Dignity and the Provision of Care and Support in ‘Old Age Homes’ in Tamil Nadu, India: A Qualitative Study

Background: In 2016, Tamil Nadu was the first state in India to develop a set of Minimum Standards for old age homes. The Minimum Standards stipulate that that residents’ dignity and privacy should be respected. However, the concept of dignity is undefined in the Minimum Standards. To date, there has been very little research within aged care facilities exploring the dignity of residents. This study draws on the concepts of (i) status dignity and (ii) central human functional capabilities, to explore whether long term care facilities uphold the dignity of residents. Objectives: The study was designed to obtain insights into human rights issues and experiences of residents, and the article addresses the research question, “to what extent do old age homes in Tamil Nadu support the central human functional capabilities of life, bodily health, bodily integrity and play, and secure dignity for older residents?”Method: A cross-sectional qualitative exploratory study design was utilised. Between January and May 2018 face-to-face interviews were conducted using a semi-structured topic guide with 30 older residents and 11 staff from ten care homes located three southern districts in Tamil Nadu, India. Framework analysis of data was structured around four central human functional capabilities. Results. There was considerable variation in the extent to which the four central human functional capabilities life, bodily integrity, bodily health and play were met,. There was evidence that Articles 3, 13, 25 and 24 of the Universal Declaration of Human Rights were contravened in both registered and unregistered facilities. Juxtaposing violations of human rights with good practice demonstrated that old age homes have the potential to protect the dignity of residents.Conclusion: The Government of India needs to strengthen care home policies to protect older residents. A new legislative framework is required to ensure that all old age homes are accountable to the State. Minimum Standards should include expectations for quality of care and dignity in care that meet the basic needs of residents and provide health care, personal support, and opportunities for leisure, and socializing. Standards should include staff-to-resident ratios and staff training requirements.

Safety, Effectiveness, and Professional Judgment: A Survey of Training-Related Perspectives Among Physiotherapists Who Practise Acupuncture in Ontario

Purpose: Physiotherapists practise various forms of acupuncture worldwide, but no international consensus exists as to the appropriate duration of related training programs. In this cross-sectional study, we aimed to characterize the training-related backgrounds and views of acupuncture-practising physiotherapists. Method: A total of 426 physiotherapists who practised acupuncture in Ontario completed an online survey that included training-related items and an open-ended question (39 provided training-related responses). Statistical analyses included multivariate and multinomial logistical regression models. Thematic analysis was used to interpret respondents’ textual responses to the open-ended question. Results: Respondents, who practised predominantly Western medical acupuncture, dry needling, or both, had completed acupuncture-related training programs ranging from < 25 to ≥ 300 hours. Those who had completed programs lasting > 100 hours were significantly more likely to self-report excellent clinical results and an enhanced ability both to recruit and retain patients and to earn a higher income. They were also more likely to endorse longer trainings as necessary for safe and effective patient care. Respondents to the open-ended question expressed a range of views, including the need for more stringent training requirements. Conclusions: PT regulatory requirements for longer (>100 hour) acupuncture trainings may better support clinical effectiveness and safety, patient satisfaction, and professional outcomes.

Family Medicine and Emergency Redeployment: Unrealized Potential

Background and Objectives: Discussions of scope of practice among family physicians has become a crucial topic amidst the COVID-19 pandemic, coupled with new attention to residency training requirements. Family medicine has seen a gradual narrowing of practice due to a host of issues, including physician choice, expanding scope of practice from physician assistants and nurses, an increased emphasis on patient volume, clinical revenue, and residency training competency requirements. We sought to demonstrate the flexibility of the family medicine workforce as shown through their scopes of practice, and argue that this is indication of their potential for redeployment during emergencies. Methods: This study computes scopes of practice for 78,416 family physicians who treat Medicare beneficiaries. We used Evaluation and Management (E/M) codes in Medicare’s 2017 Part-B public use file to calculate volumes of services done across six sites of service per physician. We aggregated counts and proportions of physicians and the E/M services they provided across sites of practice to characterize scope, and performed a separate analysis on rural physicians. Results: The study found most family physicians practicing at a single site, namely, the ambulatory clinic. However, family physicians in rural areas, where need is greater, exhibit broader scope. This suggests that a significant number of family physicians have capacity for COVID-19 deployment into other settings, such as emergency rooms or hospitals. Conclusions: Family physicians are a potential resource for emergency redeployment, however the current breadth of scope for most family physicians is not aligned with current residency training requirements and raises questions about the future of family medicine scope of practice.

The challenges confronting the training needs assessment in Saudi Arabian higher education

This research examines the problems encountered by the Training Needs Assessment (TNA) system from the perspective of faculty members and Human Resources (HR) managers in emerging public universities in the Saudi Arabian Higher Education sector. It aims to understand how problems with this will affect the success rate of Training and Development (T&D) curriculums. The research comprises an analytical study using a case study method of analysis. Qualitative data collection was carried out using semi-structured interviews with 75 senior managers and faculty members of four selected universities, selected using purposive non-random sampling. The data was analysed using Thematic Analysis (TA). The results highlight the insufficiency of the TNA techniques applied to ascertain training requirements. The primary obstacles to successful TNA were inadequate HR processes, insufficiently experienced HR directors, poor engagement, and favouritism concerning the selection of candidates for T&D. These issues affect the enthusiasm of those in the department. Additionally, resources required for T&D, particularly time and money, are misused, which could influence the growth potential of the universities against the country’s Vision 2030 plan. The findings indicate procedural differences in selecting and approving staff requests for Human Resource Development (HRD) support, managerial discretion in selecting participants for HRD programmes, and selective or restricted access to HRD programmes for foreign-born employees, which raises significant questions about equality policies. This study is unique as a contribution to the literature in exploring the challenges faced by the TNA process in Saudi Arabian Higher Education, therefore broadening understanding in the field as a whole, especially concerning the developing countries and Gulf Cooperation Council of Nations. The study concludes that there is currently unsatisfactory commitment in determining the staff training needs by the HR departments of Saudi Arabian public universities, which damages morale and leads to a lack of faith between HR directors and departmental staff. Finally, this study contributes to the area of policy decision-making by reporting the present situation surrounding the issues related to the application of TNA in T&D.

Evaluating robotic pedicle screw placement against conventional modalities: a systematic review and network meta-analysis

OBJECTIVE Several approaches have been studied for internal fixation of the spine using pedicle screws (PSs), including CT navigation, 2D and 3D fluoroscopy, freehand, and robotic assistance. Robot-assisted PS placement has been controversial because training requirements, cost, and previously unclear benefits. This meta-analysis compares screw placement accuracy, operative time, intraoperative blood loss, and overall complications of PS insertion using traditional freehand, navigated, and robot-assisted methods. METHODS A systematic review was performed of peer-reviewed articles indexed in several databases between January 2000 and August 2021 comparing ≥ 2 PS insertion methods with ≥ 10 screws per treatment arm. Data were extracted for patient outcomes, including PS placement, misplacement, and accuracy; operative time, overall complications, intraoperative blood loss, postoperative hospital length of stay, postoperative Oswestry Disability Index (ODI) score, and postoperative visual analog scale (VAS) score for back pain. Risk of bias was assessed using the Newcastle-Ottawa score and Cochrane tool. A network meta-analysis (NMA) was performed to estimate PS placement accuracy as the primary outcome. RESULTS Overall, 78 studies consisting of 6262 patients and > 31,909 PSs were included. NMA results showed that robot-assisted and 3D-fluoroscopy PS insertion had the greatest accuracy compared with freehand (p < 0.01 and p < 0.001, respectively), CT navigation (p = 0.02 and p = 0.04, respectively), and 2D fluoroscopy (p < 0.01 and p < 0.01, respectively). The surface under the cumulative ranking (SUCRA) curve method further demonstrated that robot-assisted PS insertion accuracy was superior (S = 0.937). Optimal screw placement was greatest in robot-assisted (S = 0.995) placement, and misplacement was greatest with freehand (S = 0.069) approaches. Robot-assisted placement was favorable for minimizing complications (S = 0.876), while freehand placement had greater odds of complication than robot-assisted (OR 2.49, p < 0.01) and CT-navigation (OR 2.15, p = 0.03) placement. CONCLUSIONS The results of this NMA suggest that robot-assisted PS insertion has advantages, including improved accuracy, optimal placement, and minimized surgical complications, compared with other PS insertion methods. Limitations included overgeneralization of categories and time-dependent effects.

The Need to Consider Requiring Trauma Training in Entry-Level Academic Training Programs in Clinical Mental Health Counseling

The COVID-19 pandemic and heightened awareness of racial injustice and discrimination in the United States are likely to have a negative impact on mental health. This is concerning, given the already alarming prevalence rates of trauma exposure and adverse childhood experiences in the U.S. general population prior to the current pandemic, their immediate and long-lasting effects on human development across the life span, and their documented effects on adult chronic health conditions. For clinical mental health counselors (CMHCs) to respond effectively to the needs of the U.S. general population, entry-level counseling programs must provide comprehensive trauma training and education. The purpose of this article is to provide information about clinical competencies and relevant training requirements for CMHCs in trauma prevention and treatment to highlight the need to require comprehensive trauma training in entry-level academic training programs for CMHCs through relevant research and policy.

The Tendencies of Mathematics' Teaching Staff Members in Saudi Arabia Towards Using "Blackboard" in University Teaching and Their Training Requirements: اتجاهات أعضاء هيئة تدريس الرياضيات بالجامعات السعودية نحو استخدام منصة Blackboard في التعليم الجامعي واحتياجاتهم التدريبية

The extract This study aims to detect the tendencies of the mathematics teaching staff in Saudi universities towards using the E- learning management system " Blackboard" in learning and university teaching. And it asks for their training requirements and if there are statistically significant differences between the responds of the sample studies individuals among universities teaching staff. It is about using blackboards in teaching Mathematics that could be attributed to gender variable, academic degree as well as their training background. So, for achieving this objective, the researcher has used the descriptive approach and she used " questionnaire" as a studying tool. The study sample is made up of) 73( teaching member staff whom the "questionnaire" has been sent to them Research's results showed that the tendencies' overall average for teaching member staff is positive with (2.66) percentage. Similarly, the study has shown positive results towards the need for more training on the use of the blackboard system. The study identified a set of recommendations; the most significant is related to: scaling up this experience in all Saudi universities. Beside providing the continuous and intensive training for the teaching staff members and students on the use of the E-learning management system " Blackboard".

Ethical Conduct of Public Servants

The objective of the investigation was to examine the content and specific characteristics of the ethical conduct of public officials in Ukraine and the world. To achieve the objective, the authors used the following methods: epistemological, comparative-legal, structural-functional, analytical, informative-analytical. Among the results of the article, it was possible to consider the ethical conduct of public servants in a broad and narrow sense. In the same way, the main requirements of the legislation that regulate the conduct of public servants have been analyzed and the conditions that standardize in detail the legal relationships in the field of professional activity of public servants, their relationships with each other and with citizens. Finally, everything allows us to conclude that a Code of Ethics for public servants establishes common rules of conduct for them and determines responsibility for their violation. To be effective, this regulatory legal act must also include the following obligations for public servants: requirements for the performance of official functions; requirements for advanced training; requirements for relationships with colleagues, managers, and subordinates; norms of communication with citizens and norms to resolve conflicting interests.

3D Printing Improve the Effectiveness of Fracture Teaching and Medical Learning: A Comprehensive Scientometric Assessment and Future Perspectives

Fractures of complex body parts are often serious and difficult to handle, and they have high technical and training requirements. However, the realistic situation is that there are few opportunities for the junior residents, trainee doctors, and especially medical students to contact enough clinical practice and see such fracture patients. Fortunately, with the rapid development and continuous progress of 3D printing and related technologies, this situation has gradually gotten better and better. In this research, we confirmed that 3D printing technology could improve the effectiveness of fracture teaching and medical learning from multiple dimensions. We comprehensively screened and assessed 223 papers from the Web of Science (WoS) Core Collection on October 3, 2021, with “((3D) AND ((printing) OR (printed)) AND (fracture)) AND ((education) OR (training) OR (teaching))” as the retrieval strategy. Additionally, we used the VOSviewer software to analyze the keywords and countries and the organizations of the publications, then a series of scientometric and visualized analyses were made based on the retrieval results. Afterward, multiple databases were retrieved according to our selection criteria, we selected eight studies for the extensive literature analysis. The extracted data contained information of authors, problems solved, participants, methods, assessments, results, and benefits/limitations. These intuitive and in-depth analyses further confirmed and appraised the advantages of 3D printing in complex fracture models more objectively. In conclusion, 3D printing could improve the effectiveness and extension of fracture teaching, as well as medical learning, by providing the powerful interaction with 3D effect, wakening students learning interest, and allowing the junior residents, trainee doctors to have as realistic a virtual practice experience as possible. Through this research, it is expected that more researchers could be attracted to conduct more comprehensive and thorough studies on the application of 3D printing for training and educational propose, to promote the development of 3D technology-based medical education practice and further deepen the reform of medical education and improve the quality of fracture education and learning.

A pilot study about methods to reduce prescription errors in a chemotherapy day unit – Aspects to consider in pharmacist verification process

Introduction Prescribing errors can happen unintentionally during the prescribing process, or when choosing a treatment therapy. Prescribing errors have the highest prevalence amongst common error types related to chemotherapy medication in outpatient settings. According to the Joint Commission International (JCI), prescriptions should be reviewed for appropriateness by someone else than the prescriber or practitioner to prevent medication errors. Aim The study was aimed to map out the existing type and amount of occurring deviations in prescribing and to clarify the current chemotherapy prescribing practices at the Comprehensive Cancer Center at Helsinki University Hospital. Similar research has not been published in Finland before. Methods and patients The researcher selected patients randomly from the daily outpatient attendance list following a predetermined numerical order. Data was collected by conducting a medication verification review in line with the JCI guidance by a clinical pharmacist the day before the patient's clinic appointment using the available medical documentation. A clinical pharmacist evaluated findings from prescriptions and contacted an oncologist if the findings were considered clinically significant. Results A clinical pharmacist verified prescriptions from 101 patients for appropriateness and found discrepancies in four percent of the prescriptions ( n = 4/101). The oncologist approved 50 percent of the suggested amendments by the pharmacist as clinically significant ( n = 2/4). The study revealed that patient’s regular home medications were not always correctly recorded into the database, so verification of medicine interactions could not be trusted as completely accurate. It took on average 16 min per patient to perform a medication verification review. The process was slowed down by the lack of detailed enough protocols for this purpose and the current patient care record system not having structural formatting of data entry. Conclusions Verification of prescriptions provides a tool to identify prescribing discrepancies and to prevent unintended medication errors affecting patients. The development of detailed protocols and guidelines, as well as an appropriate training program, would support pharmacists in compiling clinical medication reviews for chemotherapy patients. More research is needed to further develop the operating model in Finland. Information gathered from this study can be used for identifying training requirements.