Hospice Care for Veterans: A Community Education Program

The impact of trauma on care at end of life and the social isolation of the COVID-19 pandemic highlighted a critical gap in care of terminally ill veterans. It is estimated that 30% of Vietnam Veterans suffer from PTSD, suicide rates are 49% higher in older veterans than nonveterans, and 41% of veterans surveyed report post traumatic guilt. A survey of non-VA hospice agencies revealed many do not screen for PTSD, but desired training in this area. The VA responded to these challenges implementing an initiative to educate community caregivers on PTSD, suicide, and moral injury with expanded tele mental health services. Several VA sites were supported to participate in training focusing on PTSD, suicide, and moral injury and Telemental health. In Northeast Ohio, from 2019-20, 11 community hospice agencies participated in training, including 283 providers,120 (42%) nurses, 100 (35%) social workers, 29 (10%) volunteers, and 34 (12%) other. A majority of participants post-training (n=160) (84%-94%) reported enhanced knowledge, skills, or attitudes related to resources, education, and communication. Participants rated changes for assessment skills lowest for moral injury (34%), PTSD (41%), and suicide (56%). An analysis of telemental health visits (N=50) revealed that, 56% addressed spiritual support, (22%) family support, (10%) resources/referrals, and (8%) confusion. The majority of telehealth visits were VA initiated (84%), and 10% were hospice initiated Continued education regarding PTSD, suicide, and moral injury assessment skills is still needed for hospice care providers of veterans. These findings support the use of telemental health for care and consultation.

WESTERN NOMADIC DISCOURSE AND THE DISCOVERY OF THE OTHER

Investing in university education has spread widely in Palestine and all counties around the world. ‎This is due to several causes, such as the enormous increase in the number of students, and the ‎growth in the number of students with various academic degrees, which resulted in increasing the ‎number of public and private universities, in addition to the institutes specialized in various ‎professional studies. Many of these universities seek to develop and raise their educational ‎competencies. Therefore, they started resorting to the so-called networking between universities. ‎Consequently, the study aimed to identify the reality of networking processes between universities ‎from the point of view of the teaching staff in the universities of Jerusalem and the West Bank. The ‎study also aims to point out the reality of teaching and academic exchange, the scientific research, ‎community service and the continued education from the point of view of the teaching staff in the ‎universities of Jerusalem and the West Bank. Also, it seeks to uncover the differences in the ‎networking processes between universities from the viewpoint of the teaching staff in the ‎universities of Jerusalem and the West Bank, according to the variables of gender, academic ‎qualification, years of experience, and university. ‎ To achieve the objectives of this study, the researcher used the analytical descriptive ‎approach, in addition to a questionnaire consisted of (35) paragraphs distributed over three fields: ‎teaching and academic exchange, scientific research, community service and continued education. ‎The validity and stability of the questionnaire had been confirmed. The questionnaire is distributed ‎over a sample from the faculty that were chosen randomly from the universities of Jerusalem ‎‎(Sakhnin, Al-Qasimi, Ono, David Yellen) and the West Bank (Arab American University, An-Najah ‎National University, Birzeit, Jerusalem, Bethlehem, Al-Ahliyya Palestine, Al-Quds Open, Hebron), ‎numbering (200) individuals. After collecting the data, it was analysed through processing it ‎statistically by (SPSS). ‎ The results of the study indicated that the reality of teaching, academic exchange, scientific ‎research, community service and continuing education from the point of view of the teaching staff ‎in the universities of Jerusalem and the West Bank has come to a large extent. The results also ‎revealed that there were no statistically significant differences in the degree of reality of networking ‎operations between universities from the point of view of the teaching staff in the universities of ‎Jerusalem and the West Bank according to the variable of gender, academic qualification and years ‎of experience. However, the results indicated that there were differences according to the ‎differences among the universities‎‎.

Predicting or preventing lifelong learning? The role of employment, time, cost, and prior achievement

Although there has been a rich amount of research about lifelong learning providing benefits such as economic advancement and personal fulfillment, less is known about factors that increase or decrease a person’s likelihood of pursuing it. Nonetheless, knowing these predictors and barriers can have practical consequences on encouraging people to have continued education. Using a national US dataset ( n = 1651), our analyses showed people’s pursuit of different lifelong learning modalities and revealed significant predictors and barriers of lifelong learning. Counterintuitively, employment and time constraints did not prevent individuals from pursuing educational opportunities; they actually helped predict it. Additionally, limited information—rather than cost—was a stronger driver in preventing people from pursuing lifelong learning. Taken together, the research has implications for encouraging people to pursue lifelong learning.

Assessment of Knowledge, Attitudes and Practices Concerning Travel Health among Hajj Pilgrims (1439 H- 2018 G) at Prince Mohammad bin Abdulaziz International Airport in AL-Madina, Saudi Arabia

AIM: The Hajj pilgrimage, the world's largest annual mass gathering, is held in the Kingdom of Saudi Arabia (KSA). The Saudi Arabian Ministry of Health (MoH) issues entry visa requirements and recommendations for Hajj pilgrims visiting the country. Vaccinations, health checks, and specific immunizations are all recommended either at or before entering KSA. We assessed Hajj pilgrims’ knowledge, attitude and practices regarding preventive, curative, hygienic and health promoting measures. SUBJECTS AND METHODS: We administered a questionnaire to a cross-section of Hajj pilgrims(2018 G)traveling through Prince Mohammad bin Abdulaziz International Airport in Al-Madina, KSA. Variables collected included demographics, Hajj health preparations, and knowledge and attitudes towards travel-related health behaviors. RESULTS: Of 101 respondents, 20% were Saudi and 64%were male. Regarding travel profile, 75% were attending hajj for the first time. About half (52%) stayed in KSA for more than 2 weeks.  Knowledge regarding travel heath of respondents was high: 82% scored as excellent and 11% scored as good. Positive attitude toward travel medicine was reported by 60% of participants; 56% of them sought pre-travel advice.  Regarding health protection behaviors, 79%reported using protective measures against respiratory infections, 70%for insects, 95%for food and waterborne Diseases, 99%against heat-related conditions and 100%for injuries. CONCLUSION: Despite the health criteria for obtaining Hajj visas and the documented health risks associated with attending Hajj, we discovered that less than half of participants received pre-travel advice. To ensure that Hajj pilgrims have a secure and healthy experience in the Kingdom, we recognized the need for continued education and promotion of health preventive measures. This research could be used to help countries establish Hajj health systems, which would be immensely helpful and would go a long way toward reducing Hajj mortality and morbidity, as well as associated burdens.

CONTENT TRANSACTION CHALLENGES DURING ON-LINE CLASSES

In the globe, COVID-19 has disrupted most industries. In most nations, education is the only sector that has fully migrated to the internet environment. During the pandemic, online learning was the greatest option for continued education, particularly in higher institutions. It is common to adopt a one-size-fits-all strategy when changing modes. To put it another way, internal information is transformed into something that can be delivered to an outside audience. There is a preliminary online research of 542 pupils at a Bhopal school that examines difficulties and issues they may have in adjusting to the new "norm". The majority of pupils are not ready for online courses due to a lack of Internet connection.

EP.TU.883Improving diagnosis in all male patients admitted with right iliac fossa pain

Background Right iliac fossa pain is a common presenting complaint in males. Ultrasound is a cheap non-invasive investigation, yet results can be non-diagnostic. CT is becoming more accessible and available for patient assessment. Aim Our primary aim is to estimate how many unnecessary US scans are gained prior to CT imaging, thereby delaying surgery, increasing cost and increasing length of stay (LOS). Method We conducted a retrospective analysis of all male patients over the age of 16 admitted to a single unit with RIF pain over 12 months. Outcome and length of stay was recorded. Results 162 male patients were admitted to a single University teaching hospital between 2017 and 2018. 33% (n = 53) of patients having an US scan require further imaging, 40% ( n = 21 ) of these had a surgical pathology, 80% (n = 17) of these requiring appendicectomy. Patients (n = 39) who had an initial CT scan subsequently requiring surgery length of LOS 3.6 days compared with US imaging with additional imaging requiring surgery ( n = 17) LOS 5.8 days. Conclusion Evaluation of practice of males over the age of 16 shows that US is frequently non diagnostic, requiring further investigation with CT or MRI. Imaging initially with CT scan aid diagnosis and decrease length of stay. An education steering committee of surgical trainees, consultants and radiographers has been created to adapt practice in our centre through continued education and training.

Oncofertility Knowledge and Communication: Comparison Between Medical and Surgical Oncologists and Breast Cancer Patients in Academic Chinese Centers

Background: As cancer has become a major public health issue in China, fertility preservation remains limited despite the wide application of Assisted Reproductive Technology (ART) throughout the country.Objective: This study aimed to identify gaps in knowledge and communication as well as referrals in the previous year regarding oncofertility among medical and surgical oncologists and breast cancer patients (BCPs) in Chinese academic settings to target areas of needed improvement.Materials and Methods: A WeChat online questionnaire was designed, distributed, and compared between medical and surgical oncology specialists and reproductive age BCPs in academic teaching settings in Shanghai.Results: Sixty-one medical and surgical oncologists and 125 BCPs responded to the survey. 63.3% of oncologists were familiar with the term “oncofertility” compared to 25.6% of BCPs (p < 0.001). Oncologists were more likely to correctly know the costs associated with treatment (59.0 vs. 32.0%, p < 0.001); patient did not have to be married to undergo oncofertility treatment (50.8 vs. 24.8%, p < 0.001). Both oncologists and BCPs were similarly unlikely to know when patients could utilize cryopreserved tissue in the future (37.7 vs. 22.2%, p = 0.056). While oncologists reported they discussed all oncofertility options (41.0%) and offered psychological counseling (98.4%), significantly fewer BCPs reported receiving information on all options and offered counseling (3.2%, p < 0.001 and 85.6%, p < 0.01). Knowledge of oncofertility was the most important predictor for providing and receiving counseling from oncologists [OR = 6.44 (95% CI = 1.59–26.1, p = 0.009] and BCPs (OR = 3.73 95% CI: = 1.36–10.2, p = 0.011). Overall, 57.4% of oncologists referred <10 patients and none referred more than 25 patients in the past year.Conclusion: Data suggests a significant knowledge gap and ineffective communication/comprehension exists between academic Chinese oncologists and BCPs. Continued education and raised awareness are needed to optimize utilization of oncofertility services in China.

PREDICTORS OF BREAST SELF-EXAMINATION UPTAKE AMONG WOMEN IN MALE’ REGION, MALDIVES

Breast cancer (BC), is the most common cancer that affects women, and one of the significant causes of mortality among them. Screening and early detection of the disease are encouraged as a means of reducing mortality and enhancing the prognosis. The purpose of the study is to determine the prevalence of Breast Self-Examination (BSE) uptake and to identify the factors that are associated with the BSE uptake among Maldivian women in the Male’ region. The cross-sectional study was carried out over a period of 3 months in the Male’ region, of the Maldives. A total of 600 female citizens aged 20-79 years were selected using stratified random sampling method. Data were collected using an interviewer-administered questionnaire. About 82.70%, 54.80%, and 63.30% of the respondents had heard about BC, breast cancer screening (BCS), and BSE respectively. 50.80% of the respondents had ever performed BSE with only 22.00% performed it regularly. The significant predictors for BSE uptake were: ever heard about BC [OR=2.069, 95% CI(1.081-3.959)], ever heard about BSE [OR=2.342, 95% CI(1.326-4.137)], ever heard about clinical breast examination (CBE) [OR=1.946, 95% CI(1.117-3.390)], knowledge on early detection of BC [OR=1.077, 95% CI(1.011-1.148)], perceptions on the severity of BC [OR=1.062, 95% CI(1.010-1.116)], perceptions on barriers towards BSE [OR=0.900, 95% CI(0.846-0.958)] and self-efficacy [OR=1.112, 95% CI(1.076-1.150)]. The findings indicated that there is a pressing need for continued education and behaviour modification intervention programs using theories and models to increase women’s overall knowledge and awareness of BC and BCS and modify the long-held incorrect beliefs and misconceptions. In particular, the relevant authorities should play a proactive role in raising awareness of BC and promote BCS.

Early adulthood socioeconomic trajectories contribute to inequalities in adult cardiovascular health, independently of childhood and adulthood socioeconomic position

BackgroundCardiovascular health shows significant socioeconomic inequalities, however there is little understanding of the role of early adulthood in generation of these inequalities. We assessed the contribution of socioeconomic trajectories during early adulthood (16–24 years) to cardiovascular health in mid-adulthood (46 years).MethodsParticipants from the 1970 British Cohort Study with socioeconomic data available in early adulthood were included (n=12 423). Longitudinal latent class analysis identified socioeconomic trajectories, based on patterns of economic activity throughout early adulthood. Cardiometabolic risk factors (46 years) were regressed on socioeconomic trajectory class (16–24 years), testing mediation by adult socioeconomic position (46 years). Models were stratified by sex and adjusted for childhood socioeconomic position (SEP) and adolescent health.ResultsSix early adulthood socioeconomic trajectories were identified: (1) Continued Education (20.2%), (2) Managerial Employment (16.0%), (3) Skilled Non-manual Employment (20.9%), (4) Skilled Manual Employment (18.9%), (5) Partly Skilled Employment (15.8%) and (6) Economically Inactive (8.1%). The ‘Continued Education’ trajectory class showed the best cardiovascular health at age 46 years, with the lowest levels of cardiometabolic risk factors. For example, systolic blood pressure was 128.9 mm Hg (95% CI 127.8 to 130.0) among men in the ‘Continued Education’ class, compared with 131.3 mm Hg (95% CI 130.4 to 132.2) among men in the ‘Skilled Manual’ class. Patterns across classes 2–6 differed by risk factor and sex. The observed associations were largely not mediated by SEP at age 46 years.ConclusionFindings suggest an independent contribution of early adulthood socioeconomic trajectories to development of later life cardiovascular inequalities. Further work is needed to understand mediators of this relationship and potential for interventions to mitigate these pathways.

Developing an interplay among the psychological barriers for the adoption of industry 4.0 phenomenon

This research aims to identify, rank, and create an interplay among the psychological barriers to adopting Industry 4.0 technologies in the manufacturing sector. A comprehensive literature review tracked by a discussion with industry and academic experts recognized 20 barriers. Based on three widely acclaimed statistical techniques, hybrid AHP-TOPSIS (Analytical Hierarchy Process-Technique for Order Performance by Similarity to Ideal Solution) and ISM (Interpretative Structural Modeling), critical psychological barriers have been investigated. A group of 8 experts from industry and academia with at least 10 years of experience was consulted for AHP and ISM techniques. Whereas TOPSIS was conducted by 443 operational-level users, including managers and supervisors of different functional areas of the manufacturing industry located in Pakistan. The findings reveal that ‘Fear of job losses’, ‘Fear of data loss/Risk of security breaches, ‘Lack of advanced & continued education of employees’ and ‘Lack of standards and reference architecture’, with highest importance weights, emerged as the most prominent psychological barriers in developing economies. Then the interrelations among these barriers resulted in a four-layered structural model. The driver barriers identified in the final model advocate that development in ‘advanced & continued education of employees’, ‘standards & reference architecture’ and ‘minimization of fear of job & data loss’ can expedite the adoption of industry 4.0 (i4.0) technologies. The study uniquely develops hierarchical relationships among the psychological barriers for adopting i4.0 in the manufacturing context using AHP-TOPSIS and ISM techniques. The study would be valuable for practitioners, decision-makers and companies that wish to focus their efforts and resources on removing the most critical barriers and challenges for the seamless implementation of Industry 4.0.