3-year Program Research Articles

Navigation of Teaching Practicum Challenges An Emerging Perspective of Pre-Service Teachers

This research explored the challenges prospective teachers face during the teaching practicum at the University of Education, Attock Campus. The study adopted a qualitative descriptive phenomenological design. A census sampling strategy was deployed comprising 67 prospective teachers. Data collection employed a self-developed open-ended questionnaire, validated through expert evaluations and a pilot study. The collected data were analyzed by thematic analysis (Braun & Clarke, 2012). To ensure the rigor of thematic analysis, inter-coder reliability was established. The study delimited its geographical scope to the University of Education Attock Campus and focused on B.Ed. (Hons) 4-year teacher education program seventh-semester participants. Theoretical underpinning was drawn from the constructivist perspective. Results show that prospective teachers faced diverse challenges during their teaching practicum. These challenges included placement, orientation, classroom management, administrative cooperation, lesson planning and implementation, workload, evaluation process, transportation, feedback, school timetable, portfolio, evaluation processes, and inadequate facilities. Despite these challenges, prospective teachers highlighted the importance of supervision, modern teaching methods, and improved resources. Enhancing the teaching practicum involves setting up laboratory schools with theory-practice integration, immersive classroom experiences, and applied teaching techniques.

FEATURES OF THE BACHELOR’S EDUCATIONAL PROGRAM “POLISH STUDIES – LANGUAGE, CULTURE, SOCIETY” AT THE JAGELLONIAN UNIVERSITY (for Chinese Students)

The article examines the special 2-year double degree diploma program of the Bachelor’s Education Level “Polish studies – language, culture, society” for Chinese students at the Institute of Polish Glottodidactics of the Jagiellonian University. This is an innovative project, the idea of which appeared back in 2006, when a cooperation agreement was signed between the Jagiellonian University and the Chinese State Administration for the Development of the Chinese Language, but the idea was implemented in 2019–2020. The turning point in this direction was 2013, when the government of the People’s Republic of China adopted the initiative of the One Belt, One Road global infrastructure development strategy, which led to a number of reforms not only in the economic, but also in the educational sphere, in particular in the teaching of Polish as a foreign language. Poland became an important point in the development of the implementation of the idea of this global project as a transfer between Western Europe and China. In accordance with the signed agreement and the Common European Framework of Reference for Languages in Poland Chinese students deepen their knowledge of the Polish language, history and culture and acquire new skills and abilities. This program is implemented in two main parts (2 + 2). The first four semesters take place at the student’s home university in China, and the next four semesters are at the Jagiellonian University. The main task of this program is to train specialists who, on the one hand, have a high level of language skills, but, on the other hand, they must also have knowledge of the country whose language they are studying, have a broad global perspective and be able to participate in a strong competition and international cooperation. Also, the article pays special attention to the prerequisites for the creation of the program “Polish studies – language, culture, society”, describes the main tasks and academic disciplines, the topics of diploma theses, and also explains the mechanisms of using the experience of Polish colleagues on the Ukrainian reality. Key words: Double Degree Program, Polish Studies, Chinese students, Institute of Polish Glottodidactics, Jagiellonian University.

Identifying novel small molecule integrin agonists to mimic the favourable effects of the RGD domain of IGFBP-1 to treat cardiometabolic disease

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): British Heart Foundation (BHF) 4-Year PhD Programme Background Insulin-like growth factor binding protein (IGFBP)-1 has previously been shown to be associated with reduced type 2 diabetes (T2D) progression and preferable cardiovascular profiles in patients. Our laboratory previously demonstrated that IGFBP-1 is an insulin sensitiser in mouse models, in addition to having favourable vascular effects, independently of IGFs. IGFBP-1 has an Arg-Gly-Asp (RGD) domain which is thought to facilitate the direct interaction with the heterodimeric cell-surface receptor, integrin α5β1, inducing downstream cell signalling. We then showed the positive effects of IGFBP-1 could be mimicked with an RGD-containing linear peptide, GRGDTP, however this peptide is not a suitable therapeutic as it is rapidly metabolised in vivo. To our knowledge, RGD-based therapeutics have not been explored for cardiometabolic disease. Purpose There are currently few therapeutics which have been specifically designed to address both insulin resistance and the high risk of macrovascular disease in T2D. Therefore, exploring RGD-based integrin agonists will be essential in developing new insulin sensitising therapeutics which prevent cardiovascular complications. Methods The ROCS high speed ligand-based virtual screening tool was used to screen commercially available small molecule libraries mimicking the chemical structure of the RGD sequence of IGFBP-1. Additionally, we performed in silico modelling to predict the binding interactions of these molecules with the integrin α5β1 headpiece to select candidates. We then used a LIVE/DEAD cell viability assay to initially profile any cytotoxic effects of our selected compounds in integrin-expressing human umbilical vein endothelial cells (HUVECs) and C2C12 skeletal muscle myotubes. We further assessed the effects of compounds on relevant HUVEC functions using a high-throughput wound closure assay. Results The structure of the RGD domain of IGFBP-1 can be mimicked with small molecules containing amino acid moieties. These molecules are predicted to bind with micromolar affinity to the integrin, promoting beneficial interactions for integrin agonism. We selected 17 structurally diverse small molecules with the best predicted binding interactions. Initial in vitro profiling demonstrates that the molecules are not cytotoxic. In preliminary analyses, three of the selected compounds show a trend towards inhibition of HUVEC migration and proliferation, while six show a trend towards increased migration and proliferation. Conclusion The RGD domain of IGFBP-1 can be mimicked with novel small molecules, of which we have selected 17 ligands. Our compounds do not affect cell viability in relevant cell types, so can be further profiled. Our initial findings indicate that the compounds have different functional effects on HUVECs which allows us to prioritise hits having favourable effects in the context of T2D, such as enhancing angiogenic properties of endothelial cells.

Implementasi Program Tahfidz Al-Qur’an di SMA Muhammadiyah Pacitan

The methods used to memorize the Al-Qur'an include: Talqin method, tasmi', muroja'ah, tafsir and tadjwid. This article discusses the implementation of the Al-Qur'an memorization program at SMA Muhammadiyah Pacitan. The aim is to describe the planning, implementation and evaluation of Al-Qur'an memorization learning at SMA Muhammadiyah Pacitan. This type of research is qualitative descriptive with a field research research method. Research subjects were determined using purposive sampling techniques. The data collection techniques are observation, interviews and documentation. The results of the study show that the implementation of the Al-Qur'an memorization program at SMA Muhammadiyah Pacitan is carried out in groups based on the level of ability to read the Al-Qur'an in each class, with one accompanying teacher. The learning method uses the Talqin, Tahsin methods, while the evaluation method is muroja'ah and tasmi'. The program is held every day at school hours starting 1 hour before KBM (teaching and learning activities), with a 1-year program memorizing 1 Juz starting from juz 30, 28, and 29. To support this program, the Educational Institution collaborates with the El-Yamin Al-Qur'an Friendship Foundation. Tasmi' is held once per juz both online and offline. At the end of the semester, a tahfidz report is submitted to parents as a form of accountability.

Establishing the short course in transferable skills training program.

While PhD programs prepare graduate students to perform biomedical research, a defined systematic training program for transferable skills is generally lacking. When provided, this training is often informal, unstructured, or inconsistent. Therefore, there is a need to provide critical skills in marketing, relationship building, project management, and budgeting to prepare trainees to navigate into a productive, engaging, and rewarding biomedical research career. To address this gap in training, the School of Graduate Studies at Meharry Medical College has developed the SHort Course In transFerable skills Training (SHIFT) Program, a 1-year professional development program accessible to graduate students in the United States who are enrolled in graduate biomedical research related programs. The SHIFT Program has been launched to equip trainees with skills essential for success in all biomedical science careers. PhD students will be taught the primary constituents of career management through the use of four training modules. In Module I, students complete self-assessments and are assigned to a small peer-mentoring team with mentors. Module II consists of a 5-day workshop that encompasses instruction on the transferable skills identified as essential for career success. Module III entails monthly interactive discussions over a 6-month period involving case study review and mentor-guided discussions to further reinforce skills learned. In Module IV, students compile the information learned from Modules I-III to develop an Individual Development Plan that incorporates 3-5 specific, measurable, attainable, relevant, and time-based career goals. Collectively, the SHIFT Program will allow participants to train, practice, and refresh skills, empowering them to navigate career transitions and obtain success in the career of their choice.

Explorando el cambio de la autoestima de los estudiantes de enfermería y sus factores predictivos: Estudio de cohortes y sus retos metodológicos

ObjectiveConsidering methodological difficulties and inconsistent results of previous studies on it, the objective was to describe the change in nursing student self-esteem over time and its predictors, using a sound theoretical framework and relevant tools to measure and analyse the data. MethodCohort study. Self-esteem and related factors were assessed in nursing students in a 4-year bachelor's program at the beginning of each academic year from 2017 to 2019 and at the end of the academic year in May 2020, using he revised version of Self-liking/Self-competence scale of Tafarodi and Swann. Univariate and multivariate analyses were performed via generalized linear mixed modelling. ResultsSelf-esteem was moderate at the beginning of the program: 50.40 (9.10). It increased slightly over time: 51.15 (9.11) at T1; 51.64 (0.49) at T2; and 51.39 (10.79) at T3 (p=.002). Baseline variables that predicted self-esteem change were gender, secondary school graduation level, state anxiety, intent to continue, and self-efficacy. Assessing and improving those last variables via a strong career plan could boost student achievement and increase retention during and after training. ConclusionNursing student self-esteem can be assessed using a bidimensional model, with a two-factor scale like Tafarodi & Swann's self-liking/self-competence scale. Generalized linear mixed model is a useful way to correlate large sets of longitudinal data.

Pediatric neuropathology practice in a low- and middle-income country: capacity building through institutional twinning.

Accurate and precise diagnosis is central to treating central nervous system (CNS) tumors, yet tissue diagnosis is often a neglected focus in low- and middle-income countries (LMICs). Since 2016, the WHO classification of CNS tumors has increasingly incorporated molecular biomarkers into the diagnosis of CNS tumors. While this shift to precision diagnostics promises a high degree of diagnostic accuracy and prognostic precision, it has also resulted in increasing divergence in diagnostic and management practices between LMICs and high-income countries (HICs). Pathologists and laboratory professionals in LMICs lack the proper training and tools to join the molecular diagnostic revolution. We describe the impact of a 7-year long twinning program between Canada and Pakistan on pathology services. During the study period, 141 challenging cases of pediatric CNS tumors initially diagnosed at Aga Khan University Hospital (AKUH), Karachi, were sent to the Hospital for Sick Children in Toronto, Canada (SickKids), for a second opinion. Each case received histologic review and often immunohistochemical staining and relevant molecular testing. A monthly multidisciplinary online tumor board (MDTB) was conducted to discuss the results with pathologists from both institutions in attendance. Diagnostic discordance was seen in 30 cases. Expert review provided subclassification for 53 cases most notably for diffuse gliomas and medulloblastoma. Poorly differentiated tumors benefited the most from second review, mainly because of the resolving power of specialized immunohistochemical stains, NanoString, and targeted gene panel next-generation sequencing. Collaboration with expert neuropathologists led to validation of over half a dozen immunostains at AKUH facilitating diagnosis of CNS tumors. LMIC-HIC Institutional twinning provides much-needed training and mentorship to pathologists and can help in infrastructure development by adopting and validating new immunohistochemical stains. Persistent unresolved cases indicate that molecular techniques are indispensable in for diagnosis in a minority of cases. The development of affordable alternative molecular techniques may help with these histologically unresolved cases.

STAGES OF BECOMING A SPECIAL EDUCATION TEACHER IN FLORIDA

This article outlines the steps a teacher must take to obtain a special education teacher license in the state of Florida. It was established that there are different types of certificates: those that allow to carry out educational activities with students with general educational needs; to carry out educational activities with students with speech and language impairments; deaf and hard of hearing; and visually impaired children. To obtain a license, an applicant must complete a special education college program, complete an internship and write a coursework, pass the Florida State Teacher Certification Examination, and obtain a special education teacher certificate. The cost of college varies from state to state, but there are different types of financial aid available. Practice characteristics for special education teachers are also vary by program and course. A standard 4-year special education program involves a gradual intensity of student. After passing the practical part, a teacher pass the Florida State Teacher Certification Examination (FTCE), which consists of three different tests. The next step is obtaining a certificate (professional or temporary). There are many resources for special education teachers that are designed to support and advance the skills of special education teachers. Despite such a wide variety of professional development paths, there is an acute shortage of special education professionals in Florida. In order to eliminate the problem, the US government foresees an increase in wages and the number of jobs in the perspective of 2020‒2030. It was established that in addition to traditional classroom classes, professional development in the field of special education offers different opportunities for career growth. Knowledge of special education can also be used to work in positions funded by statewide programs aimed at meeting the needs of people with disabilities. Work experience in the field of special education gives an advantage among other applicants for teaching activities. The prospects for the work of a special teacher were outlined and the main shortcomings of this field of education were identified.

Implementing a Palliative Care Junior Faculty Visiting Professor Program: Pearls and Pitfalls.

Palliative Care (PC) is a small, relatively young interprofessional sub-specialty; hence mentorship for early-career research faculty is widely dispersed across schools and universities. We developed the Junior Visiting Professor Program (JVPP) to provide junior faculty in palliative care (PC) with opportunities to meet multidisciplinary PC researchers from other institutions and to advance their research through networking and presenting their work. We describe how we designed and implemented the program, and we report on the first cohort of participants. We invited PC research groups from US schools of medicine and nursing to participate in this 5-year interprofessional exchange program by nominating junior faculty and serving as hosts. We matched nominees to host institutions based on nominee training experiences, nominee research interests, and host institution faculty expertise. In addition, we provided logistical guidance on visit planning. Post-visit, we surveyed both hosts and junior visiting professors (JVPs) regarding their satisfaction, perceived value, and suggestions regarding the program. We recruited 13 schools to participate and matched 10 nominees to host institutions in our first year. Nine JVPs completed their visit; 6 JVPs and 8 host faculty/staff responded to the post-visit survey. Overall, JVPs were highly satisfied with their matches and the visiting professor experience. Hosts were generally satisfied with their matches and believed the program to be mutually beneficial. The most frequent suggestion was for greater administrative support to plan visits. Structured, well-supported opportunities for networking across institutions is beneficial for emerging PC researchers and for building PC research capacity.

Designing an impactful APRN residency program for rural communities.

The largest healthcare system in New Mexico, in collaboration with the University of New Mexico College of Nursing, identified an opportunity to increase and retain the number of family practice NPs and certified nurse midwives in rural communities by creating an immersive 1-year rural residency program for newly graduated advanced practice registered nurses (APRNs). This article describes the journey to design this program and build its infrastructure with the aim of addressing the needs of both APRNs during their transition to practice and patients in rural areas, while providing a return on the healthcare system's business investment. Program results are also reported. Program funding was provided by a Health Resources and Services Administration grant, the Presbyterian Healthcare Services executive team, and the Presbyterian Healthcare Foundation.

Awareness and cognitive rehabilitation in Alzheimer's disease and frontotemporal dementia.

Awareness influences the evolution of neurodegenerative dementias. We gathered participants' and caregivers assessments of dependence in daily activities and we studied how each score would be related to next year participant autonomy, independently of other explicative variables. We retrospectively analyzed data from mildly demented participants with a clinical diagnosis of Alzheimer's disease (AD, n = 186) and frontotemporal dementia (FTD, n = 29) and their relatives. A research tool was used to assess participant dependence in 98 daily activities and associated caregiver burden. A discrepancy score between the patient's and relative's judgment was calculated to evaluate awareness of dependence in activities at baseline. This dependence scores, as well as sex, age, education, and 1 year difference in Mini-Mental State Examination were taken as possible explicative variables for dependence in activities adapted by therapists during a 1-year cognitive rehabilitation program. Patients with FTD showed less awareness for daily dependence (discrepancy 20.9% vs. 11.8% in AD). Both groups benefited from cognitive rehabilitation (25% decrease in dependence) and subjective burden of relatives was decreased in both groups. In the AD group, there was a significant positive relationship between both caregiver (P < 0.001) and participant's (P < 0.02) evaluation of dependence in daily activities at inclusion and dependence of participants in adapted activities after 1 year. Awareness of impairment in daily activities is a clinical symptom that is more important at inclusion in FTD than in AD. However, in participants with AD who, as a group, significantly benefit from a cognitive rehabilitation program, not only caregiver's but also participant's assessment of dependence at baseline is correlated to subsequent, next year greater dependence in daily activities adapted by the therapists. Although discrepant, both caregiver and participant evaluations appear to be important variables to understand the evolution and the benefit of care in participants at early stages of dementia.

Distribution of internal medicine rotations among resident physicians in Japan: a nationwide, multicenter, cross-sectional study

BackgroundIn Japan, postgraduate clinical training encompasses a 2-year residency program, including at least 24 weeks of internal medicine (IM) rotations. However, the fragmented structure of these rotations can compromise the training’s quality and depth. For example, a resident might spend only a few weeks in cardiology before moving to endocrinology, without sufficient time to deepen their understanding or have clinical experience. This study examined current patterns and lengths of IM rotations within the Japanese postgraduate medical system. It scrutinized the piecemeal approach—whereby residents may engage in multiple short-term stints across various subspecialties without an overarching, integrated experience—and explored potential consequences for their clinical education.MethodsThis nationwide, multicenter, cross-sectional study used data from self-reported questionnaires completed by participants in the 2022 General Medicine In-Training Examination (GM-ITE). Data of 1,393 postgraduate year (PGY) one and two resident physicians who participated in the GM-ITE were included. We examined the IM rotation duration and number of IM subspecialties chosen by resident physicians during a 2-year rotation.ResultsApproximately half of the participants chose IM rotation periods of 32–40 weeks. A significant proportion of participants rotated in 5–7 internal medicine departments throughout the observation period. Notable variations in the distribution of rotations were observed, characterized by a common pattern where resident physicians typically spend 4 weeks in each department before moving to the next. This 4-week rotation is incrementally repeated across different subspecialties without a longer, continuous period in any single area. Notably, 39.7% of participants did not undertake general internal medicine rotations. These results suggest a narrowed exposure to medical conditions and patient care practices.ConclusionsOur study highlights the need to address the fragmented structure of IM rotations in Japan. We suggest that short, specialized learning periods may limit the opportunity to gain broad in-depth knowledge and practical experience. To improve the efficacy of postgraduate clinical education, we recommend fostering more sustained and comprehensive learning experiences.

Additive effects of a family history of schizophrenia spectrum disorders and an environmental risk score for the outcome of patients with non-affective first-episode psychosis.

First-episode psychotic disorders comprise a heterogeneous phenotype with a complex etiology involving numerous common small-effect genetic variations and a wide range of environmental exposures. We examined whether a family of schizophrenia spectrum disorder (FH-Sz) interacts with an environmental risk score (ERS-Sz) regarding the outcome of patients with non-affective first episode psychosis (NAFEP). We included 288 patients with NAFEP who were evaluated after discharge from an intensive 2-year program. We evaluated three outcome measures: symptomatic remission, psychosocial functioning, and personal recovery. We analyzed the main and joint associations of a FH-Sz and the ERS-Sz on the outcomes by using the relative excess risk due to interaction (RERI) approach. A FH-Sz showed a significant association with poor symptomatic remission and psychosocial functioning outcomes, although there was no significant interaction between a FH-Sz and the ERS-Sz on these outcomes. The ERS-Sz did not show a significant association with poor symptomatic remission and psychosocial functioning outcomes, even though the magnitude of the interaction between ERS-Sz and FH-Sz with the later outcome was moderate (RERI = 6.89, 95% confidence interval -16.03 to 29.81). There was no association between a FH-Sz and the ERS-Sz and personal recovery. Our results provide further empirical support regarding the contribution of FH-Sz to poor symptomatic remission and poor psychosocial functioning outcomes in patients with NAFEP.

Creative critical reflection through poetry and prose

ABSTRACT Artefacts considered in this paper include poetry and prose from my previous doctoral research with social work students; exploring how they experience, express, and manage the emotional content of practice learning. The poetry includes I-poems, where words of students are taken directly from verbatim research transcripts and reconstructed as part of my sense-making. Additionally, an autoethnographic response via poetry and prose creates a counterpoint and further perspective. This co-construction between my experience and that of student participants promotes authenticity via powerful messages in poetic form. In the context of performative research, these artefacts are best shared. Utilising teaching sessions within a 3-year undergraduate social work programme in the UK, as a performative medium, these research artefacts enable current social work students to explore overarching learning outcomes. Students engage with artefacts as an introduction to qualitative research. Students experience at first hand, poetry and prose as a non-traditional research medium through the methodology of interpretative phenomenological analysis (IPA). This enables exploration of artefacts, promoting a deeper engagement with complex narratives. They discover how poetry and prose present a valuable conduit for tangible emotional engagement and connection. In addition, students develop their own creativity when reflecting on practice, to support critical reflection.

A novel technique for multi-objective sustainable decisions for pavement maintenance and rehabilitation

To maintain pavement in good condition while considering financial costs and sustainability, it is necessary to develop a comprehensive pavement management plan. Pavement Maintenance and Rehabilitation (M&R) consists of two essential components: firstly, predicting the pavement condition within a specified timeframe, and secondly, employing an appropriate optimization algorithm. This study utilized three ensemble learning techniques including extreme gradient boosting, categorical boosting, and light gradient boosting machine to develop accurate predictions about the pavement condition. Subsequently, the most accurate prediction technique, which was extreme gradient boosting, was combined with non-dominated sorting genetic algorithm III which is a multi-objective metaheuristic optimization algorithm, resulting in a hybrid technique that offers highly accurate multi-objective maintenance and rehabilitation planning. Although previous studies neglected important criteria such as road closure in the optimization process, this study takes into account four objective functions including greenhouse gas emission, M&R cost, pavement condition, and road closure to be minimized over a 5-year program. This process generated 52 non-dominated optimal solutions known as the Pareto front. To compare and rank various optimal maintenance and rehabilitation plans, grey relational analysis was employed. The results suggested that there is a direct correlation between M&R costs and GHG emissions. Minimizing only pavement conditions in the planning can significantly increase GHG emissions, M&R costs, and road closure. Implementing preventive M&R actions can reduce M&R costs and overall road closure while light and medium rehabilitation actions are recommended to optimize the condition of pavements.

Effectiveness of a 5-year health empowerment programme on promoting cardiovascular health for adults from low-income families in Hong Kong

ObjectiveThis study aimed to evaluate the effectiveness of a health empowerment programme (HEP) to enhance cardiovascular health for adults from low-income families. MethodsA prospective cohort study (N = 219, Intervention group: n = 103, comparison group: n = 116) was conducted with participants recruited from January 2013 to November 2015 and followed up until January 2022. Throughout the study duration, intervention group were invited to participate in the HEP. The cardiovascular health status of both groups at baseline and follow-up were assessed using the adapted Ideal Cardiovascular Health Index (ICHI) defined by the American Heart Association. After inverse propensity score weighting, multiple linear regression and Poisson regression were employed to examine the effects of the HEP. ResultsThe HEP was associated with a greater increase in ICHI total score (B = 0.33, p < 0.001), and the increase of proportion of people achieving a normal blood pressure (Incidence rate ratio: 3.39, p < 0.05). ConclusionHEP can be an effective and sustainable strategy to reduce social disparities in cardiovascular health of adults from low-income families, as indicated by improvement in the ICHI total score and blood pressure status. Practical ImplicationsThe sustainable HEP in the community setting has potential for generalizability and scalability to other financially challenged families.

A Novel REBOA Training Curriculum for Emergency Medicine Residents: A Pilot Study

BackgroundResuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is a potentially life-saving intervention to treat noncompressible torso hemorrhage. Traditionally, REBOA use has been limited to surgeons. However, emergency physicians are often the first point-of-contact and are well-versed in obtaining rapid vascular access and damage control resuscitation, making them ideal candidates for REBOA training. Study ObjectivesTo fill this gap, we designed and evaluated a REBOA training curriculum for emergency medicine (EM) residents. MethodsParticipants enrolled in an accredited 4-year EM residency program (N = 11) completed a 12-hour REBOA training course. Day 1 included lectures, case studies, and hands-on training using REBOA task trainers and perfused cadavers. Day 2 included additional practice and competency evaluations. Assessments included a 25-item written knowledge exam, decision-making on case studies, REBOA placement success, and time-to-placement. Participants returned at 4 months to assess long-term retention. Data were analyzed using t-tests and nonparametric statistics at p < 0.05. ResultsScores on a 25-item multiple choice test significantly increased from pre-training (65% ± 5%) to post-training (92% ± 1%), p < 0.001. On Day 2, participants scored 100% on correct recognition of REBOA indications and scored 100% on correct physical placement of REBOA. Exit surveys indicated increased preparedness, confidence, and support for incorporating this course into EM training. Most importantly, REBOA knowledge, correct recognition of REBOA indications, and correct REBOA placement skills were retained by the majority of participants at 4 months. ConclusionThis course effectively teaches EM residents the requisite skills for REBOA competence and proper placement. This study could be replicated at other facilities with larger, more diverse samples, aiming to expand the use of REBOA in emergency physicians and reducing preventable deaths in trauma.

Development of a Clinical Simulation Video to Evaluate Multiple Domains of Clinical Competence: Cross-Sectional Study.

Medical students in Japan undergo a 2-year postgraduate residency program to acquire clinical knowledge and general medical skills. The General Medicine In-Training Examination (GM-ITE) assesses postgraduate residents' clinical knowledge. A clinical simulation video (CSV) may assess learners' interpersonal abilities. This study aimed to evaluate the relationship between GM-ITE scores and resident physicians' diagnostic skills by having them watch a CSV and to explore resident physicians' perceptions of the CSV's realism, educational value, and impact on their motivation to learn. The participants included 56 postgraduate medical residents who took the GM-ITE between January 21 and January 28, 2021; watched the CSV; and then provided a diagnosis. The CSV and GM-ITE scores were compared, and the validity of the simulations was examined using discrimination indices, wherein ≥0.20 indicated high discriminatory power and >0.40 indicated a very good measure of the subject's qualifications. Additionally, we administered an anonymous questionnaire to ascertain participants' views on the realism and educational value of the CSV and its impact on their motivation to learn. Of the 56 participants, 6 (11%) provided the correct diagnosis, and all were from the second postgraduate year. All domains indicated high discriminatory power. The (anonymous) follow-up responses indicated that the CSV format was more suitable than the conventional GM-ITE for assessing clinical competence. The anonymous survey revealed that 12 (52%) participants found the CSV format more suitable than the GM-ITE for assessing clinical competence, 18 (78%) affirmed the realism of the video simulation, and 17 (74%) indicated that the experience increased their motivation to learn. The findings indicated that CSV modules simulating real-world clinical examinations were successful in assessing examinees' clinical competence across multiple domains. The study demonstrated that the CSV not only augmented the assessment of diagnostic skills but also positively impacted learners' motivation, suggesting a multifaceted role for simulation in medical education.

Spatial Cluster Change of Schistosoma japonicum Transmission Foci in Indonesia During the Schistosomiasis Elimination Program.

The Government of Indonesia committed to eliminating schistosomiasis by 2025. Collaboratively snail control became one of the crucial strategies to ensure that the prevalence ofSchistosoma japonicuminOncomelania hupensis lindoensisreaches zero by the end of the program. This research investigated the spatial cluster change ofS. japonicumtransmission foci in Indonesia between 2017 and 2021. We mapped the snail foci, collected the snails, and calculated the snail density. We also conducted laboratory tests to detect the existence of cercariae in the snails. Identified infected snails were used to calculate the infection rate (IR) or snails' prevalence of schistosome cercariae among freshwater snails. We then analysed the spatial cluster using the Getis-Ord Gi* statistic to identify the hot and cold spots. The 5-year schistosomiasis elimination program successfully declined 18.84% of the snail foci and reduced 40.37% of the infected snail foci. Local spatial autocorrelation of snail density and infection rate identified that in 2017 and 2021, the number of cold spots decreased by 53.91% and 0%, while hot spots increased by 2.63% and 56.1%. The presence of more hotspots suggests a rise in the number of foci with high snail density and infection rates. The implementation of snail control was not optimal, and the parasite transmission through domestic animals still existed, causing the spatial cluster of hot spots to change during this period. Most hotspots have been observed near settlements, primarily in cocoa plantations, developed and deserted rice fields, grassland, and bush wetlands. During the schistosomiasis elimination program, the number of hot spots increased while cold spots decreased, and there were notable changes in the geographical distribution of hot spots, indicating a shift in the clustering pattern of schistosomiasis cases. The findings become essential for policymakers, particularly in selecting priority areas for intervention. In the Discussion section, we demonstrated the selection process based on the existence of hot and cold spots. Furthermore, we proposed that enhancing cross-sector integration is crucial, particularly in connection with the management of S. japonicum transmission through domestic animals.

The prevalence of depression and anxiety among medical students in Yemen: A cross-sectional study

BackgroundMedical students may experience mental health disorders like anxiety and depression during medical school, which can negatively impact their productivity, education, and overall quality of life. Currently, there are no studies examining the mental health of medical students in Yemen. Our study aimed to estimate prevalence of depression and anxiety among Yemeni medical students. MethodsThe study utilized a cross-sectional design. A survey was conducted using validated psychometric tests: the Patient Health Questionnaire-9 (PHQ-9) for depression and the Generalized Anxiety Disorder-7 (GAD-7) for anxiety. A survey of medical students from 10 Yemeni medical schools took place from June 6 to July 20, 2023. It included only actively enrolled students in the 7-year undergraduate program. ResultsA total of 706 responses were collected. The prevalence of depression was 48.4 % for cases classified as moderate, moderately severe, and severe, while it was 20 % for cases categorized as moderately severe and severe. The rate of suicide ideation was 14.7 %. Anxiety was found to have a prevalence of 34.8 % for cases categorized as moderate and severe. Furthermore, both depression and anxiety were higher among females, and in earlier academic years; all of these associations had a p-value <0.05. Conversely, age, living status, income stability, and displacement risk all showed no significant association with depression or anxiety. ConclusionOur study highlighted the prevalence of depression and anxiety among Yemeni medical students. Tailored interventions are imperative to address these challenges. Future research needs to examine the root causes that might contribute to these disorders.