Interdisciplinary Discussion Research Articles

Theoretical and methodological foundations of training future musical art teachers to play wind instruments

The purpose of the article was to clarify the theoretical and methodological foundations of training future musical art teachers to play wind instruments in an interdisciplinary discourse. Among the theoretical foundations of training future musical art teachers to play wind instruments, a number of domestic musicological and music-pedagogical dissertation studies have been identified. To implement the purpose of the publication, a complex of general scientific (analysis, synthesis, comparison, analogy, systematization, generalization, concretization), specific scientific analytical (problematic, genetic, comparative analysis of scientific sources) methods was used, with the help of which an array of domestic scientific research in the field of musicology and music-pedagogical education was systematized regarding the theoretical and methodological problems of brass performance, in particular saxophone performance, and the training of future musical art teachers to play wind instruments. It has been established that domestic performing musicology in the field of wind music began to develop actively in Independent Ukraine. The growth of research interest in the phenomenon of saxophone training and performance in the research of scientists in both art history and theory and pedagogical fields has been noted. The methodological foundations of learning to play the saxophone include instruction on holding the instrument, positions of the body, head, hands, and fingers; breath setting and embouchure; articulation; application; optimal coordination of actions of the performing apparatus. We see the prospects for further research on the problems of instrumental training of future musical art teachers in the realization of the interdisciplinary potential of musicology and music pedagogy.

P-1673. Antibiotic Stewardship in a palliative care setting reduces antimicrobial consumption and is cost-effective

Abstract Background More than 50% of patients in palliative care (PC) receive antibiotics in the final days of their life. While infection commonly occurs in this heterogenic population, clinical signs such as fever, malaise and elevation of inflammatory markers may also be attributable to the underlying disease. We evaluated the impact of a PC antimicrobial stewardship (ASP) intervention on antimicrobial consumption and cost effectiveness. Methods Starting 08/2022, the ASP and PC team of our tertiary care hospital in Switzerland conducted an interdisciplinary stewardship intervention. During weekly visits, the ASP team provided review and feedback on cases selected by the PC physicians, recommendations made were contextualized with the patient’s superordinate goals. In added teaching sequences, general stewardship principles were explained to the PC team. Cases were documented prospectively, gathering patient characteristics (i.e. age, sex, diagnoses), the ASP recommendation made regarding antimicrobials (i.e. none, start, continuation, oral switch, stop), its acceptance by the PC team (defined as realization within 48h) and hospitalization markers (i.e. length of stay (LOS), discharge location). Impact of the intervention on LOS and days of antimicrobials were estimated independently by two members of the ASP; disagreements were resolved by an arbiter. Descriptive analysis was performed, associated cost savings were calculated and offset with ASP operational costs. Proportions of recommendations made by ASP team Results Between 08/2022 and 12/2023, 96 interventions were made in 90 patients (median age 72 years), malignancy was present in 61 (68%) (Table). The most frequent recommendation was to stop antimicrobials (45%), in 17% the initiation of antimicrobials was discouraged (Figure). Overall, 96% of recommendations were accepted by the PC team, leading to an overall saving of 63 hospitalization days and 177 days of parenteral antimicrobials. Calculating the net economic effect of the ASP intervention, savings of 140’314 USD were offset by 9767 USD operational cost, resulting in overall savings of 130’547 USD. Conclusion Weekly interdisciplinary case discussions between the ASP and the PC team reduces antimicrobial consumption and hospitalization days and can be cost-effective. Disclosures All Authors: No reported disclosures

Impact of the contextual factors regarding the COVID-19 pandemic on bereavement: an integrative review of the literature from a bioethical perspective

ABSTRACT The advent of the COVID-19 pandemic has profoundly transformed grief around the world. What are the impacts of context factors regarding the COVID-19 pandemic on dysfunctional symptoms of grief? This is a study with a qualitative approach, integrative review, whose article data collection was carried out in the following databases: Biblioteca Virtual de Saúde (BVS), Portal Brasileiro de Publicações e Dados Científicos em Acesso Aberto (Oasisbr), United States National Library of Medicine (PubMed), Scientific Electronic Library (SciELO) and Web of Science. Thirty-three articles were selected for the analysis. The studies showed different results when the risk factors were detailed individually. However, the pandemic context proved to be a complex element that created vulnerability associated with grieving. Bioethics presents itself as a locus of interdisciplinary discussion for a more profound understanding of the complex specificities and, based on the social and political responsibility of Protection Bioethics to protect vulnerable populations, it is recommended to mental health professionals who intentionally explore the impacts of the pandemic on the grieving process. The suffering of people bereaved during the pandemic must be publicly recognized, offering safe spaces for reception and sharing.

Electrospun meshes for abdominal wall hernia repair: Potential and challenges.

Surgical meshes are widely used in abdominal wall hernia repairs. However, consensus on mesh treatment remains elusive due to varying repair outcomes, especially with the introduction of new meshes, posing a substantial challenge for surgeons. Addressing these issues requires communicating the features of emerging candidates with a focus on clinical considerations. Electrospinning is a versatile technique for producing meshes with biomechanical architectures that closely mimic the extracellular matrix and enable incorporation of bioactive and therapeutic agents into the interconnective porous network, providing a favorable milieu for tissue integration and remodeling. Although this promising technique has drawn considerable interest in mesh fabrication and functionalization, currently developed electrospun meshes have limitations in meeting clinical requirements for hernia repair. This review summarizes the advantages and limitations of meshes prepared through electrospinning based on biomechanical, biocompatible, and bioactive properties/functions, offering interdisciplinary insights into challenges and future directions toward clinical mesh-aided hernia repair. STATEMENT OF SIGNIFICANCE: Consensus for hernia treatments using surgical meshes remains elusive based on varying repair outcomes, presenting significant challenges for researchers and surgeons. Differences in understanding mesh between specialists, particularly regarding material characteristics and clinical requirements, contribute to this issue. Electrospinning has been increasingly applied in mesh preparation through various approaches and strategies, aiming to improve abdominal wall hernia by restoring mechanical, morphological and functional integrity. However, there is no comprehensive overview of these emerging meshes regarding their features, functions, and clinical potentials, emphasizing the necessity of interdisciplinary discussions on this topic that build upon recent developments in electrospun mesh and provide insights from clinically practical prospectives.

Formulation of Quality Improvement Methodology for Risk Mitigation in Congenital Cardiac Catheterization.

The C3PO collaborative, with a history of successful quality improvement (QI) initiatives, leveraged registry participants to develop a multi-center QI initiative to reduce adverse events (AEs) in congenital cardiac catheterization. A 32-person, interdisciplinary working group analyzed audited data for all congenital cardiac catheterization cases from 2014-2017. The primary outcome was the occurrence of any high-severity (level 3/4/5) AE. Cases were organized from shortest to longest duration, and level 3/4/5 and 4/5 AE rates were summarized for each procedure duration decile. Observations from the root cause analysis were used to inform the creation of a key driver diagram and determine change strategies and implementation tools. To facilitate pre-procedure communication and risk assessment, an online risk calculator was developed using 2014-2019 data. Between 2014-2017, 14,717 cases were entered from 10 sites. Level 3/4/5 AEs occurred in 732 (5.0%) cases, while 4/5 AEs occurred in 224 (1.5%) cases. The key driver diagram defined three drivers: (1) Pre-Procedure Risk Assessment, (2) Possibly Preventable Events, and (3) Procedure Length Optimization. Actionable change strategies organized around five communication timepoints were developed in interdisciplinary discussions. Pre-case risk calculator outputs were available as a case summary print out and incorporated into a calendar for weekly schedule planning. Pre-intervention (2019) and preliminary intervention period data (2020-2021) are presented here. Through improved resource planning, the protocol equips catheterization teams to respond efficiently to AEs and possibly prevent escalation into dangerous events. This protocol provides reproducible interventions that can be adapted to local practice.

Interfacility Transfer for VA-ECMO in Beta Blocker and Calcium Channel Blocker Overdoses: A Report of Two Cases

Introduction: Calcium channel blocker (CCB) and beta blocker (BB) overdoses are life-threatening conditions that can lead to vasoplegic and cardiogenic shock. Treatment involves a combination of vasopressors, calcium, glucagon, and/or high-dose insulin euglycemia therapy. The most severe overdoses may require venoarterial extracorporeal membrane oxygenation (VA-ECMO), which often results in interfacility transfers. This report describes two successful VA-ECMO transfers for refractory CCB/BB overdose. Case Reports: Case 1: A 56-year-old male developed severe hypotension after ingesting 40-45 tablets of 10 milligram (mg) amlodipine tablets. After initial treatment approaches were unsuccessful, an early interdisciplinary discussion facilitated timely cannulation at the initial facility and quick transfer for VA-ECMO initiation. The patient was discharged at his neurological baseline after 60 days. Case 2: A 19-year-old female presented to the emergency department after a polypharmacy ingestion including 60 tablets of 20 mg propranolol. An early interdisciplinary discussion between the medical intensive care unit, medical toxicology, and the ECMO team allowed for prompt transfer directly to the receiving hospital catheterization lab for VA-ECMO within three hours of the initial presentation. The patient was discharged to an inpatient psychiatric facility after nine days. Conclusion: Venoarterial extracorporeal membrane oxygenation for refractory shock due to CCB and BB overdoses can be a life-saving intervention. Interfacility transfer of poisoned patients for VA-ECMO is logistically challenging, which can delay the appropriate care for patients with an otherwise morbid prognosis. A streamlined interfacility transfer protocol with multidisciplinary collaboration can help optimize outcomes.

Retooling the Massive Transfusion Protocol at a Veterans Affairs Medical Center.

Massive transfusion protocols (MTPs) ensure the timely and life-saving delivery of blood products to patients who are rapidly exsanguinating. Although essential, MTPs are also highly resource-intensive. Effective MTP implementation must balance the resources of the hospital with the needs of the patient population that they serve, as well as avoid instances of unjustified activations. Toward this goal, we implemented a set of policy improvements to our institution's MTP aimed at ensuring appropriate clinical activation. Following interdisciplinary discussions with clinical teams, we revamped our institution's MTP in the spring of 2019, focusing on the improved training of junior clinicians by requiring final approval of all MTP activations by attendings and fellows, and providing opportunities to review MTP execution during quarterly meetings. Other changes included implementing blood warmers and streamlining the MTP ordering process. We then performed a retrospective study to evaluate the effects of our refurbished MTP on the frequency, characteristics, and outcomes of massive transfusions activated at the Washington DC Veterans Affairs Medical Center between March 2018 to February 2019 and March 2019 to February 2020 (before and after the policy change, respectively). Descriptive statistics were used to summarize the data. Fisher exact test, Wilcoxon test, and Poisson test were used to compare differences in categorical variables, continuous variables, and the rate of MTP activation, before and after policy changes were implemented, respectively. This study is exempt from the Institutional Review Board's review. We did not detect statistically significant changes in patient and MTP-related parameters, nor survival outcomes following policy improvement. However, we observed a decreasing trend in MTP activations, and concomitantly, a significant increase in the number of days between MTP activations, from 12.5 days (median) in the first year to 41 days (median) in the second year (P = 0.0274). In summary, we developed an MTP tailored to the needs of our Veterans Affairs Medical Center, providing a reliable system for blood product administration to patients with real massive transfusion requirements while reducing unjustified MTP activations. We credit the reduction in MTP activations mainly to improved education and training of clinicians, which, in turn, changed their ordering behaviors. Fewer unjustified MTP activations decrease the potential for wastage of resources such as blood and blood components and preserves work hours of staff for patients with true transfusion needs. We believe our strategy may have a widespread and compounding effect on improving blood stewardship nationwide, given our trainees' propensity to work at medical centers across the country and educate future trainees of their own.

Evaluation of the current status, significance, and availability of prostate MRI und MRI guided biopsy in Germany.

Evaluation of the current status, significance and availability of multiparametric prostate MRI and MRI-guided biopsy in Germany.A voluntary web-based questionnaire with 26 distinct items was emailed to members of the German Radiological Society (DRG) and the Professional Association of German Radiologists (BDR). The questions referred to personal qualification, acquisition, quality, and management of prostate MRI, and assessment of the importance of the method.In total 182 questionnaires were captured from all 10 german postal regions (over 60% of the university hospitals, almost 50% of the maximum care hospitals and approx. 12% of the practices or medical service centers). 43% of the respondents had a Q1 or Q2 quality certificate from the DRG, 10% had a certificate from the BDR, respectively. The majority (90%) criticized inadequate reimbursement of the examination. In 47% MRI cases were discussed in an interdisciplinary tumor board, in 44% case discussions happened rarely, and 12% never had interdisciplinary discussions. On a scale from 0-100 (0%: low; 100%: high) the estimation of the clinical relevance of prostate MRIs received an average of 84% (± 16%) and the estimated approval by urologists was 75% (± 21%). Lacking clinical feedback (59%) and clinical information (42%) were perceived as the largest problems.In this representative survey the respondents estimated multiparametric MRI of the prostate as highly diagnostic and relevant with an increased approval by urologists. There is still a perceived need for continuous professional education of the method for urologists and for more widespread coverage of fusion biopsy. Prostate MRI is currently primarily offered by high volume centers. Current challenges are particularly insufficient interdisciplinary communication and inadequate reimbursement. · Prostate MRI is perceived as highly diagnostic and clinically relevant.The method is currently primarily offered by high volume centers.. · Bigger current problems are insufficient interdisciplinary communication (e.g., clinical information, biopsy results) and inadequate reimbursement.. · Continuous education for urologists and expanded coverage by fusion biopsy are desirable.. · Ullrich T, Boschheidgen M, Schweyen CM et al. Evaluation of the current status, significance, and availability of prostate MRI und MRI guided biopsy in germany. Fortschr Röntgenstr 2024; DOI 10.1055/a-2416-1343.

Responsible AI and action learning

ABSTRACT This paper proposes action learning has a role to play in advancing responsible AI. Despite the recent surge in attention towards artificial intelligence, predominantly focusing on its technological and commercial aspects, the social dimensions have often been overlooked. Action learning, known for fostering interdisciplinary discourse, is proposed as a collaborative learning approach to foster responsible AI. The paper explores three potential avenues: facilitating multidisciplinary dialogue, reshaping the workforce, and promoting ethical AI practices. Emphasising the importance of cultivating critical questioning skills, we suggest an action learning approach can cultivate the innovative potential of AI, whilst mitigating its potential risks.

The Impact of Political and Cultural Changes in the European Landscape of the 20th and 21st Centuries on Children’s and Young Adult Literature

This review article discusses Political Changes and Transformations in Twentieth and Twenty-first Century Children’s Literature, edited by Bettina Kümmerling-Meibauer and Farriba Schulz (2023). The volume aims to consolidate international, interdisciplinary discourse on how political and cultural shifts in the European political landscape of the 20th and 21st centuries have influenced children’s and young adult literature. The author of the article provides a critical overview of the volume’s 17 contributions.

Trauma and Psyche in Invisible Man and the Time Regulation Institute: A Lacanian Psychoanalytical Approach

This study carefully examines Ralph Ellison’s Invisible Man (1952) and Ahmet Hamdi Tanpınar’s The Time Regulation Institute (1961), while applying Jacques Lacan’s psychoanalytic theory on identity formation as a theoretical framework. Besides their publication in a similar timeframe, both literary works delve into various themes that eventually focus on the deep trauma experienced by individuals at the time. Ellison's master work explores the racial discrimination that prevailed American society, while Tanpinar's work underscores the difficult challenges surrounding Turkish people in the middle of the turbulent years of modernization period. By applying Lacan’s concepts of the Imaginary and Symbolic orders, this analysis helps to interpret how the protagonists manage to go through instances where they face intense psychological discomfort, estrangement from societal expectations and norms, and disillusionment stemming from significant losses. More specifically, the study analyzes how trauma, consciousness, psyche and loss are portrayed and altered in different states, while shedding light on their immense influence on the characters' sense of alienation and disillusionment, discussed within the theoretical framework of Lacanian psychoanalytic theory. Through this interdisciplinary discussion, this study’s aim is to provide a wider comprehension of the complex structures of identity, trauma, and alienation portrayed in presented literature, offering acumen into the human nature within modern society.

The Deconstruction of Modern Mortality of Death: An Analysis Through Law, War, and Social Philosophy

ObjectivesThis paper aims to explore the deconstruction of contemporary mortality through a multidisciplinary approach, focusing on law, warfare, and social philosophy. It examines how modern society navigates the complexities of death, both legally and socially, and investigates the impact of warfare and aging on perceptions of mortality.Material and methodsA qualitative analysis is conducted through a review of international legal frameworks, including the Universal Declaration of Human Rights and the International Covenant on Civil and Political Rights. Additionally, case studies of modern warfare (e.g., Ukraine and Gaza) and philosophical discourse on social death are examined.ResultsThe study finds that international law prioritizes the right to life, while the right to die remains a contested issue. Modern warfare complicates traditional notions of mortality, extending death beyond the battlefield. Social death, marked by withdrawal from societal engagement, highlights the role of aging and retirement in diminishing personal identity before biological death. These findings underscore modernity’s attempt to manage and distance itself from death, while also revealing the erosion of communal coping mechanisms in the face of mortality.ConclusionsThe paper concludes that the deconstruction of modern mortality reflects a broader societal shift towards the privatization and medicalization of death. It calls for renewed engagement with mortality through collective rituals, ethical reflection, and interdisciplinary discourse. Bauman’s insights on modern mortality remain relevant, emphasizing the need for a more open, empathetic confrontation with death in contemporary society.

Making homes survival places: the experience and practices in fear of crime of young women living alone in Seoul

This study examines the vulnerability of young women living alone in Seoul, South Korea, to crime and their fear of victimization. It investigates how their experiences shape their perception of home and explores their strategies to create a sense of security within their living spaces. By conducting in-depth interviews with nine participants aged 26–31 in Gwanak-gu, Seoul, the study identifies key factors contributing to their experience and recognition of fear at home. It further highlights these women’s strategies to protect their homes and practices to alleviate anxiety and establish safety. The findings reveal that for single young women in Seoul, the concept of homes plays a significant role as a site of survival, where they strive to protect themselves and their homes from various fears and potential crime victimization. This research contributes to the interdisciplinary discourse on housing and gender studies, shedding light on the unique challenges faced by young women living alone and emphasizing the importance of understanding their experiences and developing supportive policy interventions.

Introduzione | Introduction

Writer, painter, poet, art critic and more, John Ruskin was undoubtedly a key figure in nineteenth‑century European culture (and beyond), whose multifaceted nature has been able to catalyse the interests of generations of scholars, even from distant backgrounds. Despite the numerous publications that have appeared on him over the years, Ruskin does not seem to have exhausted his appeal, lending himself – perhaps more than other figures of his time – to a multidisciplinary and interdisciplinary discourse on the arts in the broadest sense of the term.

<!--StartFragment--> The Delos Mutation: Interdisciplinary Entanglements between Biology and Architecture 1963 – 1975 <!--EndFragment-->

This article traces the interdisciplinary entanglement between biology and architecture at The Delos Symposion, a series of annual week-long architecture and urbanism symposia convened by architect and planner Constantinos Doxiadis (1913–1975), ten of which took place on a cruise ship in the Mediterranean Sea between 1963 and 1972. These Delos symposia stand out as a pioneering interdisciplinary initiative and a unique think-tank for future-oriented developments in both architectural theory and biology, united by a common interest in cybernetics. Biologist Conrad Hal Waddington (1905–1975), who attended all ten Delos gatherings, was a forerunner of such new developments in biology; at Delos he discussed how his ground-breaking theory of epigenetics would change how designers would build, plan, and conceptualize buildings and cities. This article is a critical study of how Waddington’s epigenetic theory mutated into architecture and urban theory. First, I discuss Doxiadis’ holistic urban theory of ekistics in relation to Waddington’s epigenetic theory by focusing on the notion of open-endedness in the two theories. The article then argues that the discussions on planning and design at Delos affected Waddington’s thinking, changing a structural belief in planning into a post-structural disbelief in certitude. The interdisciplinary Delos discussions about planning and architecture triggered the scientist to turn toward aesthetics and ethical epistemology as a response to an uncertain future — a transmutation that impelled ethical and epistemological developments that still resonate in critical discourses in the humanities.

P108 Immunotherapy of psoriasis in the context of underlying malignant disease: risk–benefit balance?

Abstract The recently established immunotherapeutic approaches to various malignant tumours have dramatically improved patient survival and tumour responses. Yet, they may result in a number of severe unwanted effects on various organs including the skin, which in fact makes up 20–30% of these side effects. Induction or exacerbation of psoriasis is frequent among these. Interdisciplinary care is needed to efficiently approach both tumour and organ-related side effects. This complex issue may be intensively discussed within local interdisciplinary clinical boards on chronic inflammatory diseases (ICB) and is addressed with this case report. A 67-year-old patient was diagnosed with multifocal metastasing small cell lung cancer (SCLS) of his left upper lung lobe and osseous, hepatic and soft tissue metastases. Radiochemotherapy was initiated with cumulative doses of 34 Gy and four cycles of carboplatin and etoposide as well as atezolizumab (anti-PD-L1), the latter continued for maintenance therapy. After 2 years of treatment, no pathologic lymphnodes nor organ metastases could be found with residual pneumonic condensation in his right lung. After 1 year of immune checkpoint inhibition (ICI) both psoriasis arthritis and skin psoriasis appeared with an initial PASI of 20 and a DLQI of 15 and above. The appropriate treatment within this tumour context was intensively discussed by the local ICB. Four injections of guselkumab were well tolerated, yet without any clinical effect. After 7 months of distinct improvement of both skin and joint symptoms upon bimekizumab, clinical effects waned and the therapy was changed another time to injections of adalimumab. This was well tolerated with slow improvement of skin and joint symptoms. The tumour parameters remained unchanged over time. This case demonstrates the induction of psoriasis and psoriasis arthritis by ICI, the critical risk-benefit balance of immunomodulation for psoriasis in the context of underlying malignant disease and the clinical benefit of interdisciplinary discussion within a board on chronic inflammatory diseases.

Role of the tumor board when prescribing mutant isocitrate dehydrogenase inhibitors to patients with isocitrate dehydrogenase-mutant glioma.

Isocitrate dehydrogenase (IDH)-mutant gliomas, comprising both astrocytomas and oligodendrogliomas, represent a distinct group of tumors that pose an interdisciplinary challenge. Addressing the needs of affected patients requires close collaboration among various disciplines, including neuropathology, neuroradiology, neurosurgery, radiation oncology, neurology, medical oncology, and other relevant specialties when necessary. Interdisciplinary tumor boards are central in determining the ideal diagnostic and therapeutic strategies for these patients. The key tasks of a tumor board include the evaluation of imaging findings, selecting the appropriate surgical approach, discussing additional treatment options, and identification/determination of tumor recurrence and progression. In addition to established treatments such as radiotherapy and alkylating chemotherapy, patients with an isocitrate dehydrogenase (IDH)-mutant glioma for whom additional treatment is indicated may now also have the option of receiving treatment with an mutant isocitrate dehydrogenase inhibitor such as vorasidenib or ivosidenib. In this regard, the collaborative nature of tumor boards becomes even more crucial for evaluating comprehensively the needs of these patients. Through interdisciplinary discussions, tumor boards aim to develop personalized treatment strategies that maximize therapeutic efficacy while minimizing potential side effects and preserving patients' quality of life.

ЕВРИСТИЧНИЙ ПОТЕНЦІАЛ СУЧАСНИХ ЗНАЧЕНЬ СМИСЛОВОГО ПОЛЯ КАТЕГОРІЇ «ЦІННОСТІ»

Purpose. The purpose of the article is to summarize the dynamics of changes that have taken place in the semantic field of the category of “values” and to determine their role in solving the problem of decision-making. The objectives of the study are: a) to characterize the already implemented areas of scientific research on the category of “values”; b) to identify the meanings of the category of “values” that are updated in the modern psychological and interdisciplinary discourse; c) to assess the prospects of using the identified meanings of the category of “values” in solving the problem of decision-making. Methods.The research methods used were historical, systemic and interdisciplinary approaches, which allowed to characterize new meanings in the semantic field of the category of “values”, as well as the principle of the unity of practical and theoretical knowledge. Results. The analysis of scientific approaches to transcendentalisation and subjectivisation in the study of values revealed stigmatised semantic meanings of the category “values” that do not correspond to modern scientific inquiries into the reasons for making losing decisions. Instead, in the bosom of psychology and against an interdisciplinary background, a research area related to the bio-psychological aspect of values is developing. This includes studies that focus on the dynamic, procedural nature of values. The latter makes it possible to study the disruption of the connection between the conscious and unconscious spheres, which results in mostly unconscious epiphenomena such as reality deformations, cognitive distortions, conditional values, uncontrolled actions, importation of the psyche, idealised “Self”, etc. Conclusions. The modern semantic field of the category “values” is supplemented by new meanings related to the procedural nature of values at the bio-psychic level evaluation, acquisition of values, choice as an individual trajectory of life, creation of values, conventionality of values, correlation of conscious and unconscious spheres in the process of evaluation. It is obvious that the new meanings of the semantic field of the category “values” have heuristic potential for solving urgent issues in decision-making practice.

Investigating gifted students’ higher-order thinking skills in a differentiated learning environment: A case study

Gifted learners are usually identified as students who show higher levels of aptitude or competence compared to their peers of the same age. Their advanced abilities often require specially designed educational strategies to meet their intellectual needs. By designing educational strategies that are appropriately challenging and intellectually stimulating, educators can support gifted students in reaching their full potential, ensuring that their talents are well-developed. This study aims to investigate how higher-order thinking skills (HOTs) can be developed in gifted students through their participation in an interdisciplinary project within a differentiated learning environment. The HOTs defined in this study are associated with Bloom’s upper-level taxonomy, which includes analysing, evaluating, and creating. The interdisciplinary project was designed using a “backward design” approach, incorporating three subjects: History, Islam, and Moral Education. The study focused on employing differentiated instruction in terms of both content and process. Based on the desired learning outcomes of the three courses, the “big idea” (theme), namely “Independence Commemoration,” is created to guide the instructor in designing an interdisciplinary project. A case study was adopted in the current study. The study involved 21 students, aged 15 and 16, enrolled in a high school in Northern Malaysia offering the Advanced Smart Education Program. Data was collected from interdisciplinary project discussions in Google Docs and analysed qualitatively using the content analysis method. The depth of students’ thinking levels was evaluated using the revised Bloom’s taxonomy. The findings show that the interdisciplinary project, implemented in a differentiated learning environment, was less effective in promoting students’ HOTs, as most students tended to offer superficial responses. The study discussed the challenges of designing and implementing an interdisciplinary project in a differentiated learning environment. It also outlined the implications for school and classroom practices of such a project. Additionally, the study provided recommendations or solutions to address the problems identified based on the findings.

Design of the safety climate thermometer to promote team dialogue in surgical teams, using a thematic literature review and international expert panel study

Abstract Introduction A safe work climate benefits patients and healthcare professionals. Most instruments for evaluating safety climate are lengthy questionnaires focusing on either measuring and benchmarking, or identifying areas for improvement. We aimed to design a communication instrument promoting team discussion about safety in surgical teams: the safety climate thermometer (SCT). Method First, a literature study was conducted to identify important safety themes, which were then organized into eight safety climate themes. Behavior-based assessment statements were drafted per theme. Second, an expert panel study with international experts was conducted, soliciting feedback on our initial SCT design. Their feedback led to a redesign into the SCT prototype presented in this study. Results The literature search yielded twelve existing instruments and three reviews. Twenty-two experts participated in the panel study. The final SCT prototype framed eight safety climate themes and is organized into two parts. In Part I, team members individually and anonymously evaluate team performance per theme by responding to a single statement to quickly assess global perceptions of that theme. Based on their collective scores, the team chooses one safety climate area to investigate further by scoring one set of eight in-depth statements. In Part II, a structured interdisciplinary team discussion takes place aiming to pinpoint a work floor issue and set actionable goals for improvement. Discussion/conclusion The SCT is a communication instrument for surgical teams that first focuses on identifying opportunities for improvement, and then structuring team discussion and follow-up, aiming to improve safety climate.