Game changer: direct observation to improve personalized psychotherapy in adolescent gaming disorder

6.55 Game Changer: Systematic Review of the Efficacy of CBT in Internet Gaming Disorder

Background: Every six minutes, a mother dies of postpartum hemorrhage (PPH) in low-resource countries. PPH, defined as blood loss of more than 500 ml, is the leading cause of maternal death worldwide, accounting for 27% of maternal deaths. The WHO published “Recommendations for the Prevention and Treatment of Postpartum Hemorrhage” in 2012 to provide evidence-informed recommendations for managing PPH. However, adherence to these recommendations is currently limited by several challenges, including poor maternal care where despite guideline dissemination, many health care providers (HCPs) do not provide effective care such as proper monitoring of vital signs which is key in hemodynamic assessments that can prompt early intervention. The E-MOTIVE trial supported 14 health facilities in Kenya, 7 intervention and 7 control sites. The trial introduced a blood loss monitoring chart to support HCPs in assessing women after delivery of the placenta and enabling early detection and treatment of PPH. Methods: Blood loss monitoring tool/Trigger chart was developed by the University of Birmingham. This tool was implemented in seven hospitals in Kenya with the capacity for comprehensive emergency obstetric care, including blood transfusion and cesarean delivery. In these hospitals, labor, delivery, and postpartum care are primarily provided by nurse-midwives and students. More senior clinicians, including medical officers and consultant physicians such as obstetrician, gynecologists and pediatricians, make periodic rounds and are available on-call to assist in emergencies. Data were collected from August 2021 to December 2021. Observations were conducted by the trial implementation midwives with the support of the on-site research midwives for two weeks in each of the study hospitals. Observations occurred 24 hours a day. Patients were observed from the second stage up to two hours after placental delivery. All data were collected on paper forms and then entered into a digital database using RedCap. Results: A total of 734 deliveries were observed cumulatively during the study period. All women received four clinical observations within the first hour using the blood loss monitoring chart. The frequency of observing blood loss in the calibrated drapes during monitoring by HCPs was 94%. There was 100% detection of PPH using the blood loss monitoring chart. Conclusion: Efforts to increase the rates of early PPH detection and treatment should emphasize improvements in the quality of care, with a particular focus on PPH blood loss monitoring. The blood loss monitoring chart is easy to use and can be easily adopted and scaled in low-resource settings.

The application of Sufistic counseling is beneficial for individuals, especially in changing deviant behavior. As in the Kragan Village, many children experience problems, namely online game addiction which has a negative impact on their behavior, daily activities, emotional stability, and their socialization to the community environment. Solving their problem is very important for the development children when they grow up to adults. The article aims to analyze the application of sufistic counseling in overcoming onlinebgame addiction for children at Kragan Village. The researchers used is qualitative research by conducting direct interviews and observation. The results show that the application of Sufistic counseling to children in Kragan Village who are addicted to onlinegames in a way that counselors, the family environment, schools, and the community can provide direction and guidance in accordance with the Qur'an and Hadith. Hence, they would remember their duties and obligations, change behavior, maintain emotional stability, maintain social interactions, and apply spiritual values in order to get a good mental health in their daily activities.
 Keywords: Sufistic Counseling, Overcoming Game Online, Game Online

Purpose: The purpose of the study is to identify the areas of e-commerce that can lead to sustainable logistics. Design/methodology/approach: The research methodology includes a theoretical analysis. It is based on various data collection techniques such as document review, direct observation and archival records from secondary sources such as reports, studies, statistics and internet sources. Findings: E-commerce is not yet a game changer for sustainable logistics. However, it seems to be a matter of time, and it will grow in importance and influence. For this reason, companies that want to maintain a competitive edge need to be aware of the changes and the expectations of customers, who are increasingly paying attention to sustainable development. Research limitations/implications: The research is mainly based on secondary sources. Empirical research is needed to confirm the hypotheses. Originality/value: The sustainability of e-commerce is a critical issue that needs to be addressed. Despite the increasing attention paid to sustainable logistics in e-commerce research, the literature available is still in its infancy and requires further development. This paper fills this research gap.

In residency training, the Accreditation Council for Graduate Medical Education stipulates feedback from faculty should be frequent, exist in the context of routine clinical care, include multiple evaluators, emphasize competency and milestones, and be in writing so it can be shared with the Clinical Competency Committee.Collecting frequent feedback in the context of ambulatory care is an ambitious ask. Supervision of residents in clinic can be busy, if not chaotic. Assessment surveys can be quick, and they can be web-based or smartphone application-based. Still, collection rates can be lower than is needed. Faculty reminders by email, signs in the supervision area, available program links on workplace computers, and prompts submitted by residents to supervising faculty have all been used to increase assessment completion by faculty.1Oregon Health & Science University's Internal Medicine Clinic is the resident continuity clinic for 44 trainees, supervised by more than 30 part-time faculty preceptors. We tested a method to increase case-specific direct observation feedback by preceptors.We looked to thought leaders in informatics for help in our tool design. The most frequently used clinical decision support tools are directly integrated with electronic medical record (EMR) systems. To design effective point-of-care support tools, our experts stick with these informatics rules of thumb: “Speed is everything,” “Deliver in real-time,” and “Fit into the user's workflow.”2We designed a web-based rapid assessment tool. The evaluator selects content areas or processes to score and enters a narrative comment. Our innovation was to deliver this tool directly within the preceptor workflow: we embedded a link in the cosigning (preceptor attestation) template. The location of the survey link was a game changer for our collection rate.Embedding the link into the cosigning template took some care. So that our survey hyperlink would never become part of the patient chart, we needed disappearing instructional text with automated removal from the chart when the preceptor note was signed. Many EMRs enable “prompts” in templates or text blocks. Our university utilizes EpicCare, and we were able to achieve disappearing text using the function “blank, optional SmartList.” Our function displays as a single line of text at the bottom of the preceptor note in progress, with blue font that is recognized by the clinician as disappearing text. The text contains a hyperlink to our rapid assessment.Within the attestation workflow, a preceptor has a visual reminder to provide the assessment and has the option to enter the assessment survey with a single click. The survey results can be collected at any interval by the clinic medical director, who has access to survey reports.Links to our rapid assessment tool were provided in several lower yield environments before we identified a way to embed a link into the cosigning workflow (Figure). Embedding the link within the existing preceptor workflow of chart attestation resulted in an immediate, meaningful, and sustained increase in the number of submitted assessments.The feedback entered is exceptionally relevant—it is specific and contains colorful clinical performance anecdotes that inform resident competencies. This process has been popular with residents and faculty, and it has markedly enriched our resident feedback process.

Early childhood education is very important for children's growth and development from an early age because during early childhood or what is called the golden age, 90% of your child's brain development is very good and is an important foundation to support your child's learning abilities. Playing is one way to increase children's potential at an early age. This research contradicts the increasing incidence of modern game addiction which is detrimental to children, because nowadays children like to play gadgets which can harm themselves, in contrast to the potential of traditional games which contribute to moral development. The safety of traditional games for young children is a focus because these games are an inseparable part of the nation's cultural wealth which contains benefits and moral values ​​such as honesty, patience, perseverance, responsibility and mutual respect for others. This research aims to strengthen the moral development of young children through the traditional game of hide and seek. The approach applied in this research is qualitative by collecting data through direct observation and documentary recording. Keywords: Traditional Games, Hide and Seek, Morals, Early Childhood