(1) Background: Little is known about the baroque composer Domenico Scarlatti (1685-1757), whose life was centred behind closed doors at the royal court in Spain. There are no reports about his illnesses. From his compositions, mainly for harpsichord, an outstanding virtuosity can be read. (2) Case Presentation: In this case report, the only known oil painting of Domenico Scarlatti is presented, on which he is about 50 years old. In it one recognizes conspicuous hands with hints of watch glass nails and drumstick fingers. (3) Discussion: Whether Scarlatti had chronic hypoxia of peripheral body regions as a sign of, e.g., bronchial cancer or a severe heart disease, is not known. (4) Conclusions: The above-mentioned signs recorded in the oil painting, even if they were not interpretable at that time, are clearly represented and recorded for us and are open to diagnostic discussion from today's point of view.

Objective: To evaluate the changing pattern of distribution of Schedule II and III opioids, barbiturates, and stimulants to veterinary educational institutions in the United States. Design: Longitudinal study. Sample: Veterinary teaching institutions that use Schedule II and III drugs. Procedures: Distribution of controlled substances to veterinary teaching institutions was obtained from the Drug Enforcement Administration’s Automated Reports and Consolidated Orders System (ARCOS) for opioids (e.g. methadone, fentanyl, codeine), barbiturates (pentobarbital, butalbital), and stimulants (amphetamine, methylphenidate, lisdexamfetamine) from 2006 - 2019. Opioids were converted to their morphine milligram equivalents (MME) for evaluation over time. Results: Controlled substance distribution to veterinary schools exhibited dynamic, and agent specific, changes. The total MME for eleven opioids peaked in 2013 and decreased by 17.3% in 2019. Methadone accounted for two-fifths (42.3%) and fentanyl over one-third (35.4%) of the total MME in 2019. Pentobarbital distribution was greatest by weight of all substances studied and peaked in 2011 at 69.4 kg. Stimulants underwent a pronounced decline and were very modest by 2014. Conclusions and Clinical Relevance: Opioids by total MME in veterinary teaching practice have undergone more modest changes than opioids used with humans. Hydrocodone, codeine and recently fentanyl use have declined while methadone increased. Stimulant distribution decreased to become negligible. Together, this pattern of findings warrant continued monitoring.

Introduction: COVID-19 pandemic has affected HCPs in multiple way. It has caused psychological impact in form of anxiety, depression, and insomnia. In this study, we aim to study and compare the stress level, anxiety and depression among HCPs who are posted in special COVID-19 units with the HCPs who are not posted in COVID-19 units.Methods: This cross-sectional study was conducted in June 2020, at various hospitals of Karachi, Pakistan. All health care professionals (HCPs) were invited to participate. A total of 301 HCPs completed this study, who were divided into two groups; those who are posted in COVID-19 ward (Group A) and those who are not (Group B). Psychological Impact was English version of the Depression Anxiety Stress Scale - 21 (DASS-21).Results: In Group A, 70.5% had moderate, severe, or extremely severe depression compared to 49.2% in group B. In Group A, 75.4% had moderate, severe, or extremely severe anxiety compared to 44.7% in group B. In Group A, 80.3% had moderate, severe or extremely severe stress compared to 54.2% in group B. Anxiety, depression and stress were significantly higher in HCPs who were posted in COVID-19 ward compared to those who were not posted in COVID-19 wardConclusion: There was significantly higher anxiety, stress and depression in health care professionals posted in COVID-19 ward. Both the government and health care agencies should take responsibility for protecting the psychological well-being of health care communities all over the world and ensuring a healthy work environment.

Background: The Royal College of Surgeons in Ireland - Bahrain (RCSI Bahrain) was closed due to COVID 19. The aim of this paper is to present our experience, in managing teaching and learning, during this pandemic. Methods: Following, ethical approval, several meetings were held with the senior faculty and student representatives to select alternative virtual approaches for teaching, learning and assessment with evidence-based instructional design. Informed consent was obtained from all study participants. All procedures were carried out in accordance with relevant guidelines and regulations. In alignment with global scenario, we decided upon early graduation for our students, and expedited the clinical examinations, with special permission from health and education ministries. Two major clinical examinations were redesigned to form a single hybrid clinical examination with two parts. Following all COVID 19 preventive measures, students were taken in groups of seven and simulated patients were substituted for real patients. No more than 40 students were present at any point of time, with no more than 10 examined in one block. 149 out of 152 RCSI students attended the clinical examinations and 524 students from the three RCSI campuses attended the written online examination. A structured survey was conducted to elicit students’ perceptions and participation was entirely voluntary. Results: 82% of students were happier to be joining the workforce early and, 22% expressed concerns. A comparison of student performance in these examinations against the equivalent components from semester one yielded no significant deviation in student performance, illustrating that the quality was consistent. Conclusion: We recommend that the government accredit online or distance learning programmes and explore appropriate methodologies for evaluation of online learning and assessment. Incorporating practical/clinical training, will continue to be a great challenge.

Introduction Color vision deficiency (CVD) constitutes one of the frequently observed eye disorders in all human populations. Color is a prominent sign utilized in the medical profession to study and identify histopathological specimens, lab instruments, and patient examination. Color deficiency affects the medical skills of students resulting in poor clinical examination and color appreciation. There is no effective screening of CVD at any level of the medical profession. Hence, this study was aimed to determine the prevalence of CVD among medical students. Materials and methods This was a cross-sectional study conducted from September 2019 to February 2020 over a period of six months in Karachi, Pakistan. All medical students aged 18-21 years of either gender enrolled in the first and second years of medical college were included in this study. The examination was performed during daylight. Ishihara plates were placed at a distance of 75 cm from the subject and tilted so that the plane of the paper lies perpendicular to the line of vision. Students were given five seconds to read the plate and one examiner was instructed to mark the checklist. A score of less than 12 out of 14 red/green test plates (not including the demonstration plate) was considered as a CVD. All statistical analysis was performed using Statistical Package for Social Sciences version 20.0 (Armonk, NY: IBM Corp). Results The mean age of the medical students was 19.61± 1.22 years. There were (n=123) 53.0% females and (n=111) 47.0% males. Most of the medical students (n=131, 56.0%) belonged to the upper-middle-class socioeconomic group. CVD was observed in (n=13) 6.0%of medical students. Age (p=0.001) and socioeconomic status (p=0.001) were the only demographic factors significantly associated with color deficiency. Conclusions Color deficiency, although an unnoticed concern, is fairly common among medical students. Medical students must be screened for CVD as this will enable them to be aware of their limitations in their future observational skills as a doctor and devise ways of overcoming them in clinical practice.

As medical schools cope with the consequences of the COVID-19 pandemic, a new cohort of students will be admitted in the fall. Administrators are again challenged to make unprecedented enrollment decisions without standardized exams. This challenge provides unique opportunities to support holistic admissions but also abruptly bypasses a process that has been employed since 1928. This article highlights key factors that are being considered during current medical school admission cycles, including limited opportunities to take standardized exams, heightened student anxiety, and potential exam alternatives. These factors are framed and discussed within the context of the medical college admission test (MCAT) exam.

During 2019, the number of patients suffering from cough, fever and reduction of WBC’s count increased. At the beginning, this mysterious illness was called “fever with unknown origin”. At the present time, the cause of this pneumonia is known as the 2019 novel coronavirus (2019-nCoV) or the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). The SARS-CoV-2 is one member of great family of coronaviruses. Coronaviruses can cause different kind of illnesses including respiratory, enteric, hepatic, and neurological diseases in animals like cat and bat. Coronaviruses are enveloped positive-stranded RNA viruses. The SARS-CoV-2 has some particular structures for binding to host cells, reproducing itself in cells and damaging human cells. The SARS-CoV-2 can bind angiotensin-converting enzyme 2 (ACE‐2) receptors and cause various difficulties for human. The SARS-CoV-2 can cause either not-serious issues like fever and cough or serious concerns such as multi-organ failure. Source(s) of SARS-CoV-2 is under debate. Malayan pangolin and bat are the most suspicious candidate for being sources of the SARS-CoV-2. The SARS-CoV-2 can be transmitted by various ways such as transmitting from infected human to healthy human and can make severe pneumonia, which can lead to death. The SARS-CoV-2 can infect different kind of people with different ages, races, and social and economic levels. The SARS‐CoV‐2 infection can cause various sorts of clinical manifestations like cough and fever and intensity of signs and symptoms depends on sufferer conditions. Clinicians use all of available documents and tests like laboratory, histopathological and radiological findings for diagnosing new cases and curing patients with high accuracy. At the present time, there is no particular way for treating SARS-CoV-2 infection; neither antiviral drugs nor palliative agents. It seems that the best way for standing against the SARS-CoV-2 infection is preventing from it by social distancing and vaccination. This review tries to prepare an essential brief update about SARS-CoV-2 infection for clinicians.

The medical & the dental field is a never ending field of innovations & developments and each time the reasearchers come up with something new. One such new dimension in the fields of medicine being the incorporation of Artificial intelligence assisted technologies improving diagnosis, treatmemt plan and treatment stategies. This review focusses on the application of different technologies of AI in different fields of medicine.

The development of competency frameworks in healthcare professions is characterised by potentially inadequate descriptions of practice, variable developmental approaches, and inconsistent reporting and evaluating of outcomes. This may be in part due to limited existing guidance, which neglects broader contexts, lacks organising frameworks, and fails to provide guidance on selection of methods. To address such concerns, this paper first outlines a ‘systems thinking’ conceptual framework by which to conceptualise and describe clinical practice when developing competency frameworks. This is achieved through combining Ecological Systems Theory and complexity thinking to identify, and explore the contexts and components of clinical practice. The ‘systems thinking’ conceptual framework is then integrated into a six-step model for developing competency frameworks that synthesises and organises existing advice. The six steps include (1) identify practicalities (e.g. purpose, scope, detail, timeline), (2) identify influencing contexts and factors using ‘systems thinking’, (3) use aligned mixed-methods, (4) translate data into competency frameworks, (5) report processes and outcomes, and (6) plan to evaluate, update and maintain the competency framework. The model provides a logical organising structure of principles to guide assumptions and commitments when developing competency frameworks. Additionally, the model affords the flexibility required when exploring professional practice across varying contexts, and suggests employing mixed methodological approaches that are aligned with purpose and scope. The model acknowledges changing and complex contexts, considers existing guidance, and adds a unique and complementary means to conceptualise and improve the competency framework development process.

Nursing is a part of health services that serves individuals, groups and communities. In this 21st century the need for nursing services has changed rapidly and in a complex manner. Physical limitations, is on should to be considered, while the implementation and maintenance of patient-centered service infrastructure still have to be recked. The aim of this literature review is to identify the role of telenursing in nursing services for patients. This language method uses literature reviews which are summaries of 10 articles in the publication years of 2019, 2020, and 2021 on 3 search databases, namely Scopus, Science Direct, and SAGE. This review used the new Joanna Briggs Institute and Prisma. The eligibility of these studies were from its title, abstract, research methodology, results, and discussion. The results of the review were presented in narrative form. The results of a review of 10 articles found that the form of nursing services with telenursing could prove long-distance service, time efficiency and funding allocation, but in terms of quality it had been not satisfactory related to its physical implementation of nursing service. Conclusion: The nursing paradigm in the 21st century global era has been developed with the help of technology to meet the needs of distance efficiency and cost limitations. Thus, telenursing is a solution to answer these challenges.

In Thailand, the topic of medical ethics and laws related to medical professions has been one part of the national competency assessment criteria. The objective of this article was to design legal issues into the medical curriculum and to share experiences of creative legal study. Legal contents were inserted into 10 subjects and taught for year 1 to year 6 medical students. Students were divided into multi-groups or received individual tasks and then, shared their knowledge and idea for solving legal problems. The results showed they could interpret and create novel ideas for legal and ethical reconstruction, including the topic of the principle of laws, criminal laws, civil and commercial laws, public health laws, organ donation/transplantation, end of life decisions, and legal liability for the medical profession. Finally, the creative legal study can be used as a novel approach to support creativity among medical students.

Purpose: Now traditional lecture-based teaching and learning have been affected by the COVID-19. The objectives of this article are to design the novel educational technique called ‘dynamic-based learning’ (DBL) that provides the combination of online teaching-learning methods and student’s creativity, to evaluate primary dynamic-based learning function, and to propose dynamic-based learning for higher education. Methods: DBL composes of four steps, including, preparation, homework, classroom, and evaluation, which was designed, and taught in medical and dental schools. Online support materials included mobile phone, email, Facebook Messenger, Line Messenger, Cisco Webex, and Zoom Meetings applications were recruited for this novel method. Results: A total of 32 third-year medical students and 26 sixth-year dental students was treated by DBL similarly. three subjects, including, Innovation in Dentistry, Basic Medical Research, and Principles of Pathology and Forensic Medicine were selected in this article. The results showed students could create their knowledge, ideas, and creativity during the online classes.Conclusion: DBL can be used as an alternative learning mode during the COVID-19 crisis. The benefits of DBL also include high flexibility, dynamic process, active learning, and high creativity. DBL should be tested with other disciplines such as engineering school, laws school, health sciences school, and should be compared with other traditional teaching and learning modes in the future. This method may support the global higher education systems to move forward the COVID-19 pandemic to set a novel standard of a future normal.

Clinical education is a method that is applied to formal nurse education as a step to provide real and direct learning experiences in the nursing environment correctly and effectively. The success of education in a clinical setting certainly requires the support of teaching nurses (clinical instructors) who have credibility and competence in terms of knowledge, attitudes and skills and are actively involved in professional activities. The diversity of backgrounds of nurses and students, including patients, certainly contributes to a shift in paradigms and perspectives for the nursing environment both in education and in clinical settings in health services. Responding to this cultural diversity, it is important to prepare knowledge and understanding related to transcultural nursing issues, intercultural communication and clinical education which explores the socio-cultural elements in the implementation of staff, students and patients. Purpose: The purpose of this literature review is to identify the extent to which nurse educators play a role by including socio-cultural and transcultural aspects in efforts to develop the quality of education in clinical practice environments in the millennium era. Method: The method of writing this article uses 11 literature review, the publication year period 2019,2020 and 2021 with sources from 4 databases such as science Direct, Scopus, ProQues and Elsevier. The review guidelines used are based on Prisma and the Joanna Briggs Institutute. The level of eligibility is identified through the title, abstract, research methodology as well as the type of scholarly journal and full text. Results: The results of the reviews found are presented in a narrative form. The results of the review study found that there were 11 articles explaining the competence of clinical education based on the socio-cultural approach, which is an educational strategy in the clinical area that integrates transcultural elements of nursing, intercultural communication, collaboration, self-directed with the principles of openness, honesty, and mutual respect in the implementation of team interaction and collaboration. The development of interpersonal relationships is also an important role that educators must have in helping to introduce the nurse orientation process to the organizational environment and other professional teams so that the achievement of satisfaction with clinical education is able to improve the performance of nurses and students perfectly. Conclusion: Clinical education which is supported by the competence of nurse educators (clinical instructors) who have individual and professional competences has a role to play in improving clinical learning outcomes by both students and nurses with a socio-cultural and transcultural strategic approach that will create satisfaction with the achievement of clinical competence and performance effectively.

Students' knowledge of the concept of patient safety in infection prevention and control and treatment safety is still low. Real-life problem-based learning approaches in the area of ​​clinical education assist in patient safety education. This study was designed to identify, evaluate and summarize available evidence on the effectiveness of clinical education on student achievement of patient safety competencies. The Methode that use in this study is systematic review. Search for articles in research journals obtained from Sciencedirect, Ebscohost, Garuda, Proquest and Scopus. As many as 228 articles were obtained consisting of nursing journals and health journals with the keywords clinical education, competence, and patient safety. After that, the screening process was carried out based on the inclusion criteria and obtained 25 articles that met the criteria. The result of this study are the contribution of educational institutions in the achievement of patient safety competencies for nursing students is still low and the achievement of patient safety competencies for students at the professional level is better than for students who are still learning theory in educational institutions. The conclusion of this study is clinical education carried out by educational institutions is considered ineffective in achieving the competence of patient safety for nursing students. Therefore, it is necessary to develop a patient safety model or curriculum that is attached to clinical education in nursing education institutions

Background: Industry revolution 4.0 (IR.4.0) paradigm, nurses were required to have adequate competencies to carry out their professional duties. Digital information should be mastered by the nursing student. Purpose: This study aims to explain digital literacy competencies on nursing students in the era of industrial revolution 4.0 in the Indonesian context. Methode: A literature review was conducted in this study using Rayyan Systematic Reviews Software. Results: There was 14 literature analyzed describing Student’s Information literacy competency and Internet of Thing. Conclusion: Digital literacy for nursing students today is an inevitability, and nursing students who have digital literacy competencies have the potential to be able to increase nursing knowledge and skills as ontological competencies in their learning process.

Babies born prematurely are at risk of experiencing visual disturbances, hearing loss, disabilities, the risk of infection and even death. Care for premature babies requires serious attention for both health workers and parents. The role of parents is very important both during hospitalization and at home. Therefore, in order to improve the abilities of parents, it is necessary to make educational efforts with the right method.ObjectivesThis literature review aims to provide an overview of educational methods that nurses can use to improve the ability of parents to care for or care for the development of premature babies. The method used is to search for literature that fits the established theme using 5 data based, namely Scopus, ProQuest, Science Direct, Elsevier Clinicaly for Nursing and Web of Science. The strategy used in finding literature that fits the theme and is used in this literature review uses the PICOS framework. Then conducted a review with the PRISMA method. The literature selection results obtained 572 publications, after going through the selection obtained 11 literatures that match the theme, with 11 educational methods. These methods can be grouped into ideas, namely increasing parental involvement during treatment, using technology, stress management and continuous monitoring. The ability of parents to care for premature babies is needed in order to minimize complications in infants, reduce morbidity, avoid disabilities, increase growth and development of premature babies optimally and reduce parental stress levels, increase parental confidence and good parents' self-efficacy. Choosing the right educational method can improve the ability of parents to properly care for and provide developmental care for premature babies.

Patient safety is one of the indicators of the quality of health services in the hospital, for that, it is necessary to have efforts from the hospital to create a system that can minimize the occurrence of errors and unexpected events that can harm patients, nurses as health workers who are the most numerous in the home. sick and with the patient for 24 hours, has an important role in maintaining patient safety. This study aims to explain how the role of nurses and cooperation between health workers in implementing patient safety measures in the hospital. The method used in this study is a literature review by analyzing and exploring relevant articles and focusing on interprofessional collaboration to improve patient safety. The articles used in this study were taken from 3 direct, Proquest, Pubmed science databases published in the last 3 years, namely between 2019-2021, nurses as part of the health team are required to be able to work together with other health professionals in hospitals with various characteristics, including education, gender, age, employment status and length of work, nurses are required to be committed to maintaining patient safety in the hospital.

Clinical education is a method that is applied to formal nurse education as a step to provide real and direct learning experiences in the nursing environment correctly and effectively. The success of education in a clinical setting certainly requires the support of teaching nurses (clinical instructors) who have credibility and competence in terms of knowledge, attitudes and skills and are actively involved in professional activities. The diversity of backgrounds of nurses and students, including patients, certainly contributes to a shift in paradigms and perspectives for the nursing environment both in education and in clinical settings in health services. Responding to this cultural diversity, it is important to prepare knowledge and understanding related to transcultural nursing issues, intercultural communication and clinical education which explores the socio-cultural elements in the implementation of staff, students and patients. Purpose: The purpose of this literature review is to identify the extent to which nurse educators play a role by including socio-cultural and transcultural aspects in efforts to develop the quality of education in clinical practice environments in the millennium era. Method: The method of writing this article uses 11 literature review, the publication year period 2019,2020 and 2021 with sources from 4 databases such as science Direct, Scopus, ProQues and Elsevier. The review guidelines used are based on Prisma and the Joanna Briggs Institutute. The level of eligibility is identified through the title, abstract, research methodology as well as the type of scholarly journal and full text. Results: The results of the reviews found are presented in a narrative form. The results of the review study found that there were 11 articles explaining the competence of clinical education based on the socio-cultural approach, which is an educational strategy in the clinical area that integrates transcultural elements of nursing, intercultural communication, collaboration, self-directed with the principles of openness, honesty, and mutual respect in the implementation of team interaction and collaboration. The development of interpersonal relationships is also an important role that educators must have in helping to introduce the nurse orientation process to the organizational environment and other professional teams so that the achievement of satisfaction with clinical education is able to improve the performance of nurses and students perfectly. Conclusion: Clinical education which is supported by the competence of nurse educators (clinical instructors) who have individual and professional competences has a role to play in improving clinical learning outcomes by both students and nurses with a socio-cultural and transcultural strategic approach that will create satisfaction with the achievement of clinical competence and performance effectively.

An increasing number of studies have shown that safety culture factors have a substantial influence on safety performance in a variety of industrial sectors. These factors' impact on safety performance is unclear, especially at the public service and statutory authorities. On the other hand, the understanding of indicators for safety performance in every working sector in Malaysia is on the continuing progress. Hence, this study's contribution is to explore the influence of safety culture factors (i.e., management commitment and supervision in safety, safety system) and safety competence on safety performance in government paramedic training institutes. IPMA (importance-performance map analysis) is a technique used in Smart PLS to determine the significance and performance of each of these factors. The study was conducted via an online survey and involved 258 safety and health committee members in Ministry of Health paramedic training institute. As a matter of relevance, the IPMA's empirical data study revealed that management commitment and supervision in safety were the predominant factors in determining safety performance. Meanwhile, for performance, the findings showed that worker involvement, safety system, and safety competence perform well in determining the safety performance.

Hormones must be balanced and dynamically controlled for the Female Reproductive Tract (FRT) to function correctly during the menstrual cycle, pregnancy, and delivery. Gamete selection and successful transfer to the uterus, where it implants and pregnancy occurs, is supported by the mucosal epithelial lining of the FRT ovaries, uterus, cervix, fallopian tubes, and vagina. Successful implantation and placentation in humans and other animals rely on complex interactions between the embryo and a receptive female reproductive system. The FRT's recent breakthroughs in three-dimensional (3D) organoid systems now provide critical experimental models that match the organ's physiological, functional, and anatomical characteristics in vitro. This article summarizes the current state of the art on organoids generated from various parts of the FRT. The current analysis examines recent developments in the creation of organoid models of reproductive organs, as well as their future directions.

Background: Simulation plays a crucial role in health studies, as it helps medical students apply their theoretical knowledge in real-life situations. Moulage is one of the techniques that helps in making simulation more realistic or high-fidelity. It uses special effects to emulate wounds for a better understanding of what the wound is like visually. Still, moulage is expensive, time-consuming, resource-intensive, and requires the training of staff, which is why we need to find low-cost substitutes for moulage materials. Method: When searching the database “PubMed” for the terms “Low-cost and Medical moulage”, we retrieved 222 studies, out of which when excluding results not related to low-cost, we obtained 62 studies, from which when removing studies that do not contain information regarding moulage, we found two papers, after referring to citations and cited articles of those papers, we ended up with six studies. Based on the selected articles and additional articles sourced from their reference list, a total of 11 studies were included in the review. Results: We understand that moulage is a technique that helps make simulations come alive, but the resources required to use it are at times, expensive, which is why we need to find methods to do low-cost moulage, and many studies address that it can be as simple as using homemade ingredients. Students from a previous study have talked about their opinions regarding the realistic component of moulage and whether if it is any different from other moulages. Most of the students agreed that the moulage ranked well in face and content validity. However, further innovations must be introduced in the field to be widely spread and lead to newer opportunities. Conclusion: Although the research done under moulage is limited, it is accepted that moulage is helpful for simulation-based studies and that low-cost moulage can help make medical studies a better experience for students studying it. Students have a favorable opinion on the realistic aspect of the low-cost moulage applied to them. Newer methods can be introduced to moulage, and it can be implemented in low-income countries.

Sleep deprivation (failure to get enough sleep) is a public health issue that can negatively impact our body including cognitive function. Many studies have been done in Saudi Arabia to evaluate the impact of poor sleep and academic performance but almost all of them were done at university level. To investigate the relationship between sleep quality and general degree of academic achievement in school students. This is a cross-sectional, school-based study, conducted at Jazan Region, Saudi Arabia. A total of 957 participants (615 male and 342 female) were recruited from a state school. The study used a standardized, confidential, validated self-administered questionnaire to assess sleep quality and habits. By using Statistical Package for Social Studies (SPSS 22), achievement of the students was significantly related to the following parameters; laziness and fatigue after wake-up time and during school time, lack of concentration during school time, difficulty in complete tasks during school time and inability to maintain wakefulness during school time. Furthermore, students with poor academic degrees reported more significant incidence of sleeping at school, excessive daytime sleepiness, and other sleep related disorder than good academic degrees. Students with poor sleep quality have lower school grades.

Competency frameworks outline the perceived knowledge, skills and other attributes required for professional practice. Competency frameworks have gained in popularity, in part for their ability to inform health professions education, assessment, professional mobility, and other activities. Previous research has shown inadequate reporting within reports describing their development and that may jeopardize their use and application. We aimed to develop a set of minimum criteria that provides guidance to authors (and consumers) in an effort to improve reporting of the development of competency frameworks. The checklist was developed by a 35-member expert panel and a five-member research team following published guidance from the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network. The final checklist contains 20 essential reporting items including guidance on reporting title and abstract, framework development, the development process, testing and funding/conflicts of interest. The intent of the COmpeteNcy FramEwoRk Development in Health Professions (CONFERD-HP) reporting guideline is to help readers (including researchers, educators, regulators, health professionals, and patients) develop a greater understanding of relevant terminology, core concepts, and key items to report for competency framework development in health professions.

Objectives: As institutions modified medical practices to mitigate the spread of the SARS-CoV-2 virus, providers were forced to modify care through the implementation of telemedicine. The objective of this article is to review the current practices of otolaryngology during the COVID-19 pandemic and the limitations of telemedicine in current practice. Methods: A thorough review of the PubMed and MEDLINE databases was performed for publications between 2020 and 2021. Studies discussing telemedicine in otolaryngology during COVID-19 pandemic were selected. Results: As worldwide cases of COVID-19 continue to oscillate, we must continue to be vigilant in our clinical practice, implementing safe techniques to mitigate the spread of the SARS-CoV-2 virus through the continual use of telemedicine in all specialties of otolaryngology. Trends of increased patient acceptance of the use of telemedicine have been seen across subspecialities, including otolaryngology. Conclusion: Currently there are challenges associated with the implementation of telemedicine in the field of otolaryngology that rely heavily on adjunct physical examination, imaging studies, and specialty procedures. However, telemedicine has tremendous potential and can be adapted to include in the otolaryngologist’s toolbelt during public health emergencies such as the COVID-19 pandemic.

Introduction: Perawat is very at risk of burnout due to high workload and increased work stress. Many factorsrelated to work and outside of work that cause burnout so it needs attention from professionals to reduce the effects of burnout among nursing staff. This literature aims toanalyze the application of caring, a strategy to reduce burnout in nurses. Methode: Conducting a literature review of journals using Three academic databases (Science Direct, PubMed, ProQuest and Google Scholar), Inclusion criteria in literature studies are: English articles, research on nurses on caring and burnout, publish in 2017-2022, with mix methode/quasi experiment design and cross secsional. Keywords used Caring AND Burnout AND Nurses. Instrument: Guide in reviewing journals using PRISMA. Result and Analysis: Nineteen study literature meets the criteria for inclusion in the review. The participants were nurses at various hospitals. The results of several articles show the impact of caring application on nurse burnout. Deliver burnout by building a conducive work environment, reducing workload, rewards and management support. Analysis shows association of caring application to decreased burnout incidence in female nursesDiscussion and Conclusion: There needs to be organizational support to overcome burnout. Organizational support will reduce job dissatisfaction and absenteeism . Areas of work life are predictors of work fatigue. Improving the work environment is a solution for hospitals that want to simultaneously reduce nurse fatigue and increase the satisfaction of nurses and patients in providing safe and high-quality care. Caring aspects must be applied in the self-development of nurses to improve the work environment

Ayurveda as a healthcare system has survived for thousands of years but continues to be dogged by reported lack of efficacy of the treatments in clinical trials. The reported lack of efficacy could be due to a real lack of efficacy (which then contradicts the survival of Ayurveda as a functional medical system enjoying considerable public patronage) or could be attributed to inadequacies in the efforts towards evidence generation or in a larger context the overall scientific conduct of research in Ayurveda. In an effort towards better evidence generation, there is an immediate need for standardizing the design, conduct and reporting of clinical trials of Ayurveda but it is a daunting task. For this effort to benefit the scientific endeavors of Ayurveda researchers, it should allow the researchers to be able to apply Ayurveda’s multi-component, individualized and inherently holistic approach. Statistical principles can benefit this effort. Statistical hypothesis testing (SHT) is central to these statistical principles and also aligns well with conventional scientific principles of evidence generation. Although there are challenges with SHT, good practitioners engaged in it do much more than just apply the mathematical theory behind it. As a particular example, lot of time in clinical trial designing is spent in addressing biases and designing trials prudently by minimizing the effect of such biases. SHT can benefit such an effort objectively. There is a need for Ayurveda researchers to engage deeply and mindfully about biases in study design in order to gain scientific validity and acceptability. The article highlights issues that arise in Ayurveda research, and discusses few ways of dealing with these issues using statistical principles.

Diabetes mellitus (DM) and obesity account for the highest burden of non-communicable diseases. There is increasing evidence showing therapeutic patient education (TPE) as a clinically and cost-effective solution to improve biomedical and psychosocial outcomes among people with DM and obesity. The present systematic review and meta-analysis presents a critical synthesis of development of TPE interventions for DM and obesity and the efficacy of these interventions across a range of biomedical, psychosocial and psychological outcomes. A total of 54 of these RCTs were identified among patients with obesity and diabetes and were thus, qualitatively synthesized. Out of these, 47 were included into quantitative synthesis. There was substantial heterogeneity in reporting of these outcomes (I²= 88.35%, Q= 317.64), with significant improvement (SMD=0.36, 95% CI: 0.23 to 0.49) noted in biomedical outcomes in the intervention group. The effect sizes were comparable across interventions delivered by different modes and delivery agents. These interventions can be delivered by allied health staff, doctors or electronically as self-help programs, with similar effectiveness (P < 0.001). These interventions should be implemented in healthcare and community settings to improve health of patients suffering from DM and obesity.