bluuebunny/crossref_metadata_2025 huggingface dataset:
Stereotyping, Exploitation, and Appropriation of African Traditional Religious Beliefs: The Case of Nyaminyami, Water Spirit, among the Batonga People of Northwestern Zimbabwe, 1860s–1960s
Authors: Matanzima Joshua
Published: January 2022

This article examines the forms of knowledge that existed between Africans and Europeans regarding local indigenous religious beliefs, focusing particularly on the case of Nyaminyami, a water spirit that is part of the belief systems prevalent among some BaTonga people of northwestern Zimbabwe. The article briefly outlines the “traditional” BaTonga beliefs and practices relating to Nyaminyami, which were diametrically opposed to those of the Europeans. It then scrutinizes the ways the beliefs have been exploited and appropriated by different interest groups and races from the 1860s to the 1960s. The BaTonga people, who held strong beliefs in Nyaminyami, and European colonists used the idea of Nyaminyami for different social, political, and environmental agendas prior to, during, and after resettlement. Nyaminyami played changing sociocultural and economic functions for the BaTonga people over time. They revered Nyaminyami as their river god in the nineteenth and twentieth centuries; they also appropriated the beliefs by rallying behind the river god for protection from their displacement in 1958 following the construction of the Kariba Dam on the Zambezi River. Nyaminyami was also appropriated by European interest groups who used the idea of Nyaminyami to cast Africa as the “dark continent” and to stereotype the BaTonga people as primitive. This article relies on data obtained through a reading of European explorers' texts and by gathering oral traditions among the BaTonga and Shangwe.
Percepción de igualdad de género en la formación de universitarios del área de la salud
Authors: Quintana-Lopez Victor Alexander , Bojorquez-Díaz Cecilia Ivonne , Díaz-López Karina de Jesús , Mejía-León María Esther
Published: January 2022

Incluir la perspectiva de género en el currículo educativo de universidades de México es una prioridad apremiante para una sociedad con hombres y mujeres con iguales oportunidades. El objetivo fue analizar la percepción en estudiantes universitarios del área de la salud respecto a perspectiva de género en sus programas educativos. Se realizó un estudio descriptivo-transversal utilizando la escala de Evaluación Sensible a la Formación en Igualdad de Género (ESFIG) en 99 (70,8% mujeres y 29,2% hombres) estudiantes de medicina, nutrición, odontología y posgrado en el área de la salud. El 93,4% mencionó no haber cursado una asignatura sobre género o igualdad de género durante su formación universitaria. En una escala del uno al diez los estudiantes otorgan una calificación de 9,4 a la importancia de la formación para la igualdad de género. Se obtuvo una media de 4,35 del máximo a obtener que era 6 respecto a la percepción que tienen sobre la sensibilidad institucional a la aplicación de la política de igualdad de género en su facultad de adscripción. Al comparar entre los distintos programas educativos respecto a la subescala de sensibilidad institucional a la aplicación de la política de igualdad de género en los centros. Los estudiantes de odontología, a diferencia de los de medicina, perciben que su programa educativo promueve la aplicación de la política de igualdad de género en su currículo (p= 0.03). Es importante promover la aplicación de igualdad de género en los programas educativos de los centros educativos para disminuir las desigualdades entre sexos.
Impacto social y económico del Corredor Vial Cañete – Perú
Authors: Soto Sulca Ricardo Walter , Muñoz Rojas Julissa Karent , Cáceres Quispe Yulia Nadia
Published: January 2022

Uno de los ejes centrales para el desarrollo económico y social de cualquier país es la construcción de carreteras, dado que estas vías de comunicación terrestre además de contribuir a la planificación y al ordenamiento territorial impulsa el crecimiento demográfico, económico y social de sus comunidades. El sistema de transporte genera efectos positivos en el acceso a la educación y a la salud, así como en la re-ubicación de actividades económicas, generando mayor fluidez de mercaderías, apoyando así de manera directa a las actividades productivas y al ingreso económico de su población beneficiara. La presente investigación identifica los impactos sociales y económicos, generados por la construcción del Corredor Vial Cañete en sus ámbitos territoriales, para realizar la investigación se aplicó la técnica de la encuesta, entrevista y la revisión bibliográfica, haciendo uso del método análisis síntesis. La muestra para la encuesta fue 20 comunidades, provincias y distritos de la población al pie de la carretera del Corredor Vial Cañete, de los cuales se eligieron a informantes claves (autoridades, docentes y personal de salud) para las entrevistas. Los resultados mostraron que el impacto social que ha producido en los pobladores del Corredor vial Cañete ha sido: el mayor acceso a la educación, salud (atención médica) y a mejoramiento de servicios básicos y el impacto económico ha sido: mayor acceso a los mercados para los cultivos y productos locales, el acceso a nuevas oportunidades de empleo, desarrollo de nuevas actividades económicas como el turismo y el fortalecimiento de la economía. Llegando a la conclusión que la construcción de carreteras y corredores viales como el caso del Corredor Vial Cañete, genera impactos significativos en la población beneficiaria, mejorando su calidad de vida y que las carreteras constituyen una pieza fundamental e importante en relación al desarrollo económico y social de nuestro país.
Rozszerzona Synteza: coś starego, coś nowego
Authors: Brooks Daniel R. , Sagan Dariusz
Published: January 2022

Zaćmienie darwinizmu zaczęło dobiegać końca w latach osiemdziesiątych dwudziestego wieku i obecnie proces ten znajduje się w stanie równowagi. Potrzebujemy Rozszerzonej Syntezy, przy czym termin „rozszerzona” użyty jest tutaj metaforycznie. Musimy cofnąć się w czasie, aby wydobyć ważne aspekty darwinizmu, które odstawiono na boczny tor, a później utracono w okresie panowania neodarwinizmu, i następnie wyjść poza neodarwinizm w celu ujęcia nowych danych i koncepcji. Najogólniejszy układ odniesienia Rozszerzonej Syntezy stanowi koncepcja wielkich przejść ewolucyjnych. Rozszerzona Synteza bez problemu wpisuje się w filozoficzny punkt widzenia, zgodnie z którym biologia nie musi być połączona z innymi obszarami nauki, aby znaleźć dla siebie uzasadnienie. Przekonuje mnie dawniejszy pogląd, że biologia potrzebuje nadrzędnego prawa, które połączy ją z pozostałymi obszarami nauk przyrodniczych. Karol Darwin sugerował istnienie „prawa wyższego rzędu”, ale go nie uściślił. Jeśli uda nam się zidentyfikować to prawo, to Rozszerzona Synteza stanie się Zunifikowaną Teorią Biologii, o której 25 lat temu mówili Daniel Brooks i Ed Wiley.
Polemik Memakan Darah: Studi Kasus dalam Sidang di Yerusalem
Authors: Walean Jefrie
Published: January 2022

Abstract: This study aims to find answers to the controversy about halal and haram eating blood based on investigations in the trial in Jerusalem. The polemic of eating blood has become a theological controversy among Christians from time to time. Controversy due to differences of opinion because it has a background of diverse theological assumptions. This polemic can actually be resolved if the relational perception is a win-win solution. Is in today's life the prohibition on eating blood in the Old Testament still applies and is it still a disaster for mankind? This study uses a qualitative method with library research and analysis using the principles of hermeneutic interpretation. This study concludes that the doctrinal culmination point related to the blood-eating polemic is one of the factors that breaks relations between Christian groups so that it becomes an interesting "hot" issue.Abstrak: Penelitian ini bertujuan untuk menemukan jawaban kontroversi tentang halal dan haram makan darah berdasarkan penelusuran dalam sidang di Yerusalem. Polemik makan darah telah menjadi kotroversi teologis dikalangan Kristen dari masa ke masa. Kontroversi akibat perbedaan pendapat karena memiliki latar belakang asumsi teologis yang beragam. Polemik ini sejatinya dapat diselesaikan jika persepsi relasional yang bersifat win-win solution. Apakah dalam kehidupan sekarang larangan memakan darah dalam Perjanjian Lama masih berlaku dan masih masih merupakan suatu kebinasaan bagi umat manusia? Penelitian ini menggunakan metode kualitatif dengan riset pustaka dan analisa menggunakan prinsip-prinsip penafsiran hermeneutik. Penelitian ini menyimpulan titik kulminasi doktrinal terkait polemik makan darah menjadi salah satu pemecah hubungan antar golongan orang Kristen sehingga menjadi isu yang menarik.
An Uncommon Cause of Hemoptysis Presenting Like Hemolytic Anemia
Authors: Arunprasath Thasma Santhanakrishnan , Ramanan Padmasani Venkat , Muralitharan Susruthan
Published: January 2022

Idiopathic pulmonary hemosiderosis (IPH) usually presents with hemoptysis and iron deficiency anemia. In this report, an unusual presentation of IPH is described. 11-year-old boy presented with clinical features suggestive of hemolytic anemia. However, on detailed evaluation, he was diagnosed to have IPH and confirmed by the presence of hemosiderinladen macrophages in bronchoalveolar lavage fluid (BALF). The child was managed with oral corticosteroids, and he was doing well on follow-up.
Cardiac Manifestations of Acute Febrile Illness Amongst Intensive Care Unit Patients
Authors: More Hitesh , Gondhali Gajanan , Daithankar Arun , Limbapure Amar
Published: January 2022

Background: There are various incidences of cardiac involvement in acute febrile illness (AFI). As the acute febrile illnesses are spreading, there is an increase in atypical cardiac manifestations ranging from asymptomatic bradycardia to life threatening manifestations like myocarditis and pericardial effusion. Objective: To determine cardiac manifestations of AFI amongst intensive care unit patients in rural populations. Methods: Twenty patients of AFI were studied between January 2021 to June 2021. Echocardiography (ECG), and cardiac enzymes were evaluated. Patients were from either gender from 15 to 60 years and were willing to sign consent. patients admitted with fever and on examination were found abnormal cardiac functions like hypotension, arrhythmia, hypertension, cardiac enzyme changes and reduced ejection fraction on 2D Echo. Patients with preexisting heart disease, cardioactive drugs affecting the heart rate were not involved in this study. Results: In total, 20 patients having cardiac manifestations with AFI were studied, out of which 9 cases presented with bradycardia, 3 cases presented with asymptomatic pericardial effusion, and 8 cases presented with ECG abnormalities such as narrow QRS complex, ST, and T changes. Conclusion: Cardiac Manifestations in adults with AFI were common, ranging from elevated cardiac biomarkers to myocarditis. Persistent shock despite adequate fluid resuscitation can be a crucial cardiac manifestation and should guide the treating physician towards underlying cardiac involvement such as systolic or diastolic dysfunction.
Immunologic changes after house dust mite modified rush subcutaneous immunotherapy in allergic rhinitis children
Authors: Rattanamanee Tipyapa , Lumjiaktase Putthapoom , Kemawichanura Nanthisa , Kiewnga Potjanee , Jotikasthira Wanlapa , Manuyakorn Wiparat
Published: January 2022

Background

House dust mites (HDM) are the major causative allergen for allergic rhinitis. The sole disease-modifying therapy for allergic rhinitis is allergen immunotherapy (AIT). Rush immunotherapy is the accelerated build-up schedules to reach the target maintenance dose.

Objective

To evaluate the kinetic changes of peripheral blood CD4+CD25+FOXP3+ regulatory T cells (Treg) and serum cytokines in children undergoing 2-day modified rush HDM AIT.

Methods

Children aged 5-15 years with allergic rhinitis were enrolled for a 2-day modified rush HDM AIT. Peripheral blood CD4+CD25+FOXP3+ Treg, serum interleukin (IL)-4, IL-13, interferon-γ, and IL-10 were measured at baseline, finishing rush, achieving maintenance dose, 6 months, and 12 months after reaching maintenance dose. Specific IgE (sIgE) to HDM was evaluated at baseline and 12 months after getting the maintenance dose. Rhinitis symptoms were assessed daily using a daily card.

Results

A total of 12 children with a mean age of 13 years were enrolled. Rhinitis symptom-free days per month increased significantly after reaching the maintenance dose compared to baseline (from 9.5 days to 19.5 days, p = 0.002), and the maximum improvement was seen at 1 year. The levels of Treg were significantly increased at 6 months after maintenance dose compared to baseline level (6.27%±1.63% vs. 3.83%±1.80%, p < 0.001). After treatment, there were significantly decreased serum IL-13 at 1 year after maintenance but no significant changes in sIgE to HDM. The systemic reaction during AIT occurred 7 episodes from 119 shots (5.9%).

Conclusion

Two-day modified rush HDM AIT provides acceptable systemic reactions and increases the number of CD4+CD25+FOXP3+ Treg in children.
Butterfly fauna of Rani Durgawati University Campus, Jabalpur, Madhya Pradesh, Central India
Authors: Paunikar Sanjay
Published: January 2022

The present paper deals with the variety and abundance of bufferfly fauna in Rani Durgawati University Campus, Jabalpur, Madhya Pradesh, Central India. The results of present investigation reveals the occurrence of 39 species of butterflies belonging to the 5 families viz; Papilionidae (2 species), Pieridae (7 species), Nymphalidae (24species), Lycaenidae (5 species), Hesperiidae (1 species). The family Nymphalidae is dominant as compared to other families. The two species of butterfly Euploea core core and Hypolimnas misippus are come under Wildlife Protection Act. 1972.
Taxonomic Note on Salacia Brunoniana Wight & Arn. (Celastraceae) - An Endangered Species of the Peninsular India
Authors: Shareef S. , Kumar E.S.
Published: January 2022

Taxonomic note on Salacia brunoniana Wight & Arn., an endangered and endemic species of the Peninsular India is provided with an illustration to facilitate its easy identification.
Association Between the Femoral Stem Design Type and the Risk of Aseptic Revision After Hemiarthroplasty
Authors: Okike Kanu , Chan Priscilla H. , Reddy Nithin C. , Burri Robert A. , Paxton Elizabeth W. , Prentice Heather A.
Published: January 2022

Introduction:

Although noncemented hemiarthroplasty has been associated with a higher risk of revision surgery as compared with cemented fixation, it remains uncertain whether this increased risk applies to all noncemented stem design types or only a subset. The purpose of this study was to assess the risk of aseptic revision associated with three common types of noncemented stem designs as compared with cemented fixation in the hemiarthroplasty treatment of femoral neck fractures in the elderly patients.

Methods:

This was a retrospective cohort study of patients aged 60 years and older who sustained a hip fracture and underwent hemiarthroplasty between 2009 and 2018 at one of 35 hospitals owned by a large US health maintenance organization. Hemiarthroplasty fixation was categorized as cemented or noncemented, with the noncemented stems further classified as single wedge without collar, fit and fill without collar, or fit and fill with collar. The primary outcome was aseptic revision, and the median follow-up time was 4.8 years.

Results:

Of 12,071 patients who underwent hemiarthroplasty during the study period (average age 82.0 ± 8.4 years, 67.9% women), 807 (6.7%) received a single-wedge stem without collar, 2,124 (17.6%) received a fit-and-fill stem without collar, 2,453 (20.3%) received a fit-and-fill stem with collar, and 6,687 (55.4%) received a cemented stem. Compared with cemented fixation, all the noncemented stem design types were associated with a markedly higher risk of aseptic revision in the multivariable analysis, including single wedge without collar (hazard ratio [HR] 2.00, 95% confidence interval [CI], 1.38 to 2.89, P < 0.001), fit and fill without collar (HR 1.52, 95% CI, 1.14 to 2.04, P = 0.005), and fit and fill with collar (HR 2.11, 95% CI, 1.63 to 2.72, P < 0.001).

Conclusion:

In the hemiarthroplasty treatment of elderly patients with hip fracture, all routinely used noncemented stem design types were associated with a higher risk of aseptic revision as compared with cemented fixation.
Perception of Medical Students towards Teaching and Training at Public and Private Medical Colleges of Peshawar Using Dundee Ready Education Environment Measure
Authors: Haris Sobia , Haris Muhammad , Deeba Farah , Khan Muhammad Jehangir , Karam Ahmad Sharjeel
Published: January 2022

The importance of teaching and training quality has been acknowledged as critical for successful learning and practical skill development. The perceptions of medical students toward teaching and training offer a good basis for altering and refining the quality of medical teaching. The purpose of this study was to analyses students' perceptions of teaching also training at public and private medical colleges of Peshawar, Pakistan. Materials and Methods: The Dundee Ready Educational Environment Measure (DREEM) questionnaire was given to 240 pupils from various public and private medical schools. The questionnaire has 27 items that were rated on an 0-4 Likert scale (total scores between 0-108). The questionnaire had five subscales that assessed students' perceptions of learning, teaching, environment, academic self-perception, and social self-perception. Data was collected and mean and standard deviation for each subscale was calculated using SPSS. Results: The total mean score of DREEM both public and private was 64/108 (59%). The total mean score for public and private was 65/108 (60%) and 62/108 (57%) respectively. The total score of SPL domain for public and private was 16.81/28 (61%) and 16.09/28 (57%). The total score of SPT was 19.52/32 (61%) for pubic and 19.67/32 (61%), while that of SASP was 5.02/8 (62%) and 4.33/8 (54%). The total score of SPA domain was 19.31/32 (60%) and 17.91/32 (55%) while that of SSSP was 4.9/8 (61%) and 4.49/8 (56%) for public and private medical colleges respectively. For SPA, SSSP, SASP, SPL and SPT domain the score of public medical colleges was ≥60% and for private only SPT was 61% and the remaining were <60%. Conclusions: Total DREEM score was 64.02 which are more positive than negative. However, the individual scores of domains for both public and private medical colleges were showing a positive perception of students except the SASP domain for private medical colleges, which is showing many negative aspects and needs further exploration.
Empowerment of Productive Economic Business for The Poor in Serang City
Authors: Ismawati Iis , Yazid Helmi
Published: January 2022

Community service is how to empower the poor in urban areas through productive economic efforts, problem identification The number of poor people tends to increase, the existing business opportunities are relatively limited, productive economic businesses are not optimal and market access is limited for business groups.

The purpose of the activity is to foster an entrepreneurial spirit for the poor through the formation of joint business groups, to empower the potential of the poor in increasing family income through increasing productive economic enterprises.

 The process of community empowerment in the village begins with the formation stage, then implementation and the last is the stage of handing over assistance. problems related to the factors that influence the dynamics of joint business groups in Banjar Village, increasing productive economic efforts of joint business groups, more directed to chess efforts to improve product quality, production cost efficiency, marketing expansion and business scale improvement.
ANALISIS PENGARUH JUMLAH INDUSTRI, JUMLAH PENDUDUK DAN NILAI INVESTASI SEKTOR INDUSTRI KECIL DAN INDUSTRI NON-FORMAL MANUFAKTUR DI KOTA PALEMBANG
Authors: Dwi Rama Jaya Rizky , Taufiq Ibrahim M. , Riansyah Riansyah , Nur Happy Welly
Published: January 2022

Penelitian ini bertujuan untuk mengetahui adakah pengaruh variabel jumlah industri, jumlah penduduk dan nilai investasi terhadap kesempatan kerja sektor industri kecil dan industri non formal di Kota Palembang dengan menggunakan data panel. Analisis yang digunakan dalam penelitian adalah metode analisis regresi berganda. Data yang digunakan dalam penelitian ini diperoleh dari Dinas Perindustrian Kota Palembang dan Badan Pusat Statistik (BPS) Kota Palembang dengan runtut waktu tahun 2014-2016. Berdasarkan hasil analisis dan pengujian hipotesis melalui uji f diketahui bahwa jumlah industri, jumlah penduduk, dan nilai investasi secara bersama-sama berpengaruh signifikan terhadap kesempatan kerja pada sektor industri kecil dan juga pada sektor industri non formal di Kota Palembang. Secara parsial jumlah industri berpengaruh positif dan signifikan terhadap kesempatan kerja sektor industri kecil di Kota Palembang, untuk jumlah penduduk dan nilai investasi tidak mempunyai pengaruh yang signifikan terhadap kesempatan kerja sektor industri kecil di Kota Palembang. Sedangkan untuk sektor industri non formal variabel jumlah industri, jumlah penduduk dan nilai investasi berpengaruh positif dan signifikan terhadap kesempatan kerja di Kota Palembang.
Nghiên cứu phương pháp kiểm định máy thu GNSS dựa trên giải pháp mô phỏng tín hiệu
Authors: Bùi Đăng Quang , Nguyễn Đình Thuận , Lã Thế Vinh
Published: January 2022

Trong bài viết này đề cập đến phương pháp kiểm định chất lượng phương tiện đo định vị bằng vệ tinh (máy thu GNSS) trong phòng dựa trên giải pháp mô phỏng tín hiệu. Đây là một trong những giải pháp có tính ưu việt khi thực hiện kiểm định máy thu GNSS theo chế độ định vị tuyệt đối và định vị đo động thời gian thực RTK. Phương pháp này là lựa chọn tối ưu trong việc triển khai thực hiện quản lý chất lượng phương tiện đo theo hướng đã được quy định trong Luật Đo lường số 04/2011/QH13 và Luật Đo đạc và bản đồ số 27/2018/QH14
Khảo sát độ chính xác công nghệ trạm CORS trong một số dạng công tác trắc địa độ chính xác cao
Authors: Trần Viết Tuấn , Nguyễn Văn Hiệp
Published: January 2022

Nội dung của bài báo trình bày về kết quả nghiên cứu khảo sát độ chính xác đạt được của công nghệ trạm cors khi định vị điểm đơn trong điều kiện Việt Nam. Cơ sở lý thuyết của phương pháp khảo sát, kết quả đo đạc thực nghiệm và đánh giá khả năng ứng dụng của công nghệ tiên tiến này trong một số dạng công tác trắc địa yêu cầu độ chính xác cao ở Việt Nam
2 Play to Prepare with Technology-Enhanced Simulation
Authors: Paramsothy Remi , George Michael
Published: January 2022

Traditional simulation training within medical education has been well established for several decades and involves playing out emergency situations in a role-play format. This type of simulation training is typically located at hospitals and medical centres and requires considerable organization, costs, in-person attendance and allocated time away from clinical commitments. Technological transformation within healthcare education is growing and, in particular, there has been an increase in mobile applications (apps) to aid medical education. Coupling the two together has allowed ‘gamification’ to emerge and grow in popularity as a powerful tool to enhance learning retention.

The aim of this innovation project was to create a technology-enhanced simulation app for mobile devices to train in Advanced Life Support (ALS) for cardiopulmonary arrest, using game mechanics.

A technology-enhanced simulation mobile app called ‘SimPL’ has been created to facilitate technology-enhanced learning on mobile devices. It allows the user to run physiological observations on a simulated patient. This has gained popularity on the Apple and Google Play Store amongst healthcare professionals. We now want to build on this and start by simulating ALS for cardiopulmonary arrest. A minimum viable demo that healthcare professionals can use to run an ALS scenario is being developed. The aim is to allow healthcare professionals to run through an interactive ALS scenario and give the user flexibility to make any decision they want regarding intervention and see how the patient responds to it. It provides real-time, haptic and constructive performance feedback to the intervention being carried out.

The use of technology-enhanced simulation for healthcare education is a novel area and with the fast acceleration of game mechanics development, there is scope for medical education to be delivered in this way. The technology-enhanced simulation app will be launched on the Apple and Google Play Store to all healthcare professionals around the world. Feedback will be gathered from users to allow further developments of the product. The overall outcome is to produce a network of mobile apps to deliver medical education in an interactive, engaging and easily accessible way to help clinicians prepare for emergency medical situations anytime, anywhere.
111 Using Video Teleconferencing for an Effective Remote Simulation Course in Transfer Medicine
Authors: O’dwyer Anthony , Melzer Arndt
Published: January 2022

Critically ill patients require transfer within and between hospitals – a necessity amplified by ITU capacity pressures during the COVID-19 pandemic. This rising demand highlighted the need for dedicated transfer teams. Alongside establishing and expanding a cross-sector transfer team, we necessarily needed to meet growing training requirements. Transfer medicine is a core competency for intensivists, anaesthetists, ITU nurses and pre-hospital staff, with simulation recommended in the respective curricula. However, COVID-related restrictions alongside demands on staff’s time, limited opportunities for face-to-face training. We overcame these challenges by developing an online simulation-based course. Teleconferencing has previously been received favourably and rated highly for educational benefit

The aim of the study was to test the efficacy of and response to remote simulation-based training in transfer medicine.

Before attending the online simulation, multi-disciplinary participants completed 3 hours of interactive e-learning hosted online via the platform Rise. This incorporated case-based discussions, practical assignments and filmed presentations. Simulation utilized Zoom teleconferencing to immerse participants in clinical transfers. We used high-fidelity, pre-recorded scenarios made with a mannequin simulator and high-definition video. The participants observed the simulated transfer of critically ill patients (

Example screenshot of online simulated scenario with participants observing

A total of 21 multi-disciplinary participants completed training: 43% doctors and 57% nurses. 100% of respondents (18) rated the course 5/5 on the Likert scale when asked ‘how much did you enjoy the course’ and 100% would recommend the course to colleagues. All rated the course extremely relevant to their practice. Average assessment scores pre- versus post-course improved by approximately 20% (74.3% to 94.4%) (

Results of pre- and post-course knowledge assessments

We developed an effective and well-received remote simulation transfer course to deliver training to a wide-reaching audience. Participants were enthusiastic about the innovative and interactive approach, finding the online course enjoyable and relevant to their clinical practice. Results suggest the course effectively increased learning. The flexible nature of online remote provision allows for delivery at scale, to meet a rising demand. Further evaluation will establish the extent at which this training translates to performance, such as a reduction in adverse events in transfer practice.
38 Using Simulation to Improve and Test a Novel Enhanced Care Drug Trolley
Authors: Williamson Jodie , Grundy Sarah , Rowson Mark
Published: January 2022

The Royal College of Physicians Acute Medicine Taskforce

The aim of the study was to optimize the management of life-threatening medical conditions, requiring enhanced care, whilst minimizing the time taken for commencement of drug interventions and staff using a novel Enhanced Care drug trolley.

A drawer on a sealable procedure trolley was designated for each emergency and the following items were included:

Treatment algorithm

Prescription charts

Monitoring charts (where applicable)

Medications and their diluents

Sundries (needles, flushes, sanicloths etc.)

Blood forms, bottles and blood gas kits (where applicable)

Cannulation kits

Airways (where applicable)

Oxygen mask (where applicable)

A Standard Operating Procedure (SOP) was produced detailing the responsibilities of the ward manager, pharmacy team and nursing staff. Weekly and daily checklists were produced, along with a ‘seal broken’ table. The process, procedures and innovation were discussed and approved by the Drugs and Therapeutics group.

Each emergency scenario was tested

Results from testing the enhanced care drug trolley

Simulation testing led to modifications of the contents of the trolley after feedback from the users. To embed practice, education of the nursing staff and clinicians was commenced to ensure familiarity and confidence to use the trolley, and to ensure governance adhered to.
98 ‘AOSim’: A Decision-Making Simulation Course for Acute Oncology Nurses
Authors: Bains Amarpal , Mann Karishma , Wheeler Joseph
Published: January 2022

Simulation-based education (SBE) as a learning tool is becoming more prevalent, as is the recognition of the importance of non-technical skills. With this insight comes a desire to improve clinical practice using these techniques. ‘AOSim’ has arisen from an intrinsic desire to achieve this from within an Acute Oncology Service (AOS). Wishes to improve confidence, decision-making and teamwork have guided the design and implementation of a novel simulation course in this field.

The purpose of the course has been guided by the candidates. The hope is to be able to provide a safe learning environment to explore decision-making, improve confidence in clinical practice and strengthen teamwork.

The course design was informed by direct stakeholder analysis. Pre-course surveys aided in planning the course and scenario design. The course would run over half a day and comprise three scenarios, each followed by a debrief. The candidates invited were nurses working in the local AOS and the AOS coordinator. Each scenario was designed with a particular focus in mind; ‘Respectful Challenging’, ‘Clinical Prioritisation’ and ‘Treatment Escalation’. The clinical context of the scenarios was based on oncology to provide a familiar environment for the candidates. This would also enable the focus to be paid to the non-technical skills related to the aims of the course. The scenarios were to be run in a high-fidelity setting using a mixture of role players, mannikins and plants. Faculty roles had been assigned prior to the course date.

A course overview was sent to the candidates including the planned date for running the course to allow the candidates to plan for handover of their clinical duties; this allowed protected time for the course to run. ‘AOSim’ was run in a simulation suite in the high-fidelity setting with an experienced faculty. The candidates were introduced to the simulated environment and the importance of psychological safety was explained. The three scenarios ran as planned to include subsequent informative debriefs. Immediate and post-course feedback were positive, particularly with increased confidence levels and team-working ability. This has led to aspirations to run the course again for a different candidate group in the future.
138 Student Perspectives of a Novel Remote Simulation Course
Authors: Freer Hannah , Jones Simon , Lewandowski John , Randles Derek , Dores Craig
Published: January 2022

This study was designed in response to the pandemic. This was to increase the accessibility of Simulation Training whilst under lockdown restrictions and limited departmental capacity due to social distancing.

The aim of the study was to assess final-year medical students’ perspectives on a new method of delivering a simulation course remotely.

The technique utilized in the intervention group was a guided experience via ‘Avatars’ – Faculty members who were physically present in the simulation room. Course participants joined via a live video stream and directed the ‘Avatar’ in real time. The scenarios were driven by a script that directed focus to the learning objectives. The debrief followed a ‘pause and perfect’ approach to enhance participation. During these pauses, the students, with guidance from a facilitator, reflected on developments so far and then gave their ‘Avatar’ instructions for the next stage of the scenario. The study took the form of a pragmatic cross-over trial, splitting the cohort into two groups. Group 1 received a face-to-face medicine simulation course and a remote surgery simulation course. Of this group, approximately half had the remote course first and the face-to-face second, the other half in the reverse order. Group 2 had a similar format, however with a face-to-face surgery simulation course and a remote medicine simulation course. The intention was to minimize the influence of pre-course perceptions based on what has already been experienced (i.e. a group might have a different perspective on a face-to-face course if they have had a remote course first and vice versa). Feedback was collected and compared for each.

A total of 44 final-year medical students took part in the trial. 40 feedback responses were collected for the face-to-face sessions and 37 for the remote. Overall, the face-to-face simulation sessions were received more positively with 100% of participants scoring face-to-face sessions overall as ‘Excellent’ or ‘Very Good’ compared with 70.2% for the remote simulation. Participants were asked to score out of 10 how much these sessions would change their future practice; the mean score for the face-to-face was 9.29 compared with 8.5 for the remote. Remote simulation produced lower student satisfaction scores compared with face-to-face teaching. Further research is needed to determine the differential impact on knowledge and skills transfer. If there is limited impact, remote simulation could be a viable and valuable alternative to face-to-face simulation, not only during a pandemic but also in diverse environments.
202 High-Fidelity Simulated Bronchoscopy: Incorporating Simulator into A Mannequin
Authors: Keshtkar Fatemeh , Ellerton Laura , Kelly Ryan , Parr Tim , Mercer Simon
Published: January 2022

Fiberoptic intubation (FOI) is a technique used to establish airway access in patients with anticipated and unanticipated difficult airways. Fiberoptic bronchoscopes are currently used to facilitate endotracheal intubation via either the nasal or oral route, in the positioning of endotracheal and endobronchial tubes and bronchial blocking devices, and in airway examination or evaluation. FOI is used in the management of awake spontaneously breathing patients with an anticipated difficult airway

The aim of this project was to incorporate the ORSIM® simulator into a manikin for use in high-fidelity simulation. A basic resuscitation training manikin was used (

A basic resuscitation training manikin is used. The silicone/rubber skin is removed.

The ORSIM® black sensor box is placed over the head with an exit point towards the thorax.

Place polystyrene to support head and cheek region. This could be substituted with other materials such as foam/wax.

Optional: the use of inexpensive props such as wigs/hats/shirts.

Position patient and monitor for high-fidelity simulation.

We found that the ORSIM® simulator was a useful tool for training. The virtual video guidance can be used to familiarize clinicians with different pathology and improve technical skills. By incorporating the simulator into a manikin, a more realistic model can be created. Here we have used very inexpensive and often readily available equipment within a healthcare setting to achieve this. This model can be used as part of a high-fidelity simulated scenario to improve the learning experience.
56 ‘Abducted Baby’ Simulation: Testing the System to Optimize Patient Safety on a Neonatal Intensive Care Unit
Authors: Aguirre Diana , Nash Matthew
Published: January 2022

Infant abductions are rare distressing events. The Care Quality Commission recently highlighted inadequate protective measures in other trusts as a cause of major concern

The aim of the study was to test our existing patient safety system in a real-life situation looking at human factors and equipment functionality.

An activated baby tag was placed on a mannequin which was then put into a pram. A member of staff in disguise (the ‘abductor’) pushed the pram out of the neonatal unit by ‘tailgating’ another member of staff so that the doors would not automatically lock, replicating a potential real-life scenario that exploited a known risk. The aim was to see whether the mannequin could leave the hospital. The ‘abductor’ was eventually stopped from leaving. A detailed timeline of events was recorded and analysed. Safety was ensured and participants were individually debriefed as emotions were high.

Our simulation highlighted points of excellence including a quick and calm response, the use of the panic button and appropriate persistent challenge of the ‘abductor’ without aggression. Important human factors were highlighted. There is no security staff in the hospital. The ward clerks called the porters directly, rather than dialling 2222 and saying ‘lockdown’, which triggers a lock of all doors out of the hospital. There were several system failures. The baby tag system did not alert the front of house. The panic button was broken, and a set of doors out of the hospital did not lock.

Simulation is an effective tool to identify system failures and patient safety risks. This scenario highlighted deficiencies in our system and a lack of established procedures and training. A detailed action plan has been put in place. The panic alarm, door locking mechanism and system linking the baby alarm system to the front of house are being addressed. The option of an automatic lockdown on activation of the baby tag alarm system is being explored. Finally, a standard operating procedure is being written and learning disseminated in the department. We are planning to run this simulation in other areas of the hospital to optimize patient safety.
145 Scenario-Based Perinatal Psychosis Simulation for Final-Year Midwifery Students: A Qualitative Study
Authors: Hall Verona
Published: January 2022

Approximately 20% of women will reach diagnostic thresholds for mood disorders during the perinatal period, and between 0.1% and 0.2% will experience a psychotic disorder

The aim of the study was to explore final-year midwifery students’ experiences of a perinatal psychosis, scenario-based simulation (SBS).

A 1-day SBS learning activity with two scenarios of women exhibiting psychotic symptoms. Each scenario included a background narrative, actors’ roles with partial scripts and comprehensive patient clinical information. Two midwifery students acted as assessment staff in each scenario whilst their colleagues took observer roles. Guided debriefing followed each scenario.

The study was conducted in March 2020 at a UK Higher Educational Institute. It employed an exploratory, descriptive design to capture qualitative data from 11 final-year midwifery students who took part in the SBS. Data sources included semi-structured interviews and information shared during scenario debriefings. Data were thematically analysed following the seven-step process of Dahlgren and Fallsberg

Three main themes emerged from the data. The SBS facilitated learning through different ways of knowing. Students drew on personal experiences to identify communication and care challenges, re-appraised assumptions they held about mental health and ethnicity and articulated the benefits of peer learning. Students held equivocal views concerning the adequacy of mental health content in existing curricula, and not all had encountered women with perinatal psychosis on clinical placements. Clinical environments were highly valued learning contexts for the observation of staff and the gradual, supervised application of practice skills. Both learning mechanisms were replicated in the SBS, which helped the students realize attributes and skills in themselves necessary for the care of women with perinatal psychosis. The SBS facilitated transformative learning through its realism and the development of skillsets not amendable to didactic teaching, e.g. teamwork and communication skills. Debriefing helped to cement learning in the minds of students.

The SBS was an effective form of pedagogy that enabled invigorating and deep learning. It is recommended that other educators consider its use, particularly for conditions that students do not always encounter in clinical placements. Well-prepared, detailed scenarios are recommended to promote realism and each SBS should be followed by a structured debrief. Developments should be accompanied by evaluative methodologies to gauge their impact and further research is needed to better understand how SBS can be used more effectively throughout midwifery education.
61 Exercise Martian Attack!: Using VR Feedback as a Reflective Tool for Paramedic Science Students
Authors: Rolfe Ursula , Bancroft Adam , Holley Debbie , Moran John
Published: January 2022

Paramedic students have had to overcome the restrictions COVID-19 with many of their clinical skills moving online, limiting opportunities to engage with clinical practice partners, a key requirement of their professional programme. Social distancing has been challenging to overcome and the paramedic teaching team’s solution was to offer the University underground carpark to stage a simulated Casualty Clearing Point for a Major Incident Martian Attack!

The aim of the session was to reconceptualize our simulation practice at the university level and to

Engage our students with an authentic, reflective, and clinical skills-based assessment experience

To draw upon lessons learned to improve our processes and guidelines for stakeholders involve in clinical skills assessments

To enhance the student learning with early familiarization and ‘hands on’ practice with the equipment utilized in the field of paramedic science

The paramedic teaching team created ‘Martian Attack!’ a short video to set the scene for the tasks the first-year students teams need to accomplish. The students were divided into pairs where they were tasked to triage at ‘stations’ treating mannequins with simulated injuries under time constraints. This was followed by demonstrating immobilization techniques and extracting a weighted mannequin from an enclosed space using a Saviour Technical Stretcher (STS). All these skills require a combined improvised approach towards casualty evacuation. Students were observed by critical care professionals and offered feedback. ‘There is only so much simulation that can be done in a room so I thought it was great to be able to get out and experience a “Real Life” event where we could put the skills and knowledge from the previous weeks into practice in a supported environment’. Student J.

Three-hundred-and-sixty-degree film clips captured these simulated scenarios and debriefs and were added on a virtual platform hosted by Panopto so that students could reflect on the scenarios in their own time to aid their learning and reflection. The film clips made accessible by a range of technologies, from google cardboards to OCULUS Quest, added the high-fidelity aspect of realism to the student’s learning experience. The next steps will be to consult with our practice partners to streamline and identify further areas of practice that will enhance the skill mix of students on placement.
42 Updates to the International Nursing Association for Clinical Simulation and Learning Simulation Debriefing Standard of Best Practice
Authors: Alinier Guillaume , Decker Sharon , Crawford Scott , Jenkins Deborah , Gordon Randy , Wilson Cheryl
Published: January 2022

Debriefing is a key component of all simulation-based educational (SBE) activities and is an activity for which a multitude of approaches and models have been developed and implemented (Oriot & Alinier, 2016). To improve SBE practice in general, the International Nursing Association for Clinical Simulation and Learning (INACSL) has outlined a set of Simulation Standards of Best Practice first published in 2013. Revisions to these standards have occurred every few years, including expanding the topics covered as developments in this domain have occurred and the use of simulation has expanded.

The aim of this study was to present the changes in the Simulation Debriefing Standard in comparison to those last published (INACSL Standards Committee, 2016).

From 2019 to 2021, a group of simulation educators and researchers, the authors of this abstract, representing multiple specialities, simulation societies and geographic areas began meeting to review and revise the Simulation Debriefing Standard based on the latest literature. This group identified several items that would benefit from being updated, including expanding the terminology of this Standard to encompass Feedback, Debriefing and Guided reflection as distinct but integral components of this key phase of simulation-based experiences.

An updated version of the Simulation Debriefing Standard of Best Practice will soon be published by INACSL in Clinical Simulation in Nursing. Some of the updates include expansion to understand and allow electronic systems to be recognized as components of the debriefing process and emphasizing the need for practice and review of the skill of facilitators in the techniques of debriefing. The new Simulation Debriefing Standard provides clear information and guidance to the simulationists. It includes four as opposed to the five criteria in the 2016 version (INACSL Standards Committee, 2016). The updated criteria can still be matched to those from the previous edition (see colour coding in

Criteria of the 2016 and 2021 INACSL debriefing standards of best practice

It is expected that the revised Simulation Debriefing Standard of Best Practice will be welcomed by the simulation community, which includes the healthcare educators and simulation technology developers, but also the learners. It has been designed as a guide to help educators in all the key aspects of debriefing, providing feedback and facilitating guided reflection conversations that will ultimately benefit learners. It includes an updated list of useful references readers can consult to find additional information.