Training Infrastructure Research Articles

Global health disparities in childhood cancers.

The high cure rates of children with cancer in high-income countries (HICs) are due to the impact of biomedical innovations on children with highly fatal diseases. We discuss why these innovations have not benefitted most children with cancer globally and propose broad strategies to reduce these disparities. Over 85% of children with cancer in HIC are cured while less than 20% in many low-income countries survive the disease. Hence, childhood cancer survival is poor globally since over 80% of children with cancer live in low-income and middle-income countries (LMICs). Inadequate skilled workforce and health infrastructure across all disciplines of pediatrics in LMIC are the main reasons for these disparities. Although biological differences may contribute to these disparities as well, many are unconfirmed because they are confounded by differences in referral patterns and clinical capacity. HIC partnerships with LMIC that focus on locally based pediatrics training and clinical infrastructure building are beginning to close the gap. Pediatric oncology is symbolic of the significant disparities in childhood survival arising from poverty, inadequate pediatric infrastructure, and skilled workforce in LMIC. Partnerships with HIC that build multidisciplinary pediatrics capacity and clinical infrastructure are beginning to make transformative improvements.

New Approaches to OCR for Early Printed Books

Books printed before 1800 present major problems for OCR. One of the main obstacles is the lack of diversity of historical fonts in training data. The OCR-D project, consisting of book historians and computer scientists, aims to address this deficiency by focussing on three major issues. Our first target was to create a tool that identifies font groups automatically in images of historical documents. We concentrated on Gothic font groups that were commonly used in German texts printed in the 15th and 16th century: the well-known Fraktur and the lesser known Bastarda, Rotunda, Textura und Schwabacher. The tool was trained with 35,000 images and reaches an accuracy level of 98%. It can not only differentiate between the above-mentioned font groups but also Hebrew, Greek, Antiqua and Italic. It can also identify woodcut images and irrelevant data (book covers, empty pages, etc.). In a second step, we created an online training infrastructure (okralact), which allows for the use of various open source OCR engines such as Tesseract, OCRopus, Kraken and Calamari. At the same time, it facilitates training for specific models of font groups. The high accuracy of the recognition tool paves the way for the unprecedented opportunity to differentiate between the fonts used by individual printers. With more training data and further adjustments, the tool could help to fill a major gap in historical research.

ATHLETE TRACK AND FIELD RECRUITMENT IN SPORT STUDENT TRAINING CENTER

Athlete recruitment was importance in sport achievement. If have good athlete based on good talend selected, so it will be greatest opportunities height performance achievement. PPLP given facilities and opportunities for student athlete from secondary and senior high school. The purpose of this study is to determine the management of athlete recruitment, athlete training and training programs and supporting infrastructure for athlete training. The research method used in this is qualitative. Sources of data in this study were athletes, coaches, PPLP managers and administrators of PASI KALBAR. The instruments in this study were observation, semi-structured interviews, field notes and documentation. The technique of checking the validity of the data is by triangulation. The recruitment athlete had charged in 2017, that was recruitment depend on coach recommendation. Coaches made recommendation based on athlete achievement. In 2017 that recruitment based on KEMANPORA rules. From 2012 to 2019 not yet showed significance achievement performance. Base on the data research showed, with new selection recruitment did not effect on achievement.

Courseware as Code: Instituting Agile Courseware Collaboration

In 2014, the Secretary and Chief of Staff of the Army established the Cyber branch and the U.S. Army Cyber School (USACyS). Quickly building USACyS from scratch required building courseware to fill workforce-oriented curricula. Before we could finish creating sufficient and suitable content, the Army assigned students and scheduled classes. As we worked rapidly to create content, we turned to cloud-hosted storage and synchronization options. However, we found storage options for nonmarkup-language files could not support a managed workflow of creation, sharing, review, and approval. We struggled with an appropriate access control method to enable contributions from a diverse set of authors including faculty, contractors, and even students themselves. We had already chosen to use a privately hosted instance of GitLab for our virtual training infrastructure configuration, and we began to realize the potential of this type of version control repository for courseware. Through Git, we applied the everything as code concept to our courseware.

Peritoneal dialysis patient selection from a comorbidity perspective.

Despite many medical and socioeconomic advantages, peritoneal dialysis (PD) is an underutilized dialysis modality that in most countries is used by only 5%-20% of dialysis patients, while the vast majority are treated with in-center hemodialysis. Several factors may explain this paradox, such as lack of experience and infrastructure for training and monitoring of PD patients, organizational issues, overcapacity of hemodialysis facilities, and lack of economic incentives for dialysis centers to use PD instead of HD. In addition, medical conditions that are perceived (rightly or wrongly) as contraindications to PD represent barriers for the use of PD because of their purported potential negative impact on clinical outcomes in patients starting PD. While there are few absolute contraindications to PD, high age, comorbidities such as diabetes mellitus, obesity, polycystic kidney disease, heart failure, and previous history of abdominal surgery and renal allograft failure, may be seen (rightly or wrongly) as relative contraindications and thus barriers to initiation of PD. In this brief review, we discuss how the presence of these conditions may influence the strategy of selecting patients for PD, focusing on measures that can be taken to overcome potential problems.

Evaluating the effect of strengthening nurse midwifery pre-service education in two Indian states: A single group pre – and post – intervention study

BackgroundThe high focus states of India have higher maternal and neonatal mortality rates as compared to the national average. The quality of pre-service education (PSE) in nursing midwifery institutions in these states was found to be suboptimal. In 2013, Government of India implemented the PSE strengthening program across all public sector nursing midwifery institutions. The program focused on strengthening educational processes, training infrastructure, institutional management and clinical site practices by implementing a set of performance standards. ObjectiveTo evaluate the effect of PSE strengthening program on institutional performance and maternal neonatal health (MNH) related competences of nursing midwifery students and faculty. DesignSingle group pre-post intervention study. Settings15 sampled public sector nursing midwifery institutions in the states of Madhya Pradesh and Odisha, India. ParticipantsFinal-year students and faculty involved in teaching MNH subjects. MethodsPerformance of 15 sampled institutions was assessed at baseline, midline and endline using the performance standards. Additionally, competences of 232, 295 and 298 students and 64, 62 and 63 faculty members at baseline, midline and endline respectively were assessed on six MNH related practices using objective structured clinical examination (OSCE). ResultsNone of the institutions met 70% standards during baseline. At endline, 13 of the 15 institutions met these standards. The mean OSCE scores of students and faculty at baseline was 17.1 (SD: 8.0) and 23.5 (SD: 14.3) out of 76 respectively. It significantly increased to 66.4 (SD: 8.0) and 71.1 (SD: 5.2) during the endline. The proportion of students and faculty found competent (achieved 75% in OSCE) also significantly increased from none at baseline to 91% and 98% respectively, at endline. ConclusionThe combination of attributes included in the PSE strengthening program may have contributed to improvements in institutional performance as well as MNH related competences of nursing midwifery students and faculty.

Determinants of an evidence-based practice environment: an interpretive description

BackgroundDespite the available research to inform nursing practice, many patients still fail to receive evidence-based care. Several evidence-based practice (EBP) models have been developed to guide nurses through the steps in the process, yet these models have not been uniformly adopted or consistently used. The original purpose of this research was to gather perspectives and experiences of nurses using the Iowa Model of EBP to help inform its introduction into other practice settings. As a more in-depth understanding was gained, the emphasis of the study shifted towards understanding the determinants of the EBP environment.MethodThe study was conducted in an 800-bed comprehensive academic medical centre in the USA with a 25-year history of using the Iowa Model of EBP. Semi-structured in-depth interviews were conducted with twelve nurses from various roles to ascertain their perspectives and experiences using the model. The interview transcripts were reviewed alongside relevant published literature and internal documents in a process of synthesising, theorising, and conceptualising. Data were collected during the first half of 2019.ResultsFour determinants of the local EBP environment were identified from the perspectives and experiences of participants: (1) the importance of a shared model to guide staff through the EBP process; (2) support for EBP in the form of education, hands-on training, and knowledge infrastructure; (3) active team facilitation by direct care nurses, nurse managers, nurse specialists, and nurse scientists; and (4) a culture and leadership that encourages EBP.ConclusionIntroducing an EBP model is an essential first step for an organisation to improve consistent and reliable evidence-based care; to be most effective, this should be done in conjunction with efforts to optimise the EBP environment.

Failing adult learners: Why Rwanda’s adult literacy education is not delivering

Having a literate society has been a policy objective of the Rwandan Government for 20 years. However, in practice, it has never been a high priority, although investing in adult literacy education has the potential to contribute to socio-economic transformation. This paper reports on findings from a survey, key informant interviews and focus group discussions. We show that learners rarely benefit from attending literacy classes. Extreme poverty, lack of a ‘culture of reading’ and the poor delivery of literacy classes are the main barriers to student learning. Without more investment in training tutors, infrastructure and learning resources, the policy implementation gap will persist.

‘It wasn't just the academic stuff, it was life stuff’: the significance of peers in strengthening the Indigenous health researcher workforce

Abstract Health research remains a vital activity of Indigenous health workforces. This paper reports on the main findings of yarning interviews with 14 Indigenous researchers, that was central to a project analysing the role of research training infrastructures in strengthening the Indigenous health research workforce in Australia. The findings highlighted Indigenous researcher peers as core sources of inspiration, moral support and sustenance in academia and in life. Peer generative power arising from peer groups provide a unique enriching to the educational and research experience. Indigenous researcher peers have a strong shared aspiration to champion change to health research and higher education as a key pathway to widespread positive impacting on health and well-being. We suggest the (revived) development at a collective level of a strategic and planned approach to capitalising on the positive outcomes of peer generated leadership and support.

Persepsi Peserta Atas Penyelenggaraan Massive Open Online Course (MOOC) Audit Berbasis Risiko

This study is aimed at identifying and measuring the critical success factors in the implementation of the Massive Open Online Course (MOOC) in technical training for auditor within the Badan Pengawasan Keuangan dan Pembangunan. The study is based on the perceptions of training participants obtained from the answers to the questions in the questionnaire that were filled out when completing the learning session. The questions are divided into five groups of questions which according to the literature are critical success factors including the provision of training, training materials and learning designs, online lecturers / instructors, training infrastructure, and support services. The sample in the study was taken from the MOOC learning session which included 165 responses. The results showed that the training participants perceived that the learning infrastructure factor was the most important determinant of success and was followed by the online instructor / instructor factor. While the training material and learning design factors were perceived by the training participants as the least influencing factors on the successful implementation of the MOOC. 
 
 

РЕАЛІЗАЦІЯ НАУКОВО-ПЕДАГОГІЧНОЇ ФУНКЦІЇ ВИКЛАДАЧА В КОНТЕКСТІ СТРАТЕГІЇ РОЗВИТКУ ВИЩОЇ ОСВІТИ В УКРАЇНІ

З огляду на дуальну «науково-педагогічну» функцію університетського викладача обґрунтовано умови її ефективної реалізації в конкурентоспроможному закладі вищої освіти. Серед цих умов — зниження навчального навантаження, підвищення конкурентоспроможності заробітної плати, необхідна і достатня навчальна, дослідницька, інформаційна інфраструктура закладу, посилення конкурсності відбору викладачів. У контексті стабілізації обсягів видатків на систему вищої освіти на рівні 1,2 % ВВП для створення зазначених умов насамперед потрібна оптимізація мережі закладів вищої освіти шляхом їх укрупнення, концентрації ресурсів, розвитку фінансової автономії для мотивації ефективної діяльності викладачів.

Cierre de Escuelas y Desigualdad Socioeducativa en Tiempos del Covid-19. Una Investigación Exploratoria en Clave Internacional

La pandemia del Covid-19, causada por el virus SARS-CoV-2, ha cambiado el modus vivendi de miles de personas en todo el mundo. La excepcionalidad y la emergencia ha influido en diversos sectores y ámbitos de la vida social e institucional de los seres humanos como el sanitario, económico, político o educativo. El objetivo de este estudio es ofrecer una perspectiva internacional sobre el proceso de cierre de escuelas y sus consecuencias educativo-sociales a través de las percepciones de informantes clave. Con una muestra que alcanza 23 países y 4 continentes distintos, las percepciones se han analizado en base a siete categorías: Tiempos en la ejecución, anticipación o demora de medidas. Carácter democrático-participativo de las medidas educativas tomadas. Adaptación curricular, didáctica y metodológica. Infraestructura y recursos para una adecuada formación a distancia. Percepciones acerca del profesorado. Percepciones sobre el entorno familiar. Propuestas alternativas. Los resultados muestran una elevada diversidad de maneras de afrontar esta situación, pero con similares consecuencias para la población más vulnerable. Ello implica una llamada de atención a responsables y agentes del ámbito educativo para frenar la desigualdad educativa y social que el Covid-19 puede estar generando.

Multidisciplinary Subspecialty Capacity Building for Global Pediatric Oncology

PURPOSE Specialized multidisciplinary care is central to childhood cancer control. Expertise and infrastructure in the pediatric disciplines of hematology, surgery, critical care, nursing, and pathology are as critical as pediatric oncology. Survival of the majority of children with cancer globally remains dismal because of the scarcity of multidisciplinary pediatric subspecialty services. We present the innovative approach and impact of Texas Children’s Global HOPE initiatives to cost-effectively develop capacity for specialized multidisciplinary cancer care for children in sub-Sahara Africa (SSA). METHODS Global HOPE designed and supports subspecialty training and contingent infrastructure building in SSA in the following disciplines that are critical to pediatric cancer care: pediatric hematology and oncology (PHO), pediatric surgery, pediatric critical care, anatomic and molecular pathology, and pediatric oncology nursing. Key principles underlying the design of each disciplinary program are that it enables the implementation of current best evidence-based practices, primarily uses a problem-based learning approach, and is integrated and accredited by the local health sciences university. Training primarily occurs at an African hub where Global HOPE also supports infrastructure for clinical care and research, in addition to onsite faculty and offsite telemedicine support from the headquarters in Houston, TX. RESULTS The PHO and pediatric surgery fellowship programs based at Makerere University, Kampala, are the most advanced thus far. Twenty pediatricians from 6 African countries have enrolled and 8 have graduated from the 2-year PHO program. One surgeon enrolled in the 3-year pediatric surgery fellowship annually and 6 have graduated since inception. The fellowship programs have directly affected patient outcomes because of evidence-based clinical rigor and enhanced clinical infrastructure. All graduates from the 2 fellowships are currently practicing in SSA. CONCLUSION Formal in situ pediatric subspecialty training is feasible in low- and middle-income countries and carries the critical advantages of infrastructure development, direct patient impact, and is less susceptible to brain drain.

Oncologist Confidence in Genomic Testing and Implications for Using Multimarker Tumor Panel Tests in Practice.

PURPOSEThe evolution of precision oncology increasingly requires oncologists to incorporate genomic testing into practice. Yet, providers’ confidence with genomic testing is poorly documented. This article describes medical oncologists’ confidence with genomic testing and the association between genomic confidence and test use.METHODSWe used data from the 2017 National Survey of Precision Medicine in Cancer Treatment to characterize oncologists’ confidence with genomic testing. Genomic confidence was examined separately by type of test user: next-generation sequencing (NGS) only, gene expression (GE) only, both NGS and GE, or nonuser. Predictors of genomic confidence were examined with multinomial logistic regression. The association between genomic confidence and test use was examined with multivariable linear regression.RESULTSMore than 75% of genomic test users were either moderately or very confident about using results from multimarker tumor panel tests to guide patient care. Confidence with using multimarker tumor panel tests was highest among both NGS and GE test users, with 60.1% very confident in using test results, and lowest among NGS-only test users, with 38.2% very confident in using test results. Oncologists were most confident in using single-gene tests and least confident in using whole-genome or -exome sequencing to guide patient care. Genomic confidence was positively associated with self-reported test use. In adjusted models, training in genomics, larger patient volume, and treating patients with solid tumors predicted higher genomic confidence. Onsite pathology services and receipt of electronic medical record alerts for genomic testing predicted lower genomic confidence.CONCLUSIONOncologists’ confidence varies by testing platform, patient volume, genomic training, and practice infrastructure. Research is needed to identify modifiable factors that can be targeted to enhance provider confidence with genomic testing.

Growing research in geriatric medicine: a trainee perspective.

Growing research in geriatric medicine is a priority area. Currently, involvement of geriatricians in research lags behind other specialties. The reasons for this are multifactorial, but a lack of training infrastructure within geriatric medicine higher specialist training is contributory. This is widespread across European countries and internationally. The Geriatric Medicine Research Collaborative (GeMRC) offers an opportunity to engage trainees in research, regardless of their previous individual research experiences. Utilising national trainee networks, GeMRC is able to conduct large-scale projects within short periods of time that can have real impact upon patient care. We consider that embedding GeMRC within higher specialist training with formal college support will assist to upskill trainee geriatricians in research methodology. Collaboratives are internationally recognised across disciplines. Expansion across European and international countries offers the opportunity for international collaboration in geriatric medicine. International trainee-led networks will enable the conduct of large-scale global projects in geriatric medicine.

Mobility Prediction-Based Optimisation and Encryption of Passenger Traffic-Flows Using Machine Learning.

Information and Communication Technology (ICT) enabled optimisation of train’s passenger traffic flows is a key consideration of transportation under Smart City planning (SCP). Traditional mobility prediction based optimisation and encryption approaches are reactive in nature; however, Artificial Intelligence (AI) driven proactive solutions are required for near real-time optimisation. Leveraging the historical passenger data recorded via Radio Frequency Identification (RFID) sensors installed at the train stations, mobility prediction models can be developed to support and improve the railway operational performance vis-a-vis 5G and beyond. In this paper we have analysed the passenger traffic flows based on an Access, Egress and Interchange (AEI) framework to support train infrastructure against congestion, accidents, overloading carriages and maintenance. This paper predominantly focuses on developing passenger flow predictions using Machine Learning (ML) along with a novel encryption model that is capable of handling the heavy passenger traffic flow in real-time. We have compared and reported the performance of various ML driven flow prediction models using real-world passenger flow data obtained from London Underground and Overground (LUO). Extensive spatio-temporal simulations leveraging realistic mobility prediction models show that an AEI framework can achieve 91.17% prediction accuracy along with secure and light-weight encryption capabilities. Security parameters such as correlation coefficient (<0.01), entropy (>7.70), number of pixel change rate (>99%), unified average change intensity (>33), contrast (>10), homogeneity (<0.3) and energy (<0.01) prove the efficacy of the proposed encryption scheme.

The Pico OWC wave power plant: Its lifetime from conception to closure 1986–2018

The paper describes the basic studies, design, construction and operation of a shoreline OWC wave power pilot plant on the island of Pico, Azores, Portugal. Construction began in 1996. The concrete structure of the chamber (square planform with inside dimensions of 12m×12m at mean water level) was built in-situ on rocky bottom (about 8 m water depth), spanning a small natural harbour (gully). The plant was equipped with a horizontal-axis Wells turbine-generator set rated 400 kW. The plant was fully automated in order to supply electrical energy to the island grid on a permanent basis. It became operational in 1999. The paper describes the life of the plant during the following almost twenty years, including frequent repairs, modifications and the use of the plant as supplier of energy to the island grid, and as an infrastructure for research and training.

Institutional adoption of blended learning on a budget

PurposeThis research paper aims to explore blended learning implementation in universities that are on a low budget, essentially determining the more important steps to invest during the initial stage of implementation and investing in costly IT infrastructure or training faculty for student-centred learning and relevant pedagogies.Design/methodology/approachA survey of 254 students at the University of Jordan (UJ) has been administered. Student satisfaction with blended learning is related to the two main variables of IT infrastructure and teacher training for blended learning strategies.FindingsThe results indicate that faculty training has a significantly higher impact on predictability of satisfaction than IT infrastructure. Therefore, low-budget institutions should focus first on helping instructors shift to student-centred styles of pedagogies before making large investments in IT infrastructure.Research limitations/implicationsBecause of the fact that the chosen setting did not completely lack IT infrastructure, the results may need to be retested with at least two individual institutions, one where advanced IT infrastructure is available and one where it is completely lacking. More can also be done to vary the limited location of the study.Practical implicationsThis paper suggests that making costly investments into technology is not a necessary first step during the initial stages of blended learning adoption in developing countries.Originality/valueThis paper addresses the need for more research on blended learning adoption in developing countries with scarce finances and lack of resources sufficient to achieve faculty training and IT infrastructure improvement together. Several universities make costly investments only to lack sufficient blended learning pedagogies which often results in failed blended learning implementation.

Backdoor Suppression in Neural Networks using Input Fuzzing and Majority Voting

While inference is needed at the edge, training is typically done at the cloud. Therefore, data necessary for training a model, as well as the trained model, have to be transmitted back and forth between the edge and the cloud training infrastructure. This creates significant security issues, including the inclusion of a backdoor sent to the user without the user’s knowledge. This article presents an approach where a trained model can still operate as expected, irrespective of the presence of such a backdoor.—Theocharis Theocharides, University of Cyprus —Muhammad Shafique, Technische Universitat Wien

Trauma Education and Stigma Reduction in Global Settings: An Evaluation of the Impact of a One-Day Trauma Psychoeducation Workshop with Community Stakeholders in the Caribbean Nation of Saint Lucia.

The independent island nation of Saint Lucia and surrounding Caribbean countries have fairly well-documented high reported rates of trauma, but limited training infrastructure for trauma-related mental health support and treatment services. This study addresses this disparity between high trauma exposure and sparse trauma-related resources by studying how a one-day training workshop impacted self-rated knowledge about trauma and stigma towards trauma survivors. The training was provided by a licensed clinical psychologist in partnership with a local women’s rights group. Participants (n = 41) included school counselors, nurses, psychiatric providers, health educators, and advocates on the island. Participants completed pre- and post-workshop measures examining the variables of interest. The one-day workshop provided training on trauma types, post-trauma reactions, options for treatment, and hands-on training for trauma crisis-management and short-term interventions. Following the workshop, participants reported increased knowledge of trauma, more accurate perceptions of its prevalence, better understanding of evidence-based treatments, and lower trauma survivor-related stigma. This is the first trauma-focused workshop tested in St. Lucia, where the need for such training is considerable given few treatment options for trauma survivors in this area. Work is underway to provide more expansive services for trauma across the Caribbean region, given these preliminary promising findings.