3-year Program Research Articles

Handwriting kinematics during learning to write with the dominant left hand in converted left-handers

Converting left-handers to their non-dominant right hand was previously widespread, particularly for handwriting. The present study aimed to explore the extent to which adult, converted left-handers can learn writing with their dominant left hand during a 2-year training program. Eleven converted left-handers participated in the training. Handwriting kinematics were assessed at regular intervals (seven sessions) and compared to those of 11 innate left-handed controls matched for age, gender, and overall handedness score for basic (Finger, Wrist, Circle) and complex (Sentence, Copy) handwriting tasks. Regarding basic tasks in the training group, we found rapid increases in left and right-hand frequency and no significant differences between both hands at any time point, indicating successful hand transfer. After 24 months, training participants significantly surpassed controls for writing frequency in basic tasks with their left hand. For complex tasks, we identified significant increases in the training groups’ left-hand writing frequency and duration between the first and last session. While training participants’ left-hand writing remained significantly slower than their right-hand writing, statistics confirmed final differences between hands only for the duration of the Sentence task. Importantly, left-hand writing in the training group was characterized by lower frequency, lower automaticity, and prolonged duration after 24 months compared to innate left-handers. With training participants’ left-hand writing skills significantly increasing for complex tasks and no final statistically significant differences between hands for frequency and automaticity, the program was considered effective. Nevertheless, within 2 years, training participants did not reach innate left-handers handwriting proficiency for complex tasks. Underlying reasons may be various, such as a non-optimal training program, a sensitive period for learning to write, irreversible neural changes during conversion in childhood, age-related decline of motor learning capacity, or retrograde interference between right- and left-hand writing.

Evaluation and outcomes of a 5-year assisted peritoneal dialysis program.

In 2016, Peritoneal Dialysis Assist (PDA) was implemented in British Columbia, Canada, as a pilot program to allow patients with physical, cognitive and social impairments to access an independent dialysis modality. This is a presentation of the usage and 5-year clinical outcomes of our provincial assisted peritoneal dialysis (PD) program. Patients who utilised long-term or respite PDA services in British Columbia, Canada, from 2016 to 2021 were included in this program evaluation. Incident and prevalent patient numbers were characterised annually as well as indications for PDA and patient demographics both annually and over time. Outcomes of interest included death, transfer to haemodialysis, transplantation and cessation of the PDA program but retention on PD. Three hundred twenty-two total patients received services through the PDA program. The percentage of PD patients supported by long-term PDA service has grown to 11.2% in the most recent year. Patients spend a median of 13.6 (95% CI: 11.0, 16.1) months on long-term PDA, prolonging overall patient duration on PD by a little over a year. Of the patients who exited the long-term PDA program, 73 (37.4%) were able to utilise the service until they died. PDA is an accessible, patient-centric service with clear and standardised referral criteria. Through the implementation of a local PDA program, patients have accessed PD and may have extended their PD life span, through avoidance of in-centre haemodialysis, by over 13 months during this 5-year study period. A significant proportion of patients on long-term PDA were able to use their preferred kidney replacement modality at home until they reached end of life.

Exploratory analysis of the effect of a controlled lifestyle intervention on inflammatory markers – the Healthy Lifestyle Community Programme (cohort 2)

BackgroundChronic low-grade inflammation is associated with an increased risk of chronic disease and mortality. The objective of the study was to test the effect of a healthy lifestyle intervention on biomarkers of inflammation (among other risk markers).MethodsWe conducted a non-randomized controlled trial with mostly middle-aged and elderly participants from the general population in rural northwest Germany (intervention: n = 114; control: n = 87). The intervention consisted of a 1-year lifestyle programme focusing on diet (largely plant-based; strongest emphasis), physical activity, stress management, and social support. High-sensitivity C-reactive protein (hs-CRP) was assessed at baseline, 10 weeks, 6 months, and 1 year. Homocysteine (Hcy) was assessed at baseline, 10 weeks, and 1 year. Adiponectin (Apn) was assessed at baseline and 10 weeks. An exploratory analysis of these inflammatory markers assessing the between-group differences with ANCOVA was conducted.ResultsThe 1-year trajectory of hs-CRP was significantly lower in the intervention group compared to control (between-group difference: -0.8 (95% CI -1.2, -0.3) mg/l; p = 0.001; adjusted for baseline). The 1-year trajectory of Hcy was non-significantly higher in the intervention compared to control (between-group difference: 0.2 (95% CI -0.3, 0.7) µmol/l; p = 0.439; adjusted for baseline). From baseline to 10 weeks, Apn decreased significantly more in the intervention group compared to control (between-group difference: -1.6 (95% CI -2.7, -0.5) µg/ml; p = 0.004; adjusted for baseline).ConclusionsOur study shows that healthy lifestyle changes can lower hs-CRP and Apn levels and are unlikely to significantly affect Hcy levels within 1 year.Trial registrationGerman Clinical Trials Register (DRKS; reference: DRKS00018775, registered 12 Sept 2019; retrospectively registered; www.drks.de).

Implementation of the SIMPL (Society for Improving Medical Professional Learning) performance assessment tool in the emergency department: A pilot study.

Feedback and assessment are difficult to provide in the emergency department (ED) setting despite their critical importance for competency-based education, and traditional end-of-shift evaluations (ESEs) alone may be inadequate. The SIMPL (Society for Improving Medical Professional Learning) mobile application has been successfully implemented and studied in the operative setting for surgical training programs as a point-of-care tool that incorporates three assessment scales in addition to dictated feedback. SIMPL may represent a viable tool for enhancing workplace-based feedback and assessment in emergency medicine (EM). We implemented SIMPL at a 4-year EM residency program during a pilot study from March to June 2021 for observable activities such as medical resuscitations and related procedures. Faculty and residents underwent formal rater training prior to launch and were asked to complete surveys regarding the SIMPL app's content, usability, and future directions at the end of the pilot. A total of 36/58 (62%) of faculty completed at least one evaluation, for a total of 190 evaluations and an average of three evaluations per faculty. Faculty initiated 130/190 (68%) and residents initiated 60/190 (32%) evaluations. Ninety-one percent included dictated feedback. A total of 45/54 (83%) residents received at least one evaluation, with an average of 3.5 evaluations per resident. Residents generally agreed that SIMPL increased the quality of feedback received and that they valued dictated feedback. Residents generally did not value the numerical feedback provided from SIMPL. Relative to the residents, faculty overall responded more positively toward SIMPL. The pilot generated several suggestions to inform the optimization of the next version of SIMPL for EM training programs. The SIMPL app, originally developed for use in surgical training programs, can be implemented for use in EM residency programs, has positive support from faculty, and may provide important adjunct information beyond current ESEs.

Abstract TP38: Gender Disparities In Ischemic Stroke Thrombolytic Treatment In Nebraska Hospitals

Introduction: Mission: Lifeline Stroke Nebraska was a 4-year program to enhance stroke systems of care in Nebraska. With 68% of hospitals in Nebraska participating in GWTG-Stroke, analysis of stroke treatment data can be accomplished on disparities across the state. Methods: De-identified data was accessed through AHA GWTG-Stroke registry to assess stroke outcomes of patients at 49 participating NE hospitals in 2020. Data were analyzed based on AHA specified Mission: Lifeline reporting, achievement, and pre-hospital measures. The purpose of analysis was to describe patient characteristics and determine differences in IV thrombolytic treatment and mean patient NIH stroke score (NIHSS) upon admission. Percentages and counts were reported for categorical variables. The mean, standard deviation (SD) and median were reported for continuous variables. The Kruskal-Wallis rank sum, Wilcoxon sign rank, T-tests, chi-square and one-way ANOVA tests were used, where appropriate, to assess differences in stroke outcomes by age, gender, and race/ethnicity. Results: Of the 3,952 patient encounters registered in GWTG-Stroke from 01/01/2020 to 12/31/20, 2670 (67.5 %) were patients 18+ at time of admission with clinical diagnosis of ischemic stroke. Statistically significant differences in age, NIHSS at admission, and treatment with thrombolytics by gender were observed. Compared to males, females were older (72.7 vs. 68.1 years), had a lower mean NIHSS at admission (5.8 vs. 6.0), and a smaller proportion of females received thrombolytic treatment (42% vs. 58%). Conclusions: Overall, females were less likely to receive IV thrombolytic treatment compared to males. Women in the study were older with lower NIHSS than males. Results from this analysis align with those from the study “The Impact of Sex and Gender on Stroke” (Rexrode, et al.,2022) indicating that females may present different signs of a stroke than males. Our data showed the NIHSS scores to be lower for females possibly leading to lower frequency of treatment. As a part of the Mission: Lifeline initiative, this information was shared with hospitals and providers across the state. These results led to public awareness and education targeted to women, including a local podcast and social media.

Breathing Room: Cleaner Fuels for Home Cooking in LMICs.

Breathing Room: Cleaner Fuels for Home Cooking in LMICs.

Routinised practices of community librarians: Daily struggles of Dutch public libraries to be(come) social infrastructures

Next to their traditional role as places for information provision and knowledge transmission, public libraries increasingly also function as important social infrastructures contributing to the everyday life in cities. As such, they can help to address systemic challenges such as social fragmentation, loneliness, exclusion and precarity. However, the library not merely is a social infrastructure, but becomes one each operating day through continuous labour by a network of stakeholders. This paper specifically examines library staff and their routinised practices to provide, perform and maintain the library as social infrastructure. The empirical research was carried out in four public libraries in the Netherlands and focussed on staff members who were in a 1-year post-graduate programme to become a community librarian, and their close colleagues. It consisted of two phases: first librarians were shadowed at work, followed by a focus group interview on the multiple problems librarians encounter to (re)make their library into social infrastructures. These include coping with limited space, collaborating with other institutions, difficulties to reach out to the community, financial struggles and differentiating interpretations of the library’s primary function.

Longitudinal Effects of 1-Year Smoking Cessation on Human Bronchial Epithelial Transcriptome

Longitudinal Effects of 1-Year Smoking Cessation on Human Bronchial Epithelial Transcriptome

Multidisciplinary diagnosis and treatment training simulation by paired teachers using case-based teaching of oral histopathology that promotes clinical thinking

The multidisciplinary diagnosis and treatment (MDT) model has significant advantages in the diagnosing and treatment of intricate cases. In addition, it can eliminate subspecialty barriers and provide a more accurate and individualized diagnosis and treatment plan. It has been assumed that the future development of diagnosis and treatment will retain this course, and the MDT is an essential type of clinical thinking, especially for medical students. This study attempted to guide stomatology undergraduates’ thinking via an MDT simulation in oral histopathology practicums through typical case-based education and paired-teachers’ explanations. The aim was to cultivate clinical thinking among students based on individual cases and to improve class participation and students’ clinical thinking ability. Forty-six undergraduates in a 5-year stomatology program who enrolled in 2018 participated in a simulation MDT model. Ten typical clinical cases were selected, and they were previously collected and analyzed by clinicians in accordance with the simulation MDT model and handed out to teachers and students before the class. Two to three cases were interpreted by teacher pairs that included a pathologist (oral pathology teacher) and a radiologist (oral imaging teacher). The rest of the cases were used for simulation MDT student groups in class. The oral pathology teacher and oral imaging teacher illustrated the corresponding data from typical cases in advance. The simulation MDT group members acting as a surgeon, pathologist, or radiologist demonstrated their own cases assigned randomly before the class. A curriculum satisfaction survey illustrated that the simulation MDT group agreed that simulation MDT was novel for them, and they had a strong sense of participation. The mimic MDT training with typical cases guided by paired teachers was useful for establishing student clinical thinking.

Game-based learning in dental education.

The incorporation of interactive elements using technology increases student enjoyment and classroom learning effectiveness. This study investigated the usage of an online gamification platform in the dental school environment and compared game-based learning attitudes among students in different stages of their 4-year training program. A cross-sectional survey was conducted among dental medicine students in Years: 1 (Y1), 2 (Y2), 3 (Y3), and 4 (Y4) at a US-based dental school. The 11-item survey explored student perceptions on the effects of playing the Kahoots quiz game, using the 5-point Likert scale. Responses among male and female students were analyzed using the Mann-Whitney test, with responses of students in different years of dental school analyzed using the Kruskal-Wallis test. Average student age was 25 (range 20-45 years) upon starting dental school. Of 206 study participants, n=129 (63%) were males and n=74 (36%) females, n=70 (34.0%) were Y1; n=52 (25.2%), Y2; n=48 (23.3%), Y3; and n=36 (17.5%), Y4. Males tried harder to answer game questions than females (p=0.027). Compared to students in the upper 3 years, the Y1 students reported that they tried harder to win (p=0.002), the games held (p=0.002) and motivated them to pay attention (p<0.001), helped them understand (p=0.021) and to retain lecture concepts (p=0.010), and aided in the preparation for exams (p=0.010). Dental students in all stages of their 4-year training programs, especially Y1 students, reported positive perceptions of gamified learning and believed that it was helpful in identifying difficult concepts and motivating them to study.

The Impact of a Virtual Coaching Program to Improve Instructional Alignment to State Standards

This study assesses the impact of a 2-year virtual coaching program on teacher and student outcomes. The program—Feedback on Alignment and Support for Teachers (FAST)—was intended to deepen teachers’ understanding of their state’s standards and improve the alignment of their instruction with the standards. Relying on a multisite school-level randomized controlled trial, we assessed the impact of the FAST program in fourth-grade math and fifth-grade English language arts (ELA). We found that the program had a positive impact on the alignment of teachers’ instruction with state standards for both math and ELA teachers (effect sizes = 0.70 and 0.40, respectively), although the impact was statistically significant only for math teachers. In contrast to a growing body of evidence on the benefits of instructional coaching, the program’s impact on student achievement, was in the negative direction for both fourth-grade mathematics and fifth-grade ELA (effect sizes = −0.07 and −0.10, respectively), although the impact on achievement was statistically significant only for ELA. These results suggest that improving instructional alignment alone may not be sufficient for improving student achievement.

African naturopathic education: Ghana’s model using competency-based curriculum

Despite the over 62 years of Naturopathy’s existence in the Ghanaian jurisdiction, no single tertiary program in Naturopathy or Complementary and Alternative Medicine is taught. The practice has not been streamlined and properly structured. Those who engage in the Naturopathic trade mostly receive their education through correspondence from unrecognized and unaccredited foreign schools that teach a limited aspect of naturopathy. : Following the development and approval of two Naturopathic programs; The Higher National Diploma (HND) for training Naturopaths and Bachelor of Technology in Naturopathy and Holistic Medicine, a 5-year program for Naturopathic Physicians, this paper provides a critical evaluation of the curricula approved by the Commission for Technical and Vocational Education and Training (CTVET) in Ghana. This paper employs a sequential two-stage qualitative process. In phase one, the two curricula were submitted to the World Naturopathic Federation (WNF) Canada, for evaluation. Phase two involved a document analysis using the curriculum recommended by the World Health Organization (WHO), the World Naturopathic Federation (WNF), and the South African Naturopathic curriculum. An in-depth evaluation and comparison with the Ghanaian program were conducted, together with abstracted WNF responses which were then analyzed thematically. After the necessary recommendations by WNF were adopted. The two Ghanaian curricula met the international standard. The recommendations also strengthened the mandatory general area of competence in Naturopathic training. The Ghanaian Bachelor’s in Naturopathy has total clock hours of 5,979, which surpasses the South African degree in Naturopathy(5,950) clock hours. The Ghanaian naturopathic mandatory and elective subjects in the curricula meet the international standards. Issues raised by World Naturopathic Federations (WNF) were all addressed to strengthen the program.

Career outcomes and satisfaction among graduates of a 4-year oral health and welfare baccalaureate program at Niigata University, Japan: A cross-sectional study.

Globally, baccalaureate programs in dental hygiene are increasingly established. In addition, in Japan, many dental hygienists (DHs) and social workers (SWs) are prematurely leaving the workforce. This study aimed to investigate the most recent employment, career outcomes, reasons for a job change, and satisfaction with the job and undergraduate curriculum among graduates of the baccalaureate program at the Department of Oral Health and Welfare (DOHW), Faculty of Dentistry, Niigata University. All 262 graduates (graduating classes 1-10) of the DOHW were invited to participate in this survey; an original self-administered questionnaire was distributed to those who consented. Responses were received from 114 (43.5%) graduates. Almost all respondents (89.5%) had dual licensure as both DH and certified SW. They were employed immediately after graduation (99.1%) and at the time of the survey (96.5%). Over 60% of them worked as DHs, mainly in hospitals. SWs mainly worked in administration. Among the 113 respondents who were employed, 39.8% changed jobs at least once. The main reasons for job selection were 'interest in job content' and 'flexible working hours'. Nearly 90% of the respondents felt satisfied or fairly satisfied with their job and their undergraduate education. A quality 4-year baccalaureate degree program in dental hygiene and social welfare positively influenced graduates' work continuity. Most graduates felt satisfied or fairly satisfied with their job and the undergraduate curriculum. Employment rates within each profession and the prevalence of hospital and administrative roles were higher than national averages. Long-term studies of graduates' career outcomes are warranted.

Evaluation of an experiential training program in patient-centered outcomes and comparative effectiveness research for diverse researcher communities and health care organizations

The goal of the Patient-Centered Outcomes Research Partnership was to prepare health care professionals and researchers to conduct patient-centered outcomes and comparative effectiveness research (CER). Substantial evidence gaps, heterogeneous health care systems, and decision-making challenges in the USA underscore the need for evidence-based strategies. We engaged five community-based health care organizations that serve diverse and underrepresented patient populations from Hawai'i to Minnesota. Each partner nominated two in-house scholars to participate in the 2-year program. The program focused on seven competencies pertinent to patient-centered outcomes and CER. It combined in-person and experiential learning with asynchronous, online education, and created adaptive, pragmatic learning opportunities and a Summer Institute. Metrics included the Clinical Research Appraisal Inventory (CRAI), a tool designed to assess research self-efficacy and clinical research skills across 10 domains. We trained 31 scholars in 3 cohorts. Mean scores in nine domains of the CRAI improved; greater improvement was observed from the beginning to the midpoint than from the midpoint to conclusion of the program. Across all three cohorts, mean scores on 52 items (100%) increased (p ≤ 0.01), and 91% of scholars reported the program improved their skills moderately/significantly. Satisfaction with the program was high (91%). Investigators that conduct patient-centered outcomes and CER must know how to collaborate with regional health care systems to identify priorities; pose questions; design, conduct, and disseminate observational and experimental research; and transform knowledge into practical clinical applications. Training programs such as ours can facilitate such collaborations.

Practical Strategies for Improving Sustainability and Scale-up of Noncommunicable Disease-related Public Health Interventions: Lessons from the Better Health Program in Southeast Asia.

The Better Health Program has been addressing key health system issues in the prevention and control of noncommunicable diseases (NCDs) in Malaysia, Thailand, Vietnam, and the Philippines. As the program comes to an end, the sustainability and scaling-up of issues have assumed importance. The objective is to assess how well sustainability and scale-up strategies have been integrated into the design and implementation of a 3-year multicountry technical program; to explore enablers and barriers of sustainability and scaling up; and to identify practical strategies that can improve sustainability and scale-up of Better Health Program interventions. We applied a staged approach to explore barriers and enablers and to identify practical strategies to improve sustainability and scale-up of four NCD interventions: community-based obesity prevention, front-of-pack labeling, local learning networks (LLNs), and NCD surveillance. We extracted evidence from peer-reviewed literature and local documents. We also conducted in-depth interviews with the implementation teams and key stakeholders. We conducted a thematic synthesis of the resulting information to identify practical strategies that improve sustainability and scale-up of the four interventions. Strong engagement of stakeholders at higher levels of the health system was identified as the main enabler, while limited funding and commitment from local governments were identified as a key barrier to sustainability and scale-up. Strengthening the social and institutional anchors of community health volunteers, enhancing evidence-based advocacy for front-of-pack labeling, trailblazing the LLN innovation, and securing the commitment of local governments in the implementation of NCD surveillance were among the key strategies for improving sustainability and scale-up of Better Health Program interventions in Malaysia, Thailand, Philippines, and Vietnam, respectively. This study identified practical strategies for improving sustainability and scale-up of NCD-related interventions. Implementation of the strategies that had high priority and feasibility will improve the sustainability of critical elements of the program in the respective countries.

Meeting report of the 1st SIOP Europe Course in Paediatric Oncology: Maasmechelen, Belgium, April 6–9, 2022 – The participants’ view and experience

<h2>Abstract</h2> More than 35,000 children are diagnosed with cancer and treated in Europe each year. With the 1^st SIOP Europe Course in Paediatric Oncology, the European Society for Paediatric Oncology (SIOP Europe) aimed to equip aspiring physicians to become leaders within a pan-European network and ensure state-of-the-art treatment for children across Europe. Fifty participants from 24 countries and 37 centres were enrolled on the course. With a virtual and a face-to-face meeting complete, we herewith report on the course concept, application process and first meetings of this 3-year educational program.

PECULIARITIES OF PROFESSIONAL TRAINING IN APPLIED LINGUISTICS AT CANADIAN UNIVERSITIES (CARLETON UNIVERSITY)

The article describes the history of Applied Linguistics development. It is noted that the field of Applied Linguistics not only focuses on native, foreign and second language acquisition, but also examines how language interacts with other areas such as the media and legislation. The programs for training specialists in Applied Linguistics in the leading institutions of higher education in Canada are analyzed. In particular, attention is focused on Carleton University. Bachelor's and Master's programs in Applied Linguistics are studied. A special feature of Carleton University Bachelor’s degree program is that students have the opportunity to choose between a 4-year or 3-year program of study to obtain a degree. In addition, at Carleton University, you can combine a specialization in Applied Linguistics and Discourse Studies with an additional one in modern language studies: American Sign Language, German, Italian, Japanese, Chinese, and Spanish. A feature of Applied Linguistics programs for third- and fourth-year students is the option to choose an accelerated study program at Carleton University. Master’s degree program in Applied Linguistics, conditions and criteria for admission are described and analyzed. It is found out that there are three possible ways to complete the Master's program in Applied Linguistics and Discourse Studies: writing a thesis, a research essay or a coursework paper. It is noted that students are first registered for coursework, but at the end of the first year of the master's program they must submit a proposal for writing a research essay or thesis. It is determined that after completing a master’s level of education, a student has the opportunity to continue their studies by enrolling in Carleton University PhD program, which is unique in North America due to its innovative combination of Applied Linguistics and Discourse Studies.

Spatiotemporal and Environmental Dynamics of Abundances and Diversity of Larval Fish in Artificial Reef Edge Habitats of Kitros, Pieria (Northern Aegean Sea, Eastern Mediterranean)

Spatiotemporal and physiochemical influences on the abundances and diversity of ichthyoplankton were assessed in the Thermaikos Gulf and edge habitats surrounding the Pieria (Northern Greece) artificial reef complex. The collection of data was performed in edge habitats in the marine protected area near the artificial reef offshore of Kitros. Sampling trips occurred in each season of the spring, summer, and autumn in each year from 2015–2017. This artificial reef complex lies at a distance offshore of 11.5 km from Kitros and the delta of River Aliakmonas. A bongo net sampler was used to sample ichthyoplankton over a network of 16 sampling stations. Seventy species of larval fish were identified. The greatest measures of ichthyoplankton diversity were found during warmer seasons. Non-metric multidimensional scaling showed that seasons play a significant role in species assemblages, as months during the spring, summer, and autumn from different years clustered together. Ten groups of larvae were identified to the family or genus level, such as Arnoglossus spp., Callionymus spp., Crenilabrus spp., Gobius spp., Liza spp., Scorpaena spp., Solea spp., and Spicara spp. Overall, the species with the greatest abundance was the larvae of the European anchovy (Engraulis encrasicolus). The second genera (in order of highest abundance) were Gobius spp. followed by relatively abundant (but lesser numbers of) larvae representing the families Callionymidae, Centracanthidae, and Bothidae. The largest total abundances were found in July 2015 and September 2016. The biodiversity index indicated that measures of diversity were greater in July 2015, which was the only sampling performed in the middle of the summer, and indicated higher diversity in autumn 2015. The aim of this study was to present the assemblages of fish larvae in the marine protected area surrounding the artificial reef of Kitros Pierias as the result of a 3-year sampling program (2015–2017). The novelty of this study is that it is the only study of Ichthyoplankton ever performed in Greece with seasonal repetitions and densely located stations around a coastal marine protected area.

Music education contributes to development and personal change in young adults with disabilities.

In Sweden as in many other countries, there has been increasing recognition of the importance of health, social participation, and active leisure time for people with disabilities. Against this background, a three-year music education was started for a group of young adults with disabilities in order to enhance their wellbeing, learning, and emotional and social development. The aim of the study was to evaluate the results of a 3-year education program with set goals for young adults with disabilities using a qualitative method. The study was conducted from autumn 2014 to 2018. Four semi-structured interviews were conducted with the participants, the first at the beginning of the education, after the first year, second, and third year respectively. The interviews were tape recorded and transcribed verbatim. The teachers and care staff made process notes about the development of each participant. The transcribed interviews and process notes were analyzed using Thematic Content Analysis. The education achieved its purpose and goals as evidenced by participants, teachers, and staff. It showed that music education training may revitalize people with disabilities. Furthermore, it demonstrated that persons with disabilities can learn, develop, and even change on a personal level, if they are given the right conditions.

Maintaining and Enhancing Nursing Students' Pharmacology Knowledge to Improve Patient Safety.

Nurses play a vital role in the medication administration process and are frequently involved in adverse drug events (ADEs). One identified cause of ADEs is lack of pharmacology knowledge received during their training and/or failure to maintain this core information: the latter cause has been described as skill decay. The purpose of this quality improvement project was to implement an online pharmacology review program to maintain and/or improve nursing students' pharmacology knowledge, thus decreasing skill decay over the school's summer break. Nursing students enrolled in a 4-year BSN program participated in a virtual pharmacology knowledge review program consisting of a pretest survey, learning modules, quizzes, and a final posttest survey. Comparisons showed statistical significance in test score improvement from pretest to posttest. This project demonstrates that a review program can enhance nursing students' pharmacology knowledge throughout their summer break. It adds to the limited data about the need for pharmacology programs to decrease skill decay.