Short-term Course Research Articles

Short-Term Impact of Bracing in Multi-Level Posterior Lumbar Spinal Fusion.

Clinical practice in postoperative bracing after posterior lumbar spine fusion (PLF) is inconsistent between providers. This paper attempts to assess the effect of bracing on short-term outcomes related to safety, quality of care, and direct costs. Retrospective cohort analysis of consecutive patients undergoing multilevel PLF with or without bracing (2013-2017) was undertaken (n = 980). Patient demographics and comorbidities were analyzed. Outcomes assessed included length of stay (LOS), discharge disposition, quality-adjusted life years (QALY), surgical-site infection (SSI), total cost, readmission within 30 days, and emergency department (ED) evaluation within 30 days. Amongst the study population, 936 were braced and 44 were not braced. There was no difference between the braced and unbraced cohorts regarding LOS (P = .106), discharge disposition (P = .898), 30-day readmission (P = .434), and 30-day ED evaluation (P = 1.000). There was also no difference in total cost (P = .230) or QALY gain (P = .740). The results indicate a significantly lower likelihood of SSI in the braced population (1.50% versus 6.82%, odds ratio = 0.208, 95% confidence interval = 0.057-0.751, P = .037). There was no difference in relevant comorbidities (P = .259-1.000), although the braced cohort was older than the unbraced cohort (63 versus 56 y, P = .003). Bracing following multilevel posterior lumbar fixation does not alter short-term postoperative course or reduce the risk for early adverse events. Cost analysis show no difference in direct costs between the 2 treatment approaches. Short-term data suggest that removal of bracing from the postoperative regimen for PLF will not result in increased adverse outcomes.

Оценка эффективности краткосрочного углубленного курса обучения работников скорой медицинской помощи

Introduction: Emergency medical service (EMS) is an integral part of healthcare organization system. The effectiveness of EMS provision depends on early detection of life-threatening conditions, promptness of medical and sanitary measures, availability of necessary medical care and qualifications level of medical workers. The goal of the study: To analyze the effectiveness of a short-term advanced training course for emergency medical service specialists. Materials and methods: A comprehensive retrospective preclinical and clinical training analysis of the progress of the Advanced Life Support-2 (ALS-2) course participants (n = 651) which was conducted for emergency medical service specialists was carried out. A mandatory requirement of the training process was the evaluation of initial level (pre-test) and final level of theoretical knowledge (post-test) and practical skills using manikins of different levels and clinical scenarios. Outcomes: The outcomes of emergency medical service specialists’ theoretical knowledge evaluation after the training demonstrated significant improvement, the overall knowledge growth rate was 90%, and a similar outcome was observed when analyzing data for all types of training modules and specialties. The evaluation of practical skills and abilities showed the following: the results of the training program mastering in the group of doctors were 89.0±0.47, for paramedics they were 87.2±0.25, and for nurses — 83.9±0.61. Conclusion: The use of a short-term continuing education training program Advanced Life Support-2 designed for emergency medical service workers based on innovative approaches to practical training and changes in evidence-based medicine increases the effectiveness of the training process and the quality of medical services.

Cardiac adipose tissue volume and IL-6 level at admission are complementary predictors of severity and short-term mortality in COVID-19 diabetic patients

BackgroundCOVID-19 diabetic adults are at increased risk of severe forms irrespective of obesity. In patients with type-II diabetes, fat distribution is characterized by visceral and ectopic adipose tissues expansion, resulting in systemic inflammation, which may play a role in driving the COVID-19 cytokine storm. Our aim was to determine if cardiac adipose tissue, combined to interleukin-6 levels, could predict adverse short-term outcomes, death and ICU requirement, in COVID-19 diabetic patients during the 21 days after admission.MethodsEighty one consecutive patients with type-II diabetes admitted for COVID-19 were included. Interleukin-6 measurement and chest computed tomography with total cardiac adipose tissue index (CATi) measurement were performed at admission. The primary outcome was death during the 21 days following admission while intensive care requirement with or without early death (ICU-R) defined the secondary endpoint. Associations of CATi and IL-6 and threshold values to predict the primary and secondary endpoints were determined.ResultsOf the enrolled patients (median age 66 years [IQR: 59–74]), 73% male, median body mass index (BMI) 27 kg/m2 [IQR: 24–31]) 20 patients had died from COVID-19, 20 required intensive care and 41 were in conventional care at day 21 after admission. Increased CATi and IL-6 levels were both significantly related to increased early mortality (respectively OR = 6.15, p = 0.002; OR = 18.2, p < 0.0001) and ICU-R (respectively OR = 3.27, p = 0.01; OR = 4.86, p = 0.002). These associations remained significant independently of age, sex, BMI as well as troponin-T level and pulmonary lesion extension in CT. We combined CATi and IL-6 levels as a multiplicative interaction score (CATi*IL-6). The cut-point for this score was ≥ 6386 with a sensitivity of 0.90 and a specificity of 0.87 (AUC = 0.88) and an OR of 59.6 for early mortality (p < 0.0001).ConclusionsCardiac adipose tissue index and IL-6 determination at admission could help physicians to better identify diabetic patients with a potentially severe and lethal short term course irrespective of obesity. Diabetic patients with high CATi at admission, a fortiori associated with high IL-6 levels could be a relevant target population to promptly initiate anti-inflammatory therapies.

MO303URINARY ALBUMIN-TO-CREATININE RATIO INDICATES NECROTIZING AND CRESCENTIC GLOMERULONEPHRITIS IN ANCA-ASSOCIATED VASCULITIS

Abstract Background and Aims Renal involvement is a common and severe complication of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) as it can cause acute kidney injury (AKI), end-stage renal disease (ESRD) or death. We have previously reported that elevated urinary albumin-to-creatinine ratio (uACR) correlates with rapid deterioration of kidney function in ANCA GN. Therefore, we here aimed to describe the association between proteinuric findings and histopathological diagnosis of necrotizing and crescentic ANCA GN in 50 urinary samples at admission and corresponding renal biopsies of patients with AAV. Method A total number of 50 urinary samples at admission and corresponding renal biopsies with confirmed renal involvement of AAV were retrospectively included between 2015 till 2020 in a single-center observational study. Results Renal involvement of AAV revealed variable proteinuria ranging from low-range to nephrotic syndromes, however most patients presented with subnephrotic proteinuria predominated by albumin (uACR). Severely increased uACR levels &amp;gt;300 mg/g correlated with reduction of normal glomeruli (P&amp;lt;0.001), attributed to increased glomerular crescents (P&amp;lt;0.001) and necrosis (P=0.008). By contrast, no such association was observed for global sclerotic glomeruli (P=0.58), revealing that uACR reflects necrotizing and crescentic ANCA GN rather than adaptive glomerular hyperfilitration in chronic sclerosing stage. These findings were additionnaly bolstered by histopathological subgrouping and ARRS: patients with uACR levels &amp;gt;300 mg/g were classified either into Berden’s crescentic class (P=0.002) or ANCA renal risk score (ARRS) high/intermediate risk (P=0.003). No association between uACR levels and extrarenal manifestation of AAV disease could be observered, suggesting that uACR levels reflected specific renal involvement with ANCA GN and further confirmed by survival analysis for cumulative incidence of RRT during the short-term course of disease. In summary, uACR measurements at admission were associated with renal biopsy findings thereafter. Levels of uACR &amp;gt;300 mg/g were more frequently observed in necrotizing and crescentic ANCA GN with classification either into Berden’s crescentic class or ARRS high/intermediate risk and specific for renal involvement in AAV. Conclusion Early identification of patients who mostly benefit from aggressive immunosuppressive therapy is of clinical importance. Our observation that uACR levels at disease onset predict necrotizing and crescentic ANCA GN requires further investigation for therapeutic decision especially in patients with severe deterioration of kidney function.

Role of the early short-course corticosteroids treatment in ARDS caused by COVID-19: A single-center, retrospective analysis

PurposeSevere coronavirus disease 2019 (COVID-19) is strongly related to interstitial pneumonia with frequent development of acute respiratory distress syndrome (ARDS). The role of corticosteroids (CS) treatment in these patients is still controversial. Some studies evidenced a possible role of an early short-term course of CS treatment in the treatment of severe pneumonia. Patients and methodsThis is a single-center, retrospective study considering the patients with confirmed COVID-19 pneumonia admitted to our hospital between 9th March and 15th June 2020. Two groups were considered: early high-dose of methyl-prednisolone (eHDM; n ​= ​31) and the control group (n ​= ​52). Patients in the eHDM group received the dose of 5-8 ​mg/kg/day of methyl-prednisolone for 2 consecutive days. Primary outcome was the mortality evaluation; secondary outcomes were clinical improvement, side-effects and laboratory/radiographic changes. ResultsSignificant differences between the two groups were: length of hospitalization (21.5 vs 28.4 days, p ​= ​0.026), length of non-invasive ventilation (NIV) or mechanical ventilation (11.5 vs 14.5 days, p ​= ​0.031), death (5 vs 12, p ​= ​0.006) and clinical improvement (16 vs 11, p=0.018). The following factors were related to in-hospital mortality in the multivariate analysis: comorbidities (OR ​= ​2.919; 95%CI ​= ​1.515-16.705; p<0.001), days from the onset of symptoms and the hospital admission (OR ​= ​1.404; 95%CI ​= ​1.069-12.492; p ​= ​0.011), PaO2/FiO2 (P/F) ratio (OR ​= ​3.111; 95%CI ​= ​2.334-16.991; p ​= ​0.009) and eHDM treatment (OR ​= ​0.741; 95%CI ​= ​0.129-0.917; p ​= ​0.007). ConclusionThe eHDM is an interesting and promising approach in the ARDS related to COVID-19 pneumonia, which reduces mortality, length of hospitalization and the need for mechanical ventilation.

Aggressive Resection of Malignant Paraaortic and Pelvic Tumors Accompanied by Arterial Reconstruction with Synthetic Arterial Graft

Case seriesPatients: Female, 53-year-old • Female, 70-year-old • Female, 53-year-old • Female, 48-year-old • Male, 66-year-old • Female, 43-year-old • Male, 76-year-oldFinal Diagnosis: Local recurrenceSymptoms: AsymptomaticMedication: —Clinical Procedure: Surgical resectionSpecialty: SurgeryObjective:Unusual setting of medical careBackground:Advanced malignancies in the lower abdomen easily invade the retroperitoneal and pelvic space and often metastasize to the paraaortic and pelvic lymph nodes (LNs), resulting in paraaortic and/or pelvic tumor (PPT).Case Reports:A total of 7 cases of aggressive malignant PPT resection and orthotopic replacement of the abdominal aorta and/or iliac arteries with synthetic arterial graft (SAG) were experienced during 16 years. We present our experience with aggressive resection of malignant PPTs accompanied by arterial reconstruction with SAG in detail. The primary diseases included 2 cases endometrial cancer and 2 cases of rectal cancer, and 1 case each of ovarian carcinosarcoma, vaginal malignant melanoma, and sigmoid cancer. Surgical procedures are described in detail. Briefly, the abdominal aorta and iliac arteries were anastomosed to the SAG by continuous running suture using unabsorbent polypropylene. Five Y-shaped and 2 I-shaped SAGs were used. This en bloc resection actually provided safe surgical margins, and tumor exposures were not pathologically observed in the cut surfaces. Graphical and surgical curability were obtained in all cases in which aggressive malignant PPT resections were performed. The short-term postoperative course of our patients was uneventful. From a vascular perspective, the SAGs remained patent over the long term after surgery, and long-term oncologic outcomes were satisfactory.Conclusions:To our knowledge, this case series is the first report of aggressive malignant PPT resection accompanied by arterial reconstruction with SAG. This procedure is safe and feasible, shows curative potential, and may play a role in multidisciplinary management of malignant PPTs.

Time Course of Acute Hip Adduction Range of Motion Changes Following Foam Rolling.

BackgroundWith the increased popularity of foam rolling (FR), it is important to establish the exact manner in which the practice is useful.PurposeThe purpose of this study was to examine the impact of FR the iliotibial (IT) band on hip adduction range of motion (ROM) and the short-term time course of any ROM changes that may occur.MethodIn a within-subject design, 34 subjects (21 female, 13 male) (female mean age 24.67 ± 8.6 yrs, height 161.4 ± 9.8 cm, mass 67.3 ± 12.3 kg; male mean age 22 ± 2.5 yrs, height 170.2 ± 8.2 cm, mass 76.3 ± 21.9 kg) underwent a baseline Ober’s test to measure hip adduction ROM prior to the FR and control conditions. Subjects rolled the lateral portion of each thigh for 3 bouts of 20 seconds. A tempo of 3 seconds down and 3 seconds up the leg was maintained across FR bouts. A 5-minute walk served as the control condition. The Ober’s test was repeated at less than 1 minute, 3 minutes, 10 minutes, 15 minutes, and 20 minutes following the FR bouts and the control to assess changes in hip adduction ROM over time. A blinded clinician conducted the Ober’s test. A two-way analysis of variance was used to assess differences by condition and time.ResultsNo differences in hip adduction ROM were found at baseline between FR and CON within subjects (27.9 cm ± 7.5 vs. 27.7 cm ± 6.6, p > .05). Ober’s test ROM was significantly greater in FR compared to CON immediately post-treatment (24.2 cm ± 6.3 vs. 28.2 cm ± 6.3, p = .00, d = .59), and 3 minutes post (24.6 cm ± 7.6 vs. 28.3 cm ± 5.9, p = .00, d = .56). No differences were observed 10 minutes post, 15 minutes post, or 20 minutes post FR or CON (p > .05).DiscussionCompared to walking, FR the IT band significantly increased hip adduction ROM as measured by the Ober’s test. These increases appear to dissipate between 3 and 10 minutes post-FR.ConclusionAn acute bout of 3 sets of 20 seconds of FR may be effective for transiently increasing ROM. Whether these short-term increases have implications for chronic flexibility changes is unclear.Level of evidence2

Effect of β-alanine on humoral immune response in low-dose allergy model

At the present time, the efforts of many research groups around the world are aimed at finding new factors triggering the allergic sensitization process linked with IgE synthesis to harmless allergens. According to the recent data, production of tissue cytokines is induced in tissue cells by alarmins, thus, in turn, eliciting pro-allergic immune response. Previously we have shown that β-alanine could be a potential alarmin capable to stimulate production of tissue cytokines. The aim of this work was to determine the impact of β-alanine on humoral immune response in low-dose allergy model. BALB/c mice were immunized by recombinant Asp f 2 protein or commercial ovalbumin (OVA) in the withers 3 times a week with or without β-alanine supplementation. To determine the mechanism of β-alanine effect, α-L-alanine, an isomer which is not MrgD receptor ligand, and β-aminoisobutyrate with β-alanine-like affinity to MrgD ligand, were compared. According to our data, β-alanine stimulated specific IgE and IgG1 production in a short-term course (7 immunizations) and enhanced antibody affinity after long-term (14 immunizations) protocol in the case of low-immunogenic protein Asp f 2. In the case of high-immunogenic OVA protein, the impact of β-alanine was significant only upon antibody affinity. Hence, β-alanine accelerates specific IgE production in the case of low-immunogenic protein. The impact of β-alanine on specific IgE production was not linked to specific MrgD receptor activation, because β-aminoisobutyrate, which is the other ligand of this receptor, did not have a similar effect upon humoral immune response. The effect of β-alanine on IgG1 production seems also independent of MrgD receptor, since the common proteinogenic amino acid α-L-alanine also enhanced specific IgG1 production. The effect of β-alanine on humoral immune response could be linked to its non-specific action, e.g., due to its ability to induce oxidative stress through blocking taurine transporter, or due to its ability to stimulate cellular metabolism.

Impact of the COVID-19 Pandemic on the Short-Term Course of Obsessive-Compulsive Disorder.

There is an understandable concern that obsessive-compulsive disorder (OCD) may worsen during the COVID-19 pandemic, but there are little empirical data. We report the impact of COVID-19 pandemic on the short-term course of OCD. A cohort of patients with a primary diagnosis of OCD (n = 240) who were on regular follow-up at a tertiary care specialty OCD clinic in India were assessed telephonically, about 2 months after the declaration of the pandemic ("pandemic" cohort). Data from the medical records of an independent set of patients with OCD (n = 207) who were followed up during the same period, 1 year prior, was used for comparison (historical controls). The pandemic group and historical controls did not differ in the trajectories of the Yale-Brown Obsessive-Compulsive Scale scores (chi-square likelihood ratio test of the group × time interaction = 2.73, p = 0.255) and relapse rate (21% vs. 20%; adjusted odds ratio, 0.81; 95% confidence interval, 0.41-1.59; p = 0.535). Preexisting contamination symptoms and COVID-19-related health anxiety measured by the COVID-Threat Scale did not predict relapse. Only a small proportion of patients (6%) reported COVID-19-themed obsessive-compulsive symptoms. The COVID-19 pandemic, at least in the short run, did not influence the course of illness.

The Effects of Family Psychoeducation Courses on Depression, Anxiety and Family Functioning in the Caregivers of Schizophrenic Patients

Background: Schizophrenia is one of the most serious psychiatric diseases that affects the patient’s family members in addition to the patient himself. This disease can lead to depression and anxiety in the family members of the patient and even affect their functioning. Objectives: The present study was conducted to investigate the effect of a short-term family psychoeducation course on the depression and anxiety family functioning in caregivers Methods: In this before-after clinical trial, 163 first-degree family members of patients with schizophrenia were invited to participate in a short-term FPE course. A total of 65 of this group attended the first training session. Prior to the first session, the beck depression inventory (BDI), the beck anxiety inventory (BAI), and the family assessment device (FAD) were completed for the participants based on a family functioning model. Six months after the end of the FPE course, the 36 subjects who had completed the initial questionnaires and fully attended the sessions were invited to complete the questionnaires again. A total of 31 subjects completed the questionnaires again at this stage. The data were analyzed by SPSS-20 software using Mann–Whitney and Wilcoxon rank tests. Results: The mean age of the participants in both stages of questionnaire completion was 48.64 ± 11.85 years. Among them, 16 (51.6%) were female, and 15 (48.4%) were male. Also, six (19.4%) subjects had an education above high school, and mothers were the most frequent participating family members with a frequency of 11 (35.5%). The anxiety and depression scores of these subjects were 10.8 ± 5.14 and 6.9 ± 2.45 at baseline, respectively. These scores decreased significantly after six months to 5.03 ± 2.48 and 4.40 ± 1.9, respectively. In addition, among family functioning, Role and Behavioral control was significantly improved (P-value &lt; 0.05). Conclusions: The results of this study showed that depression and anxiety levels decreased in the family members of the examined patients six months after an FPE course. This effect can be further investigated through studies conducted with control groups. These findings suggest that the integration and institutionalization of FPE programs in the healthcare system are essential for improving the status of patient caregivers with severe psychiatric illnesses and their families.

Compliance with D2 lymph node dissection in reduced-port totally laparoscopic distal gastrectomy in patients with gastric cancer

This phase II clinical trial was performed to determine whether reduced-port laparoscopic surgery with complete D2 lymph node (LN) dissection for gastric cancer is a safe and feasible surgical technique. The prospectively enrolled 65 gastric cancer patients underwent reduced-port surgery (i.e., triple-incision totally laparoscopic distal gastrectomy [Duet TLDG] with D2 lymphadenectomy). Compliance rate was the primary outcome, which was defined as cases in which there was no more than one missing LN station during D2 LN dissection. The secondary outcomes were the numbers of dissected and retrieved LNs in each station and other short-term surgical outcomes and postoperative course. The compliance rate was 58.5%. The total number of retrieved LNs was 41 (range: 14–83 LNs). The most common station missing from LN retrieval was station no. 5 (35/65; 53.8%), followed by station no. 1 (24/65; 36.9%). The overall postoperative complication rate was 20.0% (13/65). One patient underwent surgical treatment for postoperative complications. There was no instances of mortality. Duet TLDG is an oncologically and technically safe surgical method of gastrectomy and D2 lymphadenectomy.

Histopathological Findings Predict Renal Recovery in Severe ANCA-Associated Vasculitis Requiring Intensive Care Treatment.

Renal involvement is a common and severe complication of AAV as it can cause ESRD. Histopathological subgrouping and ARRS are helpful to predict long-term ESRD in patients with AAV. Because a subgroup of critically ill patients with severe AAV present with deterioration of kidney function requiring RRT at admission, we here aimed to evaluate histopathological findings and predictive value of Berden's histopathological subgrouping and ARRS for severity of AKI and requirement of RRT during the short-term clinical course in critically ill patients requiring intensive care treatment and predictors for short-term renal recovery in patients requiring RRT. A subgroup of 15/46 (32. 6%) AAV patients with biopsy-proven AAV required RRT during the short-term course of disease, associated with requirement of critical care treatment. While histopathological subgrouping and ARRS were associated with requirement of acute RRT, presence of global glomerular scarring was the strongest predictor of failure to recover from RRT after initiation of remission induction therapy. This new aspect requires further investigation in a prospective controlled setting for therapeutic decision making especially in this subgroup.

Digital Communication Tools and Knowledge Creation Processes for Enriched Intellectual Outcome—Experience of Short-Term E-Learning Courses during Pandemic

Social isolation during the pandemic contributed to the transition of educational processes to e-learning. A short-term e-marketing education program for a variety of students was introduced in May 2020 and is taught entirely online. A survey was conducted regularly in the last week of training using Google Forms, and three cohorts were surveyed in July, September, and December 2020. A high level of satisfaction indicates an interest in the content and a positive assessment of the level of comfort of an organization adapted to the needs of students; this positive result contrasted with the negative opinion of the remote learning in Russia since March 2020, and this surprising satisfaction of students has motivated the study to try to explain its reasons. This result was compared with the short-term course taught through the educational pedagogical platform of a university. The students of traditional short- and long-term university programs were asked to assess their satisfaction with different digital communication tools used for e-learning. They showed low satisfaction with the pedagogical platform and a positive reaction to the e-communication tools (messengers, social media, short surveys, video conferences, etc.). The qualitative responses helped to better understand the real problems of the cognitive process and the triple structure of intellectual production during e-learning, including interest in the intellectual outcome, the need for emotional and motivational elements of cooperation and competition between students, and smooth behavioral enrichment, which requires special efforts from students and their leading from teachers. The main conclusion concerns a practical decision to continue the implementation of the educational program in the form of an online course with the use of the mixed digital communication tools of social media, messengers, and video conferences, which most likely meets the expectations and capabilities of students.

Clinical profile and short-term course of post-traumatic headache in children with mild traumatic brain injury: a prospective cohort study.

To study the clinical profile and factors associated with post-traumatic headache (PTH) in children with mild traumatic brain injury (mTBI) attending an urban public hospital. We enrolled 130 consecutive children aged 6-12years with mTBI (as per the International Classification of Headache Disorders-III criteria), and followed them up for 7days. Those who developed PTH were further followed up monthly for 3months. Thirty (23.1%) children developed PTH; 25 (19.2%) children had acute PTH (duration 7days to 3months) and the remaining 5 (3.8%) developed persistent PTH (> 3months). Majority (50%) had bilateral headache and squeezing quality (50%). Forty percent of those with PTH met the criteria for migraine. Obesity (P =0.84), female gender (P =0.26), family history of headache (P =0.93), and prior history of concussion (P =0.70) were not associated with risk of PTH. Children who developed PTH had higher rate of nausea (RR (95% CI) = 2.42 (1.06, 5.5); P =0.03) and vomiting (RR (95% CI) = 3.76 (1.64, 8.5); P =0.001) after mTBI. Headache resolved within 1month in 63.3% of children. PTH was found to be common after mTBI in children. Protocolized follow-up and directed history taking for PTH in all children with mTBI, who are frequently discharge from the emergency department after first aid, will lead to appropriate diagnosis and management of this problem.

Development of a Short-Term Course to Strengthen the Health Communication Skills of Nursing Students During Their Undergraduate Training

Background Communication skills are of paramount importance for healthcare professionals working with patients Lau 2013. Communication is an integral part of nursing education. It has also been recognized as an important element of nursing and nursing training with many arguing that effective communication is fundamental to quality nursing practice Mullan 2010. According to Darban 2016 teaching communication skills has become a part of nurse training program in advanced countries in the recent years. However it is neglected in nursing curriculum in developing countries which lowers the communication skills of nurses below the ideal level.AimsObjectives 1. To assess the comprehension level of students and practice of communication skills related to nursing care. 2. To determine factors responsible for poor communication skills of the nurses in the patient care settings. 3. To assess the attitudes and opinions of other health team members on improving health communication skills HCS of nurses. 4. To formulate and validate possible methods of training nursing students in enhancing their health communication skills.Design amp Methods A mixed research method was used.Results A short-term course was developed for all the levels of nursing students and the modules were tested among the final year B.Sc. N students.Conclusion The importance and need for an integrated short-term course on HCS training is evident from this study. The success of the HCS training and its effectiveness in practice by nursing students depends on the larger perspective of the organizational interest towards importance of communication skills.

The impact of a short-term language course abroad on Thai students’ language skills and affective factors

The impact of a short-term language course abroad on Thai students’ language skills and affective factors

The Spread of Conditional Cash Transfer (CCT) for Tertiary Education in the Philippines: A Bass Diffusion Model

This study predicts the spread of the new government program to be availed by out of school youths whose households are beneficiaries of the Pantawid Pamilyang Pilipino Program (4Ps) using the Bass Diffusion Model. The model predicts the time and magnitudeof newly released products and services. The diffusion of innovations (DoI) paradigm is a way of studyingthe spread of a new product and servicesthat will be adopted over time by the first adapters, then subsequent imitators and adapters that could be accommodated within the program. This model is applied to the spread of the information of the government Tertiary Education Subsidy program on the Conditional Cash Transfer (CCT) among the Filipino youth with a target of spreading the information to out ofschool youths. The cash transfer allows a beneficiary to enroll in tertiary education with allowance and free tuition fees. The enrolment for the first semester for five years (CY 2014-2018) was obtained from the quarterly reports of the Department of Social Welfare and Development (DSWD) and was applied in the Bass forecasting spreadsheet. Cumulative diffusion and saturation point were categorically determined by the CCT beneficiaries from the initial adapters, imitators, and the potential imitators. Findings revealed that there was a slow diffusion at the early stage of CCT beneficiaries in tertiary education. However, the forecast revealed that almost one million of the beneficiaries could benefit from the program after 30 years. It will take four years for students to finish their higher education degree before they can be considered part of the working force. Significantly, short-term course offerings that are skill-based may be offered to students to acquire knowledge, expertise in the tools, equipment, or technology and materials used and interactions they need to get a job thus, earning wages to help the family earn a living.

Ethics in University: Cognitive Moral Development and Gender

This study examines the accounting students' level of moral development at the university. In this study, we focused on the effects of ethics subject and gender on moral development. Therefore, we compare the moral development of male and female students. We evaluated 216 students in Cognitive Moral Development (CMD) from 17 universities in Indonesia. We measured CMD with the Defining Issues Test (DIT) model developed by Rest in 1986. The findings show that there is no difference in DIT scores between students who have taken the ethics subject and who have not taken. We also confirm female students have a higher DIT score than male students. Our study results show that gender plays an important role in the ethics issue. Our study strengthens the previous research about the effect of ethics study and ethics courses on CMD. This study has an implication for ethics education in university wherein the curriculum or the system should be prepared carefully. Although the results of this study did not show that ethics subject has a strong impact on students' CMD, we still believe that the ethics course plays a significant role in the accountants' morals. For that reason, we argue that morals need time to be developed, and cannot be taught in a short-term course. Future research is needed to explore more about this issue.

Rational perioperative antibiotic prophylaxis for open damages of brush in children

Introduction. Today, hand injuries are one of the most pressing and common problems in modern traumatology worldwide. Results obtained statistically indicate a fairly high frequency of hand injuries, including open ones. Often, an incorrect prescription of antibiotics in the form of unjustified antibiotic therapy in the absence of direct indications is done.&#x0D; Aim. This study aimed to develop a rational algorithm for perioperative antibiotic prophylaxis for open hand injuries in children based on experimental and clinical research.&#x0D; Materials and methods. The study was divided into two phases: experimental and clinical. The experiment was carried out on 60 sexually mature, outbred guinea pigs. During the experiment, the analysis of clinical signs of inflammation, complete blood count and biochemical blood analysis, spiral computed tomography, and morphological study of the consolidation zone were performed. The clinical part of the work is based on the analysis of surgical treatment results of 120 children with open hand injuries, which were divided into two groups: the main group that included 50 children receiving treatment according to the experimentally developed perioperative antibiotic prophylaxis (PAP) algorithm, and the comparison group included 70 children receiving a perioperative course of antibiotics from 0 to 7 days, without a well-defined algorithm.&#x0D; Results. In the analysis of clinical results, laboratory, radiation, and morphological methods of studying the experimental material, the absence of antibiotic prophylaxis in open fractures of small tubular bones with a 90% probability was found to entail pro-inflammatory complications in the area of postoperative wound; however, a one day short-term course of PAP will prevent complications and will not have statistically significant differences with a longer course of three days.&#x0D; Discussion. Results of a clinical study proved the effectiveness of the developed algorithm and showed better results in early and late postoperative period in comparison with the chaotic prescription of antibacterial drugs without a clear algorithm; however, no statistically significant differences in the level of postoperative complications were found.&#x0D; Conclusion. On the basis of an experimental model of an open fracture of the tubular bone, osteosynthesis and various courses of antibiotic prophylaxis has proven that a short-term course of PAP within 24 h is the most optimal one, and achieving minimal risks of inflammatory complications and better anatomical and functional outcomes in clinical practice.

Evaluation of a short-term ultrasound curriculum on promoting interest in healthcare and sciences for deaf and hard of hearing students

PurposeThe objective of this study was to determine if exposure to a short-term ultrasound basic biology and anatomy course can promote interest in health careers and other science-related endeavors among DHH students.Design/methodology/approachThis was a single-site, prospective observational study of DHH high school students at a Southern California high school. All participants took a pre-test survey prior to the course. Participants then took part in three teaching sessions which taught basic anatomy using point-of-care ultrasound (POCUS). Following instruction, a post-test survey was performed to determine if students had an increased interest in medicine, science and biology (p = 0.151).Findings28 students were enrolled in the study, with an equal distribution of boys and girls. Initially, subjects reported their interest in medicine at an average of 2.8 ± 1.10. The reported interest in science was 3.0 ± 1.13 and for biology was 3.0 ± 1.19. The change in participants' interest was not statistically significant for medicine (p = 0.791), science (p = 0.225) and biology.Practical implicationsWhile our data did not demonstrate a statistically significant difference in students' interest in STEM fields after the training course, there were several students who were interested in more hands-on shadow experience after the course. Regardless, this study demonstrates persistent barriers that exist for a person who is deaf or hard of hearing to engage in the STEM fields. Future studies are needed to determine the level of instructional activities that may impact the careers of these students.Originality/valuePoint of care ultrasound has been shown to be an effective teaching modality in medical education. However, to date, no studies have been done to assess the utility of ultrasound in teaching the Deaf and Hard of Hearing (DHH) population.