Mortality gap and physical comorbidity of people with severe mental disorders: the public health scandal

Background Patients suffering from severe mental disorders, including schizophrenia, major depression and bipolar disorders, have a reduced life expectancy compared to the general population of up to 10–25 years. This mortality gap requires urgent actions from a public health perspective in order to be reduced. Main text Factors associated with the high mortality rates in patients with severe mental disorders can be grouped into four groups: those related to the patients, to psychiatrists, to other non-psychiatrist medical doctors and to the healthcare system. Each of these factors should become the target of specific and dedicated interventions, in order to reduce the morbidity and mortality rate in patients with severe mental disorders. All these elements contribute to the neglect of physical comorbidity in patients with severe mental. In particular, the long-standing separation of psychiatry from other branches of medicine and the lack of specific training on this issue further contribute to the poor attention dedicated to management of physical comorbidities. Recently, several professional associations have invited national bodies regulating education of healthcare professionals to include the management of physical health of people with severe mental disorders in undergraduate and postgraduate educational programs. Conclusions The premature mortality in patients with severe mental disorders is a complex phenomenon resulting by the interaction of several protective and risk factors. Therefore, a multilevel approach is needed, in which the different stakeholders involved in health care provision establish workforces for the long-term management of physical and mental health conditions.

Peer Interaction Opportunities for Non-Native-Speaker-of-English International Students in Postgraduate Courses of a NZ University

<p>In educational/academic contexts, participation in spoken interaction has been drawing attention as a potential source of problems for second language learners (Ferris & Tagg, 1996). Many scholars have acknowledged a need for students to participate actively in spoken communication in the higher education contexts (e.g. Mason, 1995) and also identified influential factors, including language proficiency (e.g. Xu, 1991) and socio-cultural incongruence (e.g. Lee, 2009), for the participation of non-native-speaker of English international students in their new educational practices through oral communication. While postgraduate students are assumed to have opportunities for educational interaction, the nature of activeness and collaboration in postgraduate educational practices as well as expected communicative competence need more attention. In the current study, peer interaction was conceptualized as a focal point that would help understand students’ active and collaborative learning in postgraduate education. The current study explored the processes of the creation and utilization of educational peer interaction which are afforded and constrained by contextual factors. An ethnographic approach, inspired by the development of Needs Analysis in the English for Academic Purposes research tradition and Ethnography of Communication (Gumperz & Hymes, 1972), was adopted. Specifically, insider perspectives of lecturers, local students, native-speaker and non-native-speaker international students, from three disciplines, namely, Applied Linguistics, Engineering, and Business School, were investigated through semi-structured interviews, triangulated with non-participant observations and Floor Analysis (Edelsky,1981) of audio-recorded interaction among students. Particular foci are on what types of peer interaction opportunities are created and utilized in postgraduate courses, what motivations are behind the creation and utilization of peer interaction opportunities for postgraduate learning, and how postgraduate students use communicative competence in peer interaction. Findings show that different types of peer interaction are situationally created by lecturers as well as students under the influences of multiple contextual factors, including learning objectives, pedagogical belief, and physical classroom settings. The findings also confirmed that students bring into postgraduate educational practices multi-faceted personal resources, including linguistic competence, social relations, domain knowledge, and previous educational experiences, which could accommodate or impede their participation in peer interaction. Also, students were found to utilize peer interaction opportunities to collaboratively develop their learning of the target academic knowledge while actively and interactively deploying a wide range of communicative functions, such as utterance completion, repetition, summary, validation, and information addition/edition. Pedagogical implications from this study can inform EAP practices, in the sense that EAP learner international students should be made aware of the interactive nature of learning in the target educational contexts, what factors could influence their interaction, and what sorts of communicative competence are needed in postgraduate environments where students are expected to actively and collaboratively engage in the development of their own learning.</p>

Peer Interaction Opportunities for Non-Native-Speaker-of-English International Students in Postgraduate Courses of a NZ University

<p>In educational/academic contexts, participation in spoken interaction has been drawing attention as a potential source of problems for second language learners (Ferris & Tagg, 1996). Many scholars have acknowledged a need for students to participate actively in spoken communication in the higher education contexts (e.g. Mason, 1995) and also identified influential factors, including language proficiency (e.g. Xu, 1991) and socio-cultural incongruence (e.g. Lee, 2009), for the participation of non-native-speaker of English international students in their new educational practices through oral communication. While postgraduate students are assumed to have opportunities for educational interaction, the nature of activeness and collaboration in postgraduate educational practices as well as expected communicative competence need more attention. In the current study, peer interaction was conceptualized as a focal point that would help understand students’ active and collaborative learning in postgraduate education. The current study explored the processes of the creation and utilization of educational peer interaction which are afforded and constrained by contextual factors. An ethnographic approach, inspired by the development of Needs Analysis in the English for Academic Purposes research tradition and Ethnography of Communication (Gumperz & Hymes, 1972), was adopted. Specifically, insider perspectives of lecturers, local students, native-speaker and non-native-speaker international students, from three disciplines, namely, Applied Linguistics, Engineering, and Business School, were investigated through semi-structured interviews, triangulated with non-participant observations and Floor Analysis (Edelsky,1981) of audio-recorded interaction among students. Particular foci are on what types of peer interaction opportunities are created and utilized in postgraduate courses, what motivations are behind the creation and utilization of peer interaction opportunities for postgraduate learning, and how postgraduate students use communicative competence in peer interaction. Findings show that different types of peer interaction are situationally created by lecturers as well as students under the influences of multiple contextual factors, including learning objectives, pedagogical belief, and physical classroom settings. The findings also confirmed that students bring into postgraduate educational practices multi-faceted personal resources, including linguistic competence, social relations, domain knowledge, and previous educational experiences, which could accommodate or impede their participation in peer interaction. Also, students were found to utilize peer interaction opportunities to collaboratively develop their learning of the target academic knowledge while actively and interactively deploying a wide range of communicative functions, such as utterance completion, repetition, summary, validation, and information addition/edition. Pedagogical implications from this study can inform EAP practices, in the sense that EAP learner international students should be made aware of the interactive nature of learning in the target educational contexts, what factors could influence their interaction, and what sorts of communicative competence are needed in postgraduate environments where students are expected to actively and collaboratively engage in the development of their own learning.</p>

Pedagogical Design of the Elective Part of Postgraduate Educational and Scientific Training

The article highlights the approaches to the pedagogical design of the elective part of the educational and scientific program of postgraduate training in the specialty 014 Secondary Education (Mathematics) at Cherkasy National University named after Bohdan Khmelnytsky. Based on the analysis, comparison and generalization of domestic and foreign experience in designing SNP PhD training at the third (educational-scientific) level of higher education in this specialty, the educational component of postgraduate training at Bohdan Khmelnytsky Cherkasy National University is described. Approaches to the development of a selective part of the educational component of postgraduate training are highlighted.

Postgraduate Education Strategy’s for the Smoking Control in Cuba

Background: Smoking control is full important in Cuba. Cuban tobacco industry looks for the significant tobacco consumption growing. However, Cuban Public Health has a national program against smoking. This health institution contributes to generalist some smoking researches. By this institution is possible to call the main health professional related with the smoking control around the country. Much from these professionals haven´t a sufficient academic formation in Health Economy subjects for the smoking control. This condition and previous related are showing the real necessity to make available a postgraduate strategic for the smoking economic control since the Health Economy point of view. Objective. To design a postgraduate educational strategic for the smoking economic control in Cuba. Materials and Methods. Theoric methods: inductive – deductive, comparative and systematization. Empiric method: bibliographic and documental research. Results. The postgraduate educational strategic appoint to the professionals from the Public Health close related to the smoking control. It is formed by six courses, one of them is a diploma course. Inside each course a subject is supported by the previous. By this way is possible obtain a logic process in the postgraduate teaching about the smoking economic control. Conclusions. Was designed a postgraduate educational strategic for the smoking economic control in Cuba, agree to real needs from the health professionals related with the smoking control.

An international e-Delphi study to identify core competencies for Italian cardiac nurses

Aims The management of cardiovascular patients requires increasingly competent nursing professionals. In Italy, there are no specific postgraduate courses focused on specialist cardiac skills development for nurses. To develop such courses, content incorporating appropriate competencies is required and this study was designed to meet this. To delineate a set of core competencies to develop national educational interventions to ensure cardiac nurses in Italy achieve international standards. Methods and results A three-round e-Delphi study including a panel of 32 expert cardiac nurses from the UK, Canada, Australia, New Zealand, and Italy was conducted; 26 respondents completed all three rounds. The first round sought a list of five competencies from each participant which they were asked to prioritize in Round 2. In Round 3, they were asked to prioritize again with the knowledge of the priorities identified in Round 2. The final list of competencies was those achieving 70% agreement among participants. We identified 14 core competencies spanning a range of areas of competence including technical, interpersonal, health promotion, use of evidence, and management. Only minor differences were evident between the Italian and the international panel regarding the priority given to some core competences, such a leadership and taking patient history. Conclusion This is the first study in Italy to delineate cardiac nurses’ core competencies. As such, it provides a foundation for the development of postgraduate educational programmes for cardiac nurses including competencies that are congruent with international standards.

Enhancing communication between foundation doctors and radiologists: a quality improvement project

Facilitating radiological imaging for patients is an essential task for foundation year (FY) doctors. Achieving competence in this task can significantly enhance patient management. We evaluated the confidence and skills of FY doctors in facilitating radiological imaging before and after introduction of formal training. Twenty surgical FYs working at a large teaching hospital were surveyed to evaluate their baseline level of competence in booking and discussing imaging with radiology colleagues. Parameters were measured on a Likert scale, including confidence in discussing requests and satisfaction of their own performance following discussions with radiologists. Eight radiology consultants were surveyed to evaluate their opinions on FYs’ communication and established areas for improvement. A teaching session was then delivered to improve communication skills. Furthermore, Previous investigation results, Answer you need from the scan, Clinical status and story, Crucial: how urgent is the scan, Safety (PACCSS) poster was introduced to remind the FYs of the salient information required when discussing imaging. One month after the intervention, the initial participants were resurveyed. Based on a 10-point Likert scale, the FYs demonstrated a mean improvement in self-reported confidence (2.1±1.1, p<0.01), and in satisfaction of own performance after a discussion (1.7±1.1, p<0.01). We identified deficiencies in surgical FY doctors’ confidence and skills in facilitating radiological imaging. There was a demonstrable benefit with focused training in improving these skills. This could potentially provide significant benefits in patient care and management. Interspecialty communication should be introduced into undergraduate and postgraduate educational curriculum.

Empatychni zdibnosti likariv-interniv riznoho profiliu [Empathic abilities of internship doctors of various profiles]

Background: According to the Association of American Medical Colleges, the development of empathic abilities is one of the priorities of higher medical education. Understanding the great importance of the level of empathy and emotional intelligence for the future doctor has led to an increase in research interest in this issue both abroad and in Ukraine. Purpose: To determine the level of empathy in internship doctors of various specialties who studied in the cycle “Emergencies”, to find ways to optimize and stabilize this social ability. Materials and Methods: 84 internship doctors were interviewed anonymously in various specialties using the method of determining the level of empathic abilities according to Boyko and conducted a thorough analysis. Results: A high level of empathy was found in 7.1% of respondents due to the vast majority of women. The average level of empathy was found in 66.7% of respondents, the gender distribution was 1:1. 21.4% of internship doctors showed low levels of empathy, of which two thirds were men. A low level of empathy was found in 4.8% of respondents, exclusively men. In our study, we found mostly the average level of empathic abilities in internship doctors of different profiles. Women were more empathetic than men. The results indicate the need to develop empathic abilities (intuitive, rational and emotional channels) with an emphasis on “managing their emotions” in undergraduate and postgraduate educational process in order to form communicative professional competencies during the study period. Conclusions: The vast majority of internship doctors in various specialties showed an average level of empathic abilities, which meets the requirements of their further medical activities. There is no direct relationship between the level of empathic abilities and the frequency of emotional burnout. In a higher medical educational institution, it is necessary to develop and optimize empathic abilities starting from the first courses of study

Education and clinical decision support for healthcare professionals on emergency preparedness for extremely dangerous pathogens: report of a conference workshop

Clinical decision support and e-learning will be essential if we are to achieve the goal of preventing outbreaks of infectious diseases caused by extremely dangerous pathogens. However, these resources on their own will not be enough to achieve this outcome. To achieve this outcome, resources must be integrated into undergraduate and postgraduate educational curricula, accredited as part of continuous professional development programmes, built around the knowledge and skills gaps of learners and developed using an evidence-based methodology that will enable healthcare professionals to put their learning into action for the benefit of both patients and populations. This article describes and contextualises the personal views discussed at a workshop on education and clinical decision support for healthcare professionals reacting to an infectious disease outbreak from extremely dangerous pathogens.

Diagnóstico de competitividad académica y acreditación de programas educativos de la Universidad Autónoma de Baja California, México

Under the current policy that demands that higher education in Mexico should consider academic competitiveness and the recognition of educational programs within its planning, this article shows a diagnosis of all the 46 academic units of the Autonomous University of Baja California in its three campuses. In accordance with the institutional mission of this university, this article shows four indexes of academic competitiveness related to the consolidation of teaching and research of the entire university's teachers, as well as two indices of accreditation of undergraduate and postgraduate educational programs. With this information, the university is evaluated regarding the expected competitiveness, considering the particularities of the academic units that comprise it. The conclusion shows the importance of constructing diagnoses of this type in order to promote the knowledge of the institutions for purposes of feedback and planning, avoiding the possibility of ranking among universities.