced due to the COVID-19 pandemic. Conclusion The adoption of smart learning is critical. For those who have been affected by examination delays, we recommend continuing to revise steadily using webinars, podcasts, prerecorded sessions, and social media. Routine activities such as journal clubs and departmental teaching should continue through webinars, if possible., Highlights • The first cross-sectional survey study to show the impact of COVID-19 pandemic on training programs in Saudi Arabia. • Almost 97% of the participants reported that their surgical exposure was reduced due to the pandemic. • We recommend continuing to revise steadily using webinars, podcasts, prerecorded sessions, and social media. • Routine activities such as journal clubs and departmental teaching should continue through webinars if possible.

A safe work environment is crucial in high-risk industries, such as construction refurbishment. Safety incidents caused by uncertainty and unexpected events in construction refurbishment systems are difficult to control using conventional safety management techniques. Resilience engineering (RE) is proposed as an alternative to traditional safety management approaches. It presents a successful safety management methodology designed to deal with uncertainty in high-risk work environments. Despite the fact that RE resides in the safety domain, there is no common set of RE indicators to measure and assess resilient in the work environment. The main aim of this research is to explore RE indicators that have been identified as important in developing and assessing the resilient work environment in high-risk industries, particularly in construction refurbishment. Indicators have been attained through a systematic literature review of research and scholarly articles published between the years 2004 and 2019. The literature review explored RE indicators in various industries. Descriptive analysis and co–occurrence-based network visualization were used for data analysis. The findings revealed 28 RE indicators in 11 different high-risk industries. The results show that the four commonly used indicators were: top-management commitment, awareness, learning, and flexibility, all of which have a strong relationship with RE. The findings of this study are useful for stakeholders when making decisions concerning the most important RE indicators in the context of their research or practice as this would avoid the ambiguity and disparity in the identification of RE indicators. Refereed/Peer-reviewed

Purpose Teaching certificate programs have been developed by US colleges and schools of pharmacy to provide organized instruction for pharmacy residents seeking competence in classroom teaching or clinical precepting. The objective of this study is to appraise current status of teaching certificate programs offered by US colleges and schools of pharmacy. Methods A survey instrument was developed and sent to pharmacy practice department chairs/vice chairs at 132 US colleges/schools of Pharmacy. In addition, data collection was conducted by visiting websites of 132 colleges and schools of pharmacy. Descriptive statistics and content analysis methods were used for data analysis. Results Out of 132 pharmacy schools surveyed, 69 schools reported offering teaching certificate programs for pharmacy residents. The programs enroll Post-Graduate Year 1 (PGY1) and Post-Graduate Year 2 (PGY2) residents, fellows, preceptors, and faculty. These programs utilize longitudinal, concentrated, or combination of both experiences. While various teaching activities are required by all 69 programs, the requirements for attending seminar, research design, project and grant proposal writing were reported by 62%, 12%, and 0.07% of the reported programs, respectively. Programs were found to offer seminars on various topics such as teaching or pedagogical methodologies, assessment of student learning, and development of teaching portfolios. The national guidelines and recommendations are not fully met by the existing teaching certificate programs. With a total enrollment of 2,596 residents in 34 teaching certificate programs, since their inception, the overall completion rate was 91%. This study identifies a number of challenges including financial resources to develop a quality program. Data provided by 14 teaching certificate programs demonstrate that 33% of the graduates have accepted full-time faculty positions. Conclusion Our study has identified teaching certificate programs that provide residents with opportunities for formal instruction and development of skills that can help prepare them for a faculty position. This study may assist colleges and schools of pharmacy that are planning to develop such programs for pharmacy residents and fellows.

Rationale & Objective: Older patients with advanced chronic kidney disease (CKD) use intensive care at the end of life and die in a hospital more frequently than patients with cancer or heart disease. Advance care planning (ACP) can help align treatment with patient preferences and improve patient-centered care, yet ACP quality and experiences among older patients with CKD and their care partners remain incompletely understood, particularly among the non–dialysis-dependent population. Study Design: In-person interviewer-administered surveys of patients 70 years and older with non–dialysis-dependent CKD stage 4 or 5 and their self-identified care partners. Setting & Participants: 42 participants (31 patients, 11 care partners) at 2 clinical sites in greater Boston. Outcomes: Completion of advance directives and self-reported perceptions, preferences, and experiences of ACP. Analytical Approach: Descriptive analysis of patient and care partner surveys. McNemar test analysis to compare patient and care partner responses. Results: Most patients had written advance directives (64%) and surrogate decision makers (81%). Although patients reported positive perceptions and high trust in their clinicians’ judgment, few (16%) had actually discussed preferences for life-sustaining treatment with their nephrologists. Few ACP discussions included components reflective of high-quality ACP: 16% of patients had been asked about their values concerning end-of-life care and 7% had discussed issues of decision-making capacity and consent to care should their health decline. When presented with 2 hypothetical scenarios (stroke/heart attack or dementia), nearly all patients and care partners reported a preference for comfort care over delaying death. Care partners were more likely than patients to report that they had experienced discussion components reflective of high-quality ACP with the clinical team. Limitations: Single metropolitan area; most patients did not identify a care partner; nonresponse bias and small sample size. Conclusions: Patients often believed that their clinicians understood their end-of-life wishes despite not having engaged in ACP conversations that would make those wishes known. Improving clinical ACP communication may result in end-of-life treatment that better aligns with patient goals. Index Words: Decision-making, kidney disease, advance directives, caregiving, advance care planning, shared decision-making

Highlights • Obtaining normal values for electrophysiologic studies is an arduous task. • Evidence shows that visual assessment of the e-norms plateau permits deriving normal values from one's own laboratory data. • No statistically significant difference was found between nerve conduction parameter Means obtained by different observers identifying the e-norms plateau., Objective To derive normal values from a lab’s own diagnostic studies, the e-norms method relies on the proper identification of the e-norms plateau to derive descriptive statistics of the variable under study. This work was undertaken to compare the inter and intra-rater reliability of visual identification of the plateau by different raters analyzing laboratory nerve conductions study data. Methods Twenty raters were asked to visually identify the inflection points delineating an e-norms plateau to derive the Mean value of nerve conduction study laboratory data while blinded to the parameter they were analyzing. After a delay of 1–3 months, the same raters were asked to repeat some of the e-norms plateaus identification to assess delayed intra-rater reproducibility. Results Mean values derived from the identified plateau data were compared between raters (inter-rater) using a two factor ANOVA without replication. For the immediate inter-rater no statistically significant difference was found between the Means obtained by the different raters. For the delayed intra-rater, differences were found between raters. Conclusions This study suggests that visual identification of the e-norms plateau inflection point is reliable between raters but more research is needed to assess reproducibility for the same raters. Significance E-norms is a promising method for deriving reference values using data that is available in most electrophysiology laboratories.

Highlights • The manual epidemic intelligence system was quick and accurate. • All significant alerts were identified first through unofficial sources. • The system was adaptable and allowed for monitoring of events as they evolved., Background Epidemic intelligence (EI) for emerging infections is the process of identifying key information on emerging infectious diseases and specific incidents. Automated web-based infectious disease surveillance technologies are available; however, human input is still needed to review, validate, and interpret these sources. In this study, entries captured by Public Health England’s (PHE) manual event-based EI system were examined to inform future intelligence gathering activities. Methods A descriptive analysis of unique events captured in a database between 2013 and 2017 was conducted. The top five diseases in terms of the number of entries were described in depth to determine the effectiveness of PHE’s EI surveillance system compared to other sources. Results Between 2013 and 2017, a total of 22 847 unique entries were added to the database. The top three initial and definitive information sources varied considerably by disease. Ebola entries dominated the database, making up 23.7% of the total, followed by Zika (11.8%), Middle East respiratory syndrome (6.7%), cholera (5.5%), and yellow fever and undiagnosed morbidity (both 3.3%). Initial reports of major outbreaks due to the top five disease agents were picked up through the manual system prior to being publicly reported by official sources. Conclusions PHE’s manual EI process quickly and accurately detected global public health threats at the earliest stages and allowed for monitoring of events as they evolved.

الملخص: أهداف البحث: يتقن طلاب الطب الإجراءات والمهارات من خلال عدد من العناصر، بما في ذلك القدرة على فهم الأهداف التعليمية لمهام محددة. تبحث هذه الدراسة في عمليات تحديد أهداف التعلم التي حددها طلاب الطب، وما إذا كان اختيار المحاكاة الدقيقة يؤثر على هذه القدرة في دورات المهارات السريرية الأساسية وطب المسنين بجامعة لوبلن الطبية. طرق البحث: قام ما مجموعه ١٢١ من طلاب الطب بتقييم مدى تنفيذ هدف التعلم في دورتين مع محاكاة ذات دقة عالية ومنخفضة. باستخدام استطلاع عبر الإنترنت ذي أسئلة مغلقة، بعد إرسال قائمة بأهداف التعلم المخصصة للدورات التدريبية إلى المشاركين. قام الباحثون أيضا بتقييم كيفية تقييم الدورات بشكل عام من حيث قيمتها الموضوعية والتطبيق العام. النتائج: وجدنا أن الطلاب حددوا أهدافا تعليمية مضمنة في الدورات التدريبية وقاموا بتقييم كلا الدورتين بشكل إيجابي. ارتبطت آراء المشاركين الإيجابية بالقيمة الموضوعية العالية لكلا الصفين. الاستنتاجات: قد يستفيد المعلمون ومنشئو الدورات التدريبية من ملاحظات الطلاب حول وضوح أهداف التعلم، التي يمكن أن تعزز نهج التعلم المعتمد على الطالب في المحاكاة الطبية. يمكن اعتبار هذا النهج بمثابة مدخل لاختيار المهام لتحسين تعلم الطلاب. Abstract: Objectives: The mastering of learnt procedures by medical students is triggered by numerous elements, including the ability to understand educational goals for specific tasks. In this study, the authors investigated the processes for identifying learning objectives set forth by medical students and the possibility of the chosen simulation fidelity influencing this ability in Basic Clinical Skills and Elderly Medicine courses at the Medical University of Lublin. Methods: A total of 121 medical students assessed the extent to which learning objectives were implemented in two courses with high- and low-fidelity simulation. Using an online survey with closed-ended questions, a list of learning objectives assigned to the courses was sent to participants. The authors evaluated how the courses were generally assessed in terms of their substantive value and general applicability. The Spearman rank correlation (Spearman's rho), χ2, and descriptive statistics were used for investigating research problems. Results: Students correctly identified established learning objectives embedded in the courses and positively assessed both courses. Participants' affirmative opinions were related to the high substantive value of both courses. Conclusions: Teachers and course creators could benefit from students' feedback about the clarity of learning objectives. The application of some of their ideas would promote a student-centred approach in medical simulation. This approach could be considered input for task selection and optimisation of learning. الكلمات المفتاحية: محاكاة عالية الدقة, أهداف التعلم, محاكاة الدقة المنخفضة, التعليم الطبي, طلاب الطب, Keywords: High-fidelity simulation, Learning objective, Low-fidelity simulation, Medical education, Undergraduate medical students

الملخص: أهداف البحث: تهدف هذه الدراسة لتحديد التنبؤات بالسلوكيات التعزيزية عند الأطفال الذين يعانين من اضطراب تجنب تناول الطعام المقيد من منظور إندونيسي. طرق البحث: تم توزيع هذا المسح الوصفي المقطعي على ٢٤٥ من الأمهات اللآتي يقمن برعاية أطفال يعانين من اضطراب تجنب تناول الطعام المقيد. تم تجميع المعلومات بواسطة استبانة تعبأ شخصيا. استخدم اختبار ت- المستقل، واختبار مان-ويتني، وتحليل التباين بطريقة واحدة (أنوفا) كروسكال- والس، والانحدار الخطي المتعدد لتحليل البيانات الوصفية. النتائج: تجسدت العوامل المرتبطة بالسلوكيات التعزيزية في الأبوة والأمومة المتبادلة، خصوصا من حيث رعاية الطفل والتفاعل مع الأطفال. بالإضافة إلى ذلك، أظهر الانحدار الخطي المتعدد أن الأبوة والأمومة المتبادلة استمر في نطاق التواصل، حيث الأطفال هم المتنبئون الرئيسين، بينماعدد الأطفال تتأثر السلوكيات التعزيزية. الاستنتاجات: حددت هذه الدراسة عدد الأطفال والأبوة والأمومة المتبادلة في التفاعل مع الأطفال كعوامل رئيسة تؤثر على السلوك التعويضي للأمومة. نقترح أن الرعاية التداخلية ممكن أن تحسن السلوك التعويضي للأمومة عند الأطفال الذين يعانين من اضطراب تجنب تناول الطعام المقيد. Abstract: Objectives: This study aimed to identify predictors of promotive behaviours in mothers of Indonesian children with avoidant restrictive food intake disorder (ARFID). Methods: A cross-sectional descriptive survey was administered to 245 mothers who were caring for children with ARFID. Data were collected with a self-administered questionnaire. For descriptive data analysis, independent t-test, Mann–Whitney U test, one-way analysis of variance, Kruskal–Wallis, and multiple linear regression were employed. Results: The factors related to promotive behaviours in these mothers were embodied in mutual parenting, especially in terms of childcare (p = 0.001

The evolution of mobile phone applications has opened up a platform for easy and real time dissemination and exchange of agricultural information among agricultural extension officers, farmers, agricultural institutions and non-governmental institutions. This study examined attitude, knowledge and constraint associated with the use of mobile phone apps by farmers in North West region of Nigeria. A descriptive survey design was adopted; data collection tool was pre-tested and administered as interview schedule to randomly sampled farmers. Data were analyzed using descriptive statistics and correlation. The findings showed that farmers have positive attitude towards mobile phone applications, and knowledgeable of simple phone operation techniques. The constraints to the use of mobile phone applications are high cost of phones, poor network, poor power supply, high cost of airtime and complexity in operating phones. This study recommends training and re-retraining of farmers and extension agents on the use of mobile phone apps for effective information sharing among farmers in the region.

Objective To describe the self-reported impact of the COVID-19 pandemic among final year student pharmacists enrolled in a Doctor of Pharmacy program in New York City during the first peak of the outbreak March through May 2020. Methods A required senior seminar course for graduating student pharmacists served as a conduit for faculty led monitoring of the wellbeing of the cohort through three data sources: 1) polling data regarding stress factors during a COVID-19 informational session (March 2020), 2) survey data from a 12-item COVID-19 Impact Survey developed and administered electronically in May 2020 and 3) qualitative data from reflection papers mentioning COVID-19. Descriptive statistics, bivariate analysis and thematic analysis were used to summarize data. Results In March, almost half of respondents (total = 185) reported high personal (47.6%) and school related stress (42.1%). Most students were participating in advanced pharmacy practice experiences (80%) and working in a pharmacy (80%). Survey data (n = 96) revealed the majority of participants perceived negative impact on their future career (69%) and reported concern for people close to them with suspected and confirmed COVID-19. One-third of participants reported knowing someone who died from COVID-19 and 8% were self-confirmed COVID-19 positive. Themes emerging from the reflection papers included: changed perspective, gained experience as a pharmacist during a pandemic, concern for loved ones, and positive outlook. Conclusion The COVID-19 pandemic had a significant impact on the wellbeing of a cohort of graduating student pharmacists in New York during the initial peaks of the spread in the United States. The results reinforce a need for student support during emergency situations, especially during the final year.