Educational Deficits Research Articles

COVID-19 and children: medical impact and collateral damage.

SummaryChildren mostly experience mild SARS‐CoV‐2 infections, but the extent of paediatric COVID‐19 disease differs between geographical regions and the distinct pandemic waves. Not all infections in children are mild, some children even show a strong inflammatory reaction resulting in a multisystem inflammatory syndrome. The assessments of paediatric vaccination depend on the efficacy of protection conferred by vaccination, the risk of adverse reactions and whether children contribute to herd immunity against COVID‐19. Children were also the target of consequential public health actions such as school closure which caused substantial harm to children (educational deficits, sociopsychological problems) and working parents. It is, therefore, important to understand the transmission dynamics of SARS‐CoV‐2 infections by children to assess the efficacy of school closures and paediatric vaccination. The societal restrictions to contain the COVID‐19 pandemic had additional negative effects on children’s health, such as missed routine vaccinations, nutritional deprivation and lesser mother–child medical care in developing countries causing increased child mortality as a collateral damage. In this complex epidemiological context, it is important to have an evidence‐based approach to public health approaches. The present review summaries pertinent published data on the role of children in the pandemic, whether they are drivers or followers of the infection chains and whether they are (after elderlies) major sufferers or mere bystanders of the COVID‐19 pandemic.

THE CONTRIBUTIONS OF NEUROPSYCHOPEDAGOGISM IN THE SCHOOL CONTEXT: IN THE REHABILITATION OF CHILDREN WITH LEARNING DISABILITIES IN BASIC EDUCATION

Neuropsychopedagogue in the School Context: in the Rehabilitation of Children with Learning Deficit in Basic Education. Promoting a reflection on the performance and neuropsychopedagogic contributions in the school field. Through a scientific, qualitative, bibliographic review of books, articles and documents published by theorists such as FARRELL (2008), FONSECA (2014); NIETO (2014) and The present study sought through a bibliographic review to preseent The Contributions of Collaborators; SAMPAIO (2017), VYGOTSKY apud FONTES (2003) and others. Thus, it is concluded that rehabilitation of children with learning disabilities can be a more rewarding or more frustrating job of all. The results achieved make the professional become an agent of change. On the other hand, if the work is consistent and good, the professional education will have to deal with and understand that disappointments and constraints will be inevitable. For this purpose, this research intends to contribute to the construction of actions with greater possibilities of correct answers.

The Radiology Scholars Certificate Program: A Medical Education Learning Tool

The Radiology Scholars Certificate Program (RSCP) is an extracurricular program created for preclinical medical students to address disparities in radiology education and exposure during medical school. The RSCP was designed as a year-long program for first- and second-year medical students. The 4 key components of the RSCP are: Exposure to radiology through shadowing, knowledge acquisition through self-paced case-based learning modules, knowledge application in interactive workshops, and completion of a scholarly project. Students are required to complete at least 3 hours of shadowing, attend at least 3 workshops, complete self-paced online modules, and complete a capstone project on a topic of their choosing. Pre- and post-program surveys were administered to assess trends in participants' perception of the field and imaging-related clinical knowledge. In the first year of the RSCP, 55% of the matriculating class enrolled and of those, 84% completed the program. Approximately half of participants were female. Participants demonstrated significant improvement in radiology knowledge, with average scores improving from 52.8% to 68.6% (p < .001) on the knowledge-related survey questions. Significant improvements were also observed in student-reported confidence with ordering and interpreting imaging studies and in their perceptions of the field. The RSCP is an effective tool for addressing deficits in radiology education and exposure during medical school. It is designed to be run by senior medical students under radiology resident and attending supervision. With motivated student and radiologist investment, the RSCP should be easily replicable in medical training programs worldwide.

Running on Empty: Diminished Empathetic Reserve in Frontline Nurses.

The COVID-19 pandemic has created a global health crisis. Novel and intolerable pressures have been placed upon nurses affecting their capacity to provide care. The aim of this exploratory study was to determine the impact of the COVID-19 pandemic on nursing care delivery, the empathetic response of nurses to their patients and family members, and the emotional and physical well-being of the nurses. Four frontline nurses were interviewed while in the midst of the pandemic. Common themes emerged from analysis of the nurses' narratives and included changes in role, increased workload, depersonalized and mechanical care delivery, communication challenges with patient and family members, deficits in palliative care education, perceived poor administrative support, and physical/emotional exhaustion. Clinical leaders and nursing staff have opportunities to engage in supportive endeavors, which can restore focus and regain positive perceptions, strengthen coping skills, and deliver palliative care education in response to the ongoing challenges and stressors created by the COVID-19 pandemic. Together, they can build resilience in frontline nurses and ultimately impact delivery of compassionate and empathetic care to patients.

Explaining the Status of Clinical Nursing Education: A Qualitative Research in Iran

Background: Challenges and problems of clinical nursing education are the most important factor in determining the quality of nursing students' education. Frequent assessment of the quality of nursing education without considering the existing challenges is an ineffective activity in analyzing the situation of nursing education. Objectives: This study aimed to explain the status of clinical nursing education at Jahrom University of Medical Sciences in Iran. Methods: This qualitative study based on the conventional content analysis approach was conducted at Jahrom University of Medical Sciences in 2018 - 2019. Data were collected through holding 10 semi-structured face-to-face focus group discussions (FGDs) with 110 nurses, head nurses, instructors, and students. Purposeful sampling was used and the interviews were analyzed by Graneheim and Lundman method by MAXQDA Software. Results: We obtained 626 in-vivo codes, 46 primary codes, eight subcategories (lack of attention to the evaluation process, non-participative evaluation, low staff educational cooperation, ineffective instructors, non-educational clinical space, student educational deficits, students' confusion in the clinical setting, and non-participatory planning), and three main categories (planning challenges, implementing challenges, and evaluation challenges). Conclusions: Educational leaders are recommended to shift to three areas, including democratic planning, wise implementation with frequent monitoring, and the use of modern clinical evaluation methods based on the participation of learners and other stakeholders.

ОРГАНИЗАЦИЯ ПРОФЕССИОНАЛЬНОГО САМООБРАЗОВАНИЯ ПЕДАГОГА

Self-education of a person predetermines the motivational sphere, based on the values, directions and needs of a person. In the teaching profession, the motivational sphere is determined by the aspirations for continuous development and updating of knowledge. In this regard, self-education is the core trend of the teacher’s professional activity. The federal project “Teacher of the Future” (dated December 7, 2018) aims the pedagogical community at the continuous development of professional skills, strengthening the professional readiness of the teacher in solving non-standard tasks in the field of education, and enhancing the cognitive activity of the teacher, taking into account his educational deficits. Thus, professional self-education of a teacher becomes a vector of his career growth and development. The success of the implementation of these processes depends on the conditions created in the practice of education for the teacher. The organization of professional self-development implies, firstly, the actualization of the teacher’s motivational potential for self-educational activity by activating incentives for professional self-development. Secondly, the implementation of competent assistance and support to the teacher requires the enrichment of the content of his professional activity with value orientations and attitudes towards self-education. Thirdly, professional self-education of a teacher can be organized in various forms, taking into account the possibilities of additional (formal and non-formal) education. However, the most effective ways of organizing professional self-education of a teacher today are information technologies. Modern means of communication, computer technologies, software and various information resources make it possible to work with information in a new way, activating the professional resources of teachers in building a self-educational trajectory. The potential of information technologies in the process of self-education provides variability, individualization, flexibility, continuity in mastering new or improving existing knowledge.

Health Literacy Perceptions and Knowledge in Pediatric Continuity Practices.

Background:Low health literacy affects one-third of adults in the United States and can have a negative effect on health behavior and outcomes.Objective:The goal of this study was to examine attitudes and knowledge of health literacy among pediatric residents and faculty in pediatric resident continuity clinics across the country.Methods:An online mixed-methods survey was distributed to pediatric faculty and residents through the Academic Pediatric Association's Continuity Research Network. The 20-question survey included questions about the participants' health literacy knowledge and health literacy practices in continuity clinics, such as use of universal health literacy precautions. Categorical answer choices were dichotomized into positive and negative groupings and resident and faculty responses were compared using the Chi-squared test (significance p < .05). Qualitative data were analyzed using emergent coding and grounded theory to determine themes.Key Results:Responses were received from 402 individuals at 24 pediatric residency programs. Most participants agreed or strongly agreed that they could correctly identify participants with low health literacy (76% residents vs. 53% faculty). Only 19% of residents and 26% of faculty were familiar with universal health literacy precautions. Many residents and faculty had received no training in health literacy (37% residents vs. 38% faculty). Barriers and challenges around health literacy included time, language, limited training or resources, low literacy, disease mismanagement, and fixed misconceptions.Conclusion:Despite ample evidence in the literature to the contrary, most respondents believed they could correctly identify individuals with low health literacy. Additionally, most participants had not heard of universal health literacy precautions and were unaware of their usage in their practice setting. This is not consistent with current expert recommendations. These findings are troubling as they are from academic residency programs, indicating an educational deficit. These findings point toward a next step in health literacy education for pediatric residents. [HLRP: Health Literacy Research and Practice. 2022;6(1):e51–e60.]Plain Language Summary:Pediatric residents and faculty in continuity clinics were surveyed about their opinions, health literacy knowledge, ability, and practices in continuity clinics. Despite evidence to the contrary, most respondents believed they could correctly identify individuals with low health literacy and had not heard of universal health literacy precautions. These findings highlight the need for more health literacy education for pediatric residents.

Medical Student Attitudes Towards Nutritional and Exercise Science Integration

Background Application of the fundamental principles of nutrition and exercise in clinical management can improve the outcomes of highly fatal diseases. The purpose of this study is to assess whether a knowledge gap in preventative measures of nutrition and exercise exists amongst medical students. We aim to see if current medical education provides students with the appropriate background for applying preventative medicine principles to clinical practice. Method Study participants were pooled from current 1st, 2nd, and 3rd year medical students. Of the total 614 students contacted, 42 1st year, 49 2nd year, and 45 3rd year students completed the survey. The survey consisted of 20 questions based on a 10-point Likert Scale that asked students to assess their own self-confidence on various aspects of nutrition and exercise education. Survey responses were aggregated and separated by year of medical training. Average response scores for each cohort were compared using a Mann-Whitney U test. Results Across the three classes, average self-confidence levels in baseline nutrition and exercise understanding were less than 6.6/10, and average confidence in their ability to educate patients on nutrition and exercise needs were less than 6.61/10. Yet, the average score for student perception of the importance of preventative medicine education was greater than 7.5/10. There were no statistical differences in scores amongst the three cohorts for 19 of 20 questions. Conclusion Finding no significant difference between self-confidence in an average 1st year and an average 3rd year medical student suggests an educational deficit in the current curriculum model. The self-confidence scores presented are concerning for poor understanding of exercise and nutritional science principles which could result in poor delegation of preventative advice in the clinical setting. As such, it appears that the current education model is not preparing students for counseling on patients regarding nutrition and exercise.

Оценка и развитие профессионализма преподавателей высшего педагогического образования: изменения концепции и технологии

The problem of assessing the quality of education today is relevant. There are many problematic questions: What should the technologies for implementing the links between school teachers and schoolchildren’s learning outcomes be? How to identify these connections and work with them? Is it possible to establish multidimensional relationships between the activities of a teacher, the results of students, between the competencies of a teacher and the quality of their professional training at the university? In Tomsk Oblast, the research is being carried out in two areas: (1) development and testing of a technology that makes it possible to analyze the learning outcomes of schoolchildren and establish the relationship between these results and the level of teachers’ professionalism, (2) establishment of a relationship between the identified deficits in the subject and methodological competencies of teachers and the quality of their professional training at a pedagogical university. In the first direction of work, the results of research on assessing the level of school teachers’ competence were summarized. The study used machine learning methods. The data obtained in educational institutions of Tomsk Oblast for the period from 2015 to 2019 (unified state exam in mathematics, physics, Russian language, and social studies) were processed. This work made it possible to identify learning difficulties among schoolchildren, and then to connect these difficulties with a lack of competencies in the professional activities of their teachers. In the second direction of the research, the goal is set: the development of a new concept for the assessment and development of the professionalism of teachers in the system of higher pedagogical education. The object of study is the system of continuous professional development of teachers in the system of teacher education. The study uses the methods of theoretical analysis, structural analysis, analysis of products of activity, focus group, method of expert assessments, educational design. The types of interdependence of professional and educational deficits of different subjects of educational activities are described. These types of connections are important for achieving the integrity of the assessment system, developing the professionalism of professors of teacher education and structuring managerial actions to ensure the quality of general and teacher education in the logic of their relationship. The following conclusions are made. (1) The proposed concept of assessing and developing the professionalism of professors of a pedagogical university is an element of a system for achieving the quality of school and university pedagogical education in the “school student – teacher – university teacher” logic. (2) An assessment of the level of teachers’ professional competences shows deficits that need to be addressed. (3) Changes in the preparation of students can be based on the analysis of professional deficits of teachers, which makes it possible to change the preparation of students, including ensuring the prevention of deficits.

82 Surgeons Don’t Just Operate: Improving Junior Surgical Practitioners’ Non-Technical Skills Outside of the Operating Theatre Using High-Fidelity Simulation

The non-technical skills of surgeons play a significant role in patient confidence, experience and safety The aim of the study was to improve non-technical skills and confidence of junior surgical practitioners regarding DNACPR conversations and obtaining operative consent.We have developed a speciality-specific course to address the educational deficit surrounding non-technical skills outside of the operating theatre, focussing on DNACPR and consent, for junior surgical practitioners. It was piloted at Aintree University Hospital with their Orthopaedic Department. We combined lectures and workshops delivered by subject matter specialists with simulated scenarios. The simulated scenarios were debriefed by human factors specialists using the gold standard validated NOTSS tool The pilot course in June was a resounding success; candidate confidence scores increased significantly across both skills and knowledge surrounding capacity, consent and DNACPR. All attending candidates have recommended the course to their peers and suggested integration into the Foundation training curriculum. However, identifying and implementing courses appropriate for all foundation doctors with such a specialized course would be challenging. Most foundation doctors have at least one placement in a surgical specialty. Therefore, it is more realistic to adjust the course to become less specialized, encompassing all the surgical specialities, to target all foundation doctors initially instead of juniors in each speciality. Following the capture of foundation doctors, the second phase of implementation will return to speciality-specific courses to address the learning needs of non-medical practitioners, such as Physician Associates and Advanced Nurse Practitioners, working in surgical departments.

Проучване потребностите на студенти педагози от подготовка за реализиране на свързаността „формално – неформално образование“

The article presents a survey of pegagogy students’ training needs for realisation of the connectivity “formal – non-formal education”, in response to the current challenges to education in our country. It is accepted that education is a systemic object, functioning on the basis of the relationships between its constituent formal and non-formal subsystems. The connectivity of the subsystems through the applying of two key paradigms is presented argumentatively: (1) a connectivity as a whole and a continuum and (2) a connectivity such as sharing and interdependence. This connectivity is measurable in complementarity, compensatory support, mutual support and mutual corrective. To determine pegagogy students’ training needs for realisation of the connectivity “formal – non-formal education”, a survey was conducted in the period May – July of the academic year 2020/2021, with 96 respondents from the St. Cyril and St. Methodius University of Veliko Tarnovo – Vratsa Branch and Sofia University “St. Kliment Ohridski”, which constitute a general sample. The study focuses on the connectivity between formal and nonformal education at the following levels: normative level, content level, activity level and level “results of activity”. The data collection tool is a structured questionnaire with closed-ended items, developed by the author and provided to the respondents via an access link. Based on the survey data, it should be summarized that students have needs for realistion of the connectivity “formal – non-formal education” in each of the levels and to the connectivity as a whole. And just the connection “formal – non-formal education” is what will contribute to overcoming the deficits in modern education, as an essence and manifestation in the aspects of goals, content, activities, results.

Cash transfers and the mental health of young people: Evidence from South Africa's child support grant

This study examines the longitudinal impact of the South African Child Support Grant (CSG) on risk for depression and life satisfaction among young people (15–19 years). We analysed data from the last three waves of the National Income Dynamics Study (NIDS), a nationally representative panel survey that took place every two years from 2008 to 2017. We used an instrumental variable (IV) approach that exploits multiple changes in age eligibility from 1998 to 2012. Depressive symptoms were assessed using an 8-item version of the Centre for Epidemiological Studies Depression Scale; participants who scored above 8 were considered at risk for depression. Life satisfaction was rated on a scale of 1 (‘very dissatisfied’) to 10 (‘very satisfied’); participants who scored 8 or above were classified as satisfied. We also examined impacts on educational deficit (≥2 years behind) and not being in education, employment or training (NEET) as secondary outcomes, as these are also important for mental health. Age eligibility strongly predicted CSG receipt at Wave 3. In instrumental variable models, CSG receipt did not influence the risk for depression (β = 0.10, SE = 0.10, p = 0.316), nor life satisfaction (β = −0.07, SE = 0.09, p = 0.420) at Wave 3, nor at Waves 4 or 5. Some improvements in educational deficit were observed at Wave 3 among CSG beneficiaries compared to non-beneficiaries. These results were robust to multiple specifications. CSG receipt did not improve the psychological wellbeing of adolescents and young adults, nor did it improve their education or employment outcomes. Our findings highlight the need to identify alternative social policies that address the root causes of youth social disadvantage, in conjunction with targeted approaches to improve the mental health of young South Africans living in poverty.

Abstract 1122‐000134: Social and Cultural Barriers to Global Stroke Care

Introduction : Comprehensive stroke centers require resource‐intensive patient care and supportive divisions. Resource underutilization can include: traditional beliefs about etiology of stroke, transportation barriers, or an inability to recognize early symptoms of stroke. We explore the available literature to determine region‐specific social and cultural barriers to obtaining stroke care. Methods : A literature review was performed to identify studies that described stroke care in low‐income and middle‐income countries (LMICs). We used the search term “stroke” along with the following terms: “burden”, “incidence”, “prevalence”, “awareness”, “transportation”, “stroke services”, “rehabilitation” “tissue plasminogen activator”, “acute stroke”, “emergency care”, “infrastructure”, “stroke services”, “quality improvement”, and “stroke units”, between January 1st, 2015 and August 1st, 2021. Forty‐five articles were identified. Results : We identified two broad limitations to expanding stroke care across the globe: infrastructure and education/ culture. We subdivided stroke care regionally into Middle East and North Africa (MENA), Europe, Asia, Latin America, and Subsaharan Africa. In MENA, religious health fatalism scores on questionnaires are negatively correlated with adherence to rehabilitative protocols and stroke outcome. Increased faith engagement conversely is strongly correlated with improved psychiatric outcome following stroke, indicating a role in properly educating Middle Eastern citizens regarding stroke etiology and urgency of treatment. In Europe stroke mortality and incidence is greater in rural areas in the region, likely indicating transit‐related difficulties in obtaining stroke care or deficits in education regarding lifestyle‐based measures to reduce vascular disease. Low per capita numbers of stroke‐specific care units in southern and eastern countries indicate a significant care access need in rural and low‐resource regions. For Asia, a lack of major infrastructure obstacles to wider accessibility of EVT, especially among developing countries. Only 6.5% in a nationwide survey in China were aware that there was a therapeutic window for thrombolytic therapy in 2016, increased to 32.8% after a 2 year nationwide campaign. The adept use of social media to target high‐risk populations can improve awareness of therapeutic windows. Ethnic and socioeconomic disparities are especially pronounced in this region. The RESILIENT trial demonstrated the effectiveness of EVT in Brazilian public hospitals, which helped convince the government to change policy and promote the use of EVT. Similar trials could be used to convince other governments to shift policy and promote the use of EVT as standard of care in public hospital systems. Some African communities consider stroke to be an illness of debilitating/ paralytic, ghost, or shivering etiology. Many communities rely on non medical means of care. A survey at Ignance Deen Neurology ward in 2014 revealed that only 2% of stroke patients arrived in an ambulance while 46% came by public transport and 27% arrived by personal car. Conclusions : Social and cultural barriers to obtaining stroke care are based on lack of availability and patient trust. Trust in care and compliance with preventive/rehabilitative measures may be helped by connecting NGOs such as Stroke Angels and Mission Thrombectomy 2020 with community‐based/ religious leaders to correct assumptions about origin and treatment. Targeted, culturally‐relevant messaging may help to increase awareness about symptoms, risk factors, and etiology.

Personal principles for a roadmap to educational recovery in the 'Covid decade'

The Government's roadmap to recovery from the educational deficit caused by Covid-19 appears to pivot, primarily, on 'catch-up' plans and 'discipline hubs'. Despite continuous teaching online and in Covid-restricted classroom formats, teachers have been urged to act like 'absolute heroes' and abide by their 'moral duty' to keep schools open. However, neither appeals to 'heroic' duty nor Nolan's Seven Principles of Public Life, are likely to provide the conceptual underpinning required of a roadmap to meet the complex challenges of children's new learning needs or enhance their wellbeing. This article offers an alternative approach to educational principles for navigating the unchartered territory of the 'Covid decade' now unfolding.

Characterization of Educational and Behavioral Intervention Trials in U.S. Oncology Specialties

Disproportionate educational deficits in U.S. minority cancer populations have been linked to decreased therapy compliance, suboptimal disease outcomes and low clinical trial enrollment rates. Investigating strategies to improve patient education and health-promoting behaviors is therefore critical to mitigating disparities in oncology. In this study, we characterized for the first time all current educational and behavioral intervention (EBI) studies in U.S. cancer specialties.EBI clinical trials registered on clinicaltrials.gov with completed, active or planned enrollment of adult cancer patients were collated. Clinical trials that were terminated, withdrawn or suspended were excluded from the analysis. EBI trial records were individually appraised and assigned into one of four subtype categories: prevention/screening, treatment experience/compliance, survivorship or clinical trial receptiveness study. EBI trials were further binned based on cancer specialty and type of target demographic. EBI study subtypes were compared between specialties using Chi-squared tests of independence.A total of 654 trials were reviewed, 567 met inclusion criteria. Trial subtype composition is summarized in Table 1. EBI trial subtypes included: 1) 225 prevention/screening (39.7%), 210 treatment experience/compliance (37%), 118 survivorship (20.8%), and 14 clinical trial receptiveness (2.5%). EBI trials with a recruitment focus of racial/ethnic minorities and women were 79 (13.9%) and 128 (22.6%) respectively, most of which are within medical oncology (P < 0.0001). Radiation oncology had no minority focused, survivorship or clinical trial receptiveness studies.We provide the first report of U.S. EBI trials in adult oncology. Interventions targeted towards racial/ethnic minorities are lacking in oncology and are non-existent in radiation oncology. In addition to developing EBI efforts with racial/ethnic minority cancer populations, studies aimed at improving survivorship and clinical trial receptiveness and enrollment within radiation oncology are greatly needed.

A PHARMACOVIGILANCE STUDY OF HUMAN CHORIONIC GONADOTROPIN-ASSOCIATED ADVERSE EVENTS IN MALES

Human chorionic gonadotropin (hCG) is an exogenous analog of luteinizing hormone (LH). The only FDA-approved indication for males is to treat hypogonadotropic hypogonadism and cryptorchidism. hCG is used off-label to treat other conditions, including hypogonadism with various etiologies and infertility. Thus, little has been reported on the adverse side effects of hCG. We sought to explore the W.H.O pharmacovigilance database (VigiBase), the world's largest pharmacovigilance database, based on spontaneous individual case safety reports (ICSR), in order to report adverse events associated with the use of hCG. We conducted a pharmacovigilance study using VigiBase on hCG use in men. We used reporting odds ratio (ROR), a surrogate measure of association used in disproportionality analysis, with 95% confidence intervals (CI), and descriptive demographic statistics were calculated. Conclusively for ease of interpretation, related indications and adverse events were grouped. Furthermore, we ran sensitivity analyses on indications, age, and gender to mitigate uncertainty in our results. A total of 530 adverse events of hCG usage in men were identified; only 308(58.11%) had indication reported. Age demographics were; 157(29.62%) children, 241(45.47%) adults, 132(29.91%) unknown age. There was a significant disproportionally signal with dosing and administration errors 75(14.15%) (ROR, 5.313; 95% CI, 4.162-6.784), reproduction and fertility disorders 13(2.45%) (ROR, 12.117; 95% CI, 6.987-21.012), testicular and epididymal disorders 13(2.45%) (ROR, 102.245; 95% CI, 58.919-177.430), and penile disorders 4(0.75%) (ROR, 41.819; 95% CI, 15.627-111.908). In our pediatric sub-group, edema, whether facial, peripheral, or generalized, represented 12.73% of adverse events, with a significant disproportionally signal (ROR, 10.052; 95% CI, 5.579-18.115). Main indications included; 85(16.03%) hypogonadism, 74(13.96%) cryptorchidism, 41(7.73%) anabolic steroids and substance abuse, 32(6.03%) hypothalamo-pituitary disorders, 30(5.66%) infertility, and testicular failure. We report the first global pharmacovigilance study of hCG usage and adverse events in males. hCG appears to be associated with a spectrum of perhaps under-appreciated relevant physical side effects. Additionally, we noted a strong association of dosing and medication errors which raises concern about deficits in patient education and medication packaging for hCG, suggesting further investigational studies.

Free Educational Android Mobile Application for Radiobiology

The use of mobile devices and applications dedicated to different medical fields has improved the quality and facilitated medical care, especially in the last 10 years. The number of applications running on the software platforms of smart phones or other smart devices is constantly growing. Radiotherapy also benefits from applications (apps) for TNM staging of cancers, for target volume delineation and toxicity management but also from radiobiological apps for calculating equivalent dose schemes for different dose fractionation regimens. In the context of the increasingly frequent use of altered fractionation schemes, the use of radiobiological models and calculations based on the linear quadratic model (LQ) becomes a necessity. We aim to evaluate free radiobiology apps for the Android software platform. Given the global educational deficit, the lack of experts and the concordance between radiobiology education and the need to use basic clinical notions of modern radiotherapy, the existence of free apps for the Android platform running on older generation processors can transform even an old smart device in a powerful “radiobiology station.” Apps for radiobiology can help the radiation oncologist and medical physicist with responsibilities in radiotherapy treatment planning in the context of accelerated adoption of hypo-fractionation regimens and calculation of the effect of treatment gaps, a topic of interest in the COVID-19 pandemic context. Radiobiology apps can also partially fill the educational gap in radiobiology by arousing the interest of young radiation oncologists to deepen the growing universe of fundamental and clinical radiobiology.

Exploring the educational needs of Australian naturopaths (eNAT): A cross-sectional study

IntroductionTo ensure clinical competency, and to facilitate the delivery of safe and effective care, it is important that continuing professional development (CPD) offerings for health professionals are relevant, appropriate and accessible. In the field of naturopathic medicine, there has been no research seeking to understand the educational needs and preferences of this workforce. This cross-sectional study aims to address this knowledge gap. MethodsAustralian adults holding a formal qualification in naturopathy were invited to complete a novel 29-item online questionnaire, comprising items on knowledge/skill gaps, knowledge/skill development, education delivery preferences and education barriers. ResultsOne-hundred-ten naturopaths completed the survey. The most frequently reported knowledge and skills gaps of undergraduate naturopathic training were pathology test interpretation and business development/administration, respectively. Across the four broad areas of professional/clinical skills, clinical specialities, populations and clinical settings, respondents rated, respectively, effective patient education, mental health, care of adult populations, and working in integrative health care settings as high value or important areas for further education. Respondents indicated a preference for CPD to be delivered via seminars/workshops, webinars, journals and conferences, with a penchant for blended or online delivery. Correspondingly, most respondents reported cost and distance as major/moderate barriers to further education. DiscussionThis study has identified several important knowledge/skills deficits in Australian undergraduate naturopathic medicine education. An important next step of this work is the translation of findings into future naturopathic medicine curricula and CPD offerings.

A human rights approach: The right to education in the time of COVID‐19

A human rights approach: The right to education in the time of COVID‐19

Association of Social Determinants of Health and Their Cumulative Impact on Hospitalization Among a National Sample of Community-Dwelling US Adults

ImportanceWhile the association between Social Determinants of Health (SDOH) and health outcomes is well known, few studies have explored the impact of SDOH on hospitalization.ObjectiveExamine the independent association and cumulative effect of six SDOH domains on hospitalization.DesignUsing cross-sectional data from the 2016–2018 National Health Interview Surveys (NHIS), we used multivariable logistical regression models controlling for sociodemographics and comorbid conditions to assess the association of each SDOH and SDOH burden (i.e., cumulative number of SDOH) with hospitalization.SettingNational survey of community-dwelling individuals in the USParticipantsAdults ≥18 years who responded to the NHIS surveyExposureSix SDOH domains (economic instability, lack of community, educational deficits, food insecurity, social isolation, and inadequate access to medical care)MeasuresHospitalization within 1 yearResultsAmong all 55,186 respondents, most were ≤50 years old (54.2%), female (51.7%, 95% CI 51.1–52.3), non-Hispanic (83.9%, 95% CI 82.4–84.5), identified as White (77.9%, 95% CI 76.8–79.1), and had health insurance (90%, 95% CI 88.9–91.9). Hospitalized individuals (n=5506; 8.7%) were more likely to be ≥50 years old (61.2%), female (60.7%, 95% CI 58.9–62.4), non-Hispanic (87%, 95% CI 86.2–88.4), and identify as White (78.5%, 95% CI 76.7–80.3), compared to those who were not hospitalized. Hospitalized individuals described poorer overall health, reporting higher incidence of having ≥5 comorbid conditions (38.9%, 95% CI 37.1–40.1) compared to those who did not report a hospitalization (15.9%, 95% CI 15.4–16.5). Hospitalized respondents reported higher rates of economic instability (33%), lack of community (14%), educational deficits (67%), food insecurity (14%), social isolation (34%), and less access to health care (6%) compared to non-hospitalized individuals. In adjusted analysis, food insecurity (OR: 1.36, 95% CI 1.22–1.52), social isolation (OR: 1.17, 95% CI 1.08–1.26), and lower educational attainment (OR: 1.12, 95% CI 1.02–1.25) were associated with hospitalization, while a higher SDOH burden was associated with increased odds of hospitalization (3–4 SDOH [OR: 1.25, 95% CI 1.06–1.49] and ≥5 SDOH [OR: 1.72, 95% CI 1.40–2.06]) compared to those who reported no SDOH.ConclusionsAmong community-dwelling US adults, three SDOH domains: food insecurity, social isolation, and low educational attainment increase an individual’s risk of hospitalization. Additionally, risk of hospitalization increases as SDOH burden increases.