Personal Understanding Research Articles

A biopsychosocial approach to death, dying, and bereavement: a course on end-of-life education for medical students

Background: Despite the inevitable nature of death and dying, the conversations surrounding this subject are still uncomfortable for many physicians and medical students. Methods: A six-week humanities-based course, “A Biopsychosocial Approach to Death, Dying, & Bereavement,” at Cooper Medical School of Rowan University, United States, which covers definitions of death and dying, the process of dying, ethical dilemmas, and new concepts of the grieving process. Through development of a curriculum using various academic and medical literature and resources, we sought to bring attention to the necessity of having a medical education curriculum on death and dying to prepare medical students for the difficult conversations and patient experiences that lie ahead of them. Qualitative data in the form of surveys and reflection papers submitted by students and quantitative data (Likert scores on course satisfaction) were collected and analyzed both pre- and post-course. Results: 90.7% (49/54) of the respondents answered that they agree or strongly agree with the statement that this selective course was useful in the student’s medical education experience. The top three qualitative themes brought up the most in reflection papers (n=54) were: the utility and instruction of the course (21 times), the importance of hospice and palliative care (20 times), avoidance around topics of death (15 times). Conclusions: Medical students are often not prepared to cope with the realities of patient loss and of caring for the patient and their families throughout the dying process. We created this course to familiarize medical students with an aspect of the medical experience that is frequently neglected in traditional medical curricula. We learned that integrating such a course can help educate medical students facilitate important conversations, teach them to act with kindness and dignity in a physician-patient setting, and enhance their personal understanding of death and dying.

Towards reduction of preventable hospital readmission: Older people and family members' views on planned self-management of care at home.

To reduce the likelihood of preventable readmissions, the aim was to investigate how older people (with their family members) managed their chronic health conditions at home following hospital discharge. The objectives explored older people and their family members' perspectives on how discharge plans assisted self-management of their chronic conditions, their recognition of deterioration and when to seek treatment/re-attend hospital. Chronic conditions have challenged older adults' self-management, particularly after hospital discharge and can impact on preventable readmission. Few studies have examined patients' and their family members' perspectives on the management of their conditions at home after hospitalisation. A qualitative exploratory design known as Interpretive Description was utilised. Purposeful sampling involved 27 community-dwelling older adults; nineteen were discharged patients with one or more chronic health conditions. Eight nominated family members were also recruited to enhance understanding of the older persons' self-management at home. Interviews were undertaken and thematic data analysis followed the COREQ guidelines. Five themes emerged: (1) Post-Discharge Advice; (2) Managing at Home; (3) Recognition and Response to Deterioration; (4) Community Care and Support; and (5) The "Burden" on Others of Post-Discharge Care. Older people sought a clear plan for self-management at home prior to discharge. This plan should contain potential signs of deterioration and guidance on future action. We found that support given to older people from family and friends was critical to prevent readmission. In addition, their local General Practitioner and Pharmacist played an essential part in the support of their care. For some, social support services were also important. Nurse telephone follow-up in the week following discharge was mostly absent. However, this strategy would be strongly recommended. To mitigate against preventable readmission, we recommend the above strategies to assist the older person at home with self-management of their chronic conditions.

Educational Data Mining by Optimally Fusing Shallow and Deep Features.

In order to meet the requirement of designing the educational curriculum and extract the relevant data toward students, we in this paper utilize the deep learning architecture to study the personalized understanding and educational feature extraction algorithm of the high school and college students. Aiming at the insufficiency of deep collaborative filtering recommendation algorithm that can only discover the paths that have attracted students' attention, the requirements of intelligent course are proposed by us. First, the word vector permutation discourse poke model is extracted to produce audible vectors of message data, a well-designed learning algorithm is proposed subsequently to extract and fuse multiple heterogeneous educational data. Then, the SVD algorithm program is used to reduce the range of feature vectors. And thus, the model is completely functional and we identify unified channels and users. The method of combining hand-extracted low-level features with high-level human gesture features (image visual gate features and image deep features) automatically extracted by our adopted deep network is used to identify students' various emotions. The conclusive product is a flat semantic description that effectively detects copying and objection. Experiments are performed on a generic dataset, and we use the old-fashioned manual birth method and two well-known data sets VGG16 and fine-tune AlexNet.

A general theory of consciousness II: The language problem

ABSTRACT It is generally assumed that what we hear in our head is what we think and that, when we tell a thought to somebody else, the other person understands what our thought has been. This paper analyzes how we think and what happens when we communicate our thoughts verbally to others and to ourselves. The assumption that we become conscious in language is erroneous: verbal communication is only an intermediary. The conscious experience of verbal communication is a sensory phenomenon. We think through sensory images (see Part I). This natural way of thinking, is a very refined and accurate method of translating thought into consciousness. It expresses our essentially unconscious neural cognitive activity in conscious sensory images: visual thinkers ‘see’ what they have thought. Why humans use verbal communication to express their thoughts to themselves is difficult to understand as the verbal way is extremely limited. The complex parallel cognitive activity has to be encoded into language tokens which are positioned sequentially as a string of symbols which somehow must express something comparable. Talking to oneself is directed to an imaginary person who is assumed to be the talking person himself. This imaginary person develops with the inner voice in infants and when the child grows up, that imaginary person remains there, somebody he talks to when he thinks and to which he attributes his feelings and his actions. The imaginary person is experienced as the human Self, but actually verbalizes the thoughts of the natural – animal – Self.

Assessing Barriers to use of the Specific Carbohydrate Diet in Pediatric Inflammatory Bowel Disease: A Qualitative Study.

We conducted semistructured interviews with parents of 10 children with IBD receiving care at a single academic treatment center. Parents were eligible if their child with IBD was either currently on the SCD, previously on the SCD, or opted not to initiate the SCD. Core questions were developed in conjunction with IBD clinical experts. Interviews were transcribed and analyzed using an inductive approach. Parents of children diagnosed with IBD primarily chose to try the SCD because of concerns about medication safety. Three major barriers to utilizing the SCD emerged: cost, time commitment, and psychosocial impact. Many parents also expressed that following the SCD got easier over time and some parents experienced spillover effects of improved personal health and understanding of nutrition. All parents were strong proponents of the importance of diet in managing IBD and expressed desire for more research into the SCD and other forms of dietary therapy. These findings provide important insight into factors affecting utilization of the SCD in pediatric IBD. Further research is needed to develop interventions or strategies to diminish these barriers and enable more patients to benefit from the SCD.

Review: Civil Religion Today: Religion and the American Nation in Twenty-First Century, edited by Rhys H. Williams, Raymond Haberski Jr., and Philip Goff

Review: <i>Civil Religion Today: Religion and the American Nation in Twenty-First Century</i>, edited by Rhys H. Williams, Raymond Haberski Jr., and Philip Goff

INDEKS LITERASI KESEHATAN KELUARGA PENDERITA ISPA PADA BALITA DI WILAYAH KERJA PUSKESMAS BETUNGAN KOTA BENGKULU

&lt;p&gt;Health literacy is a person's understanding of the application of health in everyday life, both in prevention, treatment, treatment, and making appropriate and fast decisions. Bengkulu Province is one of the five provinces with the highest prevalence of ARI nationally and is one of the causes of most deaths in children under five. This type of research is quantitative descriptive and data collection techniques using interview guidelines using questionnaires. The results of the study found that children and toddlers who were most infected with ARI were children aged 16 months to 5 years, with a total of 50 respondents. The literacy index of families with ARI sufferers in children under five in the Betungan of Bengkulu Health Center is still inadequate, and this is related to the limited activities of health promotion activities.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;Keywords: Health Literacy, ARI, Toddler&lt;/p&gt;

Distinctive character and added value of civil society organizations - a collaborative project within the Swedish integration system

ABSTRACT Expectations on collaboration between public authorities and civil society organizations (CSOs) have increased in Sweden the past decades, partly due to changes in the organization of welfare services. This article investigates a collaborative project within the migrant integration policy area. It is a collaboration between the employment offices in a region of Sweden and local CSOs with the common goal of easing the integration of migrants. Theories about civil society as service providers emphasize a possible added value of these non-statutory services related to CSOs distinct character. This link has seldom been empirically investigated. This article explores the distinctive character and added value of CSOs as they unfold in a collaborative project. Two previous studies were conducted by the researchers and this study is an extrapolation of the results. The analysis shows that discrepancies between CSOs and public authorities related to both ideology and organizational logics can be linked to an added value for the participants of the project. Paradoxically, the tensions and discrepancies enabled activities revolving around a more personal and informal understanding of integration that departed from the government agencies’ agenda whilst at the same time being enabled through the collaboration with them.

A biopsychosocial approach to death, dying, and bereavement: a course on end-of-life education for medical students

Background: Despite the inevitable nature of death and dying, the conversations surrounding this subject are still uncomfortable for many physicians and medical students. Methods: A six-week humanities-based course, “A Biopsychosocial Approach to Death, Dying, &amp; Bereavement,” at Cooper Medical School of Rowan University, United States, which covers definitions of death and dying, the process of dying, ethical dilemmas, and new concepts of the grieving process. Through development of a curriculum using various academic and medical literature and resources, we sought to bring attention to the necessity of having a medical education curriculum on death and dying to prepare medical students for the difficult conversations and patient experiences that lie ahead of them. Qualitative data in the form of surveys and reflection papers submitted by students and quantitative data (Likert scores on course satisfaction) were collected and analyzed both pre- and post-course. Results: 90.7% (49/54) of the respondents answered that they agree or strongly agree with the statement that this selective course was useful in the student’s medical education experience. The top three qualitative themes brought up the most in reflection papers (n=50) were: the utility and instruction of the course (23 times), the importance of hospice and palliative care (23 times), and respecting patient autonomy (16 times). Conclusions: Medical students are often not prepared to cope with the realities of patient loss and of caring for the patient and their families throughout the dying process. We created this course to familiarize medical students with an aspect of the medical experience that is frequently neglected in traditional medical curricula. We learned that integrating such a course can help educate medical students facilitate important conversations, teach them to act with kindness and dignity in a physician-patient setting, and enhance their personal understanding of death and dying.

Analysis and Application of Gymnastics Sports Characteristics Based on Artificial Neural Network and Intelligent Optimization

Gymnastics has attracted people’s attention in various competitions by virtue of its beautiful movements and difficult technical performances. The research and exploration of neural network theory are to make the process from receiving instructions to completing actions in one go while sending instructions. Compared with the previous competitive gymnastics, it mainly relies on personal understanding and coach’s guidance to get high-scoring movements. Through intelligent calculation, it can decompose and calculate each movement in detail and adjust its strength, so as to further improve its excellent characteristics. We combined artificial neural network and intelligent optimization method to achieve more scientific and reasonable guidance for gymnastics, so that people can get better performance in performance and competition. The experimental summary of this paper is as follows: (1) Under the analysis of sample data 5000, it shows that the right segmentation curve is superior to the left segmentation curve and is relatively stable. (2) The BP neural network is obviously higher than the other two algorithms in the experimental test under different dimensions, and the qualified dimension value is controlled within the standard range. (3) In the experimental diagram of mean square error, the ideal error value is about 0.005, and it is possible to reach this target value only under the condition of perfect performance. (4) Convergence function is to explore the gracefulness of action analysis, and the convergence of its artificial peak group greatly shows the performance of global exploration.

Exploring the scope of 4sb and 12a lymph node dissection for cT2-4 lower third gastric cancer: Study protocol for a prospective cohort trial.

BackgroundCurrently, the extent of 4sb and 12a lymph node dissection is not clear and is based on the personal understanding of the surgeon. It may result in damage to the splenic artery and portal vein, leading to surgical complications. Therefore, this study aims to explore the scope of 4sb and 12a lymph node dissection in cT2-4 lower third gastric cancer.MethodsThis is an ongoing prospective cohort trial. The total sample size required for the trial (March 2022 to February 2025) is approximately 524 patients. The participants are divided into the experimental (4sb first branch and 12a anterior lymphadenectomy) or control groups (traditional 4sb and 12a lymphadenectomy). Electronic data capture systems will be used to collect demographic, laboratory test, auxiliary examination, operation, postoperative condition, postoperative pathology, and follow-up data. The primary outcome is the 12a lymph node metastatic rate. Secondary outcomes include the pathology (consisting of the 4sb lymph node metastatic rate, the number of 4sb lymph nodes dissected, the number of 12a lymph nodes dissected and tumor pathological staging), a safety evaluation index (consisting of complications and mortality ≤30 days after surgery), an efficacy evaluation (consisting of operation data and postoperative recovery status), and follow-up data (consisting of 3-year or 5-year disease-free survival and overall survival).DiscussionBy exploring the scope of 4sb and 12a lymph node dissection on the premise of ensuring radical cure of the tumor, the operation is simplified, the operation time is shortened, the damage of important blood vessels is reduced, the intraoperative and postoperative complications are reduced, and the patient recovers as soon as possible. Our study is a prospective exploration of the pathology, safety, efficacy, and prognosis of the new and traditional methods of 4sb and 12a lymph node dissection.Trial registrationChinese Clinical Trial Registry, ChiCTR2200057698 (registration date: March 15, 2022).

Legal personality as licence

ABSTRACT This article extends discussion of the recently introduced licence theory of legal personality to the two remaining categories of legal personality available under Australian law, namely, Natural Legal Personality and Bodies Politic. The licence theory conceives of legal personality as designated legal functions, grouped together for nominated purposes. More particularly, it conceives of legal personality as a licensing system, whereby legal personality is granted by the State subject to various nominated conditions. These conditions reflect the overarching purpose behind the grant of legal personality, and may be organised into three general categories: Capability Conditions; Public Interest Conditions; and Use Conditions. According to the licence theory, in forming an understanding of legal personality it is necessary to consider the following design factors: i) the means by which a particular legal person is activated; ii) the purpose underwriting the grant of legal personality by the State; iii) legal capacities and obligations; and iv) the various different conditions operative in relation to the grant of a particular class of legal personality. In this article, these four factors are applied and considered in relation to both Natural Legal Personality and the Commonwealth of Australia (being the pre-eminent manifestation of the Body Politic).

Thomas Aquinas and Contemplation by Rik Van Nieuwenhove, Oxford University Press, Oxford, 2021, pp. viii + 220, £65.00, hbk

Thomas Aquinas and Contemplation by Rik Van Nieuwenhove, Oxford University Press, Oxford, 2021, pp. viii + 220, £65.00, hbk

Seeing minds, matter, and meaning: The CEEing model of pre-reflective subjective construal.

Although subjective construal (i.e., our personal understanding of situations and the people and objects within them) has been an enduring topic in social psychology, its underlying mechanisms have never been fully explored. This review presents subjective construals as a kind of seeing (i.e., pre-reflective processes associated with effortless meaning-making). Three distinct forms of "seeing" (visual, semantic, and psychological) are discussed to highlight the breadth of these construals. The CEEing model characterizes these distinct domains of pre-reflective construals as all being Coherent Effortless Experiences associated with lateral posterior parietal cortex, lateral posterior temporal cortex, tempororoparietal junction, and ventral temporal cortex in an area dubbed gestalt cortex. The link between subjective construals and gestalt cortex is further strengthened by evidence showing that when people have similar subjective construals (i.e., they see things similarly) they show greater neural synchrony (i.e., correlated neural fluctuations over time) with each other in gestalt cortex. The fact that the act of CEEing tends to inhibit alternative construals is discussed as one of the multiple reasons why we fail to appreciate the idiosyncratic nature of our pre-reflective construals, leading to naïve realism and other conflict-inducing outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Little Lewis and Latin Folk in Chaucer's Prologue to the Treatise on the Astrolabe

Little Lewis and Latin Folk in Chaucer's Prologue to the <i>Treatise on the Astrolabe</i>

A Preliminary Study to Improve Death Education for the Public and Medical Students after the Enforcement of the Life-Sustaining Treatment Decision Act

Considering the recent medicalization of death, the importance of preparing both laypersons and medical students to have meaningful end-of-life conversations, which is among the objectives of death education, will grow. The Act of Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life provided a new source of momentum to death education for both laypersons and medical professionals, as the importance of education on death is widely recognized. However, problems remain regarding how to prepare people for productive conversations at the end-of-life and how to secure the continuity of care. Different focuses and deficiencies are observed in death education programs for each category of learner. In education for laypeople, tangible information on how to actualize one’s existential and personal understanding of death through real-life options is lacking, except for presenting the “protocol” of the Act. Conversely, basic medical education lacks an understanding of or confrontation with death on the existential and personal levels. Death education should aim to build a shared understanding that can facilitate communication between the two groups. The scant overlap between layperson education and basic medical education even after the Act’s enactment is worrisome. Further fundamental changes in death education are required regarding its content. Topics that patients and doctors can share and discuss regarding death and end-of-life care should be discovered and provided as educational content both to laypeople and future medical professionals.

Conscience collective et autoconscience dans l’enseignement / apprentissage du français langue seconde et de scolarisation : quand l’interculturel et le plurilinguisme sont en jeu

This article explores the issue of the collective consciousness and self-consciousness in teaching and learning foreign languages. A review of the literature on the current issues of interculturality and plurilingualism in relation to the notions of consciousness and self-consciousness is first detailed. The issue raised allows us to question the impact of this consideration in terms of the consequences of this work on class dynamics. In fact, can the awareness and self-awareness of learners regarding intercultural and plurilingual practices exist outside of a co-construction with other learners, with the teacher? The research methodology is based on an analysis of interactions in the language class which brings into play these intercultural and plurilingual approaches (resulting from the LISTIAC and FLSCAN projects). It reports significant results on the co-construction of consciousness and emerging self-consciousness in the language class about the singular universals of languages and cultures. The discussion shows the value of a collective, and no longer purely personal understanding (for the learner) of consciousness and self-awareness of these plurilingual and cultural experiences.

A biopsychosocial approach to death, dying, and bereavement: a course on end-of-life education for medical students

Background: Despite the inevitable nature of death and dying, the conversations surrounding this subject are still uncomfortable for many physicians and medical students. Methods: A six-week humanities-based course, “A Biopsychosocial Approach to Death, Dying, &amp; Bereavement,” at Cooper Medical School of Rowan University, United States, which covers definitions of death and dying, the process of dying, ethical dilemmas, and new concepts of the grieving process. Through development of a curriculum using various academic and medical literature and resources, we sought to bring attention to the necessity of having a medical education curriculum on death and dying to prepare medical students for the difficult conversations and patient experiences that lie ahead of them. Qualitative data in the form of surveys and reflection papers submitted by students and quantitative data (Likert scores on course satisfaction) were collected and analyzed both pre- and post-course. Results: 90.7% (49/54) of the respondents answered that they agree or strongly agree with the statement that this selective course was useful in the student’s medical education experience. The top three qualitative themes brought up the most in reflection papers (n=50) were: the utility and instruction of the course (23 times), the importance of hospice and palliative care (23 times), and respecting patient autonomy (16 times). Conclusions: Medical students are often not prepared to cope with the realities of patient loss and of caring for the patient and their families throughout the dying process. We created this course to familiarize medical students with an aspect of the medical experience that is frequently neglected in traditional medical curricula. We learned that integrating such a course can help educate medical students facilitate important conversations, teach them to act with kindness and dignity in a physician-patient setting, and enhance their personal understanding of death and dying.

How nursing stakeholders in the Republic of Ireland define evidence-based practice and why it matters.

Evidence-based practice (EBP) has garnered increasing exposure in professional healthcare discourse over three decades. While the term is used frequently, its interpretation varies widely. An accurate, shared understanding of what EBP means is essential to the achievement of EBP implementation in clinical practice. As part of a national study in the Republic of Ireland, nurses, midwives, educators, and students shared their personal understanding of what EBP was to them. To establish nurses', midwives', educators', and students' knowledge and understanding of the concept of EBP in the Republic of Ireland. In a national study exploring EBP beliefs, implementation, and organizational readiness for EBP among nurses, midwives, educators, and students, an open-ended question invited participants to explain what EBP is, in their own words. Content analysis was used to interpret participants' responses. Five themes emerged from the data from the single open-ended question: (1) varying definitions of EBP, (2) best practice, (3) nurses' and midwives' role in EBP, (4) knowledge, and (5) barriers and facilitators of EBP. The dominant finding centered on the substantial conflation of EBP with research utilization and other concepts such as quality improvement. Poor knowledge and understanding of EBP is a fundamental challenge to EBP implementation. Conflation of EBP with research utilization and other healthcare concepts is not uncommon among nurses and midwives globally and has persisted for some time. This has the potential to hinder the advancement of EBP in nursing and midwifery and, therefore, measures to enhance EBP knowledge and promote EBP implementation are key. Professional regulating bodies, educators, and clinical and educational organizations all have a role to play. The findings from this aspect of this national study offer a realistic, context-specific starting point for tailored educational interventions for clinicians, educators, and students and identify professional and organizational strategies that promote EBP as the expectation and "the way things are done here."

FOREIGN LANGUAGE TEACHERS’ PREPARATION TO WORK WITH SEN CHILDREN IN NEW JERSEY

The article analyzes two university training programs for future teachers in New Jersey in accordance with the conditions of obtaining a diploma from the State Department of Education. As a result of the study, it was founded that the respondents’ understanding of the essence of working with students with special needs changed during the experiment. The university teacher’s training program General Program 101 (Gen Ed 101) does not provide adequate training, in contrast to the double degree program, which provides in-depth training, culminating in the defense of the diploma and teaching practice at school. Students in the double degree program had the opportunity to gain knowledge from two programs, compare them, and modify them to the specific cases they encounter during the internship under the guidance of teacher mentors. According to New Jersey Professional Standards for Teachers and School Leaders (2004), they felt ready to work with children with special educational needs only after employment and in the process of working together with teachers-mentors. And those students who did not have SEN students in their classes did not receive practical skills for such work at all. Thus, mentoring is a powerful tool to help future teachers develop skills in inclusive classrooms, only a double degree program can prepare future foreign language teachers to work adequately with children with special needs, only personal experience and understanding between a foreign language teacher and a special teacher can become a guarantee of the most comfortable and fruitful atmosphere for children with special educational needs in the classroom.&#x0D; Keywords: special educational needs; inclusive environment; inclusion; SEN student; inclusive education; foreign language teachers; state standards; general training program.