Primary Course Research Articles

Effect of Feedback on Learning Motivation of Primary Teacher Education Students in Primary School Physics Courses

Based on the results of the questionnaire distributed to Primary Teacher Education Students, 96% of students said that Physics is difficult to understand because the material is very complex, many formulas, especially the learning process is done online. This study aims to describe the influence of providing feedback on the motivation of Primary Teacher Education Students in primary school physics courses. The method used in this research is descriptive qualitative. Meanwhile, the instrument used was a questionnaire which was distributed to 115 elementary school education students. The result of the research shows that giving feedback consistently is able to motivate students. This can be seen from the results of the questionnaires distributed, each indicator is of very good value.

The Effectiveness of Augmented and Virtual Reality in the Education of Physical Therapy Students

<h3>Research Objectives</h3> To determine the effectiveness of augmented and virtual reality as a teaching modality on doctor of physical therapy students' learning as seen through confidence, recall, retention and application as compared to traditional teaching methods. <h3>Design</h3> Posttest only control group design with retrospective analysis. <h3>Setting</h3> Private secondary institution, doctoral physical therapy (DPT) program, American International College (AIC), Springfield, MA. <h3>Participants</h3> Convenience sample, 297 first year graduate DPT students enrolled in Gross Anatomy, AIC. Control group: 162 (cohorts 2017 & 2018); experimental group: 135 (cohorts 2019 & 2020). <h3>Interventions</h3> "Visible Body" (VB), augmented and virtual reality (VR) software used by experimental group; control group: attended traditional in-person lecture and laboratory classes. <h3>Main Outcome Measures</h3> Objective data scores (three lecture exams, Osteology Practical exam and Dissection lab exam) collected anonymously for each cohort, calculated by the primary course faculty. Subjective data (quantitative and qualitative) assessed through survey. <h3>Results</h3> Exam scores compared for three groups with different levels of exposure to VB (did not use VB (1), optional use VB (2), and required use VB (3)). Analyses (ANOVA and T-Tests) showed statistical significance with the mean performance for Group 1 being significantly lower than Groups 2 and 3. Osteology exam: No significant difference between groups noted. Dissection Exam: Group 3 scored significantly higher than the other groups. Survey data on the students' self-efficacy towards their ability to learn Gross Anatomy with the VB software proved to be statistically significant (95% CI). Researchers were blinded to all scores and surveys. <h3>Conclusions</h3> Positive correlation exists between grades and the use of the VB application, indicating that the use of VR is an effective resource for DPT students in learning Gross Anatomy. Additionally, VB may be an adequate substitute for cadaver lab for dissection, though aspects of quality and understanding of anatomical relationships may be diminished in the use of virtual software alone. Further research to substantiate these results and further analyze the benefits of VR as a superior resource for learning Gross Anatomy amongst DPT programs is necessary. <h3>Author(s) Disclosures</h3> No disclosures/conflicts.

'Just in time' rapid learning during COVID-19.

The worldwide pandemic created an urgent need for rapid learning to influence clinical practice and develop our understanding of COVID-19. Large scale trials were ongoing, but there was a need for rapid dissemination and sharing of evolving experience in order to save lives. With specialist expertise in cardiorespiratory and critical care (including ECMO), the organisations now comprising the KHP Cardiovascular and Respiratory Partnership* were in a unique position to share these strengths by disseminating learning. To facilitate this, clinical teams needed a forum to connect, discuss ideas and experiences and convert these to practical application. Virtual platforms quickly enabled ‘just in time’ learning to be possible and allowed for the dissemination of learning across geographical and institutional boundaries. Two formats were used to deliver virtual education to share knowledge and expertise at pace, to as large an audience as possible. The first was a series of weekly virtual discussions (chaired by subject matter experts) covering one topic each week. This provided clinical insights from several London hospitals into the management of patients acutely unwell with COVID-19. Topics were chosen based on evolving clinical need and included oxygen therapy, steroids, remdesivir and anticoagulation. The second format were half or full day webinars with audience and expert panel Q&A, covering several topics under an umbrella theme. Themes included COVID-19 from Bench to Bedside; Primary Care Course in Respiratory Medicine; Cardiology goes viral; Critical Care Data conference; and Paediatric Respiratory: Innovations from the Pandemic. The common aim for these courses was to explore service delivery and transformation during and postpandemic. Rapid education for immediate application in clinical care through virtual platforms helps maximise economies of scale by extending education reach and access at local, national and international levels. Short-targeted weekly facilitated virtual discussions provided a meaningful platform for iterative changes to patient care through consensus based on experience across a range of hospitals. The weekly webinars allowed discussion from a wider range of stakeholders and helped inform decisions on what should be recommended patient care moving forward. Speakers expressed that they liked not having to create presentations, and participants noted that they enjoyed the opportunity to speak about lived experiences on the wards. ‘Just in time’ virtual sessions provided the opportunity for bench to bedside learning to be applied rapidly. By facilitating discussions with multiple hospitals simultaneously, patient care was enhanced through collective learning. While this was crucial during the pandemic, this format could also be utilised in nonpandemic settings to bridge the second translational gap.

Developing Visual Literacy Skills in Teacher Education: Different Ways of Looking at the Visual Images

This article attempts to use different ways of looking that help classroom and visual art teachers analyze the meanings attributed to visual images, thereby enhancing their visual literacy skills. In the study, holistic multiple-case sampling was employed in the context of case study method as each group of teachers was individually considered as an analysis unit and their analysis of visual images through different ways of looking was evaluated in a holistic way. The participants of the study comprised of a total of 508 teachers who attended teacher training workshop of the Project titled ‘The Implementation of Visual Culture Theory on Primary and Secondary Visual Arts Courses.’ The data were collected with worksheets, artistic drawings and participant diaries and analyzed inductively. The data were presented in three themes: analyzing visual elements, approaching the visual contextually, and determining the contributions of visual experience. The results denoted that classroom and visual arts teachers interacted with images through a series of questions related to different ways of looking at visual images, questioned visual representations, artistic components and sub-meanings and created various meanings in terms of social, economic, psychological and cultural contexts, thereby increasing their visual literacy skills.

Basic Programming Concepts as Explained for Preschoolers

The development of information technologies has formed a socio-economic request to reduce the age at which children can be introduced to programming. After 6 years’ efforts, the authors managed to develop and on a large scale introduce a one-year programming course for preschoolers, which is built on a metaphor of programmed control. During the course development, a set of basic programming concepts was selected and specified to be mastered by preschoolers aged 6+ in the activity-game form. This set of concepts goes back to Seymour Papert's ideas about teaching programming by writing programs that control moving objects using intuitive sets of commands. The main feature of the proposed system of concepts, allow at the initial stage of training to demonstrate and assimilate all the elements of the concept in the real, not in the virtual world. In the picture of the World, which we explain and demonstrate to children, only one function remains at the computer - the execution of the program it has memorized. Everything else happens in the real world. In the real world, an environment is created in which a real robot will move. In the real world, a program is created from tangible objects, which will then be "shown" to the computer so that it stores it in its memory and can then execute it at the command of a human. In the real world, obeying the signals of the computer, the robot performs the work stipulated by the program. This allows you to begin acquaintance with the programming of children from 4 years old, without working individually or collectively with electronic screens, which in today's Russia is prohibited by federal medical authorities in the educational process of children under 5 years old. The course is built on the text-free pictographic programming system PiktoMir developed by Russian Academy of Sciences. The methodological content of the course allows each preschooler to gain experience in the development and debugging of 120-150 simple programs by the end of the course. The final part of the article discusses the authors' plans for the development of a three-year textless programming course, methodologically and instrumentally connected with the primary school programming course.

472Long-term effectiveness of 3-dose primary course and 4-year booster dose of pertussis vaccine in Australia

Abstract Background Australia’s National Immunisation Program recommended a 3-dose primary Diphtheria-Tetanus-Pertussis (DTP) vaccination course at 2, 4 and 6 months and a booster dose at 4 years during 2003-2015. We examined vaccine effectiveness by time since doses 3 and 4, as studies to date have shown conflicting results. Methods Perinatal, immunisation, pertussis notification and death data were linked for 1,086,319 infants born in two Australian states in 2003-2012. Administration of DTP doses 3 and 4 from 5.5-7 months and 47-53 months respectively, was considered age-appropriate. Adjusted Cox proportional hazards models with time-varying vaccination status were used to estimate vaccine effectiveness (VE = 1–hazard ratio) against notified pertussis post age-appropriate doses 3 and 4 compared to unvaccinated children, with additional benefit of dose 4 compared to receipt of primary course alone. Results Dose 3 VE declined from 79% (CI 75%-83%) from 0-6 months to 64% (CI 60%-67%) at 6-36 months and 45% (CI 31%-56%) at 36-42 months post-vaccination. Compared to unvaccinated children, VE after dose 4 declined from 83% (CI 80%-86%) at 0-12 months to 67% (CI 60%-72%) and 55% (CI 46%-63%) in the following two 12-month periods post-vaccination. When compared to dose 3, the relative VE for dose 4 was 58% (CI 51%-64%) in 0-18 months post-vaccination. Conclusion and Key messages Our study adds to previous Australian evidence for substantial waning of vaccine induced immunity against pertussis over a 3-year period following dose 3. VE was significantly higher in the 18 months following dose 4 compared to receipt of primary course alone.

473Preventable pertussis burden in Australia within the first year of life by improving vaccination timeliness

Abstract Background Previous Australian studies have shown that on-time Diphtheria-Tetanus-Pertussis (DTP) vaccination coverage is 50-60% in certain subpopulations. We estimated the potentially preventable burden of pertussis if, 1) the full primary course and, 2) each dose was given on-time. Methods Perinatal, immunisation, pertussis notification, and death data were linked for 1,412,984 infants born in two Australian states in 2000-2012. A DTP dose administered &amp;gt;15 days after the recommended age was categorised as delayed. For aim 1, pertussis rates up to 1-year of age were compared in infants with ≥1 dose delayed versus all doses on-time, using Poisson regression methods. For aim 2, the expected number of cases preventable by each dose was calculated as the product of the number of cases observed during the period of delay and (1 – dose-specific vaccine effectiveness). Results 58% of infants had all primary DTP doses on time. We estimated that 85 (95% CI: 61-109) cases per 100,000 infants, aged 39-days to 1-year, could have been prevented if all infants had been vaccinated on time; 77% of these infants had received ≥1 DTP dose within the first year of life. Estimated preventable burden attributable to delayed DTP1 (58/100,000) was higher than for DTP2 (26/100,000) and DTP3 (15/100,000). Conclusions and Key messages Poor vaccine timeliness, especially delayed DTP1, is a key contributor to the residual burden of pertussis. These findings can inform cost-benefit analyses of targeted programs and public health messaging to reduce delays.

Benefits of Coriandrum sativum L. seed extract in Maintaining Immunocompetent Cell Homeostasis

Diabetes mellitus (DM) is a metabolic disease followed by an increase in blood glucose and impaired metabolism of proteins, lipids and carbohydrates. In general, these conditions are caused by impaired insulin secretion and/or defects of insulin receptors. As yet, there is no effective drug capable of treating DM. Manifestations of DM worsen when accompanied by severe inflammation. Therefore, the avoiding strategy and management of inflammation in DM are the primary courses of action in preventing further damage. In this study, we had evidence that Coriandrum sativum L. extract (CSE) could be used as an alternative to relieve symptoms in DM mice model. Previously, CSE has been shown to be able to inhibit the synthesis of the pro-inflammatory molecule interleukin (IL)-6 by both B220 and CD11b cells. Here, we showed that CSE prevents over-activation of CD4 and CD8 T lymphocytes. The predominance of T cells expressing CD62L on both CD4 and CD8 T cells after administration of CSE indicated that there were obstacles to activation. CSE also suppressed excessive CD25 expression, causing CD25 expression in CD4 T cells to return to normal levels. Thus, this study showed the therapeutic activity of CSE in DM mice model by suppressing the pro-inflammatory cytokines, modulate the activation of naïve T cells, and maintain the population of CD4+CD25+ cells.

Factors Associated with the Equivalence of the Scores of Computer-Based Test and Paper-and-Pencil Test: Presentation Type, Item Difficulty and Administration Order

Since schools cannot use face-to-face tests to evaluate students’ learning effectiveness during the COVID-19 pandemic, many schools implement computer-based tests (CBT) for this evaluation. From the perspective of Sustainable Development Goal 4, whether this type of test conversion affects students’ performance in answering questions is an issue worthy of attention. However, studies have not yielded consistent findings on the equivalence of the scores of examinees’ answering performance on computer-based tests (CBT) and paper-and-pencil tests (PPT) when taking the same multiple-choice tests. Some studies have revealed no significant differences, whereas others have exhibited significant differences between the two formats. This study adopted a counterbalanced experimental design to investigate the effects of test format, computerised presentation type, difficulty of item group, and administration order of item groups of different difficulty levels on examinees’ answering performance. In this study, 381 primary school fifth graders in northern Taiwan completed an achievement test on the topic of Structure and Functions of Plants, which is part of the primary school Natural Science course. The achievement test included 16 multiple-choice items. After data collection and analysis, no significant differences in the answering performance of examinees were identified among the PPT, CBT with single-item presentation, and CBT with multiple-item presentation. However, after further analysis, the results indicated that the difficulty of item group and the administration order of item groups of different difficulty levels had significant influences on answering performance. The findings suggest that compared with a PPT, examinees exhibit better answering performance when taking multiple-choice tests in a CBT with multiple-item presentation.

Economics ripped from the headlines: The Economist ascourse text

The author of this article presents an innovative economics course based on current events and news, using The Economist as the primary course text. The course constructs shared learning around news in real time to inspire and excite students’ ability to see economics in their world. The course supports Allgood and Bayer’s competencies, including the application of the scientific process to economic phenomena, the ability to analyze and evaluate behavior and outcomes using economic concepts and models, critical thinking about economic methods and their applications, and communicating economic ideas in diverse collaborations. The author provides sample assignments that can be scaffolded by the instructor for implementation of this teaching strategy, as well as advice for replicating this course or adopting some of its techniques.

Invited Review: Advances in rumen efficiency

The purpose of this review was to explain how advances in our knowledge of rumen microbial ecology provide opportunities to improve ruminal fiber degradation, decrease enteric methane production, and limit wastage of dietary protein without disrupting ruminal efficiency. Peer-reviewed literature was the primary course of information reviewed. As numbers of microbial taxa in the rumen have expanded in the past 10 yr, we have gained appreciation for why rumen efficiency is so variable among dietary situations and even among dairy cattle fed the same diets. In typical dairy rations with mixed forage and grain, the primary fibrolytics support a balanced community. However, that community can be disrupted and thus limit fiber digestibility or DMI unless forage quality and particle size along with RDP are maintained. Efforts to decrease enteric methane or improve the efficiency of dietary protein usage should appreciate the complexity of the microbial community to improve consistency of responses. Many feeding practices indirectly influence the rumen microbial structure and function, and future opportunities for feed additives will likely be adjusted for likelihood of benefit using microbial sequence data.

Retrospective cohort study investigating extent of pertussis transmission during a boarding school outbreak, England, December 2017 to June 2018.

On 1 May 2018, a pertussis outbreak was declared and widespread vaccination recommended at an all-female secondary boarding school in southern England. We conducted a retrospective cohort study to determine the extent of pertussis transmission and identify risk factors in this semi-closed population. Of 504 students and staff assessed before post-exposure vaccination, 48% (n = 240) had evidence of pertussis. A sub-analysis of 409 students found that both residential dormitory (p = 0.05) and school year (p = 0.03) were associated with pertussis, with odds decreasing by 11% for each increase in school year (95% confidence interval: 0.7–20.2). Odds of pertussis were 1.7 times higher in those assumed to have received acellular vaccines for their primary course compared with those assumed to have received whole-cell vaccines (based on date of birth), although this difference was not significant (p = 0.12). Our findings support the need for timely, widespread vaccination following identification of cases among adolescents in a semi-closed United Kingdom (UK) setting and to review the evidence for the introduction of an adolescent pertussis booster to the UK routine vaccination programme.

Integrated Learning Management Based on Face-to-Face learning and Online Instruction in Primary Medical Care Course for Nursing Students in the New Normal Era

Blended learning refers to the model of integration between face-to-face learning and online instruction. This model used in coronavirus disease 2019 (COVID-19) pandemic, essential for prevention and control the emerging infectious disease transmission, and enhanced achievement of expected learning outcomes among nursing students. This article aimed to present a blended instruction based on asynchronous and synchronous online learning with face-to-face approach in primary medical care course for nursing students in the new normal era. The instructional design based on the 5 components of the ADDIE model including 1) analysis, 2) designs, 3) development, 4) implementation, and 5) evaluation. The conceptual framework for evaluating blended learning outcomes including 1) learners’ satisfaction, 2) students’ engagement, and 3) course outcomes. It was found that the learners’ satisfaction on blended learning were at high level. Blended learning performs a pivotal role in supporting nursing students’ engagement. All nursing students gained higher scores than the pass criteria. This article determined on improving nursing education through blended learning and extended novel issues for further research and development.&#x0D;

Invasive Mucormycosis in Patients with Hematological Diseases Identified in the Global Fungiscope Registry

Background:Invasive fungal diseases (IFD) are a frequent complication in hematological patients. Hematological malignancies and their treatment are main risk factors for IFD. Less frequent IFD, such as invasive mucormycoses (IM), are increasing worldwide and are associated with mortality up to 100%. Efficient diagnostic and treatment approaches for IM are not known or validated yet. Thus, it is urgent to better understand clinical presentation and management of IM in hematological patients to eventually improve patient outcome.Methods:Clinical data on IM were collected in FungiScope, an international web-based registry. Cases with cultural, histological or molecular evidence of IM are enrolled. Data collected include demographics, underlying conditions and their treatment, clinical signs and symptoms, sites of infection, diagnostic tests, antifungal treatment and outcome. Clinical isolates are collected for centralized identification, molecular analyses and exchange between collaborators.Results:To date, 194 cases of IM with an underlying hematologic disease (HD) were captured in the FungiScope database. AML, ALL, Non-Hodgkin's Lymphoma and CLL were the most frequent malignancies (50.5%, 16%, 5.6%, and 5.6%, respectively). Treatment of HD was chemotherapy in 76%, for 72% of these it was the primary course. Prolonged neutropenia (>10 days) was reported in 70% of cases (information available for 111 cases). The majority of patients received antifungal agents (94.3%; median 55 days, range 0 to 750 days) and 37% underwent surgical debridement. Antifungals known to be active against Mucorales (amphotericin B, isavuconazole, itraconazole, posaconazole) were administered in 82.5% of cases, in 16% of those amphotericin B was used as a single agent once the pathogen had been identified. Overall mortality was 62.4% and death due to IM was reported for 74% of cases. Mortality in patients receiving antifungals active against Mucorales was 56%. Median follow-up time was 45 days (range 0-2110 days). Favourable response (complete or partial response or stable disease) was present in 44% of all cases. Due to premature death, twelve patients did not receive antifungal therapy.Conclusion:The FungiScope registry is a feasible approach to collect data on a relevant amount of rare cases of rare IFD. IM remains a life threatening disease in hematological patients. Despite aggressive antifungal treatment strategies, outcome remains poor. More effective treatment strategies are urgently needed to improve patient outcome. DisclosuresKarthaus:Riemser: Honoraria, Other: Travel grant; HELSINN: Honoraria, Other: Travel grant. Vehreschild:Pfizer, MSD/ Merck, Gilead Sciences, Organobalance and Astellas Pharma: Speakers Bureau; 3M, Astellas Pharma, DaVolterra and Gilead Sciences: Research Funding; Berlin Chemie, MSD/Merck and Astellas Pharma: Consultancy. Meißner:Accelerate Diagnostics: Honoraria. Wisplinghoff:Beckmann, BioMerieux, Bruker Daltonics, Cepheid, Hologic, i-Sense, r-biopharm, Siemens, Specific Technologies: Research Funding; Beckmann, BioMerieux, Bruker Daltonics, Cepheid, Hologic, i-Sense, r-biopharm, Siemens, Specific Technologies: Consultancy; Beckmann, BioMerieux, Bruker Daltonics, Cepheid, Hologic, i-Sense, r-biopharm, Siemens, Specific Technologies: Honoraria. Vehreschild:Pfizer, Merck, Gilead, Basilea and Astellas: Speakers Bureau; Astellas, Gilead, Infectopharm, Merck/MSD, Basilea and Pfizer: Research Funding; Astellas, Gilead, Basilea and Merck/MSD: Consultancy. Cornely:Anacor, Amplyx, Actelion, Astellas, Basilea, Cidara, Da Volterra, F2G, Gilead, Janssen Pharmaceuticals, Matinas, Menarini Ricerche, Merck/MSD, Paratek Pharmaceuticals, Scynexis, Seres, Summit, Vical, Vifor: Consultancy; Actelion, Aramis Pharma, Astellas, AstraZeneca, Basilea, Bayer, Cidara, Duke University (NIH UM1AI104681), F2G, Gilead, GSK, Leeds University, MedPace, Melinta Therapeutics, Merck/MSD, Miltenyi, Pfizer, Rempex, Roche, Sanofi Pasteur, Scynexis, Seres Thera: Research Funding; Astellas, Basilea, Gilead and Merck/ MSD: Honoraria. Seidel:Basilea and Astellas: Other: Travel grant.

Non-specific effects of rabies vaccine on the incidence of self-reported common infectious disease episodes: A randomized controlled trial

Vaccines may affect recipients’ immune systems in ways that change morbidity or mortality rates to unrelated infections in vaccinated populations. It has been proposed that these non-specific effects differ by type of vaccine and by sex, with non-live vaccines enhancing susceptibility of females to unrelated infections, and live vaccines enhancing resistance in both sexes. Rabies vaccine–a non-live vaccine–has been associated with protection against unrelated central nervous system infections. Data from randomized controlled trials are needed to assess this effect against other illnesses. This phase IV, single-site, participant-blinded, randomized, placebo-controlled trial in a population of veterinary students on the rabies-free island of St. Kitts assessed the effect of a primary course of rabies vaccine on the incidence rate of weekly self-reported new episodes of common infectious disease (CID) syndromes, defined as a new episode of any one of the following syndromes in a particular week: upper respiratory illness (URI), influenza-like illness (ILI), diarrheal illness (DIA) or undifferentiated febrile illness (UFI). As a secondary objective, we tested for modification of the effect of rabies vaccine on study outcomes by sex. 546 participants were randomized (274 to rabies vaccine and 272 to placebo). No statistically significant differences between groups were observed for any study outcomes: CID incidence rate ratio (IRR) 0.95 (95% CI 0.77–1.18); URI IRR 1.15 (95% CI 0.86–1.54); ILI IRR 0.83 (95% CI 0.54–1.27); DIA IRR 0.93 (95% CI 0.70–1.24) and UFI IRR 1.09 (95% CI 0.48–2.44). In a secondary analysis, there was little evidence that sex modified the effect of vaccination on any of the evaluated outcomes, although the power to detect this was low. In conclusion, rabies vaccine did not provide protection against mild self-reported illness among a young and healthy group of adults attending veterinary school.Clinical trial registration. ClinicalTrials.gov: NCT03656198.

The Study of Primary School Visual Arts and Science Curricula in Turkey in the Context of Interdisciplinary Approaches: 1923-2020

This study aims to identify any associated subjects in the primary school Visual Arts and Science courses in Turkey from 1923 when the Republic was declared to 2020, and reveal the historical dimension of such associations between the two courses. Primary school curricula of 1924, 1926, 1936, 1948, 1968, and 1992; 2005 Science and Technology and 2006 Visual Arts course curricula; 2013 and 2018 primary school curricula have been reviewed. The data were evaluated by content analysis in the research carried out by the document review method. At the end of the research, it is recognized that the association between the two courses has been made since the 1924 Curriculum, the first program of the Republic although it was disrupted in certain periods. In addition, it has been found that in the interdisciplinary approach adopted between 1926 and 1992, the Art-Craft course was primarily seen as the field of application of the Science courses and assumed a role of an auxiliary course in teaching the Science courses and that despite the increase in the number of learning outcomes in the current programs, the learning outcomes to be associated with the two courses are still quite limited.

Online training of behavioral health providers for primary care practice.

Introduction: Many behavioral health providers have not received training in primary care practice during their education. Since 2007, the online Certificate in Primary Care Behavioral Health course has been completed by thousands of behavioral health providers. An evaluation of the course assessed whether learner's baseline confidence in their abilities to address behavioral health concerns in primary care settings changed over time, whether learning outcomes for live offerings of the course differed from asynchronous offerings, and whether learning outcomes for psychologists and social workers differed. Method: Learners were asked to rate their confidence in their abilities using 10 retrospective pre-post questions. Responses from 14 cohorts of learners, between 2011 and 2019 were assessed. T-tests and analyses of variance were used to compare groups. Results: Learners' baseline confidence in their abilities changed in three of the areas assessed. Those completing the course asynchronously reported outcomes equal to or greater than those completing the course synchronously. In all but one domain, psychologists and social workers reported equal increases in their confidence. Discussion: Learners reported significant improvements in confidence in their ability to work as behavioral health providers in primary care. With one exception, these findings did not differ for psychologists and social workers. Over time, baseline confidence of behavioral health providers enrolling in the course increased in some areas, particularly those focused on patients with substance use disorders. Learning outcomes for the asynchronous version of the course support the continued delivery of asynchronous training of behavioral health providers working in primary care. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Фінансово-економічні результати та можливості підготовки і підвищення кваліфікації лікарів, провізорів та інтернів в умовах реформування системи охорони здоров'я

Aim. to forecast the economic effect of potentialities of the Departments subordinated to the Faculty of Advanced (postgraduate) studies that deals with training of interns and tuition relating to advanced and re-training (refresher) courses for specialists. Materials and Methods. The research was carried out on the basis of actual indices of the Faculty of Advanced (postgraduate) studies at Danylo Halytsky Lviv National Medical University during 2014-2018 years. The statistical methods, structural-and-logical analysis and systemic approach were used. Results and Discussion. The number of individuals who underwent (on contract terms) the primary specialization at the Departments subordinated to the Faculty of Advanced (postgraduate) studies with regard to 29 specialties was established. The financial income, 13 million 668 thousand and 74 hryvnyas, to the special fund for the first year of interns' education was forecast. The feasibility of this forecast may become valid if the maximum possible number of applicants to the internship will be enrolled (on contract terms) regarding the specialties of eligible type. As it is forecast, the largest amount of fees for the first year of studies (29,54%), will be provided by the interns-dentists, while the smallest share in the structure of income (20,01%) will be paid by the interns who are specialized in different surgical profiles. The education at the Advanced Courses and the re-training of the maximum possible number of students of the Faculty of Advanced (postgraduate) studies, on contract terms, will provide the maximum possible income, which is 10 million 826 thousand and 33 hryvnyas; 28,67% out of them are fees for the education from the students of surgery type; 42,01% are fees from the students of therapy type, and 29,32% are fees from the students of medico-prophylactic type, organization and management of Health Care and dispensing chemists. Conclusions. The computation of the maximal loading (amount of work) at the Departments dealing with the interns' training and advanced courses for doctors and dispensing chemists is of significant practical importance for the evaluation of the potentialities of the Departments subordinated to the Faculty of Advanced (postgraduate) studies as to conducting the primary specialization, advanced courses, and re-training of specialists. This is imposed in the finances as well, primarily in the money receipts from interns' training and advanced courses and re-training of specialists on contract terms (at the expense of natural and juridical persons)

Utilizing Lean Software Methods To Improve Acceptance of Global eHealth Initiatives: Results From the Implementation of the Basic Emergency Care App.

BackgroundHealth systems in low- and middle-income countries face considerable challenges in providing high-quality accessible care. eHealth has had mounting interest as a possible solution given the unprecedented growth in mobile phone and internet technologies in these locations; however, few apps or software programs have, as of yet, gone beyond the testing phase, most downloads are never opened, and consistent use is extremely rare. This is believed to be due to a failure to engage and meet local stakeholder needs and the high costs of software development.ObjectiveWorld Health Organization Basic Emergency Care course participants requested a mobile point-of-care adjunct to the primary course material. Our team undertook the task of developing this solution through a community-based participatory model in an effort to meet trainees’ reported needs and avoid some of the abovementioned failings. We aimed to use the well-described Lean software development strategy—given our familiarity with its elements and its ubiquitous use in medicine, global health, and software development—to complete this task efficiently and with maximal stakeholder involvement.MethodsFrom September 2016 through January 2017, the Basic Emergency Care app was designed and developed at the University of California San Francisco. When a prototype was complete, it was piloted in Cape Town, South Africa and Dar es Salaam, Tanzania—World Health Organization Basic Emergency Care partner sites. Feedback from this pilot shaped continuous amendments to the app before subsequent user testing and study of the effect of use of the app on trainee retention of Basic Emergency Care course material.ResultsOur user-centered mobile app was developed with an iterative participatory approach with its first version available within 6 months and with high acceptance—95% of Basic Emergency Care Course participants felt that it was useful. Our solution had minimal direct costs and resulted in a robust infrastructure for subsequent assessment and maintenance and allows for efficient feedback and expansion.ConclusionsWe believe that utilizing Lean software development strategies may help global health advocates and researchers build eHealth solutions with a process that is familiar and with buy-in across stakeholders that is responsive, rapid to deploy, and sustainable.

Implementation of extended possibility for CPAP in general wards: A quality inter-professional intervention project

Introduction and objectivesIn a Danish Hospital, 70% of all activations of the rapid response team (RRT) in 2016 were related to adult patients with respiratory insufficiency. The most frequent RRT intervention was continuous positive airway pressure (CPAP). However, there was no systematic follow-up and patients could not receive CPAP outside of daytime hours. The aim of the study was to implement and evaluate a CPAP intervention to improve healthcare. Patients and methodsA quality inter-professional intervention project was conducted. The interventions consisted of: theoretical and practical education in respiratory insufficiency (including use of CPAP) of nurses and physicians from the general wards, physiotherapists and staff from the RRT; development of an instruction leaflet and video; an update of the existing guidelines. The interventions entailed patients being able to receive CPAP a minimum of 3 times for 5–10min within a 24-h period. All RRT activations were registered and compared in a before–after evaluation of the intervention. Additionally, all staff groups received an electronic questionnaire after implementation. ResultsAfter implementation, respiratory insufficiency was still the highest primary course for RRT activation. The use of CPAP increased, and the number of patients needing a transfer to the intensive care unit decreased. The response rate for the questionnaire was 44% (203 out of 465), and staff experienced new competences, improved inter-professional cooperation and improved healthcare. However, a substantial number of staff did not feel sufficiently trained or that the intervention was well-implemented. ConclusionThe intervention entailed new competences for the staff, as well as improved system performance, inter-professional cooperation and healthcare. However, there is a need for continuous focus on the intervention.