Журнал исследований и разработок в области медицинского образования

Background: Today, as the rapid progress of Information Technologies (I.T) in health care continues, it is crucial to find out more information about the factors that might advance or hinder the nurses’ educators’ acceptance of technological changes. The main goal of this study was to explain the use of using I.T, by focusing on sociological factors like the impact of support and influence. The study design was a quantitative research, using a written and online survey. One hundred and nine academic nurse educators from ten different academic nursing schools in Israel participated. Results: support and influence predict actual use of I.T. The Chi-square Goodness-of-Fit index presented an excellent fit for the data (p=0.46; Normed Fit Index (NFI)=0.96; Root Mean Square Error of Approximation (RMSEA)=0.00). The relationship between sociological factors from significant others and the actual use of IT was mediated by personality characteristics such as self-efficacy, and innovativeness. Conclusion: Management should ensure that sociological factors (such as support and influence) and personality characteristics (such as self-efficacy, attitudes toward I.T, and innovativeness) are considered when preparing to introduce new technologies to nurse educators. Enhancing support and influence and self-efficacy should be considered in the organization, in order to encourage favorable use among healthcare professionals.

Introduction: Ministry of Health has initiated Quality Accreditation studies with Transformation Project in Health in 2003. These studies have gained extensive momentum especially in the last decade, and have composed Quality Accreditation Programs (Quality Standards in Healthcare, associated guidelines), which are applied in all healthcare institutions and institutes. The status of achievement in applying the criteria, laid down by Quality Standards in Healthcare, is significantly affected by physical locations of institutions and institutes, technical facilities, and knowledge levels and experiences of personnel. Purpose: This study has been conducted to assess the contributions of Quality Accreditation Programs to patient safety knowledge and practices in nursing services and to measure the effects of different variables on these practices. Methods: The study has been conducted with 175 nurses in different age groups, at different educational levels, and working in hospital clinics, and having different durations of work experience. Data has been obtained by a questionnaire of 12 questions (two questions have sub-questions). Descriptive statistical methods have been used in data analysis, and Chi square test has been used in required sub-group analysis. Findings: The half of the participants was in the age group of 25-34 years. 98.9% of nurses stated that they received patient safety training. 90.9% of participants thought that these trainings were sufficient. The ratio of the ones, indicating that they needed training on this subject, was 22.3%. The ratio of the participants, reporting on patient safety, was detected as 78.3%. The ratio of nurses, reporting on this subject, was found significantly high in the age group of 25-34 years (p=0.012). The rate of receiving training was low in nurses with work experience of less than one year (p=0.038). The rate of reporting on patient safety was significantly low in participants with work experience of less than one year and with work experience of more than 10 years (p=0.049). Conclusion: Although the rate of receiving training on patient safety is high, the rate of participants, practically reporting on this subject, is low. This has led to the thought that training is not always fully effective in attitude change. We think that the implementation of short-term reminder trainings may be useful.

Background: Concurrent thyroid cancer and hyperthyroidism is rare, though increasingly reported. Hyperthyroidism due to thyroid cancer is very rare and challenging.

Case presentation: We present a 35-year-old woman who had been on irregular regimen of propanolol and digoxin as treatment for worsening palpitations for 12 months. She came to our Policlinic University for her propanolol medication evaluation. We identified features of hyperthyroidism and found a left uninodular goiter with no cervical lymphadenopathy. She was referred for thyroid assessment which suggested primary hyperthyroidism and an enlarged heterogeneous left lobe with a well-defined homogenous solid mass. We restarted her on propanolol and referred her for a new course with methimazole. At the Policlinic University, she also underwent a left thyroid lobectomy. The resected lobe was sent for cytology evaluation which revealed a neoplastic nodule with features suggestive of a papillary thyroid cancer causing hyperthyroidism. The postoperative clinical progress of the patient was good and a regression of hyperthyroidism was also evidenced.

Conclusions: The historical, clinical, and laboratory findings were suggestive of hyperthyroidism due to papillary thyroid cancer. A high index of suspicion, prompt referral, and counter-referral lead to a positive outcome of such a rare case. We advocate for systematic and careful evaluation of all thyroid nodules.

Sherlock Holmes said “it has long been an axiom of mine that the little things are infinitely the most important”, but never imagined that such a little thing, the DNA molecule, could become perhaps the most powerful single tool in the multifaceted fight against crime. 30 years after the development of DNA fingerprinting, forensic DNA analysis is to the conviction or exoneration of suspects and identification of victims of crime, accidents and mass disaster. As necessity is the mother of all invention, it drives us in the development of modern methods in molecular genetics, statistics, and the use of massive intelligence database.

Background: Breast cancer is the most common malignancy among women in Saudi Arabia. Despite the availability of early detection methods to diagnose breast cancer, a huge number of women are still unaware about these methods. This study was conducted to identify the attitude of women in Medina toward breast cancer screening methods, including breast self-examination (BSE), clinical breast examination (CBE) and mammography.

Materials and methods: A cross sectional survey has been conducted on 124 women aged from 39 and older, who attended Taibah Medical Center for cancer screening either by doctor’s recommendation, family or friends advice, or by herself. Face to face questionnaire was used to collect data. All data were analyzed by statistical analysis system software.

Results: The results showed only 35.5%, 27.4% and 37.8% of participants reported that they practiced BSE, CBE and annual mammography, respectively. Only 27.3% of women practiced BSE once per month, and 8.8% visited doctor annually for CBE. Both educational level and family history were significantly related to BSE. 57.7% of the participants who had positive family history practiced BSE, and 56.0% of the participants who practiced BSE were highly educated. Lacking awareness about BSE is the most important barrier in not practicing BSE, while not having a breast lump was the reason for not undergoing either clinical breast examination (38.7%) or periodic mammography (54.9%).

Conclusion: This study emphasized the need for massive health education program to increase awareness, and improve the attitude of women toward breast cancer screening methods.

The objective of this paper was to share the experience of virtual simulation commissioning and its use in radiation therapy of head and neck cancers at Charlotte Maxeke Johannesburg Academic hospital. The first sixty three (63) head and neck cases planned on the virtual simulation station was analyzed as well as the impression of staff members after using the system. A semi structured survey revealed that staff was overall satisfied with the system. A follow-up study with more cases planned, however, is advised.

Surgical skills simulation (SSS) tests the application of factual knowledge and shows how knowledge is applied, representing the second and third levels of Miller’s Pyramid of Learning. SSS permits high-stakes scenario testing in safe environments. Therefore, SSS incorporation into initial specialty certification began in 2002 in Australia and New Zealand. The United States began SSS incorporation into specialty certification in 2008. This paper will determine where the United States stands in the process of SSS incorporation into specialty certification. Google scholar Internet and PubMed searches phrased “medical board certification surgical skills simulation”, performed on September 1, 2016 yielded 16 relevant articles. Hand search on September 1, 2016 yielded 7 additional articles. In 2008, cardiac catheterization simulation was required for interventional cardiology maintenance of certification (MOC). In 2010 the American Board of Anesthesiology (ABA) required SSS as part of the MOC program. In 2014, the summative assessment, Colorectal Objective Assessment of Technical Skills became part of the American Board of Colon and Rectal Surgery certification. In 2017, SSS will be added to the ABA initial certification examination. The United States has been slow to incorporate SSS into initial certification and MOC. Assessment validation, capital and recurring costs, personnel, physical facility and time requirements are barriers limiting SSS expansion into specialty certification processes. As SSS allows rapid technical skill assessment, without posing a threat to patients, expansion of SSS into initial certification and MOC programs represents non-maleficence and beneficence, and should be encouraged.

Intestinal parasitic infections are among the major diseases of concern to public health throughout the world [1]. About 25% of world’s population suffers from one or more kinds of intestinal parasitic infections (helminthes/protozoa). Children because of their complex nutritional requirements and less developed immune systems are observed to be the principal sufferers of these parasitic infections [2]. Moreover, they have an extremely delicate physiology which can result in severe upsetting of their biochemical and physiological processes associated with these infections. Intestinal protozoan parasites can affect children in a variety of ways; they cause mal-absorption, reduced growth, increased risk for protein energy malnutrition, reduced psychomotor development and anemia. This report addresses Cryptosporidium, Giardia, and Entamoeba as the main parasitic protozoa of concern among children worldwide.

This research aimed to extract medical diagnostic knowledge about sleep apnea by applying theories from process control management, library science, and knowledge management. We interviewed the President of the International Sleep Science Technology Association (ISSTA), a medical doctor, on the subject of sleep apnea, and validated the research findings with four other sleep apnea experts to achieve the following: A formal knowledge extraction procedure was established for sleep apnea. All medical knowledge pertaining to sleep apnea was mapped out.

Background: Physicians’ attire can play a critical factor in patient-doctor relationship. Such relationship is necessary to improve healthcare outcomes and eventually lead to healthier children.

Objective: This study aims to assess perceptions of Saudi children and parents toward physicians’ attire within inpatient general pediatrics settings. To our knowledge, no such assessment has been presented until now.

Methods: A questionnaire was adopted and evaluated by pilot study. Then, data were collected from parents along with certain demographic data within inpatients general pediatrics settings.

Results: Perceptions of attire differ according to physician’s gender. Wearing scrubs was found more professional, approachable, and trust-worthy for male physicians by parents while wearing conservative long black skirts with lab coat perceived similarly for female physicians. However, wearing summer dress and Saudi traditional attire thought to jeopardies infection controls. Furthermore, children found these attires more intimidating. Although majority of parents thought wearing lab coat is necessary, most of children disagreed. Also, discordance in perception of decorated stethoscopes was observed. Surprisingly, tennis shoes were the preferred shoes for both male and female physicians.

Conclusion: Physicians’ attire can be interpreted as indicator of professionalism which could impact patient-doctor relationship. Moreover, children can perceive physician attire differently from their parents.

Utilization of health information is important in the provision of efficient and effective healthcare services. It is a major public health component in the ministry of health which informs decisions for efficient and effective healthcare. It involves generation, collection and analysis and use in identifying gaps in health systems to prompt planning for appropriate health interventions or actions to promote healthy. It is used for planning health projects and priority activities, budget allocations, research, monitoring and evaluation, education and health policy development. The objective of this study was to determine utilization of health information among healthcare workers in Gucha Sub County, Kisii County. This was an observational study which utilized descriptive cross-sectional study design using quantitative methods of data collection to assess utilization of health information among healthcare workers in Gucha Sub County, Kisii County. The study was conducted among healthcare workers offering healthcare services in the health facilities in Gucha Sub County. The sample size was determined by use of fisher’s formula. It was deployed stratified and quota sampling methods to reach the subjects of study. Interview schedules were designed with structured questions to collect the data after pretesting the tool and training research assistants on its application. Analysis was done using statistical package for social scientist (SPSS). The study found that data and information were managed by nonprofessionals due to inadequate health information specialists, consequently this compromised quality and use of information. Availability and accessibility were highly hampered due to inadequacy of training and electronic systems in use. From the study it was recommended that health workers to be trained in use of data tools and ICT system infrastructure be installed. Employing more health workers was important as well as developing health information policy to enhance the use information in Gucha Sub County.

Menstrual changes affect the quality of females’ lives, it indicates some underlying problems. The purpose of this research is to determine the influence of exams’ stress on menstrual dysfunctions. The objectives are to measure the common menstrual dysfunctions among girls during exams, find the most affected characteristics among the measured ones, hence figuring out any relation between the exams (as a source of stress) and the menstrual dysfunctions of 204 Saudi female college students between the age groups of 18 to 25 who matched the required criteria when completed the exam stress social networks questionnaire study on menstrual disorders. It was found that 80.9% of the sample had menstrual changes during exams. Regarding the characteristics; 59.3% had a change in the level of pain, 50% had a change in blood flow, and 54.9% had it in the menstruation timing. The dysmenorrhea was marked as the most common dysfunction within 57.4% of the students during exams. A more detailed research is highly required to explore the risk factors, the pathophysiological mechanisms underlying stress in female students during exams in contemplation to establish a modifying or abortive treatment modalities.

The monitoring of any project at scale becomes challenging issue and most of the monitoring systems are not strong enough to effectively monitor the project across difficult geographies. Monitoring at scale is a daunting task with hard to reach population and places in any given project implementation. However, projects suffer at large because of weaker monitoring system in difficult areas. Thus, Project management becomes challenging and project fails to deliver results especially when implemented at scale. The fact we all know if any project is not monitored through robust systems, project performance gets compromised. Nonetheless, where no one watching the activities it is highly likely the quality of project implementation and project management gets questioned. What could be done to build a system of project monitoring on the real-time basis and with virtual access, where one can remotely observe and track activities in the ground and on real time basis, with 100%, reach using the technology. The simple use of mobile technology built on Global Positioning System (GPS) can use Geotagging to find and link with variety of location-specific information from a device, can find images taken near a given location by entering latitude and longitude and photos can be linked to location specific information with the time stamp when and where the activity was precisely done. For monitoring of the Bihar Handwashing Programme at scale the Geotag applications has been developed along with web portal with an Android based application which serves the interface for the on-field teams to capture activity data. The application has been built with various control features to ensure that only the desired users have access to the relevant data. This is being done by way of mapping individual mobile phones via IMEI codes to Unique User IDs (Team IDs). This mapping ensures that no duplication of work is observed on the field, and one user may only access and operate upon the data pertaining to related user. The data captured on real time basis can be viewed in web portal and help program to interpret data in meaningful manner. It also ensures the quality of the programme is consistently maintained with robust monitoring system. As a result, so far over 0.4 million contacts have been rejected against the 2.7 million reached. The data collected gets audited and reviewed with external auditors and the auditors follow the operational procEducres where each photo gets validated to match with activities and sessions, and contacts get rejected if it is not matching in defined procEducres so this makes ongoing monitoring very powerful, and controls the quality of program implementation. The data automatically is synced to a web portal and is used at all levels to track program performance and also reward programme staff accordingly. Geotag system design helps in rEduccing fraud while it is cost effective. Through the inbuilt online live dash board in web portal, it helps the project to take data driven decisions for improving project performance at scale. The external evaluations conducted so far indicates that this system have substantially provided data points to improve project performance.