One must accept the complexity of modern society as a multifaceted influence that will direct the future of all social organizations. Technology has brought the people of the world into almost instant communication. Biomedical science has conquered most infectious, acute diseases and has provided several medicines for the successful maintenance therapy of chronic diseases. The lifestyle of some people as smoking and drug addiction remains a strong factor in their achievement of the health goals of the good life. Universally, economic (...) inflation and international business have created an economic interdependence among nations and dealing with the economic problems of one country must take into account this interdependence. When one views the future within this technologic-social-economic framework, he has difficulty sorting out certain directing influences that may shape the future of pharmacy practice in Libya. (shrink)

Lifelong learning is becoming part of the philosophy of professional education. Continuing medical education is the responsibility of all personnel who are responsible for the delivery of components of the healthcare delivery system. Continuing education is becoming increasingly obvious for medical universities, hospitals, and health care providers. Pharmacists who practice in a community pharmacy and hospital, and who are participating in residency recognize that the traditional role of the pharmacist is changing. Over the last decades, a host of new (...) services have been identified as a function of the pharmacist [1]. A review of these services revealed a personal commitment to continuing education. It is the absolute need to develop a level of competence that will improve patient care. In Libya, pharmacists working in the community practice setting are pharmacists with a diploma of pharmacy or with a Bachelor of Pharmaceutical Science, Master of Science, and Doctor of Pharmacy (Pharm D). The main objective is that the graduates possess the knowledge and skills needed to optimally mange the pharmaceutical services [1, 2]. Patient's expectations from pharmacists are that the medicine should be effective, safe and affordable. (shrink)

Globally, breast cancer is the most common cancer in women worldwide, it represents about 25.0% of all cancer cases. In developing countries, breast cancer is mainly discovered at a late stage, which has a negative impact on the prognosis. To determine the extent of, and the factors contributing to, delay in breast cancer presentation, and to evaluate the mammography screening practice in breast cancer Libyan women. A descriptive cross-sectional study was carried out on five hundred and one breast cancer patients (...) who attended the Oncology Outpatient Clinic of the Medical Department at Tripoli University Hospital and Tripoli Central Hospital during a period between February and August 2019, after the application of inclusion and exclusion criteria enrolled in the study. The mean age of the patients was 47.35±01.0 years, 55.1% of them were diagnosed in late stage (III and IV), and 30.9% of the patients were presented late (≥3 months). The time interval between the initial breast symptom and first presentation to a clinic ranged between 2nd day and up to three years, with a median time of 1.5 months, and the main factor of the delayed presentation to a clinic was a lack of knowledge about symptoms (33.5%). The study revealed a significant association between delayed presentation and older age (P<0.001), low educational level (P<0.001), low family income (P<0.001), unemployed women (P< 0.002), postmenopausal women (P<0.001), patients with negative family history (P<0.05). This study concluded that delayed presentation is found in less than a third of the study population, and lack of knowledge about breast cancer signs and symptoms is a common factor. Age, educational status, family income, unemployed women, menopausal status, and family history of breast cancer were all significant factors for delayed presentation. Improving women's awareness about breast cancer is needed and applying the policy of regular screening mammograms is a useful tool for early diagnosis and early treatment in Libya. (shrink)

The purpose of this study was to determine the attitudes, expectations, experiences, and barriers that physicians in Tripoli hospitals experienced when working alongside Clinical Pharmacists (CPs). A descriptive self-administered questionnaire was used for the study, and participants were selected from several Tripoli hospitals. Most of the respondents agreed that CPs are an essential part of patient care teams and that they have the legal authority to review a patient's medication regimen and response. More than half of respondents believe CPs (...) must be responsible for the medications they prescribe to patients. Half of the respondents agreed that CPs should be encouraged to play a more active role in hospitals and other healthcare facilities. The majority of participants agreed that CPs should participate in managing drug side effects and almost half agreed that CPs can contribute to decisions about drug interactions. By a low agreement rate, 42.7% of respondents thought CPs were specially qualified to counsel patients on drug therapy. A similar low trend was observed, with 40.9% agreeing to provide pharmacists with additional responsibility and authority in clinical departments, in contrast, 54.5% expressed their concern about the clinical responsibility of CPs in clinical practice. A minority of physicians agreed that Physicians should consult pharmacists in selecting the best pharmacological treatment. At the same time, the majority think that pharmacists lack clinical skills and 61.8% feel that physicians are unable to communicate effectively with CPs. 43.6% acknowledged that the traditional opposition between the two professions was a barrier to interprofessional collaboration while the absence of pharmacy space in clinical settings was cited by 39.1%. A majority of respondents agreed that physicians and pharmacists may improve their interprofessional collaboration by raising their awareness about it. A minority of respondents thought that laws and regulations governing physician collaboration should be put in place to promote effective collaboration between physicians and CPs. The study discovered that although most physicians endorse the introduction of clinical pharmacy services in hospitals and believe that physicians and pharmacists can collaborate on many tasks, respondents were not as impressed with the CPs' performance and believed that they lacked the professionalism required to carry out clinical responsibilities successfully. To facilitate the growth of clinical pharmacy services, laws and regulations must be put in place. (shrink)

Abstract The values of the healthcare sector are fairly ubiquitous across the globe, focusing on caring and respect, patient health, excellence in care delivery, and multi-stakeholder collaboration. Many individual pharmacists embrace these core values. But their ability to honor these values is significantly determined by the nature of the system they work in. -/- The paper starts with a model of the prevailing pharmacist workforce model in Scotland, in which core roles are predominantly separated into hierarchically disaggregated jobs focused on (...) one professional ‘pillar’: Clinician /Practice Provider; Educator; Leader/Manager; and Researcher. This is the ‘Atomistic’ Model. This skills-segregation yields a workforce of individuals working in isolation rather than collaborating together, and lacking a shared information flow, purpose and identity. Key strategic flaws include suboptimal responsiveness to population and subpopulation needs, inconsistency and inequity of care, an erosion of professional agency, and lower job satisfaction. It is conjectured that this results from a lack of congruence between values, professional ethos, and organizational structure. ‘Atomism’ culminates in a syndrome of widespread professional-level cognitive dissonance. -/- The paper contrasts this with a new emerging workforce vision, The Collaborative Care Model. This new model defines a systems-first-approach, built on the principle that all jobs must include all four professional ‘pillars’. Vertical skills integration, involving education and task sharing, will support sustainability and succession planning. Horizontal skills integration (across practice, leadership and research) is included to improve responsiveness to population need and individual professional agency. The working conditions, supportive ethos, and career structure needed to make the model work are described. Moral theory and workforce theory are used to justify why the model may be more effective for population health, delivering greater job satisfaction for individuals and ultimately helping systematically realize and honor healthcare values. Finally, the paper sketches the first steps needed to implement the model at the national level, starting with the operationalization of new multi-pillar professional curricula across the career spectrum. Potential pitfalls and challenges are also discussed. -/- Co-Authors: 1. Paul Forsyth (PF) Lead Pharmacist Clinical Cardiology, Pharmacy, NHS Greater Glasgow & Clyde. Contribution: Conceptualization; Model Curation; Model Theory; Model Visualization; Writing - original draft (lead author), Writing - review & editing (lead author) 2. Andrew Radley (AR), Consultant in Public Health Pharmacy, NHS Tayside. Contribution: Conceptualization; Model curation; Model Theory; Writing - review & editing 3. Gordon Rushworth (GR), MPharm MSc FFRPS FRPharmS (Consultant). Programme Director, Highland Pharmacy Education & Research Centre, NHS Highland, Inverness. Contribution: Model curation; Writing - review & editing 4. Fiona Marra (FM) National Lead Clinician Scottish Infection and Immunology Network (SPAIIN) / Advanced Pharmacist HCV / HIV, NHS Greater Glasgow & Clyde. Contribution: Model curation; Writing - review & editing 5. Susan Roberts (SR) Associate Postgraduate Pharmacy Dean, NHS Education for Scotland. Contribution: Model curation; Writing - review & editing 6. Roisin O’Hare (RO) Lead Teacher Practitioner Pharmacist, Northern Ireland University Network, Southern Health and Social Care Trust. Contribution: Model curation; Writing - review & editing 7. Catherine Duggan (CD) Chief Executive Officer, International Pharmaceutical Federation (FIP). Contribution: Model curation; Writing - review & editing 8. Barry Maguire (BM) Senior Lecturer, School of Philosophy, Psychology and Life Sciences, The University of Edinburgh. Contribution: Conceptualization; Model Curation; Model Theory; Model Visualization; Supervision; Writing - original draft (senior academic supervisor), Writing - review & editing (senior academic supervisor) -/- . (shrink)

Recent studies have shown that pharmacists have an interest in conducting research. However, barriers such as lack of confidence prevent pharmacists from participating in ruling research. This study evaluated pharmacists’ self-perceived competence and confidence scores for health-related research. A validated self-designed questionnaire was distributed to randomly recruited Libyan pharmacists in hospitals and community pharmacies. Both descriptive and inferential statistical analyses were applied to the data. The analysis included 191 responses. Most respondents had prior research experience (67.0%). Over two-thirds (72.3%) rated (...) their ability to conduct health-related research as good to excellent. The majority had not published articles in peer-reviewed journals in the past five years (71.2%) and had no abstracts or posters published at local/regional (65.4%) or international conferences (79.1%). Lack of support (55.5%) was the most common barrier to participating in health-related research, followed by lack of funds (42.9%), time (29.3%), and knowledge (26.2%). At least two-thirds of pharmacists felt somewhat competent or confident in conceptualizing research ideas, collecting data, managing and storing data, and preparing presentations. Less than 60% felt competent /confident in outlining statistical plans and using statistical software. Overall, pharmacists displayed moderate competence (median score=38.0/65) and confidence (median score=40/65) in planning and conducting health-related research. Those with prior research experience (median score=42.0 vs. 29.0) and training (median score=41.0 vs. 28.0) had significantly higher scores. Higher scores were also noted among those who had published in peer-reviewed journals (median score=46.0 vs. 37.0) and presented at regional/local conferences (median score=46.5 vs. 34.0). Most pharmacists in Libya were interested in conducting research, and the majority of them had previous research experience and previous research-related training. The pharmacists had moderate competence and confidence to plan and conduct research. Research training was recommended for practicing pharmacists and pharmacy students to improve pharmacists’ research involvement and promote the advancement of pharmacy practice in Libya. (shrink)

My journey as a teacher started in 1971, keeping the student's interests in mind. The experiences gained through observing some of the best teachers in mind like Dr. Gopalan (Director General of ICMR) Dr. Srikantia (Director, National Institute of Nutrition, Hyderabad), and Dr. Copper (Madras Medical College) I developed an interest in teaching. What I learned was to teach in a simple language that is relevant to the field of education. Being a Rotarian as well as having the opportunity of (...) being a Student Advisory Council chairman, IISc, Banglore, and Ad Hoc President of the Research Scholar’s Association, Madras University, I learned the art of speaking and communication. One of the key points of my learning is to learn the ability to develop a rapport with the students whom I teach. The workshops and training imparted by Medical Education Nodal centers, refined and made my teaching relevant to medical students. One of the most important requirements is to have practical skills that help you to adapt your teaching to the needs of the students. I developed this skill as I ran one of the ICMR-recognized diagnostic centers. The center gave me the opportunity to gain my practical skills for basic and clinical Biochemistry. (shrink)

Clinical Legal Education programmes now take place in most law schools in England and Wales. However, legal education continues to be predominantly focused on the analysis and application of rules, doctrines, and theories to hypothetical scenarios or essay questions. This form of pedagogy either minimises or ignores the role of the client in terms of supplying lawyers with knowledge pertinent to their case. In other words, it overlooks the fact that the lawyer’s acquisition of knowledge is not confined to (...) technical rationality. This article seeks to achieve three broad aims. First, to contribute to the debate concerning the epistemology of reflective practice. Second, to develop a theoretical reflective cycle, informed by Kant’s transcendental idealism, which seeks to maximise knowledge acquisition in legal education, namely knowledge supplied by the client. Third, to address implicit bias using the proposed reflective cycle. An optimal pedagogy for using this cycle is Clinical Legal Education, namely live client clinics. (shrink)

Abstract: To improve the countries’ pharmaceutical situation and to monitor the progress, the World Health Organization (WHO) and member states developed a system of indicators to measure the respective important aspects as a prerequisite step. Level I indicators to assess the country’s pharmaceutical situation include the national drug policy; legislation and regulations; drug accessibility and affordability; essential drug list; quality control; pharmacovigilance; storage and distribution; information and rational use. This study is aimed to document the professional opinion of 20 (...) class='Hi'>pharmacy practice professionals on Libya’s current pharmaceutical situation, utilizing WHO indicator-based approach. The core indicators measure the most important information needed to understand the pharmaceutical situation in a country. A closed-end questionnaire was distributed to ten practicing pharmacists and ten pharmacy teaching staff members who practice pharmacy. The questionnaires were handed over personally and collected on the same day. The responses were analyzed using simple statistics. The results were argued in the light of the first author’s observation and view, being expert in this field, with reference to the other experts’ views, relevant publications’ findings and WHO reports’ conclusions on these indicators. Suggestions and recommendations for a proper situation assessment, planning and action taking are presented. Primarily, government’s commitment towards appropriate restructuring, management and monitoring of the pharmaceutical sector is crucial. That is to enhance the country’s pharmaceutical situation, to provide and sustain efficient pharmaceutical services and to improve the overall health care system’s performance. (shrink)

Self-medication of antibiotics is an irrational use of drugs, contributing to microbial resistance, increasing healthcare costs and higher mortality and morbidity. This study aimed to assess self-medication with antibiotics without a medical prescription in the community of Libya. This is a cross-sectional study conducted from June to December 2022 and the total number of participants was 200. The design of the study and sample size were modified according to the proficiency of pharmacists and the medical and non-medical population of (...) Libya. The questionnaire was developed in English and Arabic language and was distributed through social media platforms. The questions were used after a thorough literature search and assessing the validity and reliability. The significant signs regarding reasons for the treatment by self-medication drugs of antibiotics, because of its various drugs of antibiotic by pharmacist (n=80, 40.0%) and family (n=90, 45.0%) compared with experience and physicians by used prescription was 13 (6.50%) and significant sings regarding by nasal congestion self-medication of various antibiotics (n=100, 50.0%). This sign must be practiced based on a previous physician’s prescription. The antibiotics are often self-administered as patients feel that they will save money and time but this can lead to substantial adverse drug reactions, antibiotic resistance, treatment failure and drug-related toxicity. This study respondent's medical and non-medical public of Libya who should be relatively informed and educated about the risk of treatment by self-medication of antibiotics with the development of resistance. (shrink)

This book offers fundamental insights into three main fields of education and expertise: phenomenology, neuroscience, and clinical practice. The richness and pluralism of the contributions aim to overcome the reductionist and dualistic approach to mental health and shed new light on clinical practice. Designed as both an education tool for mental health professionals, and a theoretical investigation for philosophers on the use of phenomenology in clinical practice, this book highlights the need for a new direction on mental (...) health, and more general, on human wellbeing. This volume aims to fill the gap between philosophers and mental health professionals on an educational level, in a space unique in its open and transdisciplinary approach. It appeals to students and researchers but also very much to professionals and clinicians in the field. (shrink)

CLE aims and clients’ needs conflict where students’ interests are put beyond clients’ needs. Students have interests in gaining employment, impressing instructors and supervisors, and experiencing the active application of law. Where the clients’ service-needs are subordinated to students’ interests, the relationship between the two—the ‘tension’—is tilted in a manner in which the clients are disserved through the fulfilment of students’ interests. This may be exacerbated by faulty institutional cultures where clinical faculty are treated differently, or as less accomplished (...) or ‘worthwhile’ than their ‘traditional’ counterparts. This also emphasizes that it is the clinical law faculty who may exacerbate or assuage the tension, as it is for clinical faculty to assure that clients’ needs are met on ethical grounds,20 and to equate the practice of law with excellence before students. (shrink)

Pharmacoeconomics (PE) is a relatively newly developed and fast-changing discipline [1]. PE plays a crucial role in healthcare decision-making by evaluating the costs and outcomes of different treatment options. In Libya, however, the implementation of PE evaluations faces various challenges that hinder its effective integration into healthcare systems. This communication analyses the current needs and prospects of PE by examining the challenges in its implementation, the benefits of integrating it into healthcare decision-making, and strategies to enhance its utilization in (...) the country's healthcare landscape. By exploring these different aspects, it is possible to gain a comprehensive understanding of Libya's status and potential advancements in PE. In Libya, the earliest records related to PE trace back to the late 19th century, specifically around 1835 during the Turkish colonization. During that time, various documents documented details such as drug prices, direct costs associated with specific diseases, expenditures on essential pharmaceuticals, and annual inventories of health and pharmaceutical institutions [2]. Over the past 80 years since modern Libya’s establishment after the colonial era, Libyan authorities have consistently published annual statistical reports. These reports cover expenditures on medicines, pharmaceuticals, and therapeutic materials, as well as the stock levels in healthcare facilities [3]. However, despite this data, there remains a significant lack of literature on PE, with a few exceptions that do not meet the standards expected of PE studies. (shrink)

Prescription drug misuse has emerged as a significant problem over the past decade, particularly topical corticosteroids for skin lightening. This study aimed to assess the misuse of topical corticosteroids among the female population in southern Libya; to determine prevalence, awareness, attitude, and practice regarding this drug misuse. A descriptive, cross-sectional questionnaire was distributed on January 2022 to females aged between 16-45 years old in southern Libya. Out of 200 distributed questionnaires, 155 were returned with a response rate of (...) 77.5%. The majority of the participants were aged 16-25 years (n=138, 89.0%) and over two-thirds of participants, said they obtained lightening products containing cortisone from pharmacies (n=107, 69.0%) while 36 participants indicated they obtained these products from cosmetic shops (23.2%). More than three-quarters of the participants said they were aware that they should read product ingredients (n=120, 77.4%). Just over one-quarter of respondents indicated they used the product on their face almost daily (n=41, 26.5%) while 28 participants denied using it (18.1%). The most common source of information about topical corticosteroids among participants was the Internet (n=51, 32.9%), followed by dermatologists (n=41, 26.5%), and pharmacists (n=31, 20.0%). Almost half of respondents were aware that topical corticosteroids can cause harmful effects (n=75, 48.4%). The most common indications reported for using topical corticosteroids were whitening (23.3%), and acne treatment (54.2%). Over two-thirds of participants, declared they would not use topical lightening products if they contained corticosteroids (n=107, 69.0%). In a similar attitude, nearly a third of participants stated that they would never use corticosteroid medications again if they knew about the negative effects of whitening (n=51, 32.9%). The majority of females, (87.7%), concur that only pharmacies should be able to sell and prescribe topical corticosteroid medications. The study's findings indicate that topical corticosteroids are frequently misused and that to lessen contraindications, especially for prolonged use, it is imperative to provide basic care to females who continue using topical corticosteroids in public or unlicensed marketing settings. (shrink)

Pharmacoeconomics (PE) is a relatively newly developed and fast-changing discipline [1]. PE plays a crucial role in healthcare decision-making by evaluating the costs and outcomes of different treatment options. In Libya, however, the implementation of PE evaluations faces various challenges that hinder its effective integration into healthcare systems. This communication analyses the current needs and prospects of PE by examining the challenges in its implementation, the benefits of integrating it into healthcare decision-making, and strategies to enhance its utilization in (...) the country's healthcare landscape. By exploring these different aspects, it is possible to gain a comprehensive understanding of Libya's status and potential advancements in PE. In Libya, the earliest records related to PE trace back to the late 19th century, specifically around 1835 during the Turkish colonization. During that time, various documents documented details such as drug prices, direct costs associated with specific diseases, expenditures on essential pharmaceuticals, and annual inventories of health and pharmaceutical institutions [2]. Over the past 80 years since modern Libya’s establishment after the colonial era, Libyan authorities have consistently published annual statistical reports. These reports cover expenditures on medicines, pharmaceuticals, and therapeutic materials, as well as the stock levels in healthcare facilities [3]. However, despite this data, there remains a significant lack of literature in PE, with a few exceptions that do not meet the standards expected of PE studies. (shrink)

Prescribing drugs for elderly patients is not an easy task since elderly patients frequently have comorbid conditions. In Libya, there are no guidelines for the management of medications used in elderly patients and no specialized geriatric health institutions. This study aims to assess the pattern of medication use among hospitalized elderly patients in Sebha Medical Centre and the drug-related problems associated with these patterns. This report is a descriptive and retrospective cross-sectional study conducted at Sebha Medical Center in 2021. (...) Potential drug-related problems were assessed based on the classification of Hepler and Strand. In this study, out of 195 participants, most patients have been given antibiotics (92.0%). The majority of patients have been prescribed anti-gastric agents, vitamins and anti-thrombotic agents which accounted for 75.0%, 62.0% and 55.0%, respectively. To a lesser extent, anti-hypertensive agents, analgesics and antihyperlipidemic were reported by 45.0%, 43.0% and 38.0%, respectively. Almost all the patients have at least one event of drug-related problem and more than three-quarters of the patients had more than one event of drug-related problems. The highest rate was untreated indications which were reported for 77.0% then followed by drug use without indication in nearly half of the events 48.0%. To fewer extent rates were reported: “in improper drug selection”, “drug interaction” and “adverse effects” which were reported for 25.0%, 23.0% and 18.0% of the total events, respectively. Almost all elderly patients have been prescribed antibiotics, analgesics and vitamins. Drug-related problems are predominantly prevalent in the clinical practice at the center. This study highlights the importance of activation of clinical pharmacist interventions at hospitals which can contribute to reducing the chance of risk of drug-related problems events among hospitalized elderly patients and ensuring rational drug prescribing in the geriatric clinical settings. (shrink)

Objective: This main aim of the study is to explore COVID-19 pandemic problems from the perspective of public health-clinical care ethics through online mediareports in Turkey. Method: This research was designed as a descriptive and qualitative study that assesses COVID-19 through online media reports on critics between the periods of March 11, 2020 and April 2 2020 as a quantitative as number of reports and qualitative study, across Turkey. Reports were from Turkish Medical Association websites which included newspaper reports. (...) Study data were presented as statistically and qualitative data case and headlines. No ethical or ofTicial permission was sought as the study was conducted through open access internet news sites. Results: This online reports analysis retrieved about 6723 articles about the COVID-19. According to study data, information about COVID-19 were themed as follows: general deTiciencies in taking action and isolation, lack of isolation, passengers and transport vehicles not quarantined ; insufTicient diagnostic tests, decision to test after healthcare professionals become infected, lack of equipment, lack of evaluation outbreak countries [Table 2]. Conclusion and Suggestions: COVID-19 is a pandemic and is a global public health problem that concerns every individual and needs to be handled carefully. This requires a multi-faceted preparation and education. In this context, healthcare professionals should be well trained in this aspect and have all the necessary equipment throughout the process. Additionally, it should work systematically with the cooperation of all health organizations, the Ministry of Health, local governments and of course the media, in order to inform society, fairly distribute the resources and to implement the safety measures effectively. BrieTly, lack of transparency, insufTicient information, limited resources, lack of public health protection measures such as partial quarantine decision, partial implementation of the scientiTic board's re c ommenda ti on s fo r e c on omi c rea s on s, and contradiction of the explanations are revealed as serious ethical problems. (shrink)

Diabetic ketoacidosis is a serious, medical emergency that can be fatal but treatable, we aimed to evaluate the clinical profile of patients admitted with diabetic ketoacidosis. This case series study enrolled 213 non-pregnant adult and adolescent patients admitted with diabetic ketoacidosis at Tripoli Diabetes Hospital from January to September 2023. Demographic data, clinical characteristics, laboratory findings, precipitating factors, and patient outcomes were extracted from medical records and analyzed. Type 1 diabetes mellitus was present in 187 (87.8%) of patients, (...) the age range 11-84 years, (30.26±13.28), with 130 patients ≤30 years old (61.0%), females accounting for 110 of the patients (51.6%), 109 had a diabetes duration of less than 10 years (51.2%). The most common precipitating factor was insulin omission 92 (43.2%) in patients with known diabetes mellitus, whereas, diabetic ketoacidosis as the first presentation of diabetes mellitus in 24 patients (11.7%), systolic blood pressure ranged 50-160 mmHg (112.82±16.19), diastolic blood pressure varied 30-100 mmHg (70.24±11.32). Plasma glucose at presentation ranged 183-1494 mg/dl (462.92±169.85), with Eu-glycemic diabetic ketoacidosis 100-249 mg/dl were in nine patients (4.2%), whereas most of cases (135 patients, 63.4%) present with plasma glucose 250-500 mg/dl, while hyperosmolar status (≥701 mg/dl) were present in 13 patients (6.1%). Venous pH varied from 6.7-7.42 (7.13±0.14), 132 (62.0%) patients presented with pH <7.24, while severe acidosis was pH < 7 in 32 of patients (14.6%), serum bicarbonate with 10.93±4.95, severe (<5 mmol) in 91 patients (42.7%) and moderate (5-10 mmol) were in 79 patients (37.08%). The mean length of hospital stay was 3.33 days, with an average of 2.11 days spent in the high-dependent unit. Serum potassium varied from 2.4-6.7 meq/L with 3.66± 0.63, most common complications of diabetic ketoacidosis treatment were hypokalemia observed in 82 (35.7%) of cases, and hypoglycemia was detected in 41 patients (19.2%). 170 patients were discharged in good condition (79.8%), and 17.8% of patients were transferred to another hospital to receive further management for co-morbid diseases with diabetes after controlling their hyperglycemic crises. The majority of patients presented with the critical status of diabetic ketoacidosis. The findings emphasize the importance of patient education about prevention measures prompt presentation to the hospital, and clinicians' awareness for early and aggressive treatment of hyperglycemic crises. (shrink)

The labeling of medications includes the provision of information and instructions as well as a unique identity for the medical product. It is one of the most important sources of information for patients. Good labeling practice is critical to ensuring patients' safe and effective use of products. Misreading the label, insufficient data on the label, inappropriate labeling font, writing style, and placement on the dosage form can all have disastrous consequences. The objective of this study was to assess medication labeling (...) practices among community pharmacists in Libya. A simulated client method (SCM) was used, and the study was carried out in the City of Zawia, where 146 local pharmacies were visited over three months for the investigation (January to March 2023). These visits were made at random, without the pharmacist's knowledge. The findings revealed that all dispensed drugs were not labeled, and none of the practicing pharmacists in any pharmacies visited displayed any drug label, printed or handwritten. The majority of pharmacists did not address or explain significant information to the patient in an effective manner, which led to inappropriate and harmful consumption of medications. The absence of dispensed drug labels reduces the patient's knowledge of the necessary information about the medicine, resulting in a treatment deficit or unsuccessful therapy. Thus, more effort should be made by health authorities to instruct pharmacists to use and work according to international labeling standards or to establish local labeling specifications. (shrink)

Postpartum depression is a major maternal health problem after childbirth. It can start at any time within the first year after delivery and continue for several years. It is characterized by an inability to experience pleasure, anxiety symptoms, panic attacks, spontaneous crying and depressed mood. Some women with postpartum depression even have thoughts of harming their child and self-harm. This study aims to find out the status of postpartum depression and the associated factors among postnatal mothers at the first, fourth (...) and sixth month. This study is a prospective descriptive study, carried out in three major health facilities in Misurata. This study consists of a three-part questionnaire. Part 1 covers the demographic characteristics of the participants, while Part 2 explores the associated risk factors according to the variables used. Part 3 consists of the psychological evaluation of the participants. A hundred mothers (ages between 15 and 43 years) were enrolled in this study. The findings revealed that the prevalence of depression is 60.0% and 22.0% are suffering from borderline depression. Development of depression was strongly correlated with sleeping disturbances, the state of the neonate after birth, excess consumption of stimulants, less weight acceptance by mothers during pregnancy and infant illness. There was a weak relation between depression and delivery state, maternal admission to the hospital during the current pregnancy, and infant gender dissatisfaction. No correlation was found with the development of depression regarding miscarriage, maternal medical problems after delivery, previous child sex, maternal age, education, parity or neonate weight. Thus, this study shows that the chance of having a miscarriage and an unhealthy neonate increases with advanced maternal age. It also shows that caesarean section is associated with bad neonatal outcomes, more weight gain and having gestational diabetes or preeclampsia during pregnancy. Maternal sleeping problems are more pronounced in the first month, attributed to the baby's care, compared with the fourth and sixth months. The study indicates that depression is a common state of psychiatric disorders among Libyan women and should have appropriate attention by physicians and gynecologists. (shrink)

Midazolam, a benzodiazepine medication, is used for sedation during diagnostic and therapeutic medical procedures. Insufficient doses of sedatives, including midazolam, can result in patient anxiety and awareness during the procedure. Several brands of midazolam are available in the Libyan market. This study aims to identify and estimate the medication content of intravenous midazolam in various marketed products using different analytical methods. Product identity was confirmed using Infrared methods (IR) and retention times of High-Performance Liquid Chromatographic methods (HPLC). Quantification was performed (...) using a rapid reverse-phase HPLC method. Chromatographic analysis was conducted on a C18 column (250 mm×3.3 mm I.D., 5.0 μm particle size) with a mobile phase comprising acetonitrile, methanol, and 0.065 M ammonium acetate buffer (50: 20: 30, v/v/v), adjusted to a pH of 5.5±0.02 with orthophosphoric acid, at a flow rate of 1.0 ml/min. Ultraviolet (UV) detection was set at 220 nm. The identification results met British Pharmacopeia (BP) standards. However, the midazolam content in the Tunisian brand was shallow compared to the products from Germany and Switzerland. Thus, post-marketing testing is essential to assess the quality of critical drugs like midazolam, and further investigations, including clinical evaluations and regulatory follow-up, are necessary. (shrink)

School administrators are mandated to take the instructional leadership roles. On this premise, a study assessed the extent of instructional leadership practices of public elementary school administrators in El Salvador City Division, Philippines. Also, it explored their actual practices, challenges encountered, and the ways they overcome the challenges in practicing instructional leadership. It employed a mixed-method research design. It administered the adopted assessment tool on instructional leadership to 15 school administrators and 12 of them were involved in the individual interviews. (...) This was conducted between the last quarter of 2019 and the first quarter of 2020. Descriptive statistics were used to describe the extent of instructional leadership practices. Also, it analyzed the actual practices, the challenges encountered, and the ways of overcoming these challenges using thematic narrative analysis. Results revealed that public school administrators have always practiced the four domains or strands of instructional leadership to a very high extent. Providing the technical assistance, conducting clinical supervision, and innovating teaching and learning emerged as themes of their actual practices. These administrators had encountered challenges in dealing with teachers’ attitudes, conflicting schedules and activities, and teachers’ resistance to changes. They overcome the challenges by trying to meet the competency standards, adapting and modifying the existing programs, contextualizing teaching and learning, and inculcating the value and benefits of class observation. Looking at the findings from the lens of deliberate practice theory, it was concluded that school administrators have indicated they have acquired knowledge and a high level of understanding of their instructional leadership roles. But despite of this, they still met challenges and have tried their best to manage them. This study presented some doable and practical recommendations to the Department of Education (DepEd) and concerned offices which may benefit both the internal and external stakeholders of the schools. (shrink)

Postpartum depression is a major maternal health problem after childbirth. It can start at any time within the first year after delivery and continue for several years. It is characterized by an inability to experience pleasure, anxiety symptoms, panic attacks, spontaneous crying and depressed mood. Some women with postpartum depression even have thoughts of harming their child and self-harm. This study aims to find out the status of postpartum depression and the associated factors among postnatal mothers at the first, fourth (...) and sixth month. This study is a prospective descriptive study, carried out in three major health facilities in Misurata. This study consists of a three-part questionnaire. Part 1 covers the demographic characteristics of the participants, while Part 2 explores the associated risk factors according to the variables used. Part 3 consists of the psychological evaluation of the participants. A hundred mothers (ages between 15 and 43 years) were enrolled in this study. The findings revealed that the prevalence of depression is 60.0% and 22.0% are suffering from borderline depression. Development of depression was strongly correlated with sleeping disturbances, the state of the neonate after birth, excess consumption of stimulants, less weight acceptance by mothers during pregnancy and infant illness. There was a weak relation between depression and delivery state, maternal admission to the hospital during the current pregnancy, and infant gender dissatisfaction. No correlation was found with the development of depression regarding miscarriage, maternal medical problems after delivery, previous child sex, maternal age, education, parity or neonate weight. Thus, this study shows that the chance of having a miscarriage and an unhealthy neonate increases with advanced maternal age. It also shows that caesarean section is associated with bad neonatal outcomes, more weight gain and having gestational diabetes or preeclampsia during pregnancy. Maternal sleeping problems are more pronounced in the first month, attributed to the baby's care, compared with the fourth and sixth months. The study indicates that depression is a common state of psychiatric disorders among Libyan women and should have appropriate attention by physicians and gynecologists. (shrink)

Editors' introduction to 3rd thematic issue on philosophy of medicine.

Scientisationisagrowingtrendasindividualsworldwideharnessscientific tools and knowledge to solve problems. This phenomenon is evident in biomedical research, which has increased across sub-Saharan Africa, and when encountering bioethical issues arising during the course of such research. This research synthesis considers how the constructs of culture, actors, and resources in the region shape undergraduate bioethics education. Using a lens of sociological neo-institutionalism, taken-for-granted bioethical scripts, like informed consent and medical confidentiality, are evident in this education; however, actual implementation demonstrates the way they are often adapted (...) and contextualised, with implications for students and instructors, and ultimately patients and research participants. The education considered is that for undergraduates in health sciences and medicine because they are prominent actors in research and clinical practice across the region. In considering insights from this literature, the aim is to positively impact health across sub-Saharan Africa. (shrink)

Introduction: The purpose of this study was to assess dental care professionals' drug prescription knowledge, practices, and reporting of adverse drug reactions (ADRs). -/- Methods: A cross-sectional exploratory study was conducted by using a face-to-face survey administered to a sample of dentists from tertiary care hospitals in Adana, Türkiye. A questionnaire consisted of six sections with closed-ended items including sociodemographic characteristics, knowledge about drugs, patient history information, counseling practices during prescribing, source of information and ADR reporting. -/- Results: The study (...) included 180 dentists, with a 95.3% response rate. More than half of the dentists (50.6%) stated their level of knowledge about drug price/cost as low. Most of the dentists (50.6%;n=91) claimed that they never/rarely asked about health insurance during patient history information. Moreover, most of the participants reported that they never/rarely and sometimes counsel the patients regarding drug mechanism of action, side effects of the drug, interaction of prescribed drug with other drugs/nutrients. It was determined that the dentists learned about the drugs from Vademecum (Turkish Medication Guidebook: 70%;n=126) and the internet (55%;n=99). A higher proportion (85.5%) of the dentists indicated that they did not report ADR during their clinical practice. -/- Conclusion: This study showed a general improvement in dentists prescribing knowledge and practices, although they reported some lack of knowledge regarding drug cost, discussion about the possible side effect of a drug/interaction with other drugs/nutrients with patients and under-reporting of ADRs. Periodic education and training for dentists are critical to overcoming any problem related to prescribing errors and potential ADRs. (shrink)

The objective of this article is to shed light on some challenging questions regarding public health and medical ethics that the Turkish healthcare system has recently been forced to confront. In recent years, terrorists in eastern Turkey have launched increasingly destructive attacks, including numerous attempts to undermine the social order by targeting not only government agencies but also the healthcare system. In this study, 54 terrorist incidents specifically targeting the Turkish healthcare system and healthcare professionals were analyzed and divided into (...) 6 categories according to the type of attack. Each category was evaluated in terms of the relevant ethical issues, with regard to both public health and medical ethics. This study shows that terrorist activity may lead to numerous breaches of public health and clinical ethics rules. Therefore, healthcare policy must involve special precautions to minimize breaches of public health and medical ethics in the face of terrorist attacks. (shrink)

Clinical practice is a part of the integral learning method in nursing education. The use of information and communication technologies (ICT) in clinical learning is highly encouraged among nursing students to support evidence-based nursing and student-centered learning. Through the information-processing lens of the mindsponge theory, this study views performance expectancy (or perceived usefulness) and effort expectancy (or perceived ease of use) as results of subjective benefit and cost judgments determining the students’ ICT using intention for supporting clinical (...) learning, respectively. Therefore, the study examines whether effort expectancy moderates the relationship between performance expectancy and the intention to use ICT among Moroccan nursing students. The Bayesian Mindsponge Framework (BMF) analytics was employed on a dataset of 702 Moroccan nursing students. We found that nursing students’ performance expectancy is positively associated with the intention to adopt ICT and social media, while effort expectancy positively moderates this relationship. Moreover, the model with effort expectancy as the moderator was discovered to have a significantly larger weight than the model with effort expectancy as the direct predictor, validating our information-processing reasoning. This study provides a new perspective on the interplay between the benefit and cost perceptions of ICT use to support clinical learning methods in nursing education. Moreover, given the limited education resources, especially in developing countries like Morocco, we recommend nursing education and training prioritize communicating the benefits of ICTs and social media over ease of use. Doing so would help improve the effectiveness and efficiency of nursing education and training while lowering costs. (shrink)

Mathematicians often describe the importance of well-developed intuition to productive research and successful learning. But neither education researchers nor philosophers interested in epistemic dimensions of mathematical practice have yet given the topic the sustained attention it deserves. The trouble is partly that intuition in the relevant sense lacks a usefully clear characterization, so we begin by offering one: mature intuition, we say, is the capacity for fast, fluent, reliable and insightful inference with respect to some subject matter. We illustrate the (...) role of mature intuition in mathematical practice with an assortment of examples, including data from a sequence of clinical interviews in which a student improves upon initially misleading covariational intuitions. Finally, we show how the study of intuition can yield insights for philosophers and education theorists. First, it contributes to a longstanding debate in epistemology by undermining epistemicism, the view that an agent’s degree of objectual understanding is determined exclusively by their knowledge, beliefs and credences. We argue on the contrary that intuition can contribute directly and independently to understanding. Second, we identify potential pedagogical avenues towards the development of mature intuition, highlighting strategies including adding imagery, developing associations, establishing confidence and generalizing concepts. (shrink)

Purpose: The objective of this study is to determine the importance of supplementary medical ethics course for resident physicians. In this study, we assessed the current state of their knowledge of medical ethics and aimed to improve and deepen their understanding of clinical scenarios to increase their awareness of the link between the practice of medicine and ethical issues. Methods: The course was held for groups of 10-12 people for 3 days a week for a total of 6 hours. (...) Tests given prior to and following completion of the course were used to assess the effectiveness of a medical ethics training course in which 120 resident physicians completed. The evaluation was made on the basis of the same pre-and post-tests (14 scenarios) and direct observation of participants. Result and Discussion: The average age was 28.23 ± 4.08 and 25% were female and 75% were male. Of the participants, 68.3% were training to be internists, 24.2% were training to be surgeons, and 7.5% were training in laboratory medicine. There was a significant statistical difference between the mean total scores of both tests (p=0.00). After completing the course, residents took into account the medical ethical principles while discussing ethical decisions. Conclusion: After finishing the course, participants defended their responses in regard to issues of medical ethics more carefully and articulated their thoughts more clearly. Our experience demonstrated that the trainees benefited from a structured curriculum in medical ethics. We believe that the development and implementation of our course may serve as a case study for training resident physicians in medical ethics. (shrink)

Thirty years after the rise of the evidence-based medicine (EBM) movement, formal training in philosophy remains poorly represented among medical students and their educators. In this paper, I argue that EBM’s reception in this context has resulted in a privileging of empiricism over rationalism in clinical reasoning with unintended consequences for medical practice. After a limited review of the history of medical epistemology, I argue that a solution to this problem can be found in the method of the 2nd-century (...) Roman physician Galen, who brought empiricism and rationalism together in a synthesis anticipating the scientific method. Next, I review several of the problems that have been identified as resulting from a staunch commitment to empiricism in medical practice. Finally, I conclude that greater epistemological awareness in the medical community would precipitate a Galenic shift toward a more epistemically balanced, scientific approach to clinical research. (shrink)

Innovative practice occurs when a clinician provides something new, untested, or nonstandard to a patient in the course of clinical care, rather than as part of a research study. Commentators have noted that patients engaged in innovative practice are at significant risk of suffering harm, exploitation, or autonomy violations. By creating a pathway for harmful or nonbeneficial interventions to spread within medical practice without being subjected to rigorous scientific evaluation, innovative practice poses similar risks to the wider community of (...) patients and society as a whole. Given these concerns, how should we control and oversee innovative practice, and in particular, how should we coordinate innovative practice and clinical research? In this article, I argue that an ethical approach to overseeing innovative practice must encourage the early transition to rigorous clinical research without delaying or deferring the development of beneficial innovations or violating the autonomy rights of clinicians and their patients. (shrink)

The dissertation, comprising a clinical intervention and three supporting studies, aimed to assess if it is possible to prevent nonsynostotic plagiocephaly while promoting safe infant sleeping practices. Five individuals were trained to assess cranial asymmetry and then reliability-tested; the interpreted results indicate substantial strength of rater-agreement. Intervention participants were allocated to group. Only intervention group nurses participated in the continuing education on plagiocephaly developed for nurses. A survey compared information intervention and control group parents received from nurses; intervention group (...) parents were significantly more aware of recommendations than the controls. Nurse education was evaluated by asking intervention and control group nurses and parents two open-ended questions; the intervention group reported new re-positioning strategies. The effect of the intervention on cranial shape was evaluated by assessing asymmetry at 2, 4, and 12 months (176 intervention group; 92 controls). It was nine times more common that cranial asymmetry at two months reversed by four months when parents were aware of written recommendations from their nurse (OR = 9.09 [0.02; 0.48], p = 0.004) when adjusted for group. An infant’s risk of asymmetry persisting until 12 months was significantly reduced in the intervention group (RR = 0.35 [0.13; 0.94], p = 0.03). Preventing brachycephaly was difficult. Conclusions: the assessors were considered reliable; educating nurses promoted the integration of new recommendations in practice; the intervention was associated with early reversal of nonsynostotic plagiocephaly. (shrink)

The evidence-based medicine (EBM) movement is touted as a new paradigm in medical education and practice, a description that carries with it an enthusiasm for science that has not been seen since logical positivism flourished (circa 1920–1950). At the same time, the term ‘‘evidence-based medicine’’ has a ring of obviousness to it, as few physicians, one suspects, would claim that they do not attempt to base their clinical decision-making on available evidence. However, the apparent obviousness of EBM can and (...) should be challenged on the grounds of how ‘evidence’ has been problematised in the philosophy of science. EBM enthusiasm, it follows, ought to be tempered. The post-positivist, feminist, and phenomenological philosophies of science that are examined in this paper contest the seemingly unproblematic nature of evidence that underlies EBM by emphasizing different features of the social nature of science. The appeal to the authority of evidence that characterizes evidence-based practices does not increase objectivity but rather obscures the subjective elements that inescapably enter all forms of human inquiry. The seeming common sense of EBM only occurs because of its assumed removal from the social context of medical practice. In the current age where the institutional power of medicine is suspect, a model that represents biomedicine as politically disinterested or merely scientific should give pause. (shrink)

In our article, Where the ethical action is, we argue that medical and ethical modes of thought are not different in kind but merely different aspects of a clinical situation. In response, Emmerich argues that in so doing, we neglect several important features of healthcare and medical education. Although we applaud the spirit of Emmerich’s response, we argue that his critique is an attempt at a general defence of the value of bioethical expertise in clinical practice, rather than (...) a specific critique of our account. (shrink)

In this article I propose to reframe debates about ideals of emotion in medicine, abandoning the current binary setup of this debate as one between ‘clinical detachment’ and empathy. Inspired by observations from my own field work and drawing on Sky Gross’ anthropological work on rituals of practice as well as Henri Lefebvre’s notion of rhythm, I propose that the normative drive of clinical practice can be better understood through the notion of attunement. In this framework individual types (...) of emotions are not, as such, appropriate or inappropriate, but are evaluated depending on their synchronicity with the specific rhythms of the practice. To set up this proposal, I show how typical arguments about emotions in medicine—what I call emotion-entity focused frameworks—are insufficient. I then draw on ethnographic observations from two orthopaedic departments and interviews with medical practitioners to show (1) how clinical practice is driven by rhythmicity, shaped in the case of orthopaedic surgery by a clinical aim of efficient, controlled intervention, and (2) how clinicians continuously refer to this drive and the flow of rhythms when evaluating inappropriate or problematic emotion. I argue that the use of a rhythm framework rather than ideals of detachment or empathy allows for a sensitivity to the complexity and situation-dependent elements of emotional ideals in clinical practice; and I end by proposing the term ‘attuned concern’—which stresses the importance of regulation and adjustment to circumstances rather than of maintaining a constant distance/involvement—as a more fitting alternative to ‘clinical detachment’. (shrink)

The National Center for Biomedical Ontology is now in its seventh year. The goals of this National Center for Biomedical Computing are to: create and maintain a repository of biomedical ontologies and terminologies; build tools and web services to enable the use of ontologies and terminologies in clinical and translational research; educate their trainees and the scientific community broadly about biomedical ontology and ontology-based technology and best practices; and collaborate with a variety of groups who develop and use ontologies (...) and terminologies in biomedicine. The centerpiece of the National Center for Biomedical Ontology is a web-based resource known as BioPortal. BioPortal makes available for research in computationally useful forms more than 270 of the world's biomedical ontologies and terminologies, and supports a wide range of web services that enable investigators to use the ontologies to annotate and retrieve data, to generate value sets and special-purpose lexicons, and to perform advanced analytics on a wide range of biomedical data. (shrink)

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how clinicians (...) use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

The historical relationship between health care professionals and people with disabilities is fraught, a fact all the more troubling in light of the distinctive roles clinicians play in both establishing and responding to that which is considered normal or abnormal by society at large. Those who wish to improve their clinical practice might struggle, however, to keep up with developments across numerous disability communities as well as the ever-growing body of disability studies scholarship. To assist with this goal, I (...) offer an overview of recent disability theory, outline a set of responsibilities clinicians have to disability communities, and provide recommendations for clinicians who hope to justly treat patients with disabilities and improve their care and health outcomes. (shrink)

Introduction: Clinical practice guidelines (CPGs) are an important source of justification for clinical decisions in modern evidence-based practice. Yet, we have given little attention to how they argue their evidence. In particular, how do CPGs argue for treatment with long-term medications that are increasingly prescribed to older patients? Approach and rationale: I selected six disease-specific guidelines recommending treatment with five of the medication classes most commonly prescribed for seniors in Ontario, Canada. I considered the stated aims of these (...) CPGs and the techniques employed towards those aims. Finally, I reconstructed and logically analysed the arguments supporting recommendations for pharmacotherapy. Analysis: The primary function of CPGs is rhetorical, or persuasive, and their means of persuasion include both a display of their credibility and their argumentation. Arguments supporting pharmacotherapy recommendations for the target population follow a common inductive pattern: statistical generalization from randomized controlled trial (RCT) and meta-analysis evidence. Two of the CPGs also argue their treatment recommendations for older patients in this style, while three fail to justify pharmacotherapy specifically for the older population. Discussion: The arguments analysed lack the auxiliary assumptions that would warrant making a generalization about the clinical effectiveness of medications for the older population. Guidelines reason using simple induction, while ignoring important inferential gaps. Future guidelines should aspire to be well-reasoned rather than simply evidence-based; argue from a plurality of evidence; be wary of hasty inductions; appropriately limit the scope of their recommendations; and avoid making law-like, prescriptive generalizations. (shrink)

Tourism education plays a key role in shaping students’ engagement with sustainability by providing them with the knowledge and skills to address environmental challenges and encouraging them to promote sustainable practices in the industry. This study explores how four years of tourism education at Prince of Songkla University in Phuket, Thailand, influence students’ knowledge, attitudes, and intentions toward sustainability. Despite gaining theoretical knowledge of sustainability principles, the findings reveal a decline in students’ willingness to adopt environmental sustainability practices as their (...) years of education increase. This may reflect a disconnect between classroom lessons and practical application, potentially due to limited practical learning experiences and the prevalent “eco-deficit culture” within the tourism industry, which often prioritizes profit over environmental responsibility. As a result, students may filter out information regarding environmental sustainability despite their sustainability education at the university. To support long-term engagement in sustainability, the paper recommends revising curricula to include more experiential learning opportunities, interdisciplinary collaboration, and stronger partnerships with industry stakeholders. (shrink)

Supervision of teachers is essential for ensuring effective educational practices, fostering professional development, and achieving student success. The study determined the relationship of program heads' supervisory practices to the teachers’ teaching efficacy. It was conducted in a community college in Tangub City, Misamis Occidental. The descriptive-correlational design was used in the study. There were 146 faculty and 361 students who served as the respondents selected through a stratified random sampling technique. The adapted Program Heads’ Supervisory Practices and researcher-made Teachers’ Teaching (...) Efficacy Questionnaires were used as research instruments. Mean, Standard Deviation, and Pearson Product-Moment Correlation Coefficient were used as statistical tools to analyze the data gathered. Results revealed that the program heads were good in their supervisory practices. The teachers’ teaching efficacy was very high. The program heads’ supervisory practices did not influence the teacher’s teaching efficacy. The strategies employed by program heads in their supervisory roles do not always translate into improved teaching efficiency. The study's findings indicate that program heads need to adopt more responsive and tailored supervisory practices that directly address the specific needs of teachers to enhance teaching efficacy. This may involve integrating targeted professional development focused on practical classroom strategies and fostering peer collaboration to share best practices. Program heads may prioritize open communication and continuous feedback mechanisms to better align their supervisory approaches with the realities of classroom instruction, ensuring that support translates into improved teaching efficiency. (shrink)

This paper seeks to show how MacIntyre’s concept of a practice can survive a series of ‘scope problems’ which threaten to render the concept inapplicable to business ethics. I begin by outlining MacIntyre’s concept of a practice before arguing that, despite an asymmetry between productive and non-productive practices, the elasticity of the concept of a practice allows us to accommodate productive and profitable activities. This elasticity of practices allows us to sidestep the problem of adjudicating between practitioners and non-practitioners as (...) well as the problem of generic activities. I conclude by suggesting that the contemporary tendency to regard work as an object of consumption, rather than undermining MacIntyre’s account of practices, serves to demonstrate the potential breadth of its applicability. (shrink)

Regarding the appropriateness of deception in clinical practice, two (apparently conflicting) claims are often emphasised. First, that ‘clinicians should not deceive their patients.’ Second, that deception is sometimes ‘in a patient’s best interest.’ Recently, Hardman has worked towards resolving this conflict by exploring ways in which deceptive and non-deceptive practices extend beyond consideration of patients’ beliefs. In short, some practices only seem deceptive because of the (common) assumption that non-deceptive care is solely aimed at fostering true beliefs. Non-deceptive care, (...) however, relates to patients’ non-doxastic attitudes in important ways as well. As such, Hardman suggests that by focusing on belief alone, we sometimes misidentify non-deceptive care as ‘deceptive’. Further, once we consider patients’ beliefs and non-doxastic attitudes, identifying cases of deception becomes more difficult than it may seem. In this essay, I argue that Hardman’s reasoning contains at least three serious flaws. First, his account of deception is underdeveloped, as it does not state whether deception must be intentional. The problem is that if intention is not required, absurd results follow. Alternatively, if intention is required, then identifying cases of deception will be much easier (in principle) than Hardman suggests. Second, Hardman mischaracterises the ‘inverse’ of deceptive care. Doing so leads to the mistaken conclusion that common conceptions of non-deceptive care are unjustifiably narrow. Third, Hardman fails to adequately separate questions about deception from questions about normativity. By addressing these issues, however, we can preserve some of Hardman’s most important insights, although in a much simpler, more principled way. (shrink)

A safe and secure environment is an essential part of the early childhood development of any child. This study aims to investigate the safety and protection practices of early childhood centers in the Anambra state, Nigeria, and to determine if any improvements can be made to them. This study analyzed data collected from 60 Early Childhood Care Centers (ECCE Centers) and 60 Pre-Primary Schools (Preprimary School) in Anambra State using the Evaluation of ECCE Implementation Kit (KEIEP), direct observation, and unstructured (...) interviews, all of which were conducted using the evaluation tool. Using descriptive statistics, chi-squares, and student t-statistics, the data were analyzed. According to the results of this study, 28.0% of the private ECCE centers were in compliance with the requirements for enough space for children to play, fenced facilities, a standard first aid box, a splint bandage and an antiseptic. It is important to note that the majority of public early childhood education centers (62.0%) comply with the requirements for fencing, a first aid box, splint bandages, cotton wool, antiseptic, scissors, methylated spirit, liniment, analgesics, and thermometers, whereas 31% of those centers do not have the remaining seven practices. A conclusion of the study was that both private and public ECCE centers in Anambra State comply with the safety and protection provisions and practices in place. (shrink)

Many students consider mathematics as the most dreaded subject in their curriculum, so much so that the term “math phobia” or “math anxiety” is practically a part of clinical psychological literature. This symptom is widespread and students suffer mental disturbances when facing mathematical activity because understanding mathematics is a great task for them. This paper described the students’ cognitive skills performance in Basic Mathematics based on the following logical operations: Classification, Seriation, Logical Multiplication, Compensation, Ratio and Proportional Thinking, Probability (...) Thinking and Correlation Thinking as it serves a critical element of teaching and learning, that is determining the current position of the learners’ mathematical capacity. Its implications for mathematics education were also revealed. A descriptive quantitative design was used in this study. The study included 1011 first-year college students from six state universities in the Philippines who were enrolled in the Bachelor of Science of Secondary Education Program during the first semester of the Academic Year 2019-2020. This study made use of the teacher-made test called the Test on Logical Operations. Findings revealed that the cognitive skills achievement of the first year BSE students from different state universities in the Philippines falls under the category of late concrete operational stage. As a result, students are unable to perform the logical operational skills expected of their age. At their age level, they are expected to be under the formal operational stage based on Piaget’s stages of cognitive development. These findings revealed a weak mathematical education foundation among students which requires immediate attention. This reality should be recognized by educational planners and implementers when making curricular and other instructional decisions. (shrink)

Rationale and objectives: Medical humanities are becoming increasingly recognized as positively impacting medical education and medical practice. However, the extent of medical humanities teaching in medical schools is largely unknown. We reviewed medical school curricula in Canada, the UK and the US. We also explored the relationship between medical school ranking and the inclusion of medical humanities in the curricula. -/- Methods: We searched the curriculum websites of all accredited medical schools in Canada, the UK and the US to check (...) which medical humanities topics were taught, and whether they were mandatory or optional. We then noted rankings both by Times Higher Education and U.S. News and World Report and calculated the average rank. We formally explored whether there was an association between average medical school ranking and medical humanities offerings using Spearman's correlation and inverse variance weighting meta-analysis. -/- Results: We identified 18 accredited medical school programmes in Canada, 41 in the UK, and 154 in the US. Of these, nine (56%) in Canada, 34 (73%) in the UK and 124 (80%) in the US offered at least one medical humanity that was not ethics. The most common medical humanities were medical humanities (unspecified), history, and literature (Canada); sociology and social medicine, medical humanities (unspecified), and art (UK); and medical humanities (unspecified), literature and history (US). Higher ranked medical schools appeared less likely to offer medical humanities. -/- Conclusions: The extent and content of medical humanities offerings at accredited medical schools in Canada, the UK and the US varies, and there appears to be an inverse relationship between medical school quality and medical humanities offerings. Our analysis was limited by the data provided on the Universities' websites. Given the potential for medical humanities to improve medical education and medical practice, opportunities to reduce this variation should be exploited. (shrink)

The philosophies of education serve as the guide of the teachers in handling the teaching-learning process. However, a belief will remain as a belief unless it is practiced. This study aimed to find the relationship between the philosophical beliefs and practices of the 30 teachers of the schools in San Roque, Mabini, Bohol - San Roque Elementary School and San Roque National High School, S.Y. 2019-2020. The study utilized a quantitative method descriptive survey research design. The research instrument used was (...) a self-constructed questionnaire in which the reliability was tested by a Cronbach’s Alpha using Statistical Package for the Social Science (SPSS) software. Simple percentage and weighted mean were some of the statistical treatments used. Kendall’s tau_b, a non-parametric test, was used to determine the correlation between philosophical beliefs and their equivalent pedagogical practices. All of the statistical treatments were also run using the SPSS software. Further, the researcher assured the proper observation of the research ethics protocol. Based on the results, the philosophies of Progressivism (3.63) and Perennialism (3.31) were the most and least prevailing philosophical beliefs, respectively. On the other hand, the most and least prevailing philosophies practiced are Progressivism (3.69) and Essentialism (3.19), respectively. Moreover, research findings revealed that there was a significant relationship between the philosophical beliefs of teachers and their pedagogical practices. In conclusion, this study claims that teachers’ pedagogical practices are dependent to their philosophical beliefs; and as the teachers believed on a particular philosophy of education, they practice it accordingly to the extent of their adherence to the belief. (shrink)

The relationship between space and human occurs through the actions performed with the body. The abstraction study as an exploration of the body is one of the significant practices for first-year design students. However, there are not enough investigations for design students regarding body, space and basic design principles. This paper aims to explore the potentiality and limitations of the body-abstraction process by comparing the impact of two different educational models on students' perception and improvement. The applied methodology includes comparing (...) two design processes of the basic design course depending on parameters: Given example, source of the video, type of movement, the number of the selected-used scenes, mode of sketching, the method for production, requested outcome, the scale of the study, the material of models and critique of the video. The results present that the activation of the body through mental practice, drawing and modelling stages is critical to understand its abstract and spatial capabilities. The realisation of the potentials in the relationship between body and abstraction in spatial perception would enable us to create an advanced design process addressing more original concepts. (shrink)

Background/purpose – This study analyzed the contribution of three mentorship practices relatively and cumulatively to the research productivity of early-career academics in the field of educational psychology in universities. The study was conducted in the South- South region of Nigeria. -/- Materials/methods – The research method adopted was the quantitative approach, following the ex-post facto research design. The study’s population covered 723 early-career researchers (ECRs) in educational psychology distributed across 19 universities located in South-South Nigeria. The “Mentorship Practices and Research (...) Productivity Questionnaire” (MPRPQ) was the instrument used for data collection. The questionnaire was designed by the researchers and then validated by three experts. Reliability analysis was performed using the Cronbach approach with estimates of .80, .79, .87, and .91 obtained for the four clusters. Primary data were collected from the field after copies of the instrument had been administered to respondents. -/- Results – Mentorship practices were generally revealed to significantly contribute to the research productivity of ECRs in educational psychology in universities. Specifically, the adoption of cloning and apprenticeship approaches to mentorship contributed substantially to the ECRs’ research productivity. However, the study highlighted that nurturing contributed only negligibly to the ECRs’ research productivity. -/- Conclusion – Mentorship practices are important determinants to the research productivity of early-career educational psychologists. In order to boost the productive research capacities of ECRs, there is a need for institutions to strengthen their mentorship practices. (shrink)