The Emergency Department is a crucial medical treatment unit of hospital specializing in emergency medicine. EDs are responsible for providing immediate healthcare facilities to patients arriving without prior appointment. Thus, evaluating patient satisfaction is of immense importance for efficient service delivery. Very few studies are found in Pakistan, related to patients’ satisfaction and utilization of ED services both from demand and supply perspective of ED-Services Supply Chains. Data was collected to assess 200 patient’s satisfaction towards quality of healthcare services (...) of ED of Sindh Government Qatar Hospital, Orangi town-a tertiary care hospital in Karachi. Structured questionnaire was developed to interview patients and their attendants. Results of SPSS analysis revealed that 55% of patients were transferred to ED within 5 minutes, which shows efficient patient queues and flow management. 64.5% patient’s average LOS was between 40-60 minutes. 71% get the availability of basic facilities in ED. Majority of patients i.e. 96.5% and 90.5%, showed satisfaction with the time spent and treatment given by the doctor. Majority of the patients are satisfied with the services and performance of ED of a tertiary care hospital and 76% patients showed willingness to recommend ED of Government Qatar Hospital, Karachi to others. (shrink)

Background: High ethical sensitivity positively affects the quality of nursing care; nevertheless, Chinese nurses’ ethical sensitivity and the factors influencing it have not been described. Research objectives: The purpose of this study was to describe ethical sensitivity and to explore factors influencing it among Chinese-registered nurses, to help nursing administrators improve nurses’ ethical sensitivity, build harmony between nurses and patients, and promote the patients’ health. Research design: This was a descriptive, cross-sectional study. Participants and research context: We recruited 500 nurses (...) from several departments in three tertiary hospitals. The Chinese Moral Sensitivity Questionnaire–Revised version and the Jefferson Scale of Empathy-Health Professionals were used to assess the nurses’ ethical sensitivity and empathy ability, respectively. Fifteen sociodemographic variables were included in the questionnaires. Ethical considerations: Informed consent was obtained from the participants regarding participation and data storage and handling. This program has been examined and supported by the research center of medical ethics and professional ethics of Guilin Medical University. The Approval No. was 2016RWYB04. The whole research process is conducted strictly according to ethical requirements. Results: The valid response rate was 84.40% ( n = 422). The total score of Chinese Moral Sensitivity Questionnaire–Revised was 35.82 ± 8.17. The subscale scores of moral responsibility and strength and sense of moral burden were 21.50 ± 4.91 and 14.33 ± 3.98, respectively. Significant differences were found among age groups, gender, years of working, category of profession, and quality of family communication regarding nurses’ ethical sensitivity ( p < 0.05). Regression analysis showed that the main factors influencing nurses’ ethical sensitivity were gender, years of working, quality of family communication, career satisfaction, and empathic ability. Discussion: Our findings suggest that Chinese nurses’ ethical sensitivity in tertiary hospitals in Guilin is at a medium level. Conclusion: The director of nursing schools and hospitals in China should pay attention to nurses’ ethical sensitivity and should intensify education and training to improve nurses’ ethical sensitivity. Further studies should focus on interventions aimed at improving Chinese nurses’ ethical sensitivity. (shrink)

Cohabiting has been associated with a number of problems including sexually transmitted diseases and HIV and AIDS, abortions, sexual abuse and violence, low academic performance, increased cost of medical care and unwanted pregnancies. However, there is little documented information on the extent and the factors influencing cohabitation among the youth and especially among tertiary education students. This study therefore sought to fill this gap by investigating factors that lead to the prevalence and practice of cohabitation by tertiary education (...) students. The research adopted the interpretivist philosophy. The qualitative research methodology was employed in order to understand in greater detail the behaviors, attitudes, opinions, and beliefs of the respondents on cohabitation among tertiary education students. The study used the survey research design. Primary research was conducted using questionnaire surveys that were administered to tertiary education students who participated at the Tertiary Education Sports Association of Zimbabwe in July 2016. There were 100 questionnaires distributed and 78 questionnaires were returned making 78% response rate. The respondents were randomly sampled to participate in the study. The study reflects that cohabitation among the Tertiary education students is quite common. The study noted that it is mostly caused by lack of accommodation, problems with roommates, lack of privacy and the need to be close and intimate with one's lover. In results cohabitation exposes students to premarital sex and other consequences such as unwanted pregnancies, abortion, complications and sexually transmitted infections. The study recommends that tertiary education students should be enlightened during orientations about the dangers of cohabitation. Parents should be encouraged to visit their children and find where and whom they live with while in school. (shrink)

Tertiary qualities have been studied primarily by Gestalt psychologists. My aim in this article is to revisit the theoretical assumptions regarding tertiary qualities. I start from the Galilean distinction of the qualities of experience, the Lockean subdivision of qualities, the subjectivist definition in aesthetics and the theoretical contribution of Gestalt theory, to show the theoretical value of ‘tertiary qualities’ in the current context of experimental psychological research. I conclude that tertiary qualities are a crucial keyword for (...) an experimental psychology based on the primacy of perception. Such a perspective is in favour of a neo-Gestalt Experimental Phenomenology. (shrink)

The purpose of this research was to investigate, for the first time, tertiary education students’ ethical judgements in the Republic of Cyprus academic environment. The authors developed and administered a quantitative questionnaire to a sample of 1,000 individuals currently pursuing accredited degrees at two tertiary institutions. Statistical analysis revealed four factors, named violation of school regulations, selfishness, cheating, and computer ethics that describe students’ ethical judgements in the academic environment. The results indicate that students exhibit the lowest tolerance (...) with ethical issues relevant with selfishness and highest with issues relevant with computer ethics. In addition, a number of differences were revealed when the authors investigated the relationship between the four retained factors and variables such as gender, year of study, type of academic discipline, and religion. Finally, reflecting on the research findings, a number of practical recommendations are made mainly to educational institutions that wish to redefine their policies and procedures regarding ethics within their academic environment. (shrink)

BackgroundInstitutions of higher learning are persistently struggling with issues of academic dishonesty such as plagiarism, despite the availability of university policies and guidelines for upholding academic integrity.MethodologyThis was a descriptive qualitative study conducted on 37 students of a Healthcare Ethics course at an Australian tertiary institution from February 2016 to October 2018. The purpose of the study was to explore the reasons for plagiarism detected the TurnitinR plagiarism checking software and extensive review of manuscripts. The interviews were conducted in (...) private rooms and in strict confidence. Thematic analysis was manually done.ResultsFour major themes namely, lack of interest; pressure of time with competing priorities; lack of understanding of the policy on academic honesty, and “the determined students” were identified. Sub themes under lack of interest were lack of preparation and effort, low self-efficacy, poor studying techniques, and convenience of internet sources. Under pressure of time, the subthemes were, misplaced priorities, procrastination, high workloads, poor planning, competing interests, and the perception of availability of time at the start of the semester. Regarding lack of understanding of the policy on academic honesty, the subthemes identified were, lake of awareness of plagiarism, lack of awareness of acceptable similarity, conflicting messages from tutors and confusion with high school learning. The determined students were those that either made all effort to reduce plagiarism but still remained high, used the another language at home other than English, had poor paraphrasing techniques or lacked resources for English language editing.ConclusionThere are varied and diverse reasons for plagiarism. There is a need to systematically reinforce and educate students on issues pertaining to academic dishonesty and their associated implications. (shrink)

Medical paternalism has long been a common medical practice. However, patient autonomy in healthcare has been recently adopted by doctors and patients alike. This study explored whether doctors and patients in a tertiary care hospital in Saudi Arabia preferred autonomy or paternalism in shared decision‐making. A total of 118 participants (51 patients requiring total knee replacement, owing to stages 3–4 of osteoarthritis, and 67 doctors) from the Eastern province, Saudi Arabia. responded to a 17‐question category‐based questionnaire involving four scales (...) of autonomy. Descriptive statistics and chi‐square test results revealed that in this hospital, patients preferred a paternalistic approach toward their medical care along with a full disclosure of the risks related to surgical procedures. We recommend health education regarding the specific autonomy subscales (doctor knows best, patient should decide, right to non‐participation, and obligatory risk information), and the implementation of protocols that protect patients' rights and enhance personal autonomy. (shrink)

The higher education sector was affected by this pandemic, managing enduring challenges since early 2020. Institutions of higher learning are prepared to address unsurmountable challenges to ensure that students are not deceived and are being given the proper nurture, coupled with adherence to syllabuses. Simultaneously, the COVID-19 pandemic has caused unscrupulous pressure on students of these institutions. The psychological waves are creating mammoth consequences, affecting the beneficiaries of the higher education system and their families. In recent years, with limited (...) class='Hi'>studies on psychological impact among tertiary students on a cross-country basis, general self-efficacy, and the degree of coping strategies, we were motivated to investigate the degree of depression, anxiety, and stress, among this cohort of students encompassing the pre-university/Diploma, 1st–4th-year undergraduate, and postgraduate students from private universities in Malaysia, Indonesia, India, Southern Africa, and China, representing the emerging economies. A cross-sectional survey was conducted, followed by quantitative analysis. The objective of this study was to recognize whether there is a relationship between the psychological impact of DAS and the coping strategies adopted by the undergraduate students responding during the lockdown. The findings of this study revealed that with a sample size of 397, DAS lacked any severe impact on students across gender, country, household income, and level of education. DAS was established to be well managed with a coping strategy and self-efficacy established. This study resulted in a deeper understanding of DAS among undergraduates in emerging economies and their degree of coping behavior, providing a glimpse of the approach of millennials to handle DAS during the pandemic. (shrink)

BackgroundCompetent end-of-life care is an essential component of total health care provision, but evidence suggests that it is often deficient. This study aimed to evaluate the knowledge and attitudes about key end-of-life issues and principles of good death among doctors in clinical settings.MethodsA cross-sectional study was conducted among allopathic medical doctors working in in-ward clinical settings of tertiary care hospitals in Sri Lanka using a self-administered questionnaire with open- and close-ended questions as well as hypothetical clinical scenarios. Univariate and (...) logistic regression analysis were used to identify the independent factors associated with knowledge and attitudes.ResultsOf the responders who had not been a caregiver for a terminally ill relative (n = 390), 57.9% were men with a mean age of 36.5 years (SD = 8.2). Compared to undergraduate (65.6%; n = 256), only 27.4% (n = 107) had received end-of-life care training at postgraduate level. Only 65.9% of doctors favoured disclosing terminal prognosis to patients; 27.7% of doctors were aware of advance directives; 14.6% were aware of the correct time of death when certifying brain death; 70.3% felt more comfortable in withholding than withdrawing life-sustaining treatment; 61.3% were aware of do-not-attempt cardiopulmonary resuscitation (DNACPR) decisions while 26.7% felt reluctant to administer it; 15.1% thought that all life-sustaining therapy should be withdrawn with a DNACPR decision; and only17.9% were able to name the four principles of medical ethics while 57.9% could not name a single. Participants scored a mean of 9.2 (SD = 3.9) of a maximum 14 points when tested on principles of a ‘good death’. Doctors who had pursued postgraduate studies were more likely to be aware of breaking bad news (adjusted-Odds-Ratio:1.99; 95%CI = 1.19–3.32), advance directives (adjusted-OR: 4.15; 95%CI = 2.49–6.94), aware of certifying the correct time of death (adjusted-OR:2.37; 95%CI = 1.33–4.2) and less reluctant to make DNACPR decisions (adjusted-OR:1.74; 95%CI = 1.13–2.68). Doctors who had worked in ICU were more comfortable withholding than withdrawing treatment (adjusted-OR:1.99; 95%CI = 1.2–3.31).ConclusionsKnowledge and attitudes about end-of-life care, good death and principles of medical ethics among doctors in Sri Lanka were suboptimal. Structured training of end-of-life care needs to be integrated within curricula and in-service training. (shrink)

BackgroundThe issue of stigma is very important in the battle against HIV/aids in Africa since it may affect patient attendance at healthcare centres for obtaining antiretroviral medications and regular medical check-ups. Stigmatization creates an unnecessary culture of secrecy and silence based on ignorance and fear of victimization. This study was designed to determine if there is external stigmatization of people living with HIV and AIDS by health care workers at a tertiary hospital in KwaZulu-Natal province, South Africa. The study (...) investigated the impact of knowledge of HIV/aids by HCWs on treatment of patients, as well as the comfort level and attitude of HCWs when rendering care to PLWHA.MethodsA descriptive cross sectional study was designed to collect data using an anonymous self-administered structured questionnaire from 334 HCWs. The study was conducted in clinical departments of a large multidisciplinary 922-bed tertiary care teaching hospital in Durban, KZN.ResultsOverall HCWs had an above average knowledge about HIV/aids although some gaps in knowledge were identified. Tests of statistical significance showed that there was association between level of education and knowledge of HIV/aids ; occupation and knowledge of HIV/aids ; and gender and knowledge of HIV/aids. Test for comfort level was only significant for gender, with males showing more comfort and empathy when dealing with PLWHA. The study also revealed that patients were sometimes tested for HIV without informed consent before surgery, due to fear of being infected, and there was some gossiping about patients' HIV status by HCWs, thereby compromising patient confidentiality. The majority of HCWs showed a willingness to report incidents of stigmatization and discrimination to higher authorities, for better monitoring and control.ConclusionsAlthough knowledge, attitude and comfort level of HCWs taking care of PLWHA was above average, enforcement of existing antidiscrimination laws and continuing education in medical ethics and healthcare law, would greatly improve the performance of HCWs taking care of PLWHAs. More psychological support and counselling should be provided to HCWs, to further reduce the impact of stigmatization and discrimination against PLWHA. (shrink)

On 29 July 2017, an international colloquium entitled ‘Re-Imagining Curricula for a Just University in a Vibrant Democracy – Carrying the Conversation Forward’ was held at the Faculty of Theology, University of Pretoria, Pretoria, South Africa. A wide range of scholars from African and non-African countries provided variegated perspectives on how tertiary theological and religious education could contribute positively to the development of contemporary societies – African and non-African. This article focuses on the colloquium’s African contributors by means of (...) the concept of ecodomy, envisaged as a constructive process. Whilst the attending academics came from Europe, the USA, South Africa and Ghana, this article takes into consideration only the contributions provided by African scholars. The purpose of this selection is to identify ecodomic or constructive ways to argue in favour of university education in the fields of theology and religion which share the potential to be applied across the whole African continent. Bearing in mind that Africa has been dealing with decolonisation awhile, these African contributions investigate issues such as contextualisation, science, practice, illumination and holism from the governing principle of decolonisation, which is also the overarching societal umbrella for academic development in Africa. This study concludes with an assessment and a proposal written from an exclusively South African vantage point which demonstrates the viability of tertiary theological and religious education for the ongoing ecodomic development of African societies. (shrink)

This study describes the results of a retrospective review of patients' charts who had an advanced directive (AD) and who were hospitalized in a tertiary, acute care teaching hospital. The purpose of the review was to understand from clinical, sociological, ethical and legal perspectives the nature and utility of ADs. Findings and implications of the review are discussed in terms of: patient demographics; diagnoses; quality of ADs; influence of ADs on clinical decisions; and legal aspects of ADs.

Objective To evaluate the questions asked during the informed consent process by adult and adolescent participants as well as their parents in five interventional regulatory studies conducted at our center from 2018 to 2019. Methods The study protocol was approved by Institutional Ethics Committee [EC/OA-116/2019]. Consent narratives in the source documents for the studies were evaluated. Questions asked were classified as per Indian Council of Medical Research’s (ICMR) guidelines (2017). We evaluated total number of questions, nature of questions (...) and whether there was an association between education, gender, phase of trials, physician taking consent and number questions being asked. Results A total of five studies that had N = 297 consent narratives were evaluated. Narratives of n = 284 adult participants/Guardians and of n = 13 children were analysed. A total of 374 questions were asked of which children asked only 10 questions. A total of 131/284 (40%) of the participants did not ask any question. Among the participants who asked questions, the majority132/171 (77%) participants asked about risks related to investigational products followed by questions related to study procedures 83/171 (49%). Participants/guardians with higher education (relative to those who were educated upto the secondary school and primary school) and those who consented for Phase III studies (relative to Phase I studies) asked significantly more questions (p < 0.0001). Conclusion A majority of the queries were related to the risks associated with the investigational products. Educational status and the Phase of the trial were found to be significantly associated with the number of questions being asked. (shrink)

In an oft-quoted letter, King James IV wrote to the Dominican Prior General that Scotland was "almost the most remote region in the world."1 Nevertheless, as scholarship of the past fifteen years has shown, later medieval Scotland played a central role in Latin Christendom.2 Perhaps most importantly for the current study, numerous religious orders were active in Scotland and had significant ties to the Continent.3 Many of the same questions pertaining to Continental houses also exist for Scotland. In particular, there (...) are many unanswered questions about the group known as the Franciscan third order. Sources indicate that there were a number of men and women known as... (shrink)

This article discusses twelve reasons that we must teach about the 1945 American atomic bombings of Hiroshima and Nagasaki. As with Holocaust studies, we must teach this material even though it is both emotionally and intellectually difficult—in spite of our feelings of repugnance and/or grief, and our concerns regarding students’ potential distress (“tertiary trauma”). To handle such material effectively, we should keep in mind ten objectives: 1) to expand students' knowledge about the subject along with the victims’ experience (...) of it; 2) to develop teachers’ awareness of and comfort with it; 3) to help students cope with this knowledge so they are not traumatized themselves; 4) to make sure students don't take refuge in callousness, inappropriate humor, blaming the victim, or despair; 5) to enable students to teach others about the event(s); 6) to enable students to use their increased knowledge and self-reflection individually and as part of the national dialogue; 7) to deepen and “complexify” the conversation on the bombings; 8) to develop supports for teachers and students throughout this process;” 9) to reintegrate the objective with the subjective, recognizing that emotion may be appropriate to some learning; 10) to instigate a dialogue allowing teachers and students to continue to investigate this and related topics. (shrink)

IntroductionNew nurses struggled with time management, which was a prominent theme in safety care for patients. However, the transition training of time management for new nurses was complicated and ignored by clinical managers. The purpose of this study was to understand the level of new nurses’ TMD from a nationwide perspective and detect the influencing factors of the TMD.Materials and methodsA cross-sectional study design with a stratified sampling method was sampled in China. Six hundred and seventy new nurses within the (...) first year of employment were recruited. New nurses’ time management disposition, job stressors, self-efficacy, clinical communication competence, and safety behavior were measured by corresponding scales.ResultsNew nurses showed the best sense of time’s value, followed by the sense of time efficacy and time monitoring view for time management disposition. The related factors of time management disposition were communication skills, safety behavior, job stressors, and being without a preceptor. New nurses’ time management disposition was at a moderate level and they performed worse in time allocation. The highest education, with or without a preceptor, the experience of part-time jobs, and class cadre were significantly influencing the time management disposition of new nurses.ConclusionNursing managers should pay attention to new nurses’ time management disposition. Reducing the job stressors, improving communication ability, and safe behavior were important measures to improve the time management disposition. (shrink)

This study investigated assessment of e-learning resources utilization by students of tertiary institutions in Katsina State. The descriptive survey design was adopted for this study. Three hundred and eighty-one students of tertiary institutions in Katsina State were randomly selected for the study. A researchers’ designed questionnaire titled “Utilization of E-learning Resources Questionnaire” with a Cronbach’s Alpha reliability coefficient of 0.85 was used to collect data. frequency, percentage, mean, t-test and ANOVA statistics were used to analyse the data collected. (...) Findings revealed that there is no significant difference in the e-learning utilization by students of tertiary institutions in Katsina State based on gender and agebut there is significant difference based on class levels and institutions. It was recommended that Nigerian tertiary institutions general studies curriculum should be re-designed to include e-learning utilization training to help the students understand how they can utilize e-learning resources. (shrink)

Health workers and support staff at Malawi’s major referral hospital, the Queen Elizabeth Central Hospital, Blantyre, were on strike between 5th and 19th October 2001. The health workers’ grievances included: lack of risk allowances; poor professional allowances; low salaries; and low housing allowances. The strike resulted in almost total closure of the 1500-bed hospital; only the burns and orthopaedic wards continued to serve patients. Volunteer staff, comprising the Red Cross, and nursing and medical students provided services. Verbal and written threats (...) by the authorities had minimal effect on terminating the strike; rather, they encouraged the resolve to continue with the industrial action. We report aspects of the genesis, progress and resolution of the strike. Although not much seems to have been achieved, both the employer and the workers need to draw lessons from the experience. (shrink)

The current study investigates classroom interactivity in L2 tertiary literature classrooms in Hong Kong and Taiwan when ESL/efl students engage with and interpret literary texts in classroom talk as a pedagogic process of text recontextualization. It proposes a more ecological-based approach to language and languaging dynamics that is complementary to current social semiotic approaches to multimodality. It also aims to open up a more embodied analysis of the meaning-making process in tertiary literature classrooms. The multimodal investigation of real-time (...) classroom interactivity based on a multi-scalar approach showcases an embodied coordination of vocalization and gesticulation as integral aspects of the dynamic whole-body sense-making activity that arises in the pedagogic process of text recontextualization. The dynamics vary from students’ solo speech in individual presentation to teacher–student interactions in group discussion and to student–student interactions in role-play. The distributed language view of first-order languaging dynamics demonstrates the embodied and distributed dimensions of the real-time classroom interactivity that couples pedagogic subjects to the affordances of their pedagogic environment. It also provides insights into the impact of pedagogic activities on the multi-scalar dynamics of the meaning-making process with reference to embodied speech–gesture coordination. The paper demonstrates the value of applying an ecologically embodied perspective to multimodal studies in classroom research and stimulates a re-thinking of some of the important aspects of classroom interactivity that have received little attention thus far. (shrink)

BackgroundThe principles of informed consent, confidentiality and privacy are often neglected during patient care in developing countries. We assessed the degree to which doctors in Lahore adhere to these principles during outpatient consultations.Material & MethodThe study was conducted at medical out-patient departments (OPDs) of two tertiary care hospitals (one public and one private hospital) of Lahore, selected using multi-stage sampling. 93 patients were selected from each hospital. Doctors' adherence to the principles of informed consent, privacy and confidentiality was observed (...) through client flow analysis performed by trained personnel. Overall patient perception was also assessed regarding these practices and was compared with the assessment made by our data collectors.ResultsSome degree of informed consent was obtained from only 9.7% patients in the public hospital and 47.8% in the private hospital. 81.4% of patients in the public hospital and 88.4% in the private hospital were accorded at least some degree of privacy. Complete informational confidentiality was maintained only in 10.8% and 35.5% of cases in public & private hospitals respectively. Informed consent and confidentiality were better practiced in the private compared to the public hospital (two-sample t-test > 2, p value < 0.05). There was marked disparity between the patients' perspective of these ethical practices and the assessment of our trained data collectors.ConclusionObservance of medical ethics is inadequate in hospitals of Lahore. Doctors should be imparted formal training in medical ethics and national legislation on medical ethics is needed. Patients should be made aware of their rights to medical ethics. (shrink)

Media studies as a field has traditionally been wary of the question of technology. Discussion of technology has often been restricted to relatively sterile debates about technological determinism. In recent times there has been renewed interest, however, in the technological dimension of media. In part this is doubtless due to rapid changes in media technology, such as the rise of the internet and the digital convergence of media technologies. But there are also an increasing number of writers who seem (...) to believe that media theory, and more widely social science and the humanities, needs to rethink the question of technology and its relationship to society, culture and cultural production. Andrew Feenberg has characterized the two most dominant positions as, on the one hand, the social constructivist or 'technology studies' approach to technology, and, on the other, 'substantivist' theories of technology. The social constructivist approach, aims to counter technological determinism by showing how the development of technology is shaped not by technical and scientific progress but by contingent social, cultural and economic forces. The limitation of this view, however, is that it tends to see technology as no different from any other social process and it may lose the ability to distinguish between the technical object and any other social formation or cultural artefact. Doubtless constructivism would like to see technology as a subset of the cultural artefact and not vice versa, therefore explaining technology in terms of culture and society. But there are powerful arguments for arguing something like the opposite: in other words for understanding culture and society in terms of or as technical objects. In recent years this argument has been put most forcefully by the French philosopher Bernard Stiegler and it is to his work and its implications for media theory that this essay is dedicated. In particular I will show how Stiegler might defend his ideas around technics from the charge of technological determinism. Firstly, technics is not understood in the narrow sense of techno-scientific technology but in the wider sense of all the ways in which the human is exteriorised into artefacts or organized inorganic matter. Technics in this sense is therefore inseparable from culture and society and it makes no sense either to talk of technics determining culture and society or vice versa. Culture and society are not constituted by technics as if by a cause but rather constituted through it. Secondly, a technics in Stiegler's sense does not represent scientific progress or a deterministic evolution; rather, however strange this may seem, technics is a kind of pure accidentality or contingency. For Stiegler it is because of the exteriorisation of the human into artefacts or inorganic organized matter that culture and society constitute themselves contingently. Stiegler's work therefore offers a way for us to rethink the relationship between culture and technology in ways which can productively reconfigure the concerns of critical theory. (shrink)

In the past years, many students had problems with their finances, especially their expenses for education. Many of the students are affected by the crisis financially, emotionally, and by their wellbeing. That is why the government provides programs that will help the students with their problems with school expenses, and that is through the Tertiary Education Subsidy (TES) of the Commission on Higher Education (CHED). Further, the primary goal of this study is to explore the TES Grantees' lived experiences, (...) challenges, and coping mechanisms. Furthermore, these are the study's findings: (1) The grantees find the TES very helpful regarding finances that will tackle their academic needs, such as tuition fees and school learning materials. (2) Many students value government assistance that motivates them to maintain their grades. (shrink)

BackgroundImportance of awareness of medical ethics and its integration into medical curriculum has been frequently highlighted. Study 1 aimed to assess the knowledge, attitude, and reported practices of medical ethics among clinicians at Patan Academy of Health Sciences, a tertiary care teaching hospital in Nepal. Study 2 was conducted to assess whether there was a difference in knowledge, attitude, and reported practices of medical ethics among doctors who received formal medical ethics education during undergraduate studies and those who (...) did not.MethodsTwo cross-sectional surveys using self-administered questionnaires were conducted. Study 1 included 72 participants; interns, medical officers, and consultants working at Patan Academy of Health Sciences. Study 2 was a comparative study conducted among 54 medical officers who had received formal medical ethics education (Group 1) and 60 medical officers who did not (Group 2).ResultsParticipants who had completed post-graduate education had higher knowledge (p = 0.050), practice (p < 0.001), and overall combined scores (p = 0.011). Participants with ethics education had higher knowledge (p < 0.001), attitude (p = 0.001), practice (p < 0.001), and overall score (p < 0.001). Most participants preferred consulting colleagues if an ethical dilemma arose. Fewer participants had heard of the Declaration of Helsinki. Most participants thought doctors to be most capable of judging what is best for the patient (Study 1: 70.42%, Study 2 Group 1: 42.59%, Group 2: 80%). Case scenarios in which participants demonstrated poor practice were ethical issues concerning truth-telling, end-of-life decisions, treating HIV/aids patients, treating a minor, and reporting colleague’s errors.ConclusionsThis study found that participants who have received medical ethics education have higher knowledge, attitude, and practice scores. The results further justify the need for medical ethics education to be a part of the core medical curriculum. A blame-free environment where seniors can be approached for advice should be created. Research ethics should also be given attention. During medical ethics training, ethical issues where doctors perform poorly should be given more priority and should be discussed in a country-specific context. (shrink)

Previous studies have offered a rationale for engaging students in small-group student talk for the planning of L2 individual writing. To further investigate whether such talk effectively promotes the quality of argument in the context of Chinese tertiary EFL learners’ argumentative writing and whether such effects could be retained, the current study adopted a quasi-experimental design with a pretest, a posttest, and a delayed posttest in two intact EFL classes. The performance of the intervention group and the comparison (...) group were scrutinized to examine the effects of the intervention. The analytic scores on six components of the writing task and the holistic writing scores cumulated of all these components were measured to see the immediate and sustained effects. Significant changes of the holistic scores in both the immediate posttest and the delayed posttest indicated that such small-group student talk enabled students in the treatment class to achieve better performance in the overall quality of argumentation compared with those in the comparison class. Statistical analyses revealed immediate and sustained effects of small-group student talk on the quality of counterargument claim, counterargument data, and rebuttal claim. Counterargument claim was the only element in which students in both classes made significant improvement, but the treatment class demonstrated a larger effect size. No discernible differences were found either between or within the treatment class and the comparison class with respect to the quality of claim, data, and rebuttal data across tests. Possible explanations concerning the findings and limitations of the study were discussed. (shrink)

Background No previous study has provided evidence for the scope and frequency of ethical dilemmas for paediatric nurses. It is essential to understand this to optimise patient care and tailor ethics support for nurses. Research aim The aim of this study was to explore the scope of nurses’ ethical dilemmas in a paediatric hospital and their engagement with the hospital clinical ethics service. Research design This study used a cross-sectional survey design. Participants and research context Paediatric nursing staff in a (...) tertiary paediatric centre in Australia completed an online survey asking about their exposure to a range of ethical dilemmas and their knowledge of the clinical ethics service. Analysis used descriptive and inferential statistics. Ethical considerations Ethical approval was granted from the hospital research committee. The survey was anonymous, and no identifying details of participants were collected. Results Paediatric nurses experienced a wide range of ethical dilemmas frequently, both in the intensive care and general areas. Knowledge and use of the clinical ethics service was poor and the most frequent challenge for nurses in managing dilemmas was feeling powerless. Conclusion There is a need to recognise the moral burden of ethical dilemmas for paediatric nurses in order to foster ethical sensitivity, and to provide adequate support to improve care and mitigate nursing moral distress. (shrink)

The expansion of ethics review, beyond its origins in medical research, is the subject of growing critical analysis internationally, especially from social science researchers. Our study builds on this analysis by considering ethics review specifically within tertiary-based educational research. As a foundation for a larger study, we explore the reporting of ethics review within articles from a snapshot of education journals. A cross-sectional review considered 125 articles from 24 journals spanning medical and nurse education, the Scholarship of Teaching and (...) Learning, and educational technology. Among similar types of research our findings highlight variation in institutional ethical review processes and outcomes. Despite most journals providing guidelines for reporting ethics review, adherence to these guidelines by authors or editors was not always evident, but more likely in health-related education journals. We argue that identified areas of variation may reflect the differing influence and proximity of biomedical values. This influence has been under examined in tertiary-based educational research but may contribute to inequitable learning, researching and publishing experiences, potentially adding to negative sentiment about ethics review. (shrink)

Publication date: 2 May 2019 Source: Author: Oleg Tarnopolsky The article discusses an innovative course taught to students majoring in English at Ukrainian universities. The course called “Specific Features of the English Language and English-Speaking Nations’ Cultures in the Context of International Communication” was designed to eliminate the lack of a number of issues that must be included in the curriculum of English language and culture studies to be learned by such students but which are ordinarily not included there (...) because each of them cannot make the subject matter of a separate university course and does not fit into the traditionally taught courses. The issues in question embrace: the specific role of English among other languages of international communication; World Englishes, International English and English as a lingua franca and how to choose the variety of English to be taught as a foreign language; the specifics of business negotiations in English in intercultural contexts, business presentations in English, and business telephoning in English in such contexts; communicative behavioral etiquette in intercultural communication in English; lifestyle communicative behavioral patterns of the English-speaking nations. The paper shows how teaching these issues enriches and improves the English language and culture education of English major students expanding that education and relevant practical training to fit much better the international and intercultural contexts of communication in English. (shrink)

ObjectiveThis study aimed to better understand the current situation involving work stressors and the coping styles of outpatient and emergency nurses in 29 pediatric specialty hospitals across China. The study analyzed this correlation to provide a reference for the occupational stress management of pediatric nurses.MethodsFrom June to September 2020, 1,457 outpatient and emergency nurses in 29 pediatric specialty hospitals across China were selected as study participants, and a questionnaire survey was conducted using the Basic Information Questionnaire, the Chinese version of (...) the Work Stressor Scale for Nurses, and the Simple Coping Style Scale.ResultsThe assessed stress level of outpatient and emergency nurses in 29 tertiary pediatric specialty hospitals nationwide is lower than the results of the survey of the 2007 domestic norm, p < 0.05. The stressors related to nurses’ expectations, family conflicts, the nature of nursing work, patient factors, and workload were lower compared with the national norm. The positive coping style score on the Simple Coping Style Scale for pediatric outpatient nurses was, and work stressors were positively associated with negative coping styles. Multiple regression analysis showed that the influencing factors of work stressors among pediatric outpatient and emergency nurses correlated with the authorized size, age, working years of nurses, work department, and negative coping styles.ConclusionNegative coping styles were present among pediatric outpatient and emergency nurses and were associated with work stressors. The influencing factors of stressors mainly correlated with the clinical establishment, age, years of employment as a nurse, work department, and negative coping styles. (shrink)

BackgroundCommentators believe that the ethical decision-making climate is instrumental in enhancing interprofessional collaboration in intensive care units. Our aim was twofold: to determine the perception of the ethical climate, levels of moral distress, and intention to leave one's job among nurses and physicians, and between the different ICU types and determine the association between the ethical climate, moral distress, and intention to leave.MethodsWe performed a cross-sectional questionnaire study between May 2021 and August 2021 involving 206 nurses and physicians in a (...) large urban academic hospital. We used the validated Ethical Decision-Making Climate Questionnaire and the Measure of Moral Distress for Healthcare Professionals tools and asked respondents their intention to leave their jobs. We also made comparisons between the different ICU types. We used Pearson's correlation coefficient to identify statistically significant associations between the Ethical Climate, Moral Distress, and Intention to Leave.ResultsNurses perceived the ethical climate for decision-making as less favorable than physicians. They also had significantly greater levels of moral distress and higher intention to leave their job rates than physicians. Regarding the ICU types, the Neonatal/pediatric unit had a significantly higher overall ethical climate score than the Medical and Surgical units and also demonstrated lower moral distress scores and lower “intention to leave” scores compared with both the Medical and Surgical units. The ethical climate and moral distress scores were negatively correlated ; moral distress and "intention to leave" was positively correlated ; and ethical climate and “intention to leave” were negatively correlated.ConclusionsSignificant differences exist in the perception of the ethical climate, levels of moral distress, and intention to leave between nurses and physicians and between the different ICU types. Inspecting the individual factors of the ethical climate and moral distress tools can help hospital leadership target organizational factors that improve interprofessional collaboration, lessening moral distress, decreasing turnover, and improved patient care. (shrink)

BackgroundLittle previous research has been conducted outside of major cities in China to examine how physicians currently perceive palliative care, and to identify specific goals for training as palliative care access expands. This study explored physicians’ perceptions of palliative care integration for advanced cancer patients in Changsha, China.MethodsWe conducted semi-structured qualitative interviews with physicians (n = 24) specializing in hematology or oncology at a tertiary hospital.ResultsMost physicians viewed palliative care as equivalent to end-of-life care, while a minority considered it (...) possible to integrate palliative care with active treatment. Almost all physicians maintained separate conversations about palliative care with family members and patients, communicating more directly with family members than with patients about prognosis and goals of care. Physicians described experiencing ethical tension between the desire of family members to protect the patient from knowing they have advanced cancer, and the patient’s “right to decide” about palliative treatment. Physicians varied overall regarding perceptions of the role they should have in discussions about goals of care.ConclusionsAs palliative care access expands in China, medical training should encourage earlier integration of palliative care for advanced cancer, address ethical issues faced by physicians communicating about palliative care, and establish guidance on the role of the physician in discussions about goals of care. (shrink)

Education is essential to life, and the epidemic affected everything. Parents want to get their kids the most important teaching. However, since COVID-19 has affected schools and other institutions, providing education has become the most significant issue. Online learning pedagogy uses technology to provide high-quality learning environments for student-centered learning. Further, this study explores the experiences and challenges faced by Filipino tertiary students regarding the lack of gadgets amidst online learning. Employing the Interpretative Phenomenological Analysis, the findings of this (...) study were: Some college students still have difficulty with online learning. Attending online classes is difficult, especially for students with limited resources. Smartphones, other gadgets, and internet connections play a significant role in online classrooms because they are the ones that students utilize while learning online, which is essential for successful participation in online higher education as well as for solving a variety of other difficulties in the new normal. Further, College students face similar health challenges. Having an online learning setup is not just about students' struggles with learning resources but also about their health issues. When our respondents used their smartphones for an extended period, they reported eye aches and blurred vision. They also said that some of their body parts, such as their legs and back, are aching, and feel pressured because they tend to overthink things in their surroundings, which causes them incredible difficulty in performing their best in attending online classes. Even though college students continue to suffer from a lack of learning resources during online sessions, they do their best to manage their needs and the scarcity of learning resources. Students have unique coping methods for dealing with difficulties in online classes. (shrink)

The importance of financial advice for individuals is difficult to refute, however the degree to which the financial planning industry has been able to provide this to date is in debate. As a result, the industry, which is still in its infancy, has been subject to rapid growth, various controversies and regulatory intervention. The Global Financial Crisis (GFC) has contributed to the pace of this change with increased client, regulatory and self scrutiny as a result of the heightened dissatisfaction with (...) advice outcomes. The coalescence of these factors has led to significant internal and external changes within the industry, resulting in the apparent commitment to becoming a profession. This paper will examine the implication of this agenda for tertiary education in relation to the role it could play to support the development of the financial planning profession. The paper achieves this by (1) reviewing the background to the financial planning industry and the move towards professionalism; (2) discussing current developments in the industry; (3) establishing the role of tertiary education and (4) assessing the role that tertiary education has played in supporting the financial planning sector. We argue that tertiary education has a critical role to play, however it is yet to achieve this. This study will be useful for those in both the managerial and operational/ academic elements of tertiary education in terms of providing considered avenues for engagement in this discipline. Indeed, if the paper provokes debate and discussion in tertiary education around the nation then we would consider our task complete. (shrink)

Background: It is often necessary to differentiate cutaneous signs of adverse medication reactions from other similar appearances. Because patients frequently fail to recognize the connection between drug consumption and ensuing cutaneous manifestations, early detection of these responses is imperative. Purpose: Investigating the prevalence of Cutaneous Adverse Drug Reactions (CADRs) at a teaching hospital for tertiary care is the goal of this study. Methods: A self-reporting technique was used to select cases in a prospective, observational trial that lasted six months (...) in Saudi German hospital in Jeddah. The following categories applied to Cutaneous Adverse Drug Reactions: definite, potential, and probable. Results: The most common cutaneous manifestation of ADRs (42.85%) was maculopapular rash, which was linked to antimicrobials (48.30%) and nonsteroidal anti-inflammatory drugs (21.90%) during the study period, which resulted in 91 cases of Cutaneous Adverse Drug Reactions. Conclusion: Since cutaneous adverse drug reactions are common, raising awareness of them is crucial to diagnosing and preventing them. (shrink)

Academic integrity is one of the significant issues facing assessments in higher education. While there are a plethora of papers addressing this problem in certain locales, very little research has been published regarding tertiary institutions in the Caribbean. This paper satisfies this paucity in the literature and present findings which will help benchmark it against other comparable populations. This mixed-methods case study examines first-year students’ perceptions of plagiarism definitions, its seriousness, reasons for plagiarising, and its prevalence in a General (...) Chemistry lab course at a Jamaican university. Quantitative and qualitative data were collected and triangulated using a questionnaire and document analysis to understand the complexity of participants’ views. The results show that students largely define plagiarism as copying portions of text and not citing someone else’s work. While accepting that copying large and small portions of text are serious offences, students are less inclined to perceive copying a picture and self-plagiarism as problematic. Although students believe plagiarism is prevalent, they oppose harsh consequences, citing lack of understanding, course difficulty, time management issues, lack of motivation, and fear of failure as understandable reasons. Institutional recommendations to mitigate this growing concern include implementing strategies that would broaden students’ knowledge of what constitutes plagiarism, employing pedagogic strategies that aim to increase students’ self-efficacy, creating a more supportive academic environment, and reducing participation in plagiaristic behaviour. (shrink)

Learning to adapt to the new set of conditions that confound behavioral standards was made possible by the pandemic-driven change in the school system. Due to these conditions and the COVID-19 pandemic, students may experience behaviors like social media addiction and social anxiety that may affect their well-being or happiness. Thus, this study aims to investigate the effects of social media addiction and social anxiety on the happiness of tertiary students amidst the COVID-19 pandemic. The study was conducted on (...) 316 first-year college students utilizing Google forms to disseminate questionnaires. After utilizing Bergen Social Media Addiction Scale, Social Anxiety Scale, and Oxford Happiness Questionnaire, it was found that social media addiction (β = -0.30, p<.00) and social anxiety (β = -0.003, p<.00) has a significant negative effect on happiness. Therefore, the study recommended and designed a student wellness program that provides a range of recreational, healthimproving, self-esteem-boosting, and relationship-strengthening activities for students in order to mitigate the negative effects of problematic social media usage and social anxiety that negatively effect their happiness. (shrink)

This study identified a range of pedagogies developed to promote global citizenship within a university Latin American dance unit. It implemented changes to teaching and learning approaches in the...

Government policy aims at a 'seamless web' of learning provision. This is exemplified in a local Learning and Skills Council supported by work on widening participation to higher education (HE) in another London sub-region. The emerging system described is comprehended as a whole from 'Foundation Learning' in compulsory schooling to post-compulsory 'Lifelong Learning' in further, higher and continuing education and training thereafter.

ObjectiveThis study aimed to describe how parents and physicians experienced the informed consent interview and to investigate the aspects of the relationship that influenced parents’ decision during the consent process for a randomised clinical trial in a tertiary neonatal intensive care unit. The secondary objective was to describe the perspectives of parents and physicians in the specific situation of prenatal informed consent.SettingSingle centre study in NICU of the Centre Hospitalier Intercommunal de Créteil, France, using a convenience period from February (...) to May 2016.DesignAncillary study to a randomised clinical trial: Prettineo. Records of interviews for consent. Population: parents and physicians. Mixed study including qualitative and quantitative interview data about participants’ recall and feelings about the consent process. Interviews were reviewed using thematic discourse analysis.ResultsParents’ recall and understanding of the study’s main goal and design was good. Parents and physicians had a positive experience, and trust was one of the main reasons for parents to consent. Misunderstanding was the main reason for refusal.Before birth, three situations can compromise parents’ consent: the mother already consented to participate in other studies, the absence of the father during the interview and the feeling that the baby’s birth is not an imminent possibility.ConclusionsConfronting parents and physicians’ perspectives in research can help us reach answers to sensitive issues such as content and timing of information. Each different types of study raises different ethical dilemmas for consent that might be discussed in a more individual way. (shrink)

In recent years, China has increasingly emphasized art education, particularly dance, for its therapeutic benefits and cultural significance. Dance Movement Therapy (DMT), which originated in the U.S. in the 1960s, integrates emotional and physical health through dance. This interdisciplinary approach combines art, psychology, and exercise, showing effectiveness in treating psychological disorders and enhancing well-being. Integrating DMT into Chinese higher education could improve mental health outcomes for students by offering an engaging, participatory alternative to traditional counseling methods.

Immunological mechanisms and therapy approaches in psychotic syndromes were recently supported by the discovery of autoantibody-associated limbic and non-limbic encephalitis. However, how clinical diagnostic procedures in psychiatry should be adapted to these new insights is still unclear. In this study, we analyzed the cerebrospinal fluid (CSF) and neuroimmunological alterations and their association with cerebral MRI (cMRI) and electroencephalographic (EEG) findings. From 2006 until 2013, we acquired 180 CSF samples from psychotic patients. Between 2006 and 2009, CSF examinations were only performed (...) in cases in which organic brain disease was suspected. Since then, this procedure has been integrated into our routine diagnostic workup. CSF basic diagnostics were supplemented by measuring antineuronal antibodies against intracellular synaptic antigens, antibodies against intracellular onconeural antigens, antibodies against neuronal cell surface antigens and thyroid antibodies. In addition, cMRIs and EEGs were conducted. We found white cell counts elevated in 3.4% of the cases, albumin quotient elevated in 21.8%, and protein concentration elevated in 42.2%. Evidence of intrathecal immunoglobulin synthesis was found in 7.2% of the cases. Antibodies measured against neuronal cell surface antigens were positive in 3.2%. Reactivity on antibodies against intracellular onconeural antigens were detected in 3.5%. Serum thyroid antibodies were elevated in 24.7%. Abnormalities were found in 39.5% of cMRIs and in 34.3% of EEGs. The main finding of our study was the high prevalence of CSF and autoantibody abnormalities in 54.4% of psychotic patients. In combination with cMRIs and EEGs, 75.6% showed abnormal findings. Our results are discussed with regard to the concept of immunological encephalopathy. Future studies should analyze the efficacy of immunomodulatory therapies. (shrink)

The ethical development of business graduates is a critical issue. Yet, little empirical evidence exists on the factors affecting business graduate ethical development and behaviour using an Islamic perspective. This study examines the effects of mentoring support, the perceived standard of ethical conduct of peers, and individual ethical attributes of National female (Emirati) business graduates from the United Arab Emirates. Research has shown that formal and informal mentoring relationships benefit new employees by enabling them to further learn and grow within (...) an organisation. On the other hand, some employees have also shown that these relationships can have a negative impact on a new employee’s ethical orientation. The aim of this study is to investigatethe ethical orientations of Emirati female business graduates as they move from the relative sanctity of home and university into a new multicultural, westernised business environment. The results suggest that the ethical evaluations and behavioural intentions of Emirati graduates are affected by a multiplicity of sources including professional bodies and both mentors and peers in the workplace. It may be prudent at such a significant time in the UAE’s development that educators consider introducing ethical education into tertiary curriculum. (shrink)

Background and rationale Clinicians often encounter a variety of ethical challenges in their routine clinical practice, and it varies across healthcare and cultural settings of their practice. Despite of this, there are no clear-cut available guidelines concerning the right course of action in a given ethically challenging situation. A validated instrument that could capture the health care providers’ (HCP’s) viewpoints in this regard is lacking from Indian settings. Thus, the current study aimed at developing an instrument to assess the HCP’s (...) perspective regarding different ethically challenging situations encountered in the Indian settings. Methods The questionnaire was developed by involving 15 medical experts. A mixed-method approach, Delphi-technique, and online survey were used for item generation and validation. Results The questionnaire comprised of 11 items (accounts 57% variance; having an α = 0.68) representing four factors: health-resource constraints, medical responsibility of the HCP, obtaining patients/family members’ consent for the treatment, and treatment beyond the standard protocol. The gender and clinical disciplines of the participants were related to their level of endorsement for various domains of the ECCS-Q. Conclusions Ethical challenges in the clinical practice fall in different clusters. The clinicians’ course of action in such situations have many socio-demographic and professional determinants. Future studies are warranted to investigate these phenomena. (shrink)

BackgroundPediatricians in developing countries face different ethical dilemmas than do doctors working in settings with more resources. There are very few studies from developing countries analyzing pediatricians’ knowledge and attitudes regarding the ethical dilemmas that arise in such settings. To address this gap, we explored the clinical ethical knowledge, attitude and experience of physicians who are working in the Department of Pediatrics and Child Health of St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.Study populationAll pediatric resident doctors and (...) pediatric consultants who were working in the DPCH of SPHMMC in December, 2020.MethodA structured pretested self-administered questionnaire was distributed to all 79 of the residents and consultants in the department during the period December 15–27, 2020. The questionnaire assessed the knowledge, attitude and experiences of the study participants regarding a variety of bioethical issues. Data were analyzed using SPSS version 20.0 for windows. The mean, median, standard deviation, and interquartile range of respondents’ scores were determined and compared using Fisher’s exact test.ResultA total of 59/79 physicians completed the questionnaire. The mean age of the participants was 30.7 ± 4.1 years. Thirty six were female. At the time of data collection, more than half served < 5 years as a physician. The mean ethics knowledge score of the respondents was 12.3 ± 2.34 out of 23 knowledge questions. The lowest and highest knowledge scores were 8 and 19 respectively. Scores were highest on questions about confidentiality and lowest on questions about genetic testing and diagnosis. Only 13 physicians agreed with the practice of children should never be treated without consent of the parent. ConclusionTertiary care pediatricians at one hospital in Ethiopia lack knowledge about current standards in bioethics. There is a need for more ethics education in this setting. (shrink)