Moral distress and positive experiences of ICU staff during the COVID-19 pandemic: lessons learned.

BACKGROUND: The COVID-19 pandemic causes moral challenges and moral distress for healthcare professionals and, due to an increased work load, reduces time and opportunities for clinical ethics support services. Nevertheless, healthcare professionals could also identify essential elements to maintain or change in the future, as moral distress and moral challenges can indicate opportunities to strengthen moral resilience of healthcare professionals and organisations. This study describes 1) the experienced moral distress, challenges and ethical climate concerning end-of-life care of Intensive Care Unit staff during the first wave of the COVID-19 pandemic and 2) their positive experiences and lessons learned, which function as directions for future forms of ethics support. METHODS: A cross-sectional survey combining quantitative and qualitative elements was sent to all healthcare professionals who worked at the Intensive Care Unit of the Amsterdam UMC - Location AMC during the first wave of the COVID-19 pandemic. The survey consisted of 36 items about moral distress (concerning quality of care and emotional stress), team cooperation, ethical climate and (ways of dealing with) end-of-life decisions, and two open questions about positive experiences and suggestions for work improvement. RESULTS: All 178 respondents (response rate: 25-32%) showed signs of moral distress, and experienced moral dilemmas in end-of-life decisions, whereas they experienced a relatively positive ethical climate. Nurses scored significantly higher than physicians on most items. Positive experiences were mostly related to 'team cooperation', 'team solidarity' and 'work ethic'. Lessons learned were mostly related to 'quality of care' and 'professional qualities'. CONCLUSIONS: Despite the crisis, positive experiences related to ethical climate, team members and overall work ethic were reported by Intensive Care Unit staff and quality and organisation of care lessons were learned. Ethics support services can be tailored to reflect on morally challenging situations, restore moral resilience, create space for self-care and strengthen team spirit. This can improve healthcare professionals' dealing of inherent moral challenges and moral distress in order to strengthen both individual and organisational moral resilience. TRIAL REGISTRATION: The trial was registered on The Netherlands Trial Register, number NL9177.

Diabetes and tuberculosis syndemic in India: A narrative review of facts, gaps in care and challenges.

Both diabetes mellitus (DM) and tuberculosis (TB) are prevalent all across in India. TB-DM comorbidity has emerged as a syndemic and needs more attention in India considering gaps in screening, clinical care, and research. This paper is intended to review published literature on TB and DM in India to understand the burden of the dual epidemic and its trajectory and to obtain perspectives on the gaps, constraints, and challenges in care and treatment of this dual epidemic. A literature search was carried out on PubMed, Scopus, and Google Scholar, using the key words 'Tuberculosis' OR 'TB' AND 'Diabetes' OR 'Diabetes Mellitus' AND 'India', focusing on the research published between the year 2000 to 2022. The prevalence of DM is high in patients with TB. Quantitative data on the epidemiological situation of TB/DM in India such as incidence, prevalence, mortality, and management are lacking. During the last 2 years convergence of TB-DM syndemic with the COVID-19 pandemic has increased cases with uncontrolled DM but also made coordinated control of TB-DM operationally difficult and of low effectiveness. Research regarding TB-DM comorbidity is required in the context of epidemiology and management. Detection and bidirectional screening are aggressively warranted. Management of DM in those with TB-DM comorbidity needs more efforts, including training and supervision of frontline workers.

An exploratory study to understand faculty members' perceptions and challenges in online teaching.

The government of the United Arab Emirates (UAE) considers technology to be one of the main pillars of its vision for moving towards a knowledge-based society. Due to several factors such as globalisation, demand for information technology infrastructure and COVID-19 lockdowns, e-learning has become a popular method of delivery across higher education institutions in the UAE. In a first step, the authors of this article conducted a systematic review of existing literature (49 items published between 1999 and 2020). They found that the existing literature on online learning predominantly focuses on student-specific challenges, while there is still a dearth of published work covering faculty members' specific challenges in facilitating online learning in the UAE. The second part of this exploratory study drew on stakeholders' reflections of several years of designing and delivering online courses, analysing faculty members' perspectives on online teaching and learning in the UAE. The authors present their qualitative research, which involved open-ended semi-structured interviews with 15 faculty members, followed by a thematic analysis of their responses using NVivo 12 pro software. The most critical themes which emerged were learners' expectations, culture, perception, pedagogy and technology. The article also reveals how these topics contribute to the various strategies for seamless adoption and delivery of online education in the UAE.

Une étude exploratoire pour comprendre les perceptions et les défis des enseignants dans l'enseignement en ligne ­ Le gouvernement des Émirats Arabes Unis (EAU) considère la technologie comme l'un des principaux piliers de son projet d'évolution vers une société axée sur la connaissance. En raison de plusieurs facteurs tels que la mondialisation, la demande d'infrastructures pour les technologies de l'information et les confinements dus au COVID-19, l'apprentissage en ligne est devenu une méthode d'enseignement populaire dans les établissements d'enseignement supérieur aux EAU. Dans un premier temps, les auteurs de cet article ont procédé à une revue systématique de la littérature existante (49 articles publiés entre 1999 et 2020). Ils ont constaté que la littérature existante sur l'apprentissage en ligne se concentre principalement sur les défis propres aux étudiants, alors qu'il y a encore peu de travaux couvrant les défis spécifiques aux membres du corps enseignant pour faciliter l'apprentissage en ligne aux EAU. La deuxième partie de cette étude exploratoire s'est appuyée sur les réflexions de différents acteurs sur plusieurs années de conception et d'enseignement de cours en ligne, analysant les perspectives des membres du corps enseignant sur l'enseignement et l'apprentissage en ligne aux EAU. Les auteurs présentent leur recherche qualitative, qui comprend des entretiens semi-structurés ouverts avec 15 membres du corps enseignant, suivis d'une analyse thématique de leurs réponses à l'aide du logiciel NVivo 12 pro. Les thèmes les plus importants qui ont émergé ont été les attentes des apprenants, la culture, la perception, la pédagogie et la technologie. L'article révèle également comment ces sujets contribuent aux diverses stratégies pour une adoption et une diffusion harmonieuses de l'enseignement en ligne aux EAU.

Participatory video from a distance: co-producing knowledge during the COVID-19 pandemic using smartphones.

In this paper, I outline an innovative remote participatory video (PV) methodology that makes use of participants' smartphones. It was developed as an alternative to co-production research and can be employed when face-to-face contact is impossible or undesirable. Because of the COVID-19 pandemic, face-to-face research interactions have been disrupted or become impossible. Yet it is vital to reach those who are most affected by emergencies and to include their voices. The research reported here was a collaboration between women in Medellín, Colombia, and a team of filmmakers and researchers. We developed an innovative remote PV methodology using participants' smartphones, researching how women from poorer neighbourhoods were affected by the pandemic in their everyday lives. Here, I reflect on the strengths and weaknesses of the remote PV methodology, arguing that it offers new avenues for participants to take control of the filming and editing process, and builds technical skills and capacities that have value beyond the timeframe of the project. I conclude that the remote PV method has great potential as a stand-alone method, moving the landscape of co-production research away from a requirement for geographical co-presence and potentially shifting power and ownership towards local co-researchers and participants.

An exploration into the challenges of managing the COVID-19 pandemic in mass education centers in Iran: A qualitative content analysis.

Background: During the COVID-19 pandemic, Iran's mass education centers, which house a large number of trainees, encountered numerous difficulties in managing the disease. Understanding these challenges can help manage future pandemics. This study was conducted to explore the challenges of managing the COVID-19 pandemic in mass education centers in Iran. Methods: In this qualitative study, we used a qualitative content analysis of data collected from June to October 2022 in eight mass education centers in Iran. Semi-structured interviews (n=19) were used for data collection. Results: Four main themes and eleven subthemes were identified: The essence of dormitory life (Subthemes included: "The high population density in the dormitory", "Public toilets" and, Interprovincial travel), the inflexibility of the profession (Subthemes included: "Inapplicable health protocols" and, "Inflexible rules and regulations"), Negligence (Subthemes included: "Not adhering to health protocols", "Non acceptance of illness", and "High-risk taking"), and Weakness of health-care platform (Subthemes included: "shortage of healthcare facilities", "Lack of specialized personnel", and "The uni-dimensional aspect of healthcare services"). Conclusion: We identified several challenges that made the handling of COVID-19 difficult in Iran's centers for mass education. These findings can help future research in addressing the challenges and designing adaptable plans for pandemic management in mass education centers.

Erratum: Conducting clinical research in the era of the COVID-19 pandemic: Challenges and lessons for Speech-Language Pathology and Audiology research.

No abstract available.

The Emerging Challenges and Strengths of the National Health Services: A Physician Perspective.

The National Health Services (NHS) is a British national treasure and has been highly valued by the British public since its establishment in 1948. Like other healthcare organizations worldwide, the NHS has faced challenges over the last few decades and has survived most of these challenges. The main challenges faced by NHS historically have been staffing retention, bureaucracy, lack of digital technology, and obstacles to sharing data for patient healthcare. These have changed significantly as the major challenges faced by NHS currently are the aging population, the need for digitalization of services, lack of resources or funding, increasing number of patients with complicated health needs, staff retention, and primary healthcare issues, issues with staff morale, communication break down, backlog in-clinic appointments and procedures worsened by COVID 19 pandemic. A key concept of NHS is equal and free healthcare at the point of need to everyone and anyone who needs it during an emergency. The NHS has looked after its patients with long-term illnesses better than most other healthcare organizations worldwide and has a very diversified workforce. COVID-19 also allowed NHS to adopt newer technology, resulting in adapting telecommunication and remote clinic. On the other hand, COVID-19 has pushed the NHS into a serious staffing crisis, backlog, and delay in patient care. This has been made worse by serious underfunding the coronavirus disease-19coronavirus disease-19 over the past decade or more. This is made worse by the current inflation and stagnation of salaries resulting in the migration of a lot of junior and senior staff overseas, and all this has badly hammered staff morale. The NHS has survived various challenges in the past; however, it remains to be seen if it can overcome the current challenges.

Social Transformations in India, Myanmar, and Thailand: Volume II: Identity and Grassroots for Democratic: Progress

This book explores the multifaceted obstacles to social change that India, Myanmar and Thailand face, and ways to overcome them. With a collection of essays that identify common challenges and salient features affecting diverse communities, this volume examines topics from subnational and local perspectives across the peripheries. The book argues that identity-based divisions have created a system of oppression and political contention that have led to conflicts of different kinds, and hence serving as the common cause of different social issues. At the same time, such issues have created space for marginalized groups around the world to call for change. The volume recognizes that social transformation comes into being through an active process of deconstructing and reconstructing shared norms and ideas. The contents in this book are thus centered around two focuses: The impacts of identities and grassroots. Both of these aspects are at the heart of each country's transformations towards democracy, peace, justice, and freedom. Under this framework, the chapters cover a diverse range of common issues, such as, minority grievances, gender inequality, ethnic identity, grassroots power in alliance-making towards community peace, recovery and resilience, digital freedom, democracy assistance and communication, and bridging multiple divides. As identity-based cleavages are daily lived experiences for individuals and communities, it requires grassroots initiatives and alliances as well as democratic communication to tackle obstacles at the root. Ultimately, the book convinces readers that social transformations must begin at the individual to communal level and local to national level. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022.

Smart Healthcare: Future Applications & Challenges

After the outbreak of corona virus, all counties are paying special attention to their healthcare infrastructure. During second phase of covid-19, entire world has seen health care crisis. Large number of people died globally. Entire world was affected mentally or physically. There is a great need to strengthen the healthcare infrastructure, to vaccinate the population against covid virus infection and to take proper precaution to avoid spread of the virus, so that the world will not see such deadly days again. This paper discusses how technologies like Internet of Things (IoT), Artificial Intelligence (AI), Drones etc can help in remote monitoring of patients, judicious hospital admission, conscious distribution of lifesaving drugs etc. Investment in technology with not only help in the reduction of spread of the virus but will also help in fighting with all other future pandemics. All the countries must have to invest more on latest technologies in their healthcare to make themselves ready for such future pandemics. When the things will improve, the new normal will be very much different from the life that was before pandemic. IoT, AI and other technologies will become the non-separatable part of our life. © 2023 Bharati Vidyapeeth, New Delhi.

Analysis of the effectiveness of the implementation of digital technologies in the educational process of medical HEIs: challenges, optimization

The COVID-19 pandemic has led to the more intensive use of digital technologies in higher medical education. The purpose of the study was to analyze the effectiveness of the implementation of digital technologies in the educational process of Ukrainian medical universities, to identify the current challenges e-learning faces, and to propose potential ways of optimization. General scientific methods (for example analysis, synthesis) specific pedagogical methods (specification, ion, comparison forecasting) were used for the research. The results outline the main advantages of using digital technologies in the medical higher school system. Attention is also drawn to the main challenges that have a certain negative impact on the educational process. Among the latter, problems with the practical training of future doctors were noted since distance learning does not provide an opportunity to fully implement skills building component. The results also highlight possible ways to solve the problems of using digital technologies in medical higher education institutions. It is proposed to introduce to use not only distance learning technologies, but to combine them with the traditional approach and independent learning. It is emphasized about further studies, as empirical measurements of the effectiveness of distance education in the medical field. And, this effectivenessstill needs to be ultimately proven.

Measurement and Evaluation Challenges in Distance Education: Systematic Review and Qualitative Meta-Synthesis

The challenges experienced in measurement and evaluation during the distance education process among student and instructor groups are discussed in the study. A qualitative meta-synthesis method is used in this research. Twenty studies were included in the meta-synthesis. The challenges experienced by the instructors are program utilization, technological inadequacies, a lack of in-service seminars, online exam diversity, inconsistency between what is measured and what is intended to be measured, interference of other features with the measurement, unsuitability of the measurement tools, academic dishonesty, lack of control over online exam diversity, preparation and grading challenges, infrastructural issues, and a lack or latency of feedback. Challenges experienced by learners include alienation to the electronic environment, language, technological inadequacies, lack of materials, validity-reliability issues, application difficulty, lack of guidance in exams, infrastructural issues, network problems, lack of interest and motivation, anxiety about online exams, and avoidance and resistance to self-disclosure in virtual environments.

Exploring Challenges Experienced by Teachers in Implementing Inclusive Education in Classrooms: A South African Perspective

The implementation of inclusive education in schools in South Africa has not been fully achieved despite the existence of numerous policies on the same. However, there is very scanty information on current issues that are faced by teachers during the pandemic. Therefore, the present study sought to examine challenges experienced by teachers in implementing inclusive education in classrooms within a South African context. In this study, Bronfenbrenner's ecological theory was adopted. The phenomenological research design was adopted for this study. The selected sample size in this study was eight participants obtained using purposive sampling method. In this study, semi-structured interview was used as the data collection tool. Thematic framework was adopted to analyse data in this study. The study reported that there were four main themes on classroom challenges faced by teachers namely, limited instructional time, inadequate resources, inadequate support and lastly, impact of COVID-19 pandemic. The study recommends that teachers should adopt collaborative practices with school base support teams which had the capacity to mobilise several resources available on the local community to enhance implementation of inclusive education.

Optimising students' participation during emergency remote teaching in the Covid-19 pandemic

This study examined issues related to students' participation and online absenteeism among students at Zimbabwe's universities during COVID-19 induced online teaching and learning. More specifically, the study examined some of the ethical issues related to students' participation and assessment during online learning in selected universities in Zimbabwe. The study also examined some of the strategies that can be adopted to optimize students' participation during online learning to make online learning a more honest and interactive endeavour. To fully understand the challenges related to participation and online absenteeism, the study extrapolated the perspectives of students and academic staff who had adopted online learning since the outbreak of the COVID-19 pandemic. The research was a mixed-methods study, employing a descriptive-analytical approach which utilised three main methods of data collection. Firstly, semi-structured questionnaires distributed electronically among participants in the selected universities were used to collect research data. Secondly, follow-up online focus-group discussions (FGDs) were conducted to elicit participants' views on some of the ethical challenges posed by online learning and possible strategies for dealing with the challenges. Finally, follow-up telephone interviews were also conducted with lecturers with the same objective as the FGDs. The study's population consisted of 110 students and 77 academic staff randomly selected from six universities in Zimbabwe. Two of the selected universities were privately owned and four were public universities. The study showed some of the technological and pedagogical issues regarding students' participation and strategies for optimising students' participation during online learning. The study also shared some of the ethical challenges that arose from the adoption of online teaching and assessment systems and the policy, resource and training interventions needed to make online learning more interactive, while at the same time safeguarding academic integrity. The findings of this study, therefore, have implications for universities, learners and academic staff if online learning programmes are to be successful. Firstly, universities for instance, need to ensure that students and academic staff have the prerequisite technological resources to ensure that optimal active learning takes place. Secondly, to address the shortage of resources, universities should ensure that their libraries migrate from physical to digital libraries. Universities should also ensure that both academic staff and students receive the necessary training to access these digital libraries and the services they offer.

CHALLENGES AND OPPORTUNITIES IN BEEKEEPING AND HONEY PRODUCTION DURING COVID-19 PANDEMIC – A SHORT REVIEW

Honey bees in beekeeping are commonly involved in honey production and as planned pollinators worldwide. However, at the beginning of the covid-19 pandemic, the hardworking little creatures suffered many difficulties. The entire supply chain was blocked. Consequently, the challenges directly affected honey and crop production worldwide. The pandemic issues like travel restrictions and limited access to apiaries had a detrimental influence on beekeepers' activity. Earlier sales decline during the crisis had an economic impact, with some beneficial impacts, like a rise in demand for health-related goods. However, the challenges come with opportunities, which lead to a pointy surge in demand for honey which paved the way for many women entrepreneurs as beekeepers to meet the local demands, which helps the rural economy to be sustained. Another intriguing benefit is that a drastic drop in pollution helped bees get back to their normal routine, which led to a drastic increase in honey production during the pandemic as opposed to what they experienced in normal times. This article briefly outlines such challenges faced by the beekeepers and the honey producers and also focuses on the new opportunities that rendered many values to the producers during the pandemic © Penerbit UMT

The Pandemic in Latin America and the challenges of Human Rights

The purpose of the present study is to know the impacts of Covid19 on the structures of governmental institutions in Latin America and the effects on Human Rights in terms of health and education, for example. For the analysis, we consider some elements such as the functioning of political parties, the arbitrariness of power, fiscal transparency and public spending, allowing us to take a picture of the reality to be studied regarding the quality of democracy in these countries, and also considering the cooperation efforts, in the normative and institutional scopes inside and out. As we seek to relate Human Rights and Democracy, we focus on the ethical dimension of the new challenges facing Latin America. The exposition, sometimes detailed, of situations that illustrate the malfunctioning of institutions came from observation and review of a diverse literature, and from different perspectives specifically in the scope of International Relations. © 2022, UNIV CARLOSIII MADRID. All rights reserved.

Smart-thing design by children at a distance: How to engage them and make them learn

In recent years, research in Child-Computer Interaction has shifted the focus from design with children, giving them a voice in the design process, to design by children to bring child participants different benefits, such as engagement and learning. However, design workshops, encompassing different stages, are challenging in terms of engagement and learning, e.g., they require prolonged commitment and concentration. They are potentially more challenging when held at a distance, as in recent years due to the COVID-19 pandemic. This paper explores at-a-distance smart-thing design by children, how it can engage different children and support their learning in programming. The paper reports a series of design workshops with 20 children, aged from 8 to 16 years old, all held at a distance. They were all organised with the DigiSNaP design framework and toolkit. The first workshop enabled children to explore what smart things are, to start ideating their own smart things and to scaffold their programming. The other workshops enabled children to evolve their own smart-thing ideas and programs. Data were gathered in relation to children's engagement and learning from different sources. Results are promising for future editions of smart-thing design at a distance or in a hybrid modality. They are discussed along with guidelines for smart-thing design by children at a distance. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Nanomaterial-based smart coatings for antibacterial, antifungal, and antiviral activities

Infectious diseases caused by different pathogens (parasites, protozoa, bacteria, viruses, and fungi) have affected the world at various times in the form of epidemics and pandemics. The coronavirus has also directly affected the world's economy and public health. Various drugs such as antibiotics, antimicrobials, antifungals, and antivirals have been investigated to combat these diseases. However, these fatal infections are still a major concern because of their transmission through contaminated surfaces, human-to-human contact, airborne diffusion, and microbial resistance. Therefore, considerable efforts are required to suppress the transmission of these pathogens. Smart coatings are able to sense their environment and adapt their properties according to the stimulus. Furthermore, various parameters of coating technology can be controlled on a molecular level to influence the morphology. Nanomaterial (NM)-based smart coatings are 99.99% effective against bacteria, viruses, and fungi because of the unique properties of NMs involved. Moreover, NM-based smart coatings are 1000-fold more efficient than traditional coating technologies. Besides their antifungal, antiviral, and antibacterial application, they are anticorrosive and self-cleaning. This chapter summarizes various NM-based smart coatings (organic, inorganic, and carbon) implemented in antibacterial, antifungal, and antiviral applications. Furthermore, the application of these coatings in various fields and their associated challenges will be discussed. © 2023 Elsevier Inc. All rights reserved.

A Review on the analysis of Behavioral pattern of Students during pandemic COVID-19

The widespread of (covid-19) has become the major reason for many physical illnesses in addition to psychological encounters to the whole world. The psychological challenges brought in due to the Covid-19 pandemic have resulted in decrease in the learning curve of students to a very large extent risking the academic ability of students due to psychological/mental health. Hence it is a challenge to identify valid cues for disorientation in the learning ability of the student at the right time and to suggest necessary support and guidance. This paper aims to describe about the work done so far and analyzes the future challenges to be addressed based on the learning curve of a student and gives an insight of how a student can be identified to be psychologically disturbed. © 2023 IEEE.

Where is science heading? The main challenges before today's scientists?

Anecdotal and historical accounts of science suggest that in earlier times, researchers pursued science more as a hobby at their own pace with support and encouragement from patrons and communities. This leads to inequality in scientific research, where some fields and researchers may have an easier time obtaining funding and resources, while other fields and researchers may lack this support, making it difficult to conduct meaningful research. Progress of science needs efforts from the researchers with a poly-disciplinary mindset as well as mono-disciplinary strengths.[[5]] The role of science is evident to everyone from the recent example, i.e., protecting eight billion people from the devastating effects of COVID-19 pandemic. Millions of researchers are now pursuing science as opposed to thousands and hundreds of researchers in the earlier periods of science. [Extracted from the article] Copyright of Drying Technology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Seize the day or seize theses? The challenges in undergraduate thesis writing

Thesis writing is an endeavour that many undergraduate students have to surmount coupled with its inevitable challenges. Consequently, this study was conducted to investigate the diverse thesis writing challenges experienced by arts and humanities students enrolled in Bachelor of Arts degrees in Communication, English Language, and Filipino Language in a state university in the northern part of Luzon, Philippines. A descriptive phenomenology was utilised via focus group discussions to collect data. Through thematic analysis, three main themes or facets of the diverse challenges in thesis writing have been identified. The facets are (1) student-emanating;(2) adviser-emanating;and (3) pandemic/emergency remote teaching-emanating. This research adds to the literature on the challenges in undergraduate thesis writing during emergency remote teaching, provides an input towards pedagogical implications, and recommends future research directions.