Yoxas/statistical_literacy huggingface dataset:
ECG interpretation is a life-saving skill in emergency medicine (EM), and a core competency in undergraduate medical curricula; however, confidence for residents/students is low. We developed a novel educational intervention-the HEARTS ECG workshop-that provides a systematic approach to ECG interpretation, teaches EM residents through the process of teaching medical students and highlights emergency management. We used the Kern Approach to Curriculum Development. A review of ECG education literature and a targeted needs assessment of local students/residents led to goals and objectives including systematic ECG interpretation with clinical relevance. ECGs were selected based on a national consensus of EM program directors and categorized into 5 common emergency presentations. The educational strategy included content based on HEARTS approach (Heart rate/rhythm, Electrical conduction, Axis, R-wave progression, Tall/small voltages, and ST/T changes), and methods including flipped classroom and near-peer teaching. Evaluation and feedback were based on the Kirkpatrick program evaluation. The workshop was piloted with 6 junior EM residents and 58 medical students, and repeated with nine residents and 68 students from four medical schools. Residents and students agreed or strongly agreed that the workshop improved their perceived ability (100% and 95%, respectively) and confidence (77% and 88%, respectively) in interpreting ECGs. Reports of ECG interpretation causing anxiety declined from pre-workshop (61% and 83% respectively) to post-workshop (38% and 37% respectively). Residents reported behavior change: 3 months after the workshop, 92.3% reported ongoing use of the HEARTS approach clinically and through teaching medical students on shifts. Reported workshop strengths included the pre-workshop material, the clinical application, facilitator-to-learner ratio, interactivity, the ease of remembering and applying the HEARTS mnemonic, and the iterative application of the approach. Suggested changes included longitudinal sessions with graded difficulty, and allocating more time for introductory material for ease of understanding. The HEARTS ECG workshop is an innovative pedagogical method that can be adapted for all levels of training. Future directions include integration in undergraduate medical and EM residency curricula, and workshops for physicians to update ECG interpretation skills.
ECG is a non-invasive way of determining cardiac health by measuring the electrical activity of the heart. A novel detection technique for feature points P, QRS and T is investigated to diagnose various atrial and ventricular cardiovascular anomalies with ECG signals for ambulatory monitoring. Before the system is worthy of field trials, it is validated with several databases and recorded their response. The QRS complex detection is based on the Pan Tompkins algorithm and difference operation method that provides positive predictivity, sensitivity and false detection rate of 99.29%, 99.49% and 1.29%, respectively. Proposed novel T wave detection provides sensitivity of 97.78%. Also, proposed P wave detection provides positive predictivity, sensitivity and false detection rate of 99.43%, 99.4% and 1.15% for the control study (normal subjects) and 82.68%, 94.3% and 25.4% for the case (patients with cardiac anomalies) study, respectively. Disease detection such as arrhythmia is based on standard R-R intervals while myocardial infarction is based on the ST-T deviations where the positive predictivity, sensitivity and accuracy are observed to be 94.6%, 84.2% and 85%, respectively. It should be noted that, since the frontal leads are only used, the anterior myocardial infarction cases are detected with the injury pattern in lead avl and ST depression in reciprocal leads. Detection of atrial fibrillation is done for both short and long duration signals using statistical methods using interquartile range and standard deviations, giving very high accuracy, 100% in most cases. The system hardware for obtaining the 2 lead ECG signal is designed using commercially available off the shelf components. Small field validation of the designed system is performed at a Public Health Centre in Gujarat, India with 42 patients (both cases and controls). 78.5% accuracy was achieved during the field validation. It is thus concluded that the proposed method is ideal for improvisation in cardiac health monitoring outreach in resource constrained regions.
Echogenic Intracardiac Foci (EIF) are non-structural markers identified during the routine 18-20-week foetal anomaly ultrasound scan yet their clinical significance on future outcomes for the infant is unclear. To examine the association between EIF and risk of preterm birth, chromosomal abnormalities, and cardiac abnormalities. A review across four databases to identify English language journal articles of EIF using a cohort study design. All studies were reviewed for quality using the Critical Appraisal Skills Programme (CASP) checklist and data extracted for comparison and analysis. 19 papers from 9 different countries were included. Combining these studies showed 4.6% (95% CI = 4.55-4.65%) of all pregnancies had EIF which was on the left in 86% of cases, on the right in 3% of cases and bilaterally in 10%. There was no evidence that EIF was associated with higher rates of preterm birth. However, it is possible that infants with EIF were more likely to be terminated rather than be born preterm as there was a 2.1% (range 0.3-4.2%) rate of termination or death of the foetus after week 20 among those with EIF. There was no evidence that EIF alone is highly predictive of chromosomal abnormalities. There was evidence that EIF is associated with higher rates of minor cardiac abnormalities (e.g. ventricular septal defect, tricuspid regurgitation or mitral regurgitation)) with 5.1% (224 of 4385) of those with EIF showing cardiac abnormalities (3.08% in retrospective studies and 17.85% in prospective studies). However, the risk of cardiac defects was only higher with right-sided EIF and where the EIF persisted into the third trimester. However, this is a rare event and would be seen in an estimated 4 per 10,000 pregnancies. EIF alone was not associated with adverse outcomes for the infant. Only persistent EIF on the right side showed evidence of carrying a higher risk of cardiac abnormality and would warrant further follow-up.
Economic sanctions aim to exert pressure on political and economic foundations. Hypothesizing that sanctions might affect various aspects of population health, this study, as a component of a broader investigation to ascertain the trend effects of sanctions on selected health outcomes in Iran, seeks to explore the experiences of Iranian citizens associated with the imposed sanctions. This is a qualitative study. We conducted 31 semi-structured interviews with randomly selected patients diagnosed with at least one chronic and rare disease from diverse backgrounds across four provinces in Iran. We analyzed data using an inductive content analysis approach, facilitated by the MAXQDA10 software. We identified three primary themes: direct effects, side effects, and coping strategies. The immediate effects were perceived to be manifested through the restriction of healthcare service availability and affordability for citizens. The side effects included the economic hardships experienced in individuals' lives and the perceived devastation caused by these difficulties. Some coping mechanisms adopted by patients or their families/relatives included prioritizing comorbidities, prioritizing health needs within families with multiple ill members, and readjusting health/illness requirements in light of daily living needs. In addition to the inherent burden of their illness, patients faced substantial healthcare costs as a result of sanctions, restricted access to medications, and availability of low-quality medications. We advocate considering these challenges within the healthcare system resilience framework as a crucial first step for policymakers, aiming to determine actionable measures and mitigate the adverse effects of sanctions on citizens, particularly the most vulnerable groups.
Ecosystem state transitions can be ecologically devastating or be a restoration success. State transitions are common within aquatic systems worldwide, especially considering human-mediated changes to land use and water use. We created a transferable conceptual framework to enable multiscale assessments of state resilience and early warnings of state transitions that can inform strategic restorations and avoid ecosystem collapse. The conceptual framework integrated machine learning predictions with ecosystem state concepts (e.g., state classification, gradients of vulnerability, and recovery potential leading to state transitions) and was devised to investigate possible environmental drivers. As an application of the framework, we generated prediction probabilities of submersed aquatic vegetation (SAV) presence at nearly 10,000 sites in the Upper Mississippi River (United States). Then, we used an interpretability method to explain model predictions to gain insights into possible environmental drivers and thresholds or linear responses of SAV presence and absence. Model accuracy was 89% without spatial bias. Average water depth, suspended solids, substrate, and distance to nearest SAV were the best predictors and likely environmental drivers of SAV habitat suitability. These environmental drivers exhibited nonlinear, threshold-type responses for SAV. All the results are also presented in an online dashboard to explore results at many spatial scales. The habitat suitability model outputs and prediction explanations from many spatial scales (4 m to 400 km of river reach) can inform research and restoration planning.
Ectopic pregnancy (EP) is a significant cause of maternal morbidity and mortality. This study aimed to explore the understanding and experience of women with EP in the Islamic Republic of Iran. This qualitative study carried out through a Heideggerian hermeneutic/interpretative phenomenological approach, using face-to-face semi-structured phenomenological interviews with twenty-five participants referred to a public maternity hospital in Rasht, Iran. Data were collected and analyzed using the seven-step analytical approach of Dickelman et al. (The NLN criteria of appraisal of baccalaureate programs: A critical hermeneutic analysis, NLN Press, 1989; Journal of Nursing Education. 32:245-250, 1993) to phenomenological studies. The results reveal how living in the shadow of Islamic Sharia Law in Iran turns EP into a trauma and creates a different experience and meaning of EP for each woman. In this view, multiple factors, including 'family support' and 'faith in Islamic Sharia,' have determined how married women experience sociocultural and psychological consequences of EP. These findings apply to women with EP in Iran. Given that EP is more than an anomalous pregnancy with socially culturally constructed suffering in the context of the Islamic Republic of Iran. Hence, policymakers and healthcare providers should consider a multidimensional approach to this devastating event in pregnancy and support and empower the women whose dream of motherhood is jeopardized and terminated by the experience of EP.
Editor's Note: This column continues the JACM commentary series from the Society for Acupuncture Research (SAR). The authors, Claudia Citkovitz, PhD, LAc, from NYU Langone Hospital - Brooklyn and Rosa N. Schnyer, DAOM, LAc, from the University of Texas, are both licensed East Asian Medicine (EAM) clinicians as well as researchers. The dual roles inform this commentary. As clinicians, they respect development over the centuries of strategies toward epidemics by the Chinese and are intrigued by the high use of Chinese herbal medicine to treat COVID-19 in China. As researchers, they are aware of the robust exploration of integrative strategies in China and the dearth of such interest of exploration by most agencies in the West. In their column, Citkovitz and Schnyer highlight what self-respecting clinician researchers are doing to fill the knowledge gap. They provide background on three separate data gathering initiatives that have collaborated to keep their reporting structures comparable in order to "improve clinical practice in real time": one for detailed case reports, a second via a registry, and the third an observational study that provides quantitative and qualitative data regarding clinical reasoning and patient response. At JACM, we look forward to seeing the kinds of reports these initiatives can cast on the widespread patient experience with integrative and EAM COVID-19. -John Weeks, Editor-in-Chief, JACM.
Editor's note: This is the 21st article in a series on clinical research by nurses. The series is designed to be used as a resource for nurses to understand the concepts and principles essential to research. Each column will present the concepts that underpin evidence-based practice-from research design to data interpretation. To see all the articles in the series, go to https://links.lww.com/AJN/A204.
Education and counseling during marriage is an opportunity to raise some issues needed by couples on the verge of marriage. This study was conducted with the aim of improving reproductive and sexual health literacy of couples on the verge of marriage. This study was a mixed-methods participatory action research conducted based on the Find, Organize, Clarify, Understand, Select-Plan, Do, Check, Act (FOCUS-PDCA) model in nine steps during 2019-2020 in the city of Bandar Abbas. The Reproductive Health Literacy Scale and the Service Quality (SERVQUAL) Questionnaire were used to evaluate the interventions. Data were analyzed by SPSS version 26. A significance level of less than 0.05 was considered. The mean age of women and men participating in the quantitative part of the study was 21 ± 5 and 25.84 ± 3.9 years, respectively, which was similar to their counterparts in this part of the study, and the difference in the mean scores of reproductive health literacy before and after the changes in the program showed a significant difference (p > 0.001). The study results showed that, except for the understanding dimension, most participants were at an insufficient level in other dimensions of reproductive health literacy. The result of measuring the satisfaction of service recipients indicated good satisfaction in the two dimensions of warranty and accountability, and there was a gap in empathy, assurance, and tangibility dimensions, which the biggest gap was related to the empathy dimension. The changes made in improving the reproductive health literacy of couples were effective, which can be taken into consideration based on the added items in the current program of providing educational services in marriage preparation classes for couples.
Education and literacy have long been associated with a range of economic and social outcomes in industrialized societies. Recent research based on large-scale national and international surveys has examined effects of education and literacy on individuals' social and economic outcomes. This paper takes a further step in understanding the importance of literacy for individuals' economic and social outcomes by disentangling the effects of two different aspects of literacy, literacy proficiency as measured by standardized tests and reading engagement as measured by self-reports of everyday reading activities. Using recent nationally representative survey data from New Zealand, multivariate regression models estimate the effects of reading engagement on earnings, health, social trust, political efficacy and civic engagement. Reading engagement has statistical and substantial positive effects on each of these outcomes with the effects of literacy proficiency, education and other important variables held constant. Although these results do not imply a causal relationship between reading engagement and the outcomes, they have important implications for policy and practice in adult education as well as for future research about the role of reading engagement in wellbeing more generally.
Education and training about emergency cases are necessary for different medical groups such as midwives. Teaching puerperal sepsis is important for midwives. The teaching method is one of the challenges of the educational system in universities. This study was conducted to compare lecture and concept map methods on the level of learning and satisfaction in puerperal sepsis education of midwifery students. This semi-experimental study was conducted in 2022 at Ardabil Nursing and Midwifery School on 50 midwifery students. Students randomly were placed in lecture and concept map teaching groups. To collect data, a 23-question satisfaction questionnaire and a 15-question test taken from the WHO books on the management of puerperal sepsis were used to check students' knowledge and learning. The data were analyzed by using descriptive statistics and independent and paired t-test SPSS software. The average learning score of the students after teaching in the concept map group was 10.28 ± 1.90 and the lecture group 9.20 ± 1.70, the difference was statistically significant (p = 0.04). The average satisfaction score in the concept map group was 107.92 ± 4.46 and in the lecture group 105.68 ± 6.84, this difference was statistically significant (p = 0.03). The teaching of puerperal sepsis with the concept map method had a greater effect on the learning and satisfaction of midwifery students. Therefore, it is recommended to use this educational method.
Education can create better opportunities for health, and vice versa. Using a so-called 'add-in' approach, school-based physical activity (PA) promotion and prevention of sedentary behaviours can increase pupils' wellbeing and learning and, on the longer term, reduce the risk of non-communicable diseases. A PA 'add-in' approach involves integrating PA into teachers' curricular obligations without being an extra burden as opposed to an 'add-on' approach which requires additional operational resources and include activities that do not explicitly contribute towards curricular targets making them less long-term acceptable in a school-based context. Previous studies investigating education outside the classroom (EOtC) show mutual benefits for both health and education outcomes among children and adolescents. However, the evidence is of mixed quality and questionable certainty, which calls for further investigation. The aim of this study protocol is to describe and discuss the study design and methods to investigate the efficacy and mechanisms of EOtC as a vehicle for health and education. The study investigates the intervention developed and conducted in the TEACHOUT study with updated and strengthened design and measures. The efficacy of EOtC will be investigated in a cluster randomised waitlist design. Participants will be pupils in ~54 classes, grades 4-10 (ages 10-15 years) in ~30 Danish elementary schools. Fifteen schools will be randomised to the intervention: a two-day EOtC training course targeting teachers followed by the teachers implementing EOtC >5 hours weekly over the course of one school year. Pre- and post-measures of health (PA and wellbeing) and learning (school motivation and academic achievement) will be collected. Investigation of pedagogical and motivational mechanisms will be based on observations of EOtC. The updated randomised controlled design will provide firmer evidence for the efficacy and mechanisms of EOtC and provide knowledge about how mutual benefits of health and education can be obtained. Registered with ClinicalTrials.gov (ID NCT05237674 ) [University of Copenhagen. MOVEOUT: a Cluster RCT of the Efficacy, Mechanisms, and Mediation of an Education Outside the Classroom Intervention on Adolescents' Physical Activity, 2023], February 14, 2022. Most recently updated on November 23, 2022 (Version 2).
Education has a pivotal role in preparing society to address the forthcoming health impacts of the climate crisis. Education provides the tools necessary to instil both individual and collective attitudes for mitigating climate change, fosters the development of adaptive skills and mindsets, and promotes a critical understanding of climate change. The aim of the PERSIST project was to assess the effectiveness of a school educational intervention to strengthen literacy on the climate crisis, pro-environmental behaviours, and systems thinking in high school students (aged 14-18 years). Three meetings were carried out in a scientific high school in the suburbs of Rome (Italy) between March 21, and April 12, 2023, using complex systems models, group activities, and collective discussions. Pre-intervention and post-intervention questionnaires were administered to students to record knowledge, climate-related emotions, and pro-environmental behaviours. Questionnaires that were complete were considered valid. The anonymously collected data were processed using descriptive statistics and t test. A total of 273 students in ten different classes attending between grades 1 and 4 took part in the project. 78 (36%) participants were female, 133 (62%) were male, and four (2%) did not disclose their gender. The mean age was 15 years. We received 211 pairs of valid pre-intervention and post-intervention questionnaires. The preliminary analysis showed an average increase of 19% in correct responses to knowledge questions, a 21·2% increase in pro-environmental behaviours, and no discernible differences in climate-related emotions between pre-intervention and post-intervention questionnaires. An interactive approach and the use of complex systems might improve students' literacy and attitudes towards the climate crisis, without increasing negative ecological emotions. This pilot project can guide similar, repeatable programmes in other schools and countries and it represents the first measure of climate-related emotions after school intervention. None.
Education has an important meaning for the Japanese. However, the COVID-19 pandemic has had a major impact on the education sector, giving rise to new problems due to the unpreparedness of society to face sudden changes. Elementary school is the most basic education in the formal education system in Japan, so it plays an important role as the main gate for Japanese society to obtain a formal education. Previous research has not specifically discussed the impact of the COVID-19 pandemic on elementary school education in Japan, therefore the discussion of this research focuses on phenomena that occur in elementary schools in Japan to find out more about the impacts of the COVID-19 pandemic and the educational policies made by the government. This study uses qualitative and descriptive-analytical methods through a literature review of books, journals, articles, and government or institutional reports related to elementary school in Japan during the COVID-19 pandemic. Based on the data, it was found that compared to higher education, basic education in Japan is far behind in using technology as a learning media. In addition, there was an increase in cases of child violence and child suicide in Japan during the COVID-19 pandemic. The Japanese government tried to overcome education challenges during the COVID-19 pandemic.