Transforming the wellbeing focus in education: A document analysis of policy in Aotearoa New Zealand.

Purpose: Understanding the nature of wellbeing as multidimensional and complex provides a policy window to generate a strengths-based policy orientation to promote wellbeing in education settings. The purpose of this exploratory paper is to map how wellbeing is interpreted across public education policy documents in Aotearoa New Zealand. Method: To explore the narrative that this group of documents weave, we draw on models of holistic wellbeing, ecological systems and appreciative inquiry. Policy documents were analysed using text mining software to track notions of wellbeing; their occurrence and co-occurrence with related concepts. Results: Key findings include the predominance of wellbeing, the interrelatedness of wellbeing with relationships, and the predominance of student wellbeing over the wellbeing of other stakeholders, highlighting that current education policy does not interpret wellbeing as relational, complex or contextual. Conclusion: We argue that interpreting such documents through a wellbeing lens demonstrates the complexity and disparity of the conceptualization and contextualization. We assert that it is critical to explore possibilities for deliberate and ecological wellbeing connections within educational policy and practice for the good of all stakeholders.

Accuracy of acupuncture point location among first-year acupuncture students: A pilot study evaluating the impact of training and use of an adjustable ruler.

BACKGROUND: The proportional method of acupuncture point location (APL) currently taught at Endeavor College of Natural Health and advocated by the World Health Organization Regional Office for the Western Pacific (WPRO) was found to be imprecise and/or inaccurate in previous student studies. The ruler and elastic methods of APL were identified as more accurate or precise than the proportional method of APL but were not well received by student participants. Use of an adjustable ruler may overcome barriers to uptake of the more accurate APL methods. This pilot study was the first to evaluate the comparative accuracy of the adjustable ruler and the proportional methods of APL in first-year students at a major Australian acupuncture training college. METHODS: After 10 weeks of in-class instruction in both proportional and adjustable ruler methods of APL, student participants (n = 14) attempted location of three acupuncture points (LI10, SP6 and ST38) on a volunteer using both APL methods of interest. A self-administered questionnaire and lecturer field notes elucidated attitudes to implementation of both APL methods. RESULTS: Points marked using the adjustable ruler were closer to the correct location than those marked using the proportional method across all three acupuncture points. Students and lecturers rated the adjustable ruler more highly than the proportional method for ease of learning and ease of use. CONCLUSION: Encouraging results with the adjustable ruler method warrant further larger scale studies. Use of the adjustable ruler method of APL should be considered for use in point location training at educational institutions teaching traditional acupuncture.

Mindfulness Workshops Effects on Nurses' Burnout, Stress, and Mindfulness Skills.

Burnout decreases work performance and quality of care and can result in medical errors, lower patient satisfaction, and higher rates of turnover. A study of 68 000 registered nurses showed that 35% of hospital nurses were experiencing symptoms of burnout. A systematic review identified that mindfulness-based interventions for health care professionals reduced stress and burnout and increased self-compassion and general health. However, the authors determined that more high-quality research is needed. This study examined the impact of a 4-hour workshop on burnout syndrome, perceived stress, and mindfulness skills. The objective of this study was to determine whether a 4-hour mindfulness workshop was effective in reducing burnout and perceived levels of stress and increasing mindfulness. Nurses at a Midwest academic medical center were recruited through e-mail to attend a 4-hour mindfulness workshop. Participants completed the Maslach Burnout Inventory-Human Service Survey, Perceived Stress Scale, and Cognitive and Affective Mindfulness Scale-Revised prior to the start of the workshop and 1 and 6 months after the workshop. The study design allowed for comparisons preintervention and postintervention. Of the 52 nurses who completed the baseline questionnaires, 94% were female with an average age of 38 years. Thirty-one percent completed the questionnaires at 1 month and 20 nurses at 6 months. At 1 month, nurses reported statistically significant decreased perceptions of stress (-2.31, P = .01) and emotional exhaustion (-4.78, P = .03). Mindfulness skills, personal accomplishment, and depersonalization improved but were not statistically significant. At 6 months, statistically significant findings included increased perceptions of mindfulness (2.50, P = .04), personal accomplishment (4.43, P = .04), and decreased emotional exhaustion (-6.21, P = .05). Perceptions of stress and depersonalization improved but were not statistically significant. In this study, nurses reported decreases in burnout and perceived stress and increases in mindfulness after attending a 4-hour mindfulness workshop. Further research is needed to determine the long-term impact of mindfulness-based training on nurses' burnout, stress, and mindfulness skills. The results of this study add to the body of literature that supports the benefits of mindfulness-based interventions.

Expert Opinions on Web-Based Peer Education Interventions for Youth Sexual Health Promotion: Qualitative Study.

BACKGROUND: Participatory education, in the form of peer education, may be an effective way to promote youth sexual health. With the advent of the internet, web-based interventions have potential as an attractive new tool for sexual health promotion by peers. OBJECTIVE: The aim of this study was to evaluate professional experts' opinions on the perspectives for web-based participatory interventions to promote sexual health by peers and among young people. METHODS: Semistructured interviews were carried out with 20 experts (stakeholders in direct contact with young people, researchers, and institutional actors) specializing in sexual health, health promotion, peer education, youth, internet, and social media. After coding with N'Vivo, data were subjected to qualitative thematic analysis. RESULTS: The majority of experts (18/20, 90%) found this kind of intervention to be attractive, but highlighted the necessary conditions, risks, and limitations attached to developing an acceptable peer intervention on the internet for sexual health promotion among young people. Five main themes were identified: (1) an internet intervention; (2) sexual health; (3) internet skills, and uses and the need for moderation; (4) multifaceted peers; and (5) minority peers. In the absence of youth interest for institutional messages, the experts highlighted the attractive participatory features of web-based interventions and the need for geolocalized resources. However, they also warned of the limitations associated with the possibility of integrating peers into education: peers should not be mere messengers, and should remain peers so as not to be outsiders to the target group. Experts highlighted concrete proposals to design an online participatory peer intervention, including the process of peer implication, online features in the intervention, and key points for conception and evaluation. CONCLUSIONS: The experts agreed that web-based participatory interventions for youth sexual health promotion must be tailored to needs, uses, and preferences. This type of action requires youth involvement framed in an inclusive and holistic sexual health approach. Peer education can be implemented via the internet, but the design of the intervention also requires not being overly institutional in nature. Involving young people in their own education in an interactive, safe online space has the potential to develop their empowerment and to foster long-term positive behaviors, especially in the area of sexual health.

Workshop Report: FDA Workshop on Improving Cardiotoxicity Assessment With Human-Relevant Platforms.

Given that cardiovascular safety concerns remain the leading cause of drug attrition at the preclinical drug development stage, the National Center for Toxicological Research of the US Food and Drug Administration hosted a workshop to discuss current gaps and challenges in translating preclinical cardiovascular safety data to humans. This white paper summarizes the topics presented by speakers from academia, industry, and government intended to address the theme of improving cardiotoxicity assessment in drug development. The main conclusion is that to reduce cardiovascular safety liabilities of new therapeutic agents, there is an urgent need to integrate human-relevant platforms/approaches into drug development. Potential regulatory applications of human-derived cardiomyocytes and future directions in employing human-relevant platforms to fill the gaps and overcome barriers and challenges in preclinical cardiovascular safety assessment were discussed. This paper is intended to serve as an initial step in a public-private collaborative development program for human-relevant cardiotoxicity tools, particularly for cardiotoxicities characterized by contractile dysfunction or structural injury.

The Bell Tolls for Homeopathy: Time for Change in the Training and Practice of North American Naturopathic Physicians.

North American naturopathic medicine is a distinct form of practice that is woven into the larger fabric of integrative medicine; in a number of US states and Canadian provinces, naturopathic doctors enjoy a wide scope of practice, including the ability to make diagnoses, order tests, use medical technology, write prescription drugs, and perform minor surgeries. However, the basic premise of naturopathic medicine and its guiding principles-considering the whole person and supporting healthy lifestyle behaviors-is the unifying approach in clinical practice. In the 1970s, homeopathy-considered in many circles to be a hypothesis-driven, fringe form of alternative medicine-became embedded into the training and practice of North American naturopathic doctors. Since the earliest days of its theory (circa 1800), homeopathy has escaped, and continues to escape, biological plausibility; however, the persistence of this modality (and the insistence by both its consumers and practitioners that it provides benefit) speaks to the role of expectations, beliefs, values, agency, context effects, and the placebo-at-large. It is our contention that the progression of professional naturopathic medicine in the 21st century requires a major transition in how it approaches the subject of homeopathy. We propose that students should be encouraged to critically analyze the tenets of homeopathy, its lesser known history, and the idea of homeopathy as a biomedicine that simply awaits untold chemicophysical mechanisms. Furthermore, the modality of homeopathy should be incorporated into the larger context of placebo studies, narrative medicine, ethics, and psychotherapeutic techniques.

Health promotion programs in higher education: integrative review of the literature.

OBJECTIVE: to characterize the interventions of health promotion programs implemented in Health Promoting Universities; to analyze the results of the interventions of health promotion programs. METHOD: integrative review carried out in EBSCO, PubMed, SciELO, Scopus and Web of Science. Articles published between 2000 and 2014 were selected, with evidence of health promotion intervention programs and evaluation of results. Results: 17 articles were included. The health promotion programs aimed at increasing the welfare of students, with an emphasis on physical activity, sexual health and on improving the environment of health support within the university community. CONCLUSION: health promotion strategies in an university context do not always result from the convergence between educational, political, legislative or organizational actions that support lifestyles and conditions which are favorable to the health of individuals or groups, and that contribute to improving the physical and social environment.

Teaching Guatemalan traditional birth attendants about obstetrical emergencies.

INTRODUCTION: Guatemala's Maternal Mortality Rate is 65th highest in the world at 120 deaths per 100,000 births. Contributing to the problem is traditional birth attendants (TBAs) attend most births yet lack knowledge about obstetrical emergencies. Government trainings in existence since 1955 have not changed TBA knowledge. Government trainings are culturally insensitive because they are taught in Spanish with written material, even though most TBAs are illiterate and speak Mayan dialects. The purpose of the observational study was to evaluate the effect of an oral training, that was designed to be culturally sensitive in TBAs' native language, on TBAs' knowledge of obstetrical emergencies. METHODS: one hundred ninety-one TBAs participated. The study employed a pretest-posttest design. A checklist was used to compare TBAs' knowledge of obstetrical emergencies before and after the training. FINDINGS: the mean pretest score was 5.006±SD 0.291 compared to the mean posttest score of 8.549±SD 0.201. Change in knowledge was a P value of 0.00. DISCUSSION: results suggest an oral training that was designed to be culturally sensitive in the native language improved TBAs' knowledge of obstetrical emergencies. Future trainings should follow a similar format to meet the needs of illiterate audiences in remote settings.

Evaluation of learning from Practical Obstetric Multi-Professional Training and its impact on patient outcomes in Australia using Kirkpatrick's framework: a mixed methods study.

OBJECTIVES: The aim of this study was to evaluate the implementation of the Practical Obstetric Multi-Professional Training (PROMPT) simulation using the Kirkpatrick's framework. We explored participants' acquisition of knowledge and skills, its impact on clinical outcomes and organisational change to integrate the PROMPT programme as a credentialing tool. We also aimed to assess participants' perception of usefulness of PROMPT in their clinical practice. STUDY DESIGN: Mixed methods approach with a pre-test/post-test design. SETTING: Healthcare network providing obstetric care in Victoria, Australia. PARTICIPANTS: Medical and midwifery staff attending PROMPT between 2013 and 2015 (n=508); clinical outcomes were evaluated in two cohorts: 2011-2012 (n=15 361 births) and 2014-2015 (n=12 388 births). INTERVENTION: Attendance of the PROMPT programme, a simulation programme taught in multidisciplinary teams to facilitate teaching emergency obstetric skills. MAIN OUTCOME MEASURE: Clinical outcomes compared before and after embedding PROMPT in educational practice. SECONDARY OUTCOME MEASURE: Assessment of knowledge gained by participants through a qualitative analysis and description of process of embedding PROMPT in educational practice. RESULTS: There was a change in the management of postpartum haemorrhage by early recognition and intervention. The key learning themes described by participants were being prepared with a prior understanding of procedures and equipment, communication, leadership and learning in a safe, supportive environment. Participants reported a positive learning experience and increase in confidence in managing emergency obstetric situations through the PROMPT programme, which was perceived as a realistic demonstration of the emergencies. CONCLUSION: Participants reported an improvement of both clinical and non-technical skills highlighting principles of teamwork, communication, leadership and prioritisation in an emergency situation. An improvement was observed in management of postpartum haemorrhage, but no significant change was noted in clinical outcomes over a 2-year period after PROMPT. However, the skills acquired by medical and midwifery staff justify embedding PROMPT in educational programmes.

Strengthening the Quality and Quantity of the Nursing and Midwifery Workforce: Report on Eight Years of the NEPI Project.

In response to the urgent need to scale up access to antiretroviral therapy, the Global Nursing Education Partnership Initiative (GNCBP), a PEPFAR program administered by the U.S. Department of Health Resources and Services Administration (HRSA), was implemented from 2011 to 2018 by ICAP at Columbia University. Working closely together, HRSA and ICAP partnered with local nursing leaders and ministries of health to strengthen the nursing and midwifery workforce across 11 countries. This multi-country project, developed to address critical gaps in nursing education and training worked across six building blocks of health workforce strengthening: infrastructure improvement, curricula revision, clinical skills development, in-service training, faculty development and building partnerships for policy and regulation to increase the quality and quantity of the nursing and midwifery workforce. As a result, 13,387 nursing and midwifery students graduated from schools supported under GNCBP. A total of 5,554 nurses received critical in-service training and 4,886 faculty, clinical mentors and preceptors received training in key clinical care areas and modern teaching methodologies. ICAP completed 43 infrastructure enhancements to ensure environments conducive to learning and strengthened nursing leaders as best evidenced by the election and formation of Mozambique's first national nursing council and the NEPI Network. Going forward, efforts to strengthen nursing and midwifery can build on the results of the GNCBP project. Going forward, a new group of African nursing leaders are being supported to advocate for high quality patient-care led through inter-professional collaboration and participation in international efforts championing the critical role of nurses in achieving universal health coverage.

Health promotion programs in higher education: integrative review of the literature / Programas de promoción de la salud en la enseñanza superior: revisión integrativa de literatura / Programas de promoção da saúde no ensino superior: revisão integrativa de literatura

ABSTRACT Objective: to characterize the interventions of health promotion programs implemented in Health Promoting Universities; to analyze the results of the interventions of health promotion programs. Method: integrative review carried out in EBSCO, PubMed, SciELO, Scopus and Web of Science. Articles published between 2000 and 2014 were selected, with evidence of health promotion intervention programs and evaluation of results. Results: 17 articles were included. The health promotion programs aimed at increasing the welfare of students, with an emphasis on physical activity, sexual health and on improving the environment of health support within the university community. Conclusion: health promotion strategies in an university context do not always result from the convergence between educational, political, legislative or organizational actions that support lifestyles and conditions which are favorable to the health of individuals or groups, and that contribute to improving the physical and social environment.

RESUMEN Objetivo: caracterizar las intervenciones de los programas de promoción de la salud implementados en Universidades Promotoras de Salud; analizar los resultados de las intervenciones de los programas de promoción de la salud. Método: revisión integrativa realizada en la EBSCO, PubMed, SciELO, Scopus y Web of Science. Se seleccionaron artículos publicados entre los años 2000 y 2014, con evidencias de programas de intervención de promoción de la salud y evaluación de resultados. Resultados: se incluyeron 17 artículos. Los programas de promoción de la salud tenían el objetivo de aumentar el bienestar de los estudiantes, con énfasis en la actividad física, salud sexual y mejora del entorno de apoyo a la salud en el ámbito de la comunidad universitaria. Conclusión: las estrategias de promoción de la salud en el contexto universitario no siempre resultan de la convergencia entre acciones educativas, políticas, legislativas u organizacionales que apoyan estilos de vida e condiciones favorables a la salud de los individuos o colectividades y que contribuyen a la mejora del entorno físico y social.

RESUMO Objetivo: caraterizar as intervenções dos programas de promoção da saúde implementados em Universidades Promotoras de Saúde; analisar os resultados das intervenções dos programas de promoção da saúde. Método: revisão integrativa realizada na EBSCO, PubMed, SciELO, Scopus e Web of Science. Selecionaram-se artigos publicados entre os anos de 2000 e 2014, com evidências de programas de intervenção de promoção da saúde e avaliação de resultados. Resultados: foram incluídos 17 artigos. Os programas de promoção da saúde visavam aumentar o bem-estar dos estudantes, com ênfase na atividade física, saúde sexual e melhoria do ambiente de suporte à saúde no âmbito da comunidade universitária. Conclusão: as estratégias de promoção da saúde em contexto universitário nem sempre resultam da convergência entre ações educativas, políticas, legislativas ou organizacionais que apoiam estilos de vida e condições favoráveis à saúde dos indivíduos ou coletividades e que contribuem para melhoria do ambiente físico e social.

Enhancement of Pulmonary Tuberculosis Prevention Behavior With Role Play Among Elementary School Students.

Tuberculosis as an infectious disease is increasing in both the number of cases and severity of impact, and the number of cases among school-aged children is also increasing. Health promotion campaigns in schools have not been intensive, and there is poor behavior in tuberculosis prevention. Role play-playing roles actively with provided materials-is one health education method that can empower school-aged children to understand tuberculosis prevention. The purpose of this research is to identify the influence of role playing on tuberculosis transmission prevention in school-aged children. Study participants were 100 school-aged children. The study used quasi-experimental types of pre-test and post-test, with a control group. The t test results showed that improvement of tuberculosis prevention behaviors in the intervention group was higher than the control group (p value = .000). The role play method is recommended for health education for at least 6 sessions in school-aged children.

Physical Performance and Attrition Among U.S. Air Force Trainees Participating in the Basic Military Training Fueling Initiative.

INTRODUCTION: Dietary intake of military initial entry trainees is often inadequate because of the structured food environment, lack of snacking, and limited time for meals. Inadequate intake during training increases risk for injury, poor performance, and attrition from training. A performance nutrition initiative was implemented at Joint Base San Antonio Lackland to mitigate this inadequacy in Air Force trainees and better reflect recommendations for active populations and mitigate nutritional inadequacy. MATERIALS AND METHODS: Trainees (N = 867) in two squadrons either received a nutrition bar before bed (snack squadron n = 423) or did not (standard squadron n = 444). This study retrospectively compared trainees' attrition and fitness measures as recorded in the Basic Military Training (BMT) Surveillance database. RESULTS: Both groups had similar rates of attrition and graduation at the end of 8 weeks (p = 0.23). At the start of training, only one out of four trainees in either Squadron passed the Physical Fitness Assessment (PFA). Although both squadrons' fitness measures improved as a result of the effects of training, the snack squadron had a significantly greater percent improvement in all PFA categories (p < 0.001), as represented by improved muscular fitness measures (p < 0.001), decreased median run time (p = 0.001), and greater improvement in scaled run scores (p = 0.013) as compared to the standard squadron. Those who received the snack were 1.62 (confidence interval: 1.2-2.2) times more likely to pass the PFA at 4 weeks than those who did not receive the snack. CONCLUSION: This study shows that military trainees' fitness improves with a modest nutritional supplement and suggests that optimizing overall nutrition benefits trainees. Attrition from BMT costs the U.S. Air Force up to $22,000 per trainee lost. In contrast, a trainee could receive one nutrition bar per day during BMT for $34. As the nutrition bar initiative improves fitness as well as costs less than recruiting and medically treating trainees whom ultimately attrite from training, the snack intervention was beneficial. Future studies of strategic nutrition interventions in military training populations can help trainees to better meet their macronutrient and micronutrient needs and further optimize training performance.

Toward Preventing Post-Traumatic Stress Disorder: Development and Testing of a Pilot Predeployment Stress Inoculation Training Program.

The objective of this pilot study was to design, develop, and evaluate a predeployment stress inoculation training (PRESIT) preventive intervention to enable deploying personnel to cope better with combat-related stressors and mitigate the negative effects of trauma exposure. The PRESIT program consisted of three predeployment training modules: (1) educational materials on combat and operational stress control, (2) coping skills training involving focused and relaxation breathing exercises with biofeedback, and (3) exposure to a video multimedia stressor environment to practice knowledge and skills learned in the first two modules. Heart rate variability assessed the degree to which a subset of participants learned the coping skills. With a cluster randomized design, data from 351 Marines randomized into PRESIT and control groups were collected at predeployment and from 259 of these who responded to surveys on return from deployment. Findings showed that the PRESIT group reduced their physiological arousal through increased respiratory sinus arrhythmia during and after breathing training relative to controls. Logistic regression, corrected for clustering at the platoon level, examined group effects on post-traumatic stress disorder (PTSD) as measured by the Post-traumatic Stress Checklist after controlling for relevant covariates. Results showed that PRESIT protected against PTSD among Marines without baseline mental health problems. Although limited by a small number of participants who screened positive for PTSD, this study supports the benefits of PRESIT as a potential preventive strategy in the U.S. military personnel.

The importance of taking a religious and spiritual history.

OBJECTIVE: The objective of this study was to explain the reasons for taking a religious and spiritual history, which is often neglected by psychiatrists, and to introduce some religious and spiritual assessment tools to assist those psychiatrists who feel inexperienced in this area. CONCLUSION: Religious and spiritual assessment enhances quality of patient care. Training programs for psychiatry registrars need to include modules on religious and spiritual assessment of patients.

Neurociencia y Educación: ¿podemos ir de la investigación básica a su aplicación? Un posible marco de referencia desde la investigación en dislexia1 / Neurociencia y Educación: ¿podemos ir de la investigación básica a su aplicación? Un posible marco de referencia desde la investigación en dislexia

La neurociencia podría transformar la educación, pues proporciona nuevos métodos para comprender el aprendizaje y el desarrollo cognitivo, sus mecanismos causales y una forma empírica de evaluar la eficacia de diferentes pedagogías. No obstante, éste sería un objetivo a largo plazo. Desde la neurociencia educativa se debería empezar estudiando cómo los sistemas cognitivos se construyen sobre los sensoriales a lo largo del desarrollo. Aquí me centraré en el lenguaje. Pequeñas diferencias individuales iniciales en una función sensorial, por ejemplo la auditiva, podrían ser el origen de notables diferencias individuales en el desarrollo lingüístico. La neurociencia podría proporcionar una comprensión detallada de los mecanismos causales del desarrollo que vinculan la audición, el desarrollo fonológico y el desarrollo de la alfabetización. Este tipo de investigación neurocientífica básica podría orientar al campo de la educación y la pedagogía explorando los efectos que sobre estos mecanismos ejercen diferentes contextos pedagógicos y de aprendizaje

Neuroscience has the potential to transform education because it provides novel methods for understanding human learning and cognitive development. It therefore offers deeper understanding of causal mechanisms in learning and an empirical approach to evaluating the efficacy of different pedagogies. However, this will be a long-term enterprise and there will be few immediate pay-offs. Here I set out one possible framework for linking basic research in neuroscience to pedagogical questions in education. I suggest that the developing field of educational neuroscience must first study how sensory systems build cognitive systems over developmental time. I focus on one cognitive system, language, the efficient functioning of which is critical for reading acquisition. Small initial differences in sensory function, for example auditory function, have the potential to cause large differences in linguistic performance over the learning trajectory. The tools offered by neuroscience can enable better understanding of the causal developmental mechanisms linking audition, phonological development and literacy development, in fine-grained detail. Following this basic research, neuroscience can then inform education and pedagogy by exploring the effects on these neural mechanisms of different learning contexts and pedagogies

Healthcare lecturers' perceptions of spirituality in education.

AIM: The aim of this research was to identify healthcare teaching staff's understanding of spirituality, how their understanding may shape teaching practice and how this may contribute to the documented issues around incorporating spirituality into patient assessment and care. METHOD: A mixed-method, small-scale explorative online survey was used. FINDINGS: Several perceptions and practices were identified that led to a better understanding of the obstacles to teaching in this area. Suggestions were made about how to shape teaching spirituality to improve patients' experience and ensure spirituality is integrated more fully into assessment and care. CONCLUSION: This study brought a better understanding of obstacles to integrating spirituality into teaching for healthcare lecturers and offered some ideas on how to best address these obstacles.

Impact of a standardized training program on midwives' ability to assess fetal heart anatomy by ultrasound.

BACKGROUND: Studies of prenatal detection of congenital heart disease (CHD) in the UK, Italy, and Norway indicate that it should be possible to improve the prenatal detection rate of CHD in Sweden. These studies have shown that training programs, visualization of the outflow tracts and color-Doppler all can help to speed up and improve the detection rate and accuracy. We aimed to introduce a more accurate standardized fetal cardiac ultrasound screening protocol in Sweden. METHODS: A novel pedagogical model for training midwives in standardized cardiac imaging was developed, a model using a think-aloud analysis during a pre- and post-course test and a subsequent group reflection. The self-estimated difficulties and knowledge gaps of two experienced and two beginner midwives were identified. A two-day course with mixed lectures, demonstrations and hands-on sessions was followed by a feedback session three months later consisting of an interview and check-up. The long-term effects were tested two years later. RESULTS: At the post-course test the self-assessed uncertainty was lower than at the pre-course test. The qualitative evaluation showed that the color Doppler images were difficult to interpret, but the training seems to have improved their ability to use the new technique. The ability to perform the method remained at the new level at follow-up both three months and two years later. CONCLUSIONS: Our results indicate that by implementing new imaging modalities and providing hands-on training, uncertainty can be reduced and examination time decreased, but they also show that continuous on-site training with clinical and technical back-up is important.

Reducing teachers’ psychological distress through a mindfulness training program

Teachers constitute one of the professional collectives most affected by psychological problems. The purpose of this quasi-experimental study is to examine the efficacy of a mindfulness training programme to reduce psychological distress in a group of teachers. The sample comprised 68 teachers of Secondary School Education, from various public schools; half of them formed the experimental group, and the another half the control group. The levels of psychological distress were measured, in both groups, by the Symptom Checklist-90-R (SCL-90-R) before and after the application of the programme. Statistical analysis shows the significant reduction of three general measures of psychological distress (Global Severity Index, Positive Symptom Distress Index, and Positive Symptom Total), as well in all its dimensions (somatization, obsessive-compulsive, interpersonal sensibility, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism), in the experimental group compared with the control group. Follow-up measures show that these results were maintained for four months after termination of the intervention in the experimental group (AU)

Los docentes constituyen uno de los colectivos profesionales más afectados por problemas de tipo psicológico. El objetivo de este estudio cuasi-experimental es examinar la eficacia de un programa de entrenamiento en mindfulness para reducir el malestar psicológico en un grupo de docentes. La muestra estuvo constituida por 68 profesores de Educación Secundaria, de varios centros públicos; la mitad de ellos formaron el grupo control, y la otra mitad el grupo experimental. Los niveles de malestar psicológico fueron evaluados, en ambos grupos, mediante el Symptom Checklist-90-R (SCL- 90-R) antes y después de aplicación del programa. Los análisis estadísticos muestran la reducción significativa en las tres medidas generales de malestar psicológico (Índice de Severidad Global, Índice de Distrés de Síntomas Positivos y Total de Síntomas Positivos), así como en todas sus dimensiones (somatización, obsesión-compulsión, sensibilidad interpersonal, depresión, ansiedad, hostilidad, ansiedad fóbica, ideación paranoide y psicoticismo), en el grupo experimental en comparación con el grupo control. Medidas de seguimiento mostraron que estos resultados se mantuvieron transcurridos cuatro meses tras la finalización de la intervención en el grupo experimental (AU)

Educational impact of a hospital-based neonatal resuscitation program in Ghana.

AIM OF THE STUDY: To assess midwives' baseline cognitive knowledge of evidence-based neonatal resuscitation practices, and short- and long-term educational effects of teaching a neonatal resuscitation program in a hospital setting in West Africa. METHODS: All midwives (n=14) on the labor ward at Ridge Hospital in Ghana were trained using materials modified from the American Academy of Pediatrics (AAP) Neonatal Resuscitation Program (NRP). This training program included didactic and practical teaching and was assessed by direct observation within delivery rooms and written pre- and post-test evaluations. Written and practical modules 9-12 months after the initial training session were also conducted to assess retention of NRP knowledge and skills. RESULTS: Fourteen midwives received NRP training on the labor ward. Both written and practical evaluation of neonatal resuscitation skills increased after training. The percentage of items answered correctly on the written examination increased from 56% pre-training to 71% post-training (p<0.01). The percentage of items performed correctly on the practical evaluation of skills increased from 58% pre-training to 81% (p<0.01). These results were sustained 9-12 months after the initial training session. CONCLUSION: After receiving NRP training, neonatal resuscitation knowledge and skills increased among midwives in a hospital in West Africa and were sustained over a 9-month period. This finding demonstrates the sustained effectiveness of a modified neonatal resuscitation training program in a resource constrained setting.