[Midwives as influencers in skin care for newborns at risk of atopic diseases : Survey of midwives' current recommendations]. / Hebammen als Influencer bei der Hautpflege atopisch prädisponierter Neugeborener : Eine Umfrage zu den aktuellen Empfehlungen von Hebammen.

INTRODUCTION: The prevalence of atopic diseases remains high. Initial studies suggest that primary prevention with regular basic care may influence the incidence of atopic dermatitis in infants; however, data are unclear. Midwives play an important role in the care of women in the peripartum period and therefore also in providing advice on topics such as skin care, breastfeeding and nutrition of the newborn and young infant. The aim of this study was to determine the care recommendations for newborns by midwives. METHODS: We conducted a cross-sectional survey among German midwives using questionnaires on the topic of newborn skin care. RESULTS: A total of 128 questionnaires were analyzed. The most common recommendations were oil-based herbal topicals (34.9%) and plain water (34.0%). Approximately 70% of midwives reported recommending various options when there was a known family history of atopic diathesis. It was remarkable that most of the midwives' recommendations were identical regardless of the presence of an atopic diathesis. Essential care products are only used "when necessary". CONCLUSION: Training programs for midwives on the topic of "care and strengthening of the skin barrier", taking into account the current guidelines for allergy prevention, should be implemented.

Drug Abuse Educational Program for Saudi University Students: A Pre-test and Post-test Design.

Background and objective Designing a consistent preventive drug abuse program and evaluating the educational needs of diverse target groups, school curricula, and new instructional materials customized to a country's socioeconomic and cultural characteristics should be used. This research aims to assess the influence of an educational program on university students' awareness of drug abuse. Methodology A cross-sectional study using a pre-test questionnaire with predetermined questions was conducted with 102 participants. The educational program about drug abuse prevention measures was subsequently implemented. After the program was completed, a post-test was administered to the students, and the results were compared to the pre-test results. The data were collected from male and female Saudi students at a university in the western area of Saudi Arabia. Results The pre-test findings indicate that the students had already received some information on drug use and abuse, but the post-test results show that their awareness rose as a result of the drug abuse educational program. Conclusion Drug abuse is a major problem all across the world, including in Saudi Arabia. However, educational programs will help to increase knowledge and awareness of this issue.

[Key challenges in the dietary intake structure and cutting edge technologies for optimizing nutrition to protect the health of the Russian рopulation].

This article presents an analysis of some of the results of the work of the Federal Research Center for Nutrition and Biotechnology (Center) in recent years, highlighting the most important, promising areas of Nutrition Science and Food Hygiene that need further development. The priority area of Center functioning is scientific support for the implementation of the Doctrine of Food Security of the Russian Federation (Decree of the President of the Russian Federation dated January 21, 2020 No. 20), Decree of the President of the Russian Federation dated July 21, 2020 No. 474 «On the national development goals of the Russian Federation for the period until 2030 «in terms of ensuring an increase in life expectancy and improving the life quality of the population, the Strategy for Improving the Quality of Food Products in the Russian Federation until 2030 (Order of the Government of the Russian Federation dated June 29, 2016 No. 1364-r). The Center coordinates all research on medical nutrition problems in the Russian Federation within the framework of the work of the Problem Commission on Nutrition Hygiene of the Scientific Council of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare, the Scientific Council of the Russian Academy of Sciences on Medical Nutrition Problems, the Scientific and Technical Committee of the Comprehensive Scientific Program «Priority Research in the Field of Nutrition of the Population¼, Profile Commission on Dietetics of the Expert Council in the Field of Health of the Ministry of Healthcare of Russian Federation, ensuring the implementation of their results with the participation of members of the Consortium "Healthcare, Nutrition, Demography". The most important area of the Center's work is scientific and expert support in the field of international and national technical regulation of the production and turnover of foods and raw materials, in particular, the work of the Russian national contact point of the Codex Alimentarius Commission (established by FAO and WHO), as well as the work of the Russian side in the Eurasian Economic Commission regarding the preparation of proposals for technical regulations of the Customs Union in the field of food safety, evaluation of draft technical regulations and amendments and additions to them.

Redefining Competencies for Nurse Anesthesia Education--Integrating Emotional Intelligence Assessment and Training into a Nurse Anesthesia DNP Program.

We present an overview of best practices for integrating emotional intelligence into a nurse anesthesia educational program. We first cover a brief history of the importance of emotional intelligence to the healthcare, nursing, and nurse anesthesia fields and then present the processes we undertook to integrate emotional intelligence holistically into our curriculum.

The Development and Implementation of an Evidence-Based Tumescent Liposuction Protocol, Online Educational Course for Perioperative Staff, and Discharge Instructions: A Quality Improvement Project.

PURPOSE: The purpose of this quality improvement project was to improve perioperative management of patients undergoing tumescent liposuction (TL) through the development and implementation of a perioperative evidence-based protocol, educational course for perioperative staff, and patient discharge instructions. DESIGN: The TL protocol was validated using the modified Delphi process. The educational course and discharge instructions used a pre and postimplementation design. METHODS: An evidence-based protocol, an educational course for perioperative staff, and readable discharge instructions for patients undergoing TL were developed in accordance with best practice guidelines. The protocol was validated by subject matter experts at the facility and submitted for adoption. The evidence-based educational course was implemented, and the effectiveness of the course was evaluated for improving providers' knowledge and self-confidence. The evidence-based discharge instructions were implemented and evaluated for patient satisfaction and readability. FINDINGS: Three items were removed from the protocol, 2 items were modified, and 25 items were accepted with no change from modified Delphi analysis. Provider knowledge scores improved from 85.7% ± 16.18 to 97.1% ± 4.88; however, this was not statistically significant (P = .066). There was a trend toward improved confidence scores (P = .180). Overall patient satisfaction scores slightly improved postimplementation; results were not statistically significant (P > .05). CONCLUSIONS: All three phases of perioperative care in patients receiving TL were evaluated, reflecting best practice guidelines and successful adoption. There was no statistically significant improvement in provider knowledge, provider self-confidence, or patient satisfaction. A small sample size was a significant limiting factor.

Interpretive Qualitative Evaluation Informs Research Participation and Advocacy Training Program for Seniors: A Pilot Study.

Background: An 8-week educational intervention co-taught by medical students and faculty was designed to foster communication between clinical researchers and populations of interest to ultimately increase participation in clinical research by older adults, including underrepresented groups. Weekly topics focused on age-related changes and health conditions, socio-contextual factors impacting aging populations, and wellness strategies. Objectives: To evaluate the successes and weaknesses of an educational intervention aimed at increasing the participation of older adults in clinical research. Design: A focus group was assembled after an 8-week educational intervention, titled DREAMS, to obtain participants' feedback on the program, following a pre-formulated interview guide. Settings: Participants were interviewed in a health center office environment in the United States of America in April of 2016. Participants: A post-intervention focus group was conducted with a group of eight older adults (mean age = 75.8 ± 11.4 years) from 51 total participants who completed the intervention. Methods: The focus group was interviewed loosely following a pre-formed question guide. Participants were encouraged to give honest feedback. The conversation was recorded, transcribed verbatim, and analyzed using thematic analyses. Results: While participants viewed most aspects of the study as a success and stated that it was a productive learning experience, most participants had suggestions for improvements in the program content and implementation. Specifically, the composition of and direction to small breakout groups should be carefully considered and planned in this population, and attention should be paid to the delivery of sensitive topic such as death and dementia. A clear main benefit of this programmatic approach is the development of a rapport amongst participants and between participants and clinical researchers. Conclusions: The results provide useful insights regarding improving participation among hard-to-reach and historically underrepresented groups of older adults in clinical research. Future iterations of this program and similar educational interventions can use these findings to better achieve the programmatic objectives.

The role of different educational programs in specialty preference among Chinese medical students: a cross-sectional study.

BACKGROUND: The imbalanced supply of physicians in different specialties and the decreasing number of young doctors in China have made it important to understand specialty preference and influencing factors and to evaluate the role of different programs in specialty choice and career planning among Chinese medical students to help shape the social healthcare system and ensure adequate medical practitioners in each specialty. METHOD: A cross-sectional study comprising medical students from 5-year and 8-year program was conducted online. Demographics, specialty preferences and influencing factors, and career planning situations were collected and analysed by the chi-square test. Binary logistic regression analysis was performed in each program to identify the association between influencing factors and each specialty. RESULTS: A total of 128 students (57.03% 5-year, 42.97% 8-year) responded to our survey. More 8-year students had a doctor in their household than 5-year students (25.45% vs. 10.96%, p < 0.05). The most preferred specialty among 5-year students was surgery, followed by others and internal medicine, while that most preferred by 8-year students was surgery, followed by internal medicine, obstetrics/gynecology and anesthesiology. Compared with 5-year students, more 8-year students considered 'personal competencies' (66.67% vs. 40.85%, p < 0.05), 'the reputation of the specialty' (18.52% vs. 7.04%, p ≤ 0.05), 'fewer doctor‒patient disputes' (27.78% vs. 11.27%, p < 0.05) and 'advice from family members' (24.07% vs. 7.04%, p < 0.05) influential. Among 5-year students, 'personal competencies' was positively associated with preference for surgery and 'work-life balance' was negatively associated. Among 8-year students, 'personal competencies' and 'work-life balance' were positively associated with internal medicine, while 'interests in the specialty' and 'broad career prospects' were negatively related. Many students need further career guidance, and personalized tutoring was the most wanted method. CONCLUSIONS: There was no difference between 5-year and 8-year students regarding specialty preference, but bias existed, possibly due to the influence of the real-world situation. Improving the working environment and welfare might be beneficial for developing a balanced distribution of the workforce among different medical departments. It is necessary for medical schools to develop programs accordingly to help them better plan their future careers.

Awareness of individual goals, preferences, and priorities of persons with severe congenital haemophilia A for a tailored shared decision-making approach to liver-directed gene therapy. A practical guideline.

In clinical medicine, shared decision making (SDM) is a well-recognized strategy to enhance engagement of both patients and clinicians in medical decisions. The success of liver-directed gene therapy (GT) to transform severe congenital haemophilia A (HA) from an incurable to a curable disease has launched a shift beyond current standards of treatment. However, GT acceptance remains low in the community of HA persons. We argue for both persons with haemophilia (PWH) and specialists in HA care including clinicians, as needing SDM-oriented educational programs devoted to GT. Here, we provide an ad hoc outline to implement education to SDM and tailor clinician information on GT to individual PWHs. Based on routine key components of SDM: patient priorities; recommendations based on individual risk reduction; adverse effects; drug-drug interactions; alternatives to GT; and ongoing re-assessment of the objectives as risk factors (and individual priorities) change, this approach is finalized to exploit efficacious communication.

Interprofessional Education in NAACLS MLT and MLS Programs: Results of a National Survey.

BACKGROUND: Interprofessional education is essential for students enrolled in health care professional programs. OBJECTIVES: We assessed the attitudes towards and the beliefs about interprofessional education (IPE) among program directors of medical laboratory science (MLS) and medical laboratory technician (MLT) programs accredited by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS). We also investigated the inclusion of IPE in the curricula of such programs. METHODS: We emailed the link to an anonymous 22-item cross-sectional survey to 468 program directors and tabulated the responses. RESULTS: Program directors who support the need to include IPE within the curricula of MLT and MLS programs showed a generally positive attitude towards IPE. The beliefs about IPE among our respondents were not homogeneous. Program directors who have not yet implemented IPE in the curriculum may not have had an opportunity to experience the practical benefits of IPE. CONCLUSION: Although barriers to IPE implementation exist, half of the respondents reported having already implemented IPE within their curricula.

Impact of Coding Educational Programs (CEP) on Digital Media Problematic Use (DMPU) and on Its Relationship with Psychological Dependence and Emotional Dysregulation.

Alongside the positive effects linked to the introduction of digital technologies into our lives, particular dysfunctional behaviors in the use of digital tools have appeared, through which the expression of conditions such as addiction, difficulties in affective and behavioral self-regulation and mental health problems have been channeled. The present study aims to investigate, in a sample of young students aged m = 12.91 (ds = 0.56) years, whether Coding Educational Programs (CEP), deployed to 44.9% of the sample, is effective in psychological dependence, emotional self-regulation and Digital Media Problematic Use (DMPU), as self-assessed through questionnaires (DERS, DSRS, IAT, MPIQ and MPPUS). CEP had no effect on emotional dysregulation or on DMPU. They were effective in the time management of mobile phone use, with students rescheduling from daytime use on working days to daytime use on the weekend. Moreover, people who attended CEP more frequently used smartphones for orienting themselves and for obtaining information. In conclusion, CEP are effective in achieving a more functional and important use of smartphones and better time management. It is possible that CEP effect on metacognition could reduce DMPU if alternative ways to regulate emotions are available.

Should Animal Welfare be Included in Educational Programs? Attitudes of Secondary and University Students from Eight EU Countries.

Animal Welfare (AW) educational programs aim to promote positive attitudes of future generations toward animal production systems. This study investigated whether secondary and university students in the majors that are not related to AW teaching believe that this concept should be included also in their educational programs. The determinant factors affecting students' attitudes toward such a decision were analyzed. This research has focused on eight European countries (Spain, the United Kingdom, Poland, Greece, Lithuania, Romania, Italy, and Sweden) targeting 3,881 respondents composed of 1,952 secondary and 1,929 university students. The results showed that female university students with a high level of subjective and objective knowledge on AW and who required more restrictive AW regulations, gave support to include the concept in their educational programs. However, Students who support medical experiments that use animals to improve human health were less likely to accept AW education. Furthermore, students in Italy compared to those in Sweden were prone to support AW educational programs. Results highlight the importance of teaching the AW concept as a comprehensive teaching tool at universities and schools' programs as it may constitute a starting point for a more sustainable society toward improving animal living conditions, mainly in the Mediterranean countries in secondary schools.

Progress, and prospects in the therapeutic armamentarium of persons with congenital hemophilia. Defining the place for liver-directed gene therapy.

In persons with congenital severe hemophilia A (HA) living in high-income countries, twice weekly intravenous infusions of extended half-life (EHL) factor VIII (FVIII) products, or weekly/biweekly/monthly subcutaneous injections of emicizumab are the gold standard home treatments to grant days without hurdles and limitations. Once weekly/twice monthly infusions of EHL Factor IX (FIX) products achieve the same target in severe hemophilia B (HB). Gene therapy, which is likely to be licensed for clinical use within 1-2 years, embodies a shift beyond these standards. At an individual patient level, a single functional gene transfer leads to a > 10-yr almost full correction of the hemostatic defect in HB and to a sustained (3-6-yrs) expression of FVIII sufficient to discontinue exogenous clotting factor administrations. At the doses employed, the limited liver toxicity of systemically infused recombinant adeno-associated virus (rAAV) vectors is documented by long-term (12-15 yrs) follow-ups, and pre-existing high-titer neutralizing antibodies to the AAV5 vector are no longer an exclusion criterion for effective transgene expression with this vector. A safe durable treatment that converts a challenging illness to a phenotypically curable disease, allows persons to feel virtually free from the fears and the obligations of hemophilia for years/decades. Along with patient organizations and health care professionals, communicating to government authorities and reimbursement agencies the liberating potential of this substantial innovation, and disseminating across the Centers updated information on benefits and risks of this strategy, will align expectations of different stakeholders and establish the notion of a potentially lifelong cure of hemophilia.

Social support experiences of students and clinicians with disabilities in health professions.

Social support is vital in promoting the health, well-being, and performance of students and clinicians in health professions. Health settings' demanding and competitive nature imposes unique challenges on students and clinicians with disabilities. This paper aims to explore the trajectories and experiences of social support interactions amongst students and clinicians with disabilities in health professions. In a qualitative longitudinal study, 124 in-depth semi-structured interviews were conducted with 27 health students and 29 health clinicians with disabilities. Data analysis was informed by grounded theory as an adapted analytic approach involving constant comparisons. A few main characteristics of social support and trajectories in which social support is negotiated emerged from the data: (1) The need to be accepted and not questioned when asking for support, (2) Support interactions that do not heighten otherness, (3) Failure to acknowledge the challenges, (4) Interactions that support the process of disclosure (5) Interactions that allow mobilization of social support without strain or an extra effort. These findings have important implications for designing more supportive health professions, educational programs, and workplaces for people living with disabilities.

Ethnicity affects the risk factors of acute myocardial infarction and should be considered in educational programs.

Acute Myocardial infarction is a non-communicable disease representing the leading cause of death in Saudi Arabia. Studying the ethnicity in its risk factors has been poorly investigated. Objectives: To compare risk factors among Saudi nationals and expatriates. Methods: A retrospective cohort study for patients admitted to the Cardiac Care Unit of one of the largest tertiary care hospitals in Tabuk diagnosed with acute myocardial infarction from September 2018 to August 2019. Risk factors were compared among groups on the basis of their ethnicity. Results: In total 18,746 patients were included. Gender and age were the predominant risk factors; Male (p < 0.05) and age >50 years (p < 0.05). There were significant differences between Saudis and expatriates in all measurable parameters indicating that a genetic factor contributes to the risk factors, which was proved by the significant differences between the Middle East North Africa and South Asia subgroups. Interestingly, the mean values of laboratory results were higher than Saudi populations. Conclusions: The disparity in lipid profile among the studied groups addresses the patient ethnicity should be considered during education programs for the risk factors of cardiovascular disease.

[Dental caries prevention program in children and adolescents living in residential institutions]. / Model' profilaktiki kariesa zubov sredi detei i podrostkov, prozhivayushchikh v organizovannom detskom kollektive.

THE AIM OF THE STUDY: Was to assess the effectiveness of a new dental caries prevention program in children of various ages living in residential institutions. MATERIALS AND METHODS: The program of oral health promotion and caries prevention was introduced in the autonomous non-profit organization «Social rehabilitation center Solba¼. The study comprised 98 children aged 12-17 years divided into two groups: the main group of 52 children aged 12-16 years enrolled in the program in 2013 in pre-school (32 children) and primary school age (20 children) and the control group of 46 adolescents aged 12-17 years not included in the program. DMFT and OHI-S index were compared in both groups as well as in children enrolled in the program at various ages. RESULTS: The overall caries prevalence was 84.7%. Statistically significant differences were documented between children enrolled in the program in pre-school and primary school ages regarding both caries prevalence (78% and 89%, respectively) and intensity (3.5 and 5.4 tooth, respectively (p=0.01)). Non-satisfactory, poor and very poor OHI-S was observed in 15.4% of children in the main group and 54.3% of controls. Good oral hygiene was seen in 67.3 and 37%, satisfactory - in 17.3 and 8.7% of children, respectively (p<0.05). CONCLUSION: Programs of dental caries prevention with oral health promotion component are effective for oral hygiene improvement in children living in residential institutions. The key for long-term effectiveness and dental caries prevalence and intensity reduction is the start of the program in pre-school age and education of caregivers and teachers to provide control of dental care in pre-school and primary school children.

Do Faculty Members Apply the Standards for Developing Gifted Students at Universities? An Exploratory Study.

Many studies indicate the importance of the management and nurturing of giftedness. They also focus on talent development, primarily, where the main objective is enhancing academic abilities. To achieve this goal, it is necessary to explore the reality of faculty members' application of talent development standards; this is necessary for laying the practical foundations to enhance the academic abilities of talented students according to the standards for verifying quality, and for clarifying the skills and concepts that are taught. The current study was based on the opinions of 122 faculty members from Saudi public universities who had experiences with gifted students, whereby they answered the following question: Do faculty members apply the standards for developing gifted students at universities? The data were collected by developing an instrument. The data were analyzed using descriptive statistics that mostly showed the reality of the application of the selected gifted development standards. The results of the perceptions of the faculty members participating in the study showed differences in the application of the proposed gifted development standards according to their academic rank.

Barriers and facilitators for Indigenous students and staff in health and human services educational programs.

Indigenous Peoples are underrepresented in many of the Health and Human Services Educational Programs (HHSEP, e.g.: Nursing, Social Work). As various studies have reported the benefits of diversifying HHSEP, the barriers and facilitators of increasing the number of Indigenous Peoples in these professions must be identified. The purpose of this exploratory study is to identify and understand the barriers and facilitators Indigenous Peoples face when entering, learning or working in HHSEP. A narrative approach was used in the facilitation of culturally safe sharing circles with Indigenous students and staff to collect perspectives based on their individual experiences in HHSEP. Inductive thematic analysis was used to identify emerging themes in participant experiences and the impact of those experiences on participation in learning and working at the university in these educational programs. Results from this exploratory study identified current academic structures and ideologies rooted in colonialism, that act as barriers for engagement and inclusion of Indigenous students, staff, and clinical and academic faculty. These findings shaped the main themes of this study including negotiation of identity in different spaces, negotiating colonial structures in HHSEP, and negotiating changes and transitions in HHSEP. We anticipate these preliminary results will act as a catalyst for uncovering further changes to be made regarding attitudes, procedures, and practices present in an academic environment that limit the inclusion of Indigenous Peoples in HHSEP.

Implementing a flipped classroom model in an evidence-based medicine curriculum for pre-clinical medical students: evaluating learning effectiveness through prospective propensity score-matched cohorts.

BACKGROUND: In a flipped classroom (FC) model, blended learning is used to increase student engagement and learning by having students finish their readings at home and work on problem-solving with tutors during class time. Evidence-based medicine (EBM) integrates clinical experience and patient values with the best evidence-based research to inform clinical decisions. To implement a FC and EBM, students require sufficient information acquisition and problem-solving skills. Therefore, a FC is regarded as an excellent teaching model for tutoring EBM skills. However, the effectiveness of a FC for teaching EBM competency has not been rigorously investigated in pre-clinical educational programs. In this study, we used an innovative FC model in a pre-clinical EBM teaching program. METHODS: FC's teaching was compared with a traditional teaching model by using an assessment framework of prospective propensity score matching, which reduced the potential difference in basic characteristics between the two groups of students on 1:1 ratio. For the outcome assessments of EBM competency, we used an analysis of covariance and multivariate linear regression analysis to investigate comparative effectiveness between the two teaching models. A total of 90 students were prospectively enrolled and assigned to the experimental or control group using 1:1 propensity matching. RESULTS: Compared with traditional teaching methods, the FC model was associated with better learning outcomes for the EBM competency categories of Ask, Acquire, Appraise, and Apply for both written and oral tests at the end of the course (all p-values< 0.001). In particular, the "appraise" skill for the written test (6.87 ± 2.20) vs. (1.47 ± 1.74), p < 0.001), and the "apply" skill for the oral test (7.34 ± 0.80 vs. 3.97 ± 1.24, p < 0.001) had the biggest difference between the two groups. CONCLUSIONS: After adjusting for a number of potential confunding factors, our study findings support the effectiveness of applying an FC teaching model to cultivate medical students' EBM literacy.

Impact of the COVID-19 pandemic on surgical trainee education and well-being spring 2020-winter 2020: A path forward.

BACKGROUND: The time course and longitudinal impact of the COVID -19 pandemic on surgical education(SE) and learner well-being (LWB)is unknown. MATERIAL AND METHODS: Check-in surveys were distributed to Surgery Program Directors and Department Chairs, including general surgery and surgical specialties, in the summer and winter of 2020 and compared to a survey from spring 2020. Statistical associations for items with self-reported ACGME Stage and the survey period were assessed using categorical analysis. RESULTS: Stage 3 institutions were reported in spring (30%), summer (4%) [p < 0.0001] and increased in the winter (18%). Severe disruption (SD) was stage dependent (Stage 3; 45% (83/184) vs. Stages 1 and 2; 26% (206/801)[p < 0.0001]). This lessened in the winter (23%) vs. spring (32%) p = 0.02. LWB severe disruption was similar in spring 27%, summer 22%, winter 25% and was associated with Stage 3. CONCLUSIONS: Steps taken during the pandemic reduced SD but did not improve LWB. Systemic efforts are needed to protect learners and combat isolation pervasive in a pandemic.