A Pedagogical Paradigm Shift

This chapter provides an insight into the theoretical perspectives which form the foundation of extended reality (XR) and its emergence in practice as a fundamental part of medical and healthcare curricula. Issues such as the authenticity of learning, the validity and reliability of XR within processes of assessment, and the theoretical underpinnings of pedagogical approaches in health professions pedagogy are illuminated. Also considered are the implications of XR within the context of non-patient-based learning and the delineation of cognitive, affective, and psychomotor domains of learning in relation to patient outcomes at the front line of care in applied practice. The COVID-19 pandemic, which has impacted all global higher education institutional (HEI) learning since March 2020, is also considered in the context of moves to ensure that medical and healthcare education can continue, albeit via hybrid models of learning as opposed to traditional pedagogical approaches, which have remained little altered over the last century.

Detoxification II Prescription Suppresses the Th-17/IL-17 Inflammatory Axis to Improve the Liver Function of ACLF-Rats via Inactivating the P38MAPK Pathway

Hepatitis is a metabolic system disease which is a serious challenge to the medical and healthcare system of the world. This study attempted to investigate the therapeutic effect and illustrate the regulation pharmacological mechanism of Detoxification II Prescription on ACLF. In this study, the rats were injected with D-galactosamine to establish ACLF-rat models, and the levels of cholinesterase (CHE), alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBiL) were measured with the related kits to reflect the liver functions of the rats. The levels of IL-17, IL-6, and IFN-γ in the serums of the rats were detected by qRT-PCR, and the percentages of Th-17 cells in CD4+ cells of the rats were measured by flow cytometry assay. In the results, the increased ALT, AST, TBiL, IL-6, IL-17, IFN-γ, and percentage of Th-17 cells in CD4+ and decreased ALB and CHE were found in the serums of the ACLF-rats, while Detoxification II Prescription could partly reverse those indexes of the ACLF-rats. Moreover, it was also found that Detoxification II Prescription could inhibit the expression of P38MAPK, and P38MAPK downregulation obviously improved the liver function indexes of the ACLF-rats including the levels of ALT, AST, TBiL, IL-6, IL-17, IFN-γ, and percentage of Th-17 cells in CD4+ cells. In conclusion, this study suggested that Detoxification II Prescription could suppress the Th-17/IL-17 inflammatory axis to improve the liver function of ACLF-rats via inhibiting the activity of the P38MAPK pathway.

Isolation and Loneliness: Implications for Health and Well-Being of Older Populations

Evidence suggests social isolation and loneliness are prevalent within the population and may potentially be exacerbated due to the pandemic. Social connections have powerful influences on health and longevity, and lacking social connection qualifies as a risk factor for premature mortality. Evidence from the recent National Academy of Science consensus report on social isolation and loneliness among older adults will be summarized, providing the scope of the health effects, potential mechanisms and risk factors, as well as current gaps in the evidence. Importantly, this evidence points to several implications for solutions across sectors, including medical and healthcare practice and policy.

Change in medical and health care decision-making patterns at the End-of-Life: A cohort of the very old people

How does medical and healthcare decision-making among the very old people change in their last year before death? We explored patterns of decision-making in the Health ABC cohort study in 2011-14 (years 15-17), which involved 12 waves of quarterly phone interviews. When the participant was unable to do the interview, a proxy completed it instead. We identified a sample of 291 decedents (aged 90.0±2.9 at death, 35.7% Black, 52.6% female) with at least 1-year follow-up before death. Percentages of decedents who have made medical or healthcare decisions in the last four quarters before death were 32.0%, 31.2%, 32.6%, 41.9%, respectively. Decedents made more healthcare decisions in the last quarter before death (P<0.01), compared to the baseline. Across all quarters, decision-making is most in need for medications (17.6%), hospital admission (13.2%), and ER/urgent care visit (13.2%). We matched a 1:1 sample of survivors at the time of death by race, sex, and age (within ±3 years). In random effects models with multiple imputations of missing data, we found that decedents were more likely to make healthcare decisions than survivors across all four quarters before death or censor (Odds ratio=1.99, 95%CI: 1.49-2.65, P<0.01). The significance still held after adjusting for age, female, race, education, and interview methods. Overall, compared to matched survivors, the frequency of making medical and healthcare decisions among the very old decedents has already been high in the last year before death. This frequency rose sharply in the last quarter before death.

Positive impacts of Covid-19 pandemic to strengthen National Health Defense

During the past one and a half year, we all have faced the COVID-19 pandemic. In national defense perspective, COVID-19 Pandemic could be viewed as a non-military threat to national defense. The COVID-19 pandemic is a wake-up call that improves our awareness on the necessity to be fully independent and self-sufficient in health sector. So far, we have been complacent with the ease of importing raw materials for medicines and medical devices. Thus, the advent of the COVID-19 pandemic has made us aware to reduce Indonesia’s high dependence on import of health and medicine goods. Despite of the losses and prolonged sadness brought by the COVID-19 pandemic, there are also positive impacts for this nation as the result of the COVID-19 pandemic. One of the impacts on the National Health System is the strengthening and involvement of all levels of society and the apparatus in dealing with COVID-19 pandemic, which can be seen in the prevention, detection, and orderly response to COVID-19. Adjustment of public health service capacity is also carried out very swiftly to respond the pandemic situation. Another indicator is seen in the financing of medical and healthcare sector that was able to rapidly finding sources of funding for a very sharp increase in public health needs. Meanwhile, Human Resources capacity development appears to be very prominent as seen from the rapid improvement of training and research in medical and healthcare competences. No less important is the pharmaceuticals and medical devices sectors that are more determined to improve their independence and self-sufficiency in terms of drugs and vaccines raw materials. Independent raw materials provision for drugs and vaccines has an important value in the national economy and strengthening national security in the public health sector.

Glove Industry Spikes during Covid-19 Pandemic: A Case Study of Comfort Gloves Berhad (CGB)

The glove industry in Malaysia continues to grow with the strong demand from the domestic and international markets. During the Covid-19 pandemic, the worldwide demand for gloves surges to a higher level due to huge demand for the medical and healthcare usage. This creates opportunities for gloves manufacturers to increase their production lines and produce more gloves to fulfil the markets’ demand. The paper studies the glove industry in Malaysia and applies a case study of Comfort Gloves Berhad, which is a glove manufacturer in Malaysia to look in depth the opportunities and threats faced by glove manufacturers during the Covid-19 pandemic. The authors studied the published resources to collect information and further analysed the data and information collected. This paper discusses the SWOT analysis and Porter Five Forces in influencing the markets. The recommendations and conclusion are provided at the end of the paper.