Survey of knowledge, attitude and practice of healthcare professionals on dengue transmission, diagnosis and clinical classification

Background To investigate the knowledge, attitudes, and practices of the healthcare professionals (HCPs) including physicians and nurses regarding dengue transmission, diagnosis and clinical classification using the warning signs of World Health Organization (WHO) 2009 classification. Results Out of 471 respondents from three countries, 80.9% of physicians and 74% of nurses did not receive previous training regarding the dengue infection. The majority of respondents could identify the primary dengue vector (86%), while only a third of HCPs knew the biting time of dengue mosquitoes. Only half of our respondents knew about immunity induced by serotypes; Moreover, half of our participants could determine the diagnostic tests. On the other hand, about 90% of the respondents took responsibility for talking to the patients about preventive measures. Our respondents also showed wide variations in definition of warning signs listed in the WHO 2009 classification. Multivariate analysis linked the impact of different cofactors including prior training on dengue infection, type of profession, frequency of taking care of dengue patients and country on how HCPs defined these warning signs. Conclusions This study could declare the variation in employing the warning signs listed in the WHO 2009 classification. We have figured that most of the HCPs did not take prior training on the dengue viral infection; Also, we found gaps in the knowledge regarding various topics in dengue fever. This paper recommends the gathering of efforts to establish the proper knowledge of dengue infection and the warning signs listed by the WHO.

An assessment of oncology pharmacy educational needs among community pharmacists in Zimbabwe

Background: Oncology pharmacy is a specialty that is central to provision and use of anti-cancer medications. In Zimbabwe, pharmacists rely on a Bachelor of Pharmacy degree (B.Pharm.) and in-house training in the provision of oncology services. This study sought to assess knowledge, perceptions, current practices and prior education in oncology pharmacy among community pharmacists. Methods: A cross-sectional survey was carried out among pharmacists working in community pharmacies in Harare. Results: A response rate of 93.0% was achieved. The mean knowledge score was 4.0%. Up to 96.8% of pharmacists thought that prior training in oncology was inadequate. Only ten pharmacists in the sample actually dispensed chemotherapy regularly. Of these, none comprehensive measures for the safe handling of hazardous drugs. Conclusion: A B.Pharm. degree does not provide pharmacists with adequate scientific knowledge and competencies required for the provision of oncology pharmacy services. Structured educational programmes for pharmacists in oncology should be implemented.

Immediate Postpartum IUD Training Within a Regional Network of Family Medicine Residencies

Background and Objective: Immediate postpartum placement of intrauterine devices (PPIUD) offers important benefits to patients. Little is known about PPIUD training or knowledge within family medicine residency programs. We evaluated PPIUD experience and prior training among family medicine residents and faculty. Methods: We conducted a cross-sectional survey of residents and faculty in 24 regional family medicine residency programs in 2018. Survey questions focused on reception of PPIUD training and experience with PPIUD counseling and placement. Results: The final survey sample included 203 residents and 100 faculty with an overall response rate of 39%. About 26% (n=79) of all participants reported receiving prior training for counseling and placement of PPIUDs, while 16% (n=48) of participants had ever placed a PPIUD. Twenty-six percent (n=78) of participants reported that their residency programs offered PPIUD training. Residents and faculty who reported past PPIUD training and/or placement experience were more likely to have ever counseled patients about PPIUD (P<.001) and report that their primary training hospital offered PPIUD to patients (P<.001) and their residency programs offered PPIUD training (P<.001). Conclusions: Few programs offer routine PPIUD training opportunities for family medicine residents and faculty, which may contribute to limited availability of PPIUD to patients. There is a need to improve PPIUD training and placement opportunities for both family medicine residents and faculty.

ASTRO

We present the design, implementation, and experimental evaluation of ASTRO, a modular end-to-end system for distributed sensing missions with autonomous networked drones. We introduce the fundamental system architecture features that enable agnostic sensing missions on top of the ASTRO drones. We demonstrate the key principles of ASTRO by using on-board software-defined radios to find and track a mobile radio target. We show how simple distributed on-board machine learning methods can be used to find and track a mobile target, even if all drones lose contact with a ground control. Also, we show that ASTRO is able to find the target even if it is hiding under a three-ton concrete slab, representing a highly irregular propagation environment. Our findings reveal that, despite no prior training and noisy sensory measurements, ASTRO drones are able to learn the propagation environment in the scale of seconds and localize a target with a mean accuracy of 8 m. Moreover, ASTRO drones are able to track the target with relatively constant error over time, even as it moves at a speed close to the maximum drone speed.

Artificial Generation of Realistic Voices

In this paper, we propose an end-to-end text-to-speech system deployment wherein a user feeds input text data which gets synthesized, variated, and altered into artificial voice at the output end. To create a text-to-speech model, that is, a model capable of generating speech with the help of trained datasets. It follows a process which organizes the entire function to present the output sequence in three parts. These three parts are Speaker Encoder, Synthesizer, and Vocoder. Subsequently, using datasets, the model accomplishes generation of voice with prior training and maintains the naturalness of speech throughout. For naturalness of speech we implement a zero-shot adaption technique. The primary capability of the model is to provide the ability of regeneration of voice, which has a variety of applications in the advancement of the domain of speech synthesis. With the help of speaker encoder, our model synthesizes user generated voice if the user wants the output trained on his/her voice which is feeded through the mic, present in GUI. Regeneration capabilities lie within the domain Voice Regeneration which generates similar voice waveforms for any text.

Hepatitis update program: need of the situation to co-manage viral hepatitis and COVID-19

Background: Government of India has taken several initiatives towards combating viral hepatitis but due to sudden surge in COVID-19 cases resulted in suspension of viral hepatitis program related activities. Moreover, COVID-19 has several liver related complications hence more special precautions are required to manage patients with known liver diseases. Nurses play an important role in management of any disease. However, there is limited knowledge among nurses on co-management of COVID-19 and viral hepatitis. With this background, two-day training program for nursing professionals was conceptualized under the project PRAKASH to educate and train the nurses about co-management of COVID-19 and viral hepatitis. Methods: A pre-post study was undertaken among nurses who have registered for hepatitis update program. The online link to 25-knowledge related questions along with demographic variables was shared with the registered participants. Paired t test and other statistical analyses were done using SPSS v-21. Level of significance was taken at p<0.05Results: A total of 1151 responses were received out of 1477 trained participants. The mean age of the nursing participants was 32.5±6.95 years. The overall mean knowledge score in the pre-assessment was found to be 15.47±4.13 out of 25, which further increased to 20.72±3.81 in the post-assessment. Gender, type of facility, education, willingness to get trained and prior training related to viral hepatitis were found to be independently associated with pre-knowledge score.Conclusions: Training programs should be encouraged for diseases which are of public health importance and can’t be ignored with respect to increasing burden of COVID-19 cases.

Breaking bad news in the oncologic population: Residents' perspective.

e24113 Background: Delivering bad news to patients is a delicate but required skill for doctors as part of patient care. There has been evidence that good communication from health care providers can improve patients' compliance to treatment as well as be beneficial emotionally. While many studies have been done in regards to patients' perceptions of receiving bad news, there are limited studies looking at a physicians' perspective, and even more so concerning residents' perceptions. In community hospitals, many patients are diagnosed with cancer, and resident physicians are often responsible for informing the patients and their families regarding the diagnosis. The manner in which the news is delivered is important, however it is unclear how much training is provided to residents before they are required to break bad news to patients. The lack of training can often result in improper delivery and poor patient care. Methods: We surveyed Internal Medicine and General Surgery residents at Mercy Catholic Medical Center, a conglomeration of two community teaching hospitals in Philadelphia, about prior training, confidence level, attitudes, and need for further education on delivering bad news to oncologic patients using a survey created after extensive research. The factors associated with confidence level were analyzed using paired T-test and ANOVA methods. Results: A total of 65 residents (72%) participated. No statistical significance was seen between American versus foreign medical graduates, MD vs. DO residents, or among those in different specialties when assessing their confidence in delivering bad news. Though only 62% of participants reported having had prior training in delivering bad news, residents with previous training (p1) or who have had to deliver bad news previously (p2) reported higher confidence when it came to delivering a new diagnosis of cancer (p1 0.03, p2 0.001), delivering news regarding the progression of cancer (p1 0.03, p2 0.02), delivering news regarding the recurrence of cancer (p1 0.04, p2 0.002), and delivering news regarding end-stage cancer with little to no treatment options left (p1 0.04, p2 0.003). 100% of participants thought communicating bad news is an important skill for a physician, and 92% of participants thought further education would help prepare them for similar scenarios in the future. Simulated patient scenarios (64%), grand rounds lectures/presentations (59%), and feedback from faculty after actual patient scenarios (57%) were the most requested whereas pamphlets/brochures (17%) and online training courses (20%) were less popular. Conclusions: Our study highlights the importance of prior training or exposure among residents in being able to deliver bad news to patients effectively. We propose that implementing further training in the form of simulated scenarios and lectures can improve residents' confidence at delivering bad news and result in a better physician-patient relationship.

The attitudes of healthy children and researchers towards the challenges of involving children in research: an exploratory study

Background A growing trend in research is to involve co-researchers. It is referred to as Patient and Public Involvement (PPI) and comprises three groups: the patients, the public, and the researchers. Like in adult public involvement, healthy children can also be considered as ‘the public’. Paediatric patients and researchers experienced in conducting child-inclusive research are often asked about their attitudes towards the challenges they encounter. This is not the case for healthy children and researchers without such experience. Our aim was to investigate the attitudes of these children and researchers towards the challenges encountered during child-inclusive research. Methods This was an exploratory study. We interviewed healthy children and adult researchers without prior experience in child-inclusive research. We recruited the children through a foundation for young researchers and the adult researchers from two hospitals, both in Groningen, the Netherlands. We audio recorded the interviews, and they were transcribed verbatim. We analysed the data using qualitative content analysis. Results We interviewed five adult researchers and seven healthy children, aged 9 to 14 years. Both groups thought that it was best to involve children in paediatric research from as early a stage as possible. The children assumed that no prior training would be needed because they had already been trained at school. The researchers’ attitudes varied regarding training children beforehand. Both groups thought that researchers did not need prior training on how to involve children if they worked with children on a daily basis. The children felt that recognition and a modest financial reward was appropriate. Adult researchers were cautious about rewarding the children. They feared it might render the children less intrinsically motivated. Conclusion Our study indicated that young and adult researchers have clear attitudes towards the challenges encountered during child-inclusive research. Young researchers could help adult researchers to find solutions to these challenges, even if they have no prior experience in child-inclusive research. Adult researchers who acknowledge the importance of child-inclusive research represent a significant step towards meaningful involvement of children. Our results imply that children could be involved in the decision-making process concerning the challenges encountered in child-inclusive research.

Teachers’ Knowledge Regarding Autism Spectrum Disorder(ASD): A Systematic Review

The increasing number of students with autism spectrum disorder (ASD) in mainstream education environments require teachers to know how to identify their needs, being capable to adapt their education processes and make their inclusion easier. The purpose of this study is to conduct a systematic review about teachers’ knowledge of ASD, including teachers from any stage and specialization. The research has been conducted from four databases (Web of Science, Scopus, PsycInfo and Google Scholar) during the period of 2015–2020. In total, 25 articles were analyzed. The results show that, in general, teachers’ knowledge of ASD is poor. It depends on the education stage (being higher in early childhood teachers and in university professors), prior training and possible prior contact with students with ASD.

Evidence That Sleep Is an Indicator of Overtraining during the Competition Phase of Adolescent Sprinters

Although sleep disturbance is a common complaint in overtrained athletes, the role of sleep in the overtraining process is not clear. This study aimed (i) to compare sleep efficiency/quantity at the start of a competition phase in elite adolescent sprinters who adapted to prior training with that in those who maladapt and (ii) to examine the influence of prior training, fatigue, and sleep on performance through a moderated mediation model. Fatigue (via Profile of Mood State) and internal training load (via session rating of perceived exertion and duration of training as volume) were measured in 20 sprinters (mean age: 15.9 ± 1.7 years) across 4 mesocycles (baseline (T1); preparatory (T2); precompetitive (T3); and competitive (T4) phases), over 26 weeks. Performances were assessed during the competitive period (T3, T4), while sleep was monitored (via actigraphy) for a week during T4. It was inferred that sprinters who had increasingly greater fatigue and concomitant decrements in performance (35%) were maladapted to training and the remaining sprinters who improved fatigue and performance (65%) were adapted to training. Sleep efficiency (91 ± 3% vs. 82 ± 3%, p < 0.001 ) and quantity (425 ± 33 min vs. 394 ± 20 min, p < 0.001 ) at the start of T4 were significantly greater in sprinters who adapted. Moreover, higher prior training volume (mean of T1 to T3 training volume) was associated with lower sleep efficiency at the start of T4 (R2 = 0.55, p < 0.001 ) which was associated with poorer performance (R2 = 0.82, p < 0.001 ). Fatigue moderated the indirect effect of prior training volume on performance through its moderation of the effect of sleep efficiency on performance (R2 = 0.89, p < 0.001 ). Impaired sleep as a result of greater prior training volume may be related to performance decrements through fatigue. Athletes should improve sleep during periods of higher training volume to reduce fatigue for better adaptation to training.