LkeRec: Toward Lightweight End-to-End Joint Representation Learning for Building Accurate and Effective Recommendation

Explicit and implicit knowledge about users and items have been used to describe complex and heterogeneous side information for recommender systems (RSs). Many existing methods use knowledge graph embedding (KGE) to learn the representation of a user-item knowledge graph (KG) in low-dimensional space. In this article, we propose a lightweight end-to-end joint learning framework for fusing the tasks of KGE and RSs at the model level. Our method proposes a lightweight KG embedding method by using bidirectional bijection relation-type modeling to enable scalability for large graphs while using self-adaptive negative sampling to optimize negative sample generating. Our method further generates the integrated views for users and items based on relation-types to explicitly model users’ preferences and items’ features, respectively. Finally, we add virtual “recommendation” relations between the integrated views of users and items to model the preferences of users on items, seamlessly integrating RS with user-item KG over a unified graph. Experimental results on multiple datasets and benchmarks show that our method can achieve a better accuracy of recommendation compared with existing state-of-the-art methods. Complexity and runtime analysis suggests that our method can gain a lower time and space complexity than most of existing methods and improve scalability.

Operation notes in orthopaedics: Beliefs and practices in a developing country

Maintaining accurate and complete operation notes is an essential metric of the quality of surgical care. While developed countries have implemented electronic health records to improve documentation, financial constraints prevent this realisation in the Caribbean. Somewhat paradoxically, previous studies in this area have focussed on ‘process’ while neglecting the key role of the surgeon. We conducted a 25-item Knowledge, Attitudes and Practices survey of orthopaedic doctors to identify any culturally unique health-related behaviours. Our results indicate that while most doctors understand the importance of operation notes, many are unaware of international note-keeping recommendations. Legibility was identified as a significant issue by 92% of doctors. A disturbing and previously unreported finding from the study revealed that 72% of surgeons would occasionally write the operation notes, although they were not scrubbed in for the procedure. We suggest that future studies examine this peculiar behaviour in greater detail.

Evaluation of a ‘serious game’ on nursing student knowledge and uptake of influenza vaccination

Background Influenza is a serious global healthcare issue that is associated with between 290,000 to 650,000 deaths annually. The aim of this study is to evaluate the effect of a ‘serious game’ about influenza, on nursing student attitude, knowledge and uptake of the influenza vaccination. Methods 1306 undergraduate nursing students were invited, via email, to play an online game about influenza between September 2018 and March 2019. 430 nursing students accessed the game and completed an 8-item questionnaire measuring their attitudes to influenza between September 2018 and March 2019. In April 2019, 356 nursing students from this sample completed a follow-up 2-item questionnaire about their uptake of the influenza vaccination. A larger separate 40-item knowledge questionnaire was completed by a year one cohort of 124 nursing students in August 2018 prior to receiving access to the game and then after access to the game had ended, in April 2019. This sample was selected to determine the extent to which the game improved knowledge about influenza amongst a homogenous group. Results In the year preceding this study, 36.7% of the sample received an influenza vaccination. This increased to 47.8% after accessing to the game. Nursing students reported perceived improvements in their knowledge, intention to get the vaccination and intention to recommend the vaccination to their patients after playing the game. Nursing students who completed the 40-item pre- and post-knowledge questionnaire scored an average of 68.6% before receiving access to the game and 85.2% after. Using Paired T-Tests statistical analysis, it was determined that this 16.6% increase was highly statistically significant (P < 0.001). Conclusions The research highlights that the influenza game can improve knowledge and intention to become vaccinated. This study suggests that improvement in influenza knowledge is likely to encourage more nursing students to receive the influenza vaccination.

Enhancing Existing Medical School Curricula with an Innovative Healthcare Disparities Curriculum

Background: Effective healthcare disparities curricula are essential to improve care of minority patients. Methods: A cost-neutral, evidence-based curriculum was created by enhancing established medical school lectures at the UCLA David Geffen School of Medicine class of 2021 (n=188). Lectures within an 8-week course were evaluated for “teachable moments” or broad topics suitable to introduce specific healthcare disparities content. A lecture-enhancing curriculum based on Society of General Internal Medicine learning objectives was introduced into the DGSOM learning management system via supplemental PDF documents. Results: A total of 92 of 188 students completed curricular assessments and were stratified into intervention group (“utilized materials” n=52) and comparison (“did not utilize the material” n=40) groups based on self-reported use of materials. Minorities were more likely to utilize the material (41% of the intervention group vs 17% of the comparison group, p<.01). Post-course 16-item knowledge composite scores, and confidence in addressing healthcare disparities improved only in the intervention group (p=0.001), and 96% of respondents described the health disparities curriculum as a valuable learning resource. Conclusions: Enhancing pre-existing lectures by identifying and harnessing “teachable moments” is a cost-neutral and effective strategy to integrate a healthcare disparities curriculum.

Louisiana Geriatric Workforce Enhancement Program: Analysis of Learning Outcomes From Dementia Training

A recent Alzheimer’s Association report noted that by year 2050, the number of Americans diagnosed with Alzheimer’s disease and related dementias (ADRD) will triple to over 15 million. The report referred to primary care as the front line for meeting this demand, yet the nation faces a severe shortage of ADRD trained, primary care professionals (PCPs). Louisiana Geriatric Workforce Enhancement Program (LA-GWEP) addresses this demand. The purpose of this study was to examine preliminary data respective to LA-GWEP effectiveness with interdisciplinary education and training seminars, primarily aimed at medical, nursing, and social work PCPs. Three seminars were conducted in south Louisiana: Seminars 1 and 2 addressed effective communication, verbal and nonverbal, among persons with ADRD and caregivers; Seminar 3 offered basic overview of dementia symptomology, stages, and behaviors. Pre- and post-training session data were collected on-site. Participants completed questionnaires that included a 10-item knowledge assessment and 20-item Dementia Attitudes Scale (DAS). These measures contained Likert response formats; higher scores indicating greater levels of ADRD knowledge, in patient and caregiver contexts. Paired sample t-tests were conducted to observe any significant pre-to-post improvement, Cohen’s d for effect size. Seminar 1 revealed no significant pre-to-post difference: t = -1.019, p = 0.320. Adjusting content from audience feedback, Seminar 2 revealed significant pre-to-post difference: t = -7.516, p &lt; .001, Cohen’s d = 1.2. Seminar 3 yielded significant improvement on DAS scores: t = -2.96, p &lt; .01, Cohen’s d = 0.34. Implications for seminars in future years of LA-GWEP are discussed.

Dementia Knowledge and Caregiving Skills Improvement From Using the PAC Model: A Pilot Comparative Evaluation

The diverse needs of persons living with dementia in nursing home settings presents challenges for Certified Nursing Assistants (CNAs) to provide quality care. There is a lack of educational preparedness among nursing home CNAs regarding dementia knowledge and skills required to care for a person living with dementia. As direct caregivers for persons living with dementia, CNAs play an important role in long-term care. This pilot study evaluated the dementia knowledge and caregiving skills of newly trained CNA students. The students were trained by an instructor certified using Teepa Snow’s Positive Approach to Care (PAC) curriculum. Conducted in a rural southwestern Indiana community, this study evaluated CNA students’ knowledge and perception of dementia, as well as their skill performing the Positive Physical Approach™ (PPA™) technique to approach and connect. A 38-item knowledge and perception survey and a 12-step observed skills assessment using a standardized patient encounter were administered to CNA students. Data were analyzed using descriptive statistics and bivariate analysis. Preliminary results indicate that 100% of students correctly answered the survey item regarding non-confrontational body language, while 29% of students correctly performed the corresponding PPA skill. There is a statistically significant association between the knowledge that people find pressure in their palm comforting and the ability to perform the corresponding Hand-under-Hand® and PPA techniques. Incorporation of PAC into current CNA curriculum may equip CNAs with the knowledge and skills required to provide better care, with the potential to improve the overall quality of life for persons living with dementia.

Gaps in Knowledge About COVID-19 Among US Residents Early in the Outbreak

Objectives The novel coronavirus disease 2019 (COVID-19) resulting from severe acute respiratory syndrome coronavirus 2 began to affect the United States in early 2020. This study aimed to assess the US public’s initial understanding about the disease and virus to inform public health communication efforts. Methods We conducted a survey of US households from February 28 through March 2, 2020, using a probability-based web-panel survey of 1021 US residents. To assess knowledge about COVID-19, we asked respondents a series of 16 true/false questions. We conducted descriptive statistics and linear regression analyses to examine differences in knowledge scores based on demographic and background characteristics. Results Knowledge about COVID-19 and the virus was relatively low overall at the beginning of the outbreak, with average scores of 62% on a 16-item knowledge index (ie, answers for 6 of the 16 questions were incorrect or unknown). Knowledge was especially low among people who had low education and income levels, were unemployed, were Hispanic, were non-Hispanic Black, were aged 18-24 and 35-49, indicated having “other” health insurance, and had limited exposure to information about the pandemic. Non-Hispanic Black respondents were less knowledgeable about COVID-19 and the virus at every education level compared with non-Hispanic White respondents at higher education levels. Non-Hispanic Black respondents with <high school degree were the least knowledgeable of all subgroups. Conclusions The findings of our study highlight the need for widespread, ongoing public health education about the virus and COVID-19, especially among certain populations. It is critical to effectively translate complex clinical and epidemiologic evidence into messages that most people can understand and act on during a pandemic, that combat misinformation about the virus and COVID-19, and that consider low levels of health literacy.

Educational needs of nursing home staff: does a needs-based palliative care course make a difference?

ObjectiveIn Singapore, more elderly are living in nursing homes (NHs), with a resultant increase in deaths occurring in NHs. However, palliative care training is limited in Singapore’s core nursing curriculum, and many NHs rely on foreign-trained staff who may not have previous palliative care training. Our study aimed to evaluate whether a needs-based course can improve the palliative care knowledge and attitudes of NH nurses in Singapore.MethodsTwenty-five nurses participated in the study. The intervention was an 8-week palliative care course developed based on needs assessment and led by a multidisciplinary faculty. A 50-item knowledge test was administered at baseline and 0 day and 3 and 6 months postcourse. Semistructured interviews were conducted at 3 months to assess for changes in attitudes and nursing practices.ResultsThe mean knowledge score increased significantly from 31.4 (±4.4) precourse to 35.1 (±5.1) at 3 months. Knowledge scores in end-of-life care increased up to 6 months, and scores for pain and symptom management increased significantly at 3 months. Participants reported a positive change with improved communication skills and increased compassion. There was a lack of opportunities to apply some new knowledge and skills due to regulations and perceived residents’ preferences to engage more local senior staff.ConclusionThe multidisciplinary needs-based palliative care course using various teaching modalities with follow-up knowledge tests helped to increase knowledge and improve communication skills and attitudes of NH nurses towards palliative care. The increase in knowledge and positive change in attitudes was noted to be sustained for at least 3 months postcourse.