ABSTRACT
Purpose of Study: Since 1972, Bhutan has followed the philosophy of Gross National Happiness (GNH) - an alternative to GDP which quantifies the holistic wellness of its citizens' as opposed to the production of materials as a metric of the nation's development & prosperity. Nonetheless, the government identified youth and young adult (YYA) mental health to be a major/increasing point of concern from a 2015 national survey, indicating need for a closer look at Bhutan's mental health burden. By exploring YYA perspectives of mental health via an online survey, we hope to inform resource creation, support existing infrastructure, & guide future research. Methods Used: Survey questions were developed via collaboration of Canadian and Bhutanese shareholders to ensure cultural appropriateness and relevance. In all, 11 demographics questions, 17 10-point Likert scale questions, and 7 written answer questions were included in the survey. Students enrolled at university in Thimphu, Bhutan, between the ages of 18-25 inclusive and who are Bhutanese citizens or who have lived the majority of their life in the country were recruited via email. 289 participants consented to & completed the online survey via Qualtrics. Survey responses were quantitatively analyzed in R-Studio, save for written responses still under qualitative analysis in NVivo and not included in this discussion. Summary of Results: On average, YYA indicated feeling sad, anxious, and/or depressed more frequently than they perceived peers/family to feel the same. Strong agreement was seen regarding treatability of mental health conditions (median of 9 on 10-point Likert scale). Environmental factors, adverse childhood experiences, & personal weakness were noted to have detrimental impacts on wellbeing. The majority of respondents indicated positive familial relationships & confidence in parents to understand/support mental health issues, with medians for all family-related 10-point Likert scale questions being above 7.5. Most respondents agreed they were able to get through difficult times and be self-reliant, with all associated 10-point Likert questions having a median over 5 for moderate agreement. A general positive response to using apps or websites as mental health resources was noted. Relating to COVID-19, minimal negative outcomes in terms of diet, anxiety/depression, home life, & substance use were reported. Strong agreement (median of over 7.5 on 10-point Likert scale) was noted with regard to increases in domestic violence as a result of the pandemic. Conclusion(s): Differences between self-ratings and perceptions of others' mental health by Bhutanese YYA indicate a lack of open communication about the topic. Directing resources towards discussions about mental health may be beneficial - especially if technologically accessible. Impacts of the pandemic may continue to develop as Bhutan emerges from lockdown protocols;increasing domestic violence is a primary concern of Bhutanese YYA meriting research.
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Objective To evaluate the evidence of the experience with medical sewage treatment procedures in medical institutions in China. Methods Databases including CNKI, WanFang Data, PubMed, Web of Science, and EBSCO were electronically searched to collect studies on the medical sewage treatment process, flow, and specifications in medical institutions in China. We used the quality evaluation system to classify and grade the experiences based on the principles and methods of evidence-based science and performed a descriptive analysis. Results After the SARS pandemic in 2003, China systematically established and standardized the technical criteria of medical sewage treatment and discharge. Moreover, a prevention system for the epidemic using medical sewage was constructed, which guaranteed that the quality of medical sewage treatment and discharge would meet the criteria and protect the citizens, and the technical specifications of medical sewage treatment would progress and increase strictly. At present, medical sewage treatment in medical institutions in China was based on mechanical and biological methods, and disinfection was mainly performed using chlorine and its compounds, ozone, and ultraviolet light. Conclusion The COVID-19 pandemic requires a higher quality of medical sewage treatment and discharge criteria for medical institutions in China. To meet these criteria, all medical institutions in China should check, replace, and update their old facilities;strengthen personnel training and effectively ensure the quality of medical sewage treatment.
ABSTRACT
BACKGROUND: Online education has been increasingly utilized over the past decades. The COVID-19 pandemic accelerated the transition of conventional face-to-face curricula to online platforms, with limited evidence for its teaching efficacy. This systematic review aims to assess the effectiveness of online video-based education compared with standard conventional education in teaching basic surgical skills to surgical trainees and students undergoing medical training. METHODS: We performed a literature search in Embase, Medline, Cochrane CENTRAL and Scopus from inception until February 2022. Studies included were randomised controlled trials (RCTs) and observational studies. We included randomised controlled trials only for meta-analysis. The primary outcome was surgical skill proficiency. The secondary outcomes were participant perception, confidence and satisfaction. Two authors independently assessed the search results for eligibility, extracted the data and assessed the risk of bias using the Cochrane Risk of Bias tool 2. Where appropriate, we performed random effects meta-analyses of the pooled study data to calculate a standardized mean difference. RESULTS: A total of 11 studies met the inclusion criteria totaling 715 participants; 603 were included in qualitative analysis and 380 in meta-analysis. All included studies were assessed as having a low risk of bias. The majority of studies found no significant difference between conventional and video-based education in teaching basic surgical skills, three studies found video-based education was superior and one study found conventional education was superior. There was no statistically significant difference in skill proficiency between the two groups (standardized mean difference of -0.02 (95% CI: -0.34, 0.30); p=0.90). Video-based education results in an equivalent improvement in confidence and satisfaction rates. Additional benefits of video-based education include convenience, accessibility and efficiency. CONCLUSIONS: Basic surgical skills can be taught as effectively through online video-based education as conventional teaching methods. Online education should be utilized as an adjunct to medical curricula beyond the COVID-19 era.