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Background: Patient awareness of asthma severity is important for optimal asthma management. However, there is often a discrepancy between physician assessment of asthma control based on guidelines and patient discernment of control. We compared physician and patient perception of asthma control in a clinic population seen at a tertiary hospital in Addis Ababa, Ethiopia.Methods: In this cross-sectional study, 182 consecutive patients with a physician diagnosis of asthma seen in Chest Clinic at Tikur Anbessa Specialized Hospital (TASH) between July and December 2015 were studied. Demographics, asthma symptoms, medication use in the past month, and self-perception of asthma control in the past 7 days were obtained from the clinic records. Physician assessed asthma control was based on the GINA asthma symptom control assessment tool. Lung function was measured using a Diagnostic EasyOne Plus model 2001 SN spirometer. The institutional review board approved the study protocol.Results: Of the 182 subjects, 68.1% were female. The mean age was 52 ± 12 years, and the mean (SD) duration of asthma was 19.4 ± 12.7 years. Forty-four (24.2%) patients had physician determined well-controlled asthma and 138 (75.8%) patients had physician determined partly controlled/uncontrolled asthma. One hundred and fifty-one (83%) patients thought their asthma control was good. However, the degree of concordance between physician evaluation and patient perception of asthma control was low (kappa index = 0.09). On multivariate analysis, self-perceived poor asthma control was associated with any activity limitation due to asthma and inconsistent inhaled corticosteroid use.Conclusion: In our study, the first of its kind in Ethiopia, a high percent of patients with physician determined well-controlled asthma has appropriate perception of their disease state. However, those patients with partly controlled/uncontrolled asthma had poor self-perception of their disease, emphasizing the need for further patient education. These conclusions may be especially useful in the care of asthmatics from other low-income countries. [ABSTRACT FROM AUTHOR]

Aim: Childhood obesity continues to be a major health issue for children world-wide, with well-recognised major health effects. This study evaluated the prevalence of obesity in children presenting to secondary care in Southern New Zealand, as well as their clinical management.Methods: Obesity prevalence was determined by a review of data contained in the electronic anthropometry database in the region for the period 19 July 2010-16 July 2015. All clinical records were further examined using a standard data extraction form for 333 obese children regarding their clinical management.Results: A total of 8551 individuals were identified in the database for review. The prevalence of overweight and obesity was higher than the average national rates but stable over the 5-year period. Children of Maori and Pacific Island ethnicity, those most deprived and males were over-represented in terms of obesity. Of the 333 obese children whose clinical management was examined, 45.0% received a diagnosis of obesity. Of those diagnosed, 24.7% had further investigations related to possible obesity complications, and 72.7% were given management plans. Older females were more likely to receive clinical intervention, while Maori and Pacific Island children were less likely.Conclusions: Of the children seen in this secondary care setting, 40% are overweight or obese, and yet the rate of clinical intervention left room for improvement, suggesting a need for further staff education and clear guidelines. Maori and Pacific Island children have higher obesity burden but were less likely to receive clinical intervention. This may highlight a need for specific education regarding cultural practices. [ABSTRACT FROM AUTHOR]

Objective To demonstrate the differences between the English-speaking and Spanish-speaking patients evaluated at a Memory Disorders Clinic. Participants and Method Through a foundation grant to reduce barriers to appropriate neurological care, we established a bilingual/bicultural neuropsychology post-doctoral fellowship. In the initial 2 years, 405 new patients were seen at our multidisciplinary memory disorders clinics for neuropsychological and neurological evaluations. These patients were 63% female (n = 256), and had a mean age of 73.09 (SD = 10.63, range 52-98). Fifty-eight percent of our population identified as Hispanic/Latino (primarily Puerto Rican and Dominican) and 42% were evaluated in Spanish. Results Patients evaluated in Spanish had less education (p <.001) and were younger (p =.03) than those evaluated in English (including our Hispanic/Latino English speaking patients). Individuals evaluated in Spanish performed worse on a mental status exam (Blessed) than those evaluated in English (p =.001) even after controlling for age and education (p =.048). However, those evaluated in Spanish were more likely to do better on memory tasks than those evaluated in English, compared to their respective normative peers. Higher levels of anxiety and depression were evident in Hispanics/Latinos compared to non-Hispanics with highest levels in Hispanics evaluated in English. Conclusions Through a grant to expand services to the previously underserved Spanish-only speaking population of the Bronx, we were able to validate the need for appropriate language and cultural resources in our robust medical community. We demonstrated that our Spanish speaking population is diverse and requires different resources from their English-speaking counterparts. Our data supports the establishment of additional studies (including improved cultural and language specific normative data) and further education of providers working with our diverse populations. [ABSTRACT FROM AUTHOR]

The importance of Geoinformatics (GI) is well established across natural and social science disciplines. This has led to a high demand for GI experts worldwide. Particularly, in developing countries the number of trained staff and students in this domain is very limited compared to current demand. To address this, eLearning is gaining increasing interest. This is particularly true for Central Asia (Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan). But what are the benefits and challenges of using eLearning in this region? Which recommendations can be given to foster the benefits and to meet the challenges of eLearning? To answer these questions, a survey directed towards teachers working at Central Asian universities was conducted. The results show that eLearning is seen to bring both advantages and disadvantages. Recommendations to increase the use of eLearning in these countries range from awarenessraising on the wide range of web-based tools available for this, to foster further education of teachers regarding the use of eLearning (concepts, tools, and materials), to focus on local topics to motivate self-study, and to pay attention to required computer resources and Internet connectivity as an essential basis for eLearning. [ABSTRACT FROM AUTHOR]

Understanding the perspectives and opinions of facial plastic surgeons on opioid dependence is critical in a national epidemic of opioid overuse. Findings may encourage surgeon education so that facial plastic surgeons may be able to judiciously prescribe opioids, improving patient outcomes and reducing healthcare opioid-related spending. The objective of this study is to understand facial plastic surgeons' perspectives on opioid dependence in rhinoplasty patients. A key secondary objective was to quantify facial plastic surgeons' opioid prescribing patterns. This was a prospective survey study. A nine-question survey was sent to all members of the American Academy of Facial Plastic and Reconstructive Surgery in July of 2018, and analysis of the data was completed in August of 2018. The primary study outcome measurement was surgeon perspectives on opioid dependence. This was measured by an online survey. A total of 164 facial plastic surgeons responded to the survey (response rate: 6.6%). The majority were experienced surgeons in practice for more than 10 years (61.96%) who perform less than five rhinoplasties per week (84.15%). Of the facial plastic surgeons, 89.51% prescribe some variation of opioids following rhinoplasty. Most surgeons believe that opioid dependence is not a problem in rhinoplasty patients (86.96%), but that it is a problem among surgical patients in general (61.11%). The majority (52.45%) of surgeons prescribe between 11 and 25 tablets of opioids following rhinoplasty, with 25.17% of surgeons prescribing > 25 tablets of opioids. Facial plastic surgeons do not believe opioid dependence to be a problem among rhinoplasty patients. Resultantly, many facial plastic surgeons can prescribe more than 25 tables of opioids following rhinoplasty. The findings suggest that facial plastic surgeons may require further education and complete more research regarding opioid dependence among the rhinoplasty population. Additionally, the findings are important for health policy in that they encourage the creation of rhinoplasty specific opioid prescription guidelines. [ABSTRACT FROM AUTHOR]

School STEM Culture—an aspect of culture within a school community—is defined as the beliefs, values, practices, and resources in STEM fields as perceived by students, parents, teachers, and administrators and counselors within a school. This study validates the STEM Culture Assessment Tool (STEM‐CAT), an instrument intended to advance the use of the School STEM Culture construct within the research community. Internal consistency was determined through the use of Cronbach's alpha and factor analyses, and the instrument was found to be a reliable measure of School STEM Culture. The instrument can be used in future research to quantify School STEM Culture to determine if interventions change the culture of a school to further STEM education. [ABSTRACT FROM AUTHOR]

Background. Poland is considered among the European countries with an average incidence of cervical cancer (CC; about 3,000-3,500/year) and at the same time with high mortality (5-year survival rate - 55.2%). For this reason, in 2006 Poland introduced a Population-Based Cervical Cancer Prevention and Early Detection Program addressed to women aged 25-59 years, in which a cytological test is carried out every 3 years. Objectives. The aim of the study was to assess the changes in the curability of CC patients brought by the introduction of the Screening Program in the Lower Silesian voivodeship and to identify the subpopulation of women for whom activities aimed at increasing adherence rates must be intensified. Material and methods. The 5-year relative survival in 3,586 CC patients from 2000-2010 registered in the Lower Silesian Cancer Registry was analyzed. Results. In the Lower Silesian voivodeship, a 55.1% 5-year survival rate was recorded in 2000-2004 and 70.5% in 2010. The highest increase in 5-year relative survival rates was found in rural communities (from 53.1% in 2000-2004 to 77.7% in 2010) and in Wrocław (56.8% and 74.2%, respectively). In the study group, the number of patients with invasive CC (C53) detected in the local stage of the disease increased systematically from 61.5% in 2000-2004 to 74.3% in 2010. Conclusions. The introduction of the population-based screening program improved the curability rate in CC patients in the Lower Silesian voivodeship. In order to maintain the recent positive trends, further education should be continued, and activities aimed at increasing adherence to screening tests should be intensified, especially in urban-rural communities. [ABSTRACT FROM AUTHOR]

Background: Direct-acting antivirals have changed the landscape of hepatitis C virus (HCV) care. While transplantation with HCV-positive donor organs is increasing, little is known about providers' attitudes toward this topic. The aim of this study is to determine providers' attitudes toward HCV-positive kidney transplantation.Methods: Willing transplant and nontransplant nephrologists, transplant surgeons, and mid-level providers completed an online survey from April through May 2018. The survey asked about HCV knowledge and willingness to transplant HCV-positive antibody, nucleic acid testing-positive kidneys into HCV-negative recipients. Descriptive analyses including mean and median for continuous variables and frequencies for categorical variables were calculated.Results: Seven-hundred surveys were emailed and 99 providers (62 transplant nephrologists, 28 nontransplant nephrologists, 7 transplant surgeons, and 2 advanced practice providers) completed the survey (participation rate 14.1%). All providers knew that HCV was curable, with 60% believing that it had no effect on transplant success and 32% thinking it reduced transplant success. Providers were significantly more likely to offer a HCV-positive organ to HCV-positive recipients compared to HCV-negative recipients in all queried circumstances (p < 0.005 in all cases), especially with increasing impact on patient's quality of life. While only 39% of providers would offer a HCV-positive organ for transplant to a patient without HCV if it reduced the waitlist time by 1 year, 92% would offer a HCV-positive organ if it reduced the waitlist time by 4 years. However, only 47% thought that the use of HCV-positive kidneys should be for routine care, while 38% believed it should be reserved for research purposes only. There were no significant differences between transplant and nontransplant nephrologists in attitudes toward HCV-positive kidney transplantation. Providers believed that donor organs from those who were obese, >50 years old, or had died from a cardiac arrest were significantly more likely to reduce the likelihood of a successful transplant 1-year posttransplant when compared with a HCV-positive organ (p < 0.005 in all cases). Eighty-six percent of providers had concerns about HCV curability posttransplant.Conclusion: Although 92% of providers were willing to offer a HCV-positive kidney for transplant as patient waitlist time increases, less than half supported offering HCV-positive transplantation for routine care rather than for research. The results underscore the need for further education and data about the efficacy and safety of HCV-positive kidney transplantation. [ABSTRACT FROM AUTHOR]

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Objectives: Feedback is one of the most important methods for competency-based teaching. A survey was conducted to learn more about the use of feedback methods at five medical faculties. Methods: In the 2017 summer semester, teachers at Baden-Wurttemberg's medical schools in Freiburg, Heidelberg, Mannheim, Tuebingen and Ulm were invited to participate in the survey. The link to the questionnaire was sent to the teaching coordinators at the various departments at each of the five medical schools. The teaching coordinators were asked to forward the link to the questionnaire to all instructors in their department. At one location, all instructors were directly addressed. The data were collected online. Results: A total of 464 instructors participated in the survey. Most consider feedback in medical education as important (23%) or very important (72%). However, some feedback methods are hardly used. The reason for this is, in particular, that some of the feedback methods are unfamiliar, e.g. checklists (56%), or not considered necessary by the instructors, e.g. written feedback (31%). Fifty-five percent of the instructors would like to receive further education or information on feedback. Conclusion: The results show that the use of feedback methods in medical teaching is expandable and that teachers find feedback to be important. Accordingly, nothing should stand in the way of a greater use of feedback methods in teaching. However, in order for this to happen, it is important that instructors are made more familiar with feedback methods. [ABSTRACT FROM AUTHOR]

Aim: This study aims to estimate the knowledge of lifestyle modification among pregnant women. Objective: The objective of this study was to analyze the level of awareness and knowledge of lifestyle modification among pregnant women. Materials and Methods: A well-defined questionnaire, with 15 questions along with demographic data, was distributed among 100 pregnant women. An online application called Survey Planet was used to distribute the questionnaire. The data then collected were analyzed using Microsoft Excel. Results and Conclusion: Health promotion and healthy lifestyle need to be an integral part of health services provided for pregnant women. Although women are aware of the necessary lifestyle modification, further education and implementation are required. [ABSTRACT FROM AUTHOR]

Background: Polycystic Ovarian Syndrome (PCOS) is a problematical disorder with various presentations. The disorder, however, can be treated carefully and efficiently to aid the female student patients to increase their fertility and lead healthy lives. Objective: The objective of this article is to evaluate the impact of an educational program on the knowledge of adolescent female students about PCOS. Methodology: A quasi-experimental design was conducted at the College of Nursing University of Mosul for the period 16th to (19th) February 2018 on sixty female students who were divided randomly into two groups (study=30 and control=30). Before implementation of the EP, both groups were exposed to pretest. Only the study group was enrolled in the EP. After one week both groups were exposed to the post-test. Results: Before implementing the EP both groups show low levels of knowledge regarding POCS. After one week of the implementation of the teaching program the study group shows improvement in their knowledge scores about all knowledge categories related to POCS. Statistically significant difference was found between students’ age and family factor with their knowledge at pretest. Conclusions: The EP had a positive impact on students’ knowledge concerning POCS. The study recommends that further education programs regarding POCS should be implemented in multi-setting on different target populations in order to generalize the outcomes. [ABSTRACT FROM AUTHOR]

This paper aims to link the basic structure of the 4th Industrial Revolution to skill needs and further to education, though there is little discussion in these domains. Much of the literature describes or analyzes the job characteristics related to the 4th Industrial Revolution without discussing the interlinkage inherent in the revolution. This paper seeks to give a better understanding of the whole range of features of the revolution and further discusses the challenges for innovative human resource development (HRD). It provides an overview of the technological competition in the 4th Industrial Revolution, the changes in the skills needed, the new labor practices, and the change in education focusing on new competences. Then, the paper examines the challenges for innovative human resource development. [ABSTRACT FROM AUTHOR]

Using the Youth in Transition Survey, we estimate a Roy model with a three-dimensional latent factor structure to consider how parental valuation of education, cognitive skills, and noncognitive skills influence endogenous schooling decisions and subsequent labor market outcomes. We find that the effect of cognitive skills on adult incomes arises by increasing the likelihood of obtaining further education. Furthermore, we find that both noncognitive skills and parental valuation for education play a larger role in determining income at age 25 than cognitive skills. Last, our analysis uncovers striking differences between men and women in several of the estimated relationships. [ABSTRACT FROM AUTHOR]

The English further education sector has undergone significant change since the Further and Higher Education Act (1992) encouraged a culture of entrepreneurship, competition and the use of what was seen as best practice from the commercial sector. This led to a cultural shift and the introduction of many new initiatives – a situation that still exists now. The implementation of these initiatives was often delegated to middle managers – a group of people who occupied the gap between the senior leaders and the lecturers in the classroom. Current austerity measures, restructuring and the shift towards the creation of larger organizations have resulted in reorganizations that could present opportunities for middle managers to participate in the strategic processes and leadership of the organization, further developing their role (Greatbatch and Tate, 2018). The purpose of this article is to investigate the leadership and management aspects of the middle-manager's role within the context of further education in England. Although many managers in the sector are reluctant to identify as leaders (Briggs, 2006), our research shows that their role has evolved so that they are undertaking a range of activities that could be classified as leadership. We suggest that using 'practice' rather than 'process' as a descriptor of the role would reframe, identify and bring forward the leadership aspects of what they do. Encouraging a focus on a holistic, practice-based approach, rather than a succession of process-driven tasks, could help managers to perform their role more effectively. Findings taken from interviews with 32 participants and a questionnaire with 302 responses are used to illustrate our argument. [ABSTRACT FROM AUTHOR]

Background: Many physicians experience barriers such as lack of time and expertise, as well as facilitators such as collaboration with other healthcare professionals, when providing care for individuals with autism spectrum disorder (ASD). This study aimed to identify barriers and facilitators that Ontario physicians encounter when providing care for individuals with ASD. Method: Twenty-seven physicians practicing in Ontario participated in a two-phase study. During the first phase, participants completed a questionnaire regarding their demographic information as well as their knowledge, competency and experiences when providing care for individuals with ASD. During the second phase, five participants answered questions about their experiences when providing care for individuals with ASD. Results: In this study, physicians expressed their needs for further education and training regarding ASD. Despite physicians' reported lack of comfort and expertise in diagnosing individuals with ASD, they identified working in an interdisciplinary team as a facilitator in helping them to provide care for this population. The findings also revealed that previous work experiences with individuals with ASD, and collaborating with parents of children with ASD enhance physicians' experiences when providing care for this population. Conclusions: Findings have implications for raising awareness in healthcare and educational systems regarding the steps need to be taken to enhance Ontario physicians' experiences when providing care for individuals with ASD. [ABSTRACT FROM AUTHOR]

In Romania, education is a major objective for which significant efforts have been made focused on improving the education system. However, over time, economic, social and cultural factors have led to a significant decrease in the percentage of graduating high school and university students. The general objective of this article is to represent it the main indicators that limit the sustainable economic development through education in Romania, in order to identify the educational means for counteracting them. I will consider analyzing the rate of early drop out, but also that of young people who are neither employed nor involved in further education or training. Thus, in order to eliminate this situation of young people in Romania, I will identify strategies and programs that improve the current education system. [ABSTRACT FROM AUTHOR]