The effectiveness of cultural competence education in enhancing knowledge acquisition, performance, attitudes, and student satisfaction among undergraduate health science students: a scoping review

Elio Arruzza,Minh Chau 한국보건의료인국가시험원 2021 보건의료교육평가 Vol.18 No.-

Purpose: Cultural competence in healthcare assists in the delivery of culturally sensitive and high-quality services. This scoping review aims to provide an overview of the available evidence and to examine the effectiveness of classroom-based intervention strategies used to enhance the cultural competence of undergraduate health science students. Methods: A comprehensive and systematic literature search was undertaken in databases, including Cochrane Library, Medline, and Emcare. Articles were eligible if they employed an experimental study design to assess classroom-based cultural competency education for university students across the health science disciplines. Two reviewers independently screened and extracted relevant data pertaining to study and participant characteristics using a charting table. The outcomes included knowledge, attitudes, skills, and perceived benefits. Results: Ten studies were analysed. Diverse approaches to cultural education exist in terms of the mode, frequency, and duration of interventions. For the knowledge outcome, students who experienced cultural education interventions yielded higher post-test scores than their baseline cultural knowledge, but without a significant difference from the scores of students who did not receive interventions. Data relating to the skills domain demonstrated positive effects for students after experiencing interventions. Overall, students were satisfied with their experiences and demonstrated improvements in confidence and attitudes towards culturally competent practice. Conclusion: Across health science disciplines, cultural competency interventions were shown to be effective in enhancing knowledge acquisition, performance of skills, attitudes, and student satisfaction. Future research is necessary to address the significant absence of control arms in the current literature, and to assess long-term effects and patient-related outcomes.

Organizing Healthcare for Optimal Acute Ischemic Stroke Treatment

Simone Vidale,Elio Clemente Agostoni 대한신경과학회 2020 Journal of Clinical Neurology Vol.16 No.2

Stroke is a major health-care problem that represents a leading cause of death and also the top cause of disability in adulthood. In recent years there has been a significant paradigm shift in treatments for acute ischemic stroke to favor earlier reperfusion therapy, mainly using the systemic infusion of recombinant tissue plasminogen activator. Subsequent trials found that combining this treatment with endovascular therapy was effective in selected patients. The increased complexity of acute stroke treatments has resulted in a substantial reorganization of stroke care. This review reports on the evolution of acute ischemic stroke treatment and describes the main organizational models based on the hub-and-spoke system. The lack of evidence for comparisons of the effectiveness of different paradigms means that some decision-analysis models predicting the best organizational pathways are also reported, with a particular emphasis on the workflow timing in the prehospital and in-hospital settings. Major benchmarks and performance measures are also reported, focusing on the timing of interventions and rates of process indicators. Finally, future directions are illustrated, including using telemedicine for stroke, mobile stroke units, and artificial intelligence and automated machines to produce software for detecting large-vessel occlusion.

Design of Shield Blanket Near NB Port and Development of Be/Cu Joining for ITER

Fu Zhang,Elio Filippo,Jiming Chen,Weishan Kang,Youkun Fu 한국물리학회 2006 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.49 No.III

The design of two shield blanket modules near the neutral beam (NB) port was developed at Southwestern Institute of Physics (SWIP) in collaboration with the ITER International Team. Some results are given in this paper. The HIP technology for Be/Cu joining in the first wall is being qualified at SWIP and it is also introduced.

Agrobacterium tumefaciens-mediated genetic transformation of Digitalis purpurea L.

Naivy Pe´rez-Alonso,Elio Jime´nez,Borys Chong-Pe´rez,Alina Capote,Anabel Pe´rez,Yovanny Izquierdo,Geert Angenon 한국식물생명공학회 2014 Plant biotechnology reports Vol.8 No.5

Genetic transformation is a tool of specialinterest for developing new biotechnological strategies forthe production of bio-active compounds such as cardenolides,which are exclusively obtained from plants. To date,Digitalis plants are the main economically viable source ofcardenolides for the pharmaceutical industry. This studydescribes the development of efficient plant regenerationand Agrobacterium-mediated genetic transformation protocolsfor Digitalis purpurea L. First, a plant regenerationprocedure starting from leaf segments of in vitro-cultivatedplants was established and the minimal inhibitory concentrationof G-418 (geneticin) for callus induction wasdetermined. Both leaf segments and callus tissue weresensitive to G-418 70 mg l-1. Afterwards, two Agrobacteriumstrains were used to test their T-DNA transferability on D. purpurea leaf tissues, EHA105 andC58C1RifR (pMP90), both harboring the binary vectorpTJK136. Strain C58C1RifR (pMP90) yielded a highernumber of transformed plants than EHA105. Successfultransformation was confirmed by histochemical b-glucuronidase(GUS) assays of the putative transgenic tissuesand PCR analyses using b-glucuronidase (uidA)- andneomycin phosphotransferase II (nptII)-specific primers. Southern blot hybridization confirmed the stable integrationof the nptII gene in the transgenic plants. In total, 518independent transgenic lines were regenerated with anaverage of 6.91 transgenic lines per initial leaf segmentinfected with A. tumefaciens strain C58C1RifR (pMP90). To date, only a few studies have been published on thegenetic transformation of Digitalis species. The protocolsfor plant regeneration and genetic transformation describedin this paper will contribute to functional studies for abetter understanding of cardenolide biosynthetic pathwaysand the metabolic engineering of cardenolides to develophigh-yielding improved genotypes.

Pyroprocess Experiments at ENEA Laboratories

Giorgio DE ANGELIS,Elio BAICCHI,Mauro CAPONE,Carlo FEDELI,Massimo SEPIELLI,Giuliano TIRANTI,Mirko DA ROS,Francesca GIACOBBO,Marco GIOLA,Elena MACERATA,Mario MARIANI 한국방사성폐기물학회 2015 방사성폐기물학회지 Vol.13 No.S

A new facility, known as Pyrel III, has been installed at ENEA laboratories for pyrochemical process studies under inactive conditions. It is a pilot plant which allows electrorefining and electroreduction experiments to be conducted on simulated fuel. The main component of the plant is a zirconia crucible. The crucible is heated by a furnace which is supported in an externally water-cooled well under the floor of a steel glove-box, where an argon atmosphere is maintained by a continual purge of about 10 L·min-1. The vessel is loaded with LiCl-KCl eutectic salt (59-41 mol%) and is currently operated at 460 °C. Several improvements on Pyrel II (the previous operating plant) have been introduced into Pyrel III. They are described in detail, together with the results from the first experimental campaign which used lanthanum metal. Moreover, studies about the treatment of chloride salt wastes from pyroprocesses have been conducted in parallel. They follow two main routes: on one hand, a matrix termed sodalite, a naturally occurring mineral containing chlorine, has been synthesized from a mix of nepheline, simulated exhausted salts and glass frit; on the other hand, a novel method proposed by Korea Atomic Energy Research Institute (KAERI) is under assessment. The final waste forms have been fully characterized with the support of the Politechnique of Milan, by means of density measurements, thermal analysis, and stereomicroscopy observations, FTIR, XRD, and RAMAN spectra, as well as leach tests under static conditions.

Oxidative Stress and Inflammatory Biomarkers in People with Methamphetamine Use Disorder

Çetin Turan,Güliz Şenormancı,Salim Neşelioğlu,Yasemin Budak,Özcan Erel,Ömer Şenormancı 대한정신약물학회 2023 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.21 No.3

Objective: This study aimed to investigate the blood serum levels of biomarkers specifying oxidative stress status and systemic inflammation between people using methamphetamine (METH) and the control group (CG). Serum thiol/disulfide balance and ischemia-modified albumin levels were studied to determine oxidative stress, and serum interleukin-6 (IL-6) levels and complete blood count (CBC) were to assess inflammation. Methods: Fifty patients with METH use disorder (MUD) and 36 CG participants were included in the study. Two tubes of venous blood samples were taken to measure oxidative stress, serum thiol/disulfide balance, ischemia-modified albumin, and IL-6 levels between groups. The correlation of parameters measuring oxidative stress and inflammation between groups with sociodemographic data was investigated. Results: In this study, serum total thiol, free thiol levels, disulfide/native thiol percentage ratios, and serum ischemia-modified albumin levels of the patients were statistically significantly higher than the healthy controls. No difference was observed between the groups in serum disulfide levels and serum IL-6 levels. Considering the regression analysis, only the duration of substance use was a statistically significant factor in explaining serum IL-6 levels. The parameters showing inflammation in the CBC were significantly higher in the patients than in the CG. Conclusion: CBC can be used to evaluate systemic inflammation in patients with MUD. Parameters measuring thiol/disulfide homeostasis and ischemia-modified albumin can be, also, used to assess oxidative stress.

Mothership versus Drip-and-Ship Model for Mechanical Thrombectomy in Acute Stroke: A Systematic Review and Meta-Analysis for Clinical and Radiological Outcomes

Michele Romoli,Maurizio Paciaroni,Georgios Tsivgoulis,Elio Clemente Agostoni,Simone Vidale 대한뇌졸중학회 2020 Journal of stroke Vol.22 No.3

Background and Purpose Substantial uncertainty exists on the benefit of organizational paradigms in stroke networks. Here we systematically reviewed and meta-analyzed data from studies comparing functional outcome between the mothership (MS) and the drip and ship (DS) models. Methods The meta-analysis protocol was registered international prospective register of systematic reviews (PROSPERO) and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, EMBASE, and Cochrane Central databases were searched for randomized-controlled clinical trials (RCTs), retrospective and prospective studies comparing MS versus DS. Primary endpoints were functional independence at 90 days (modified Rankin Scale <3) and successful recanalization (Thrombolysis in Cerebral Infarction Scale [TICI] >2a); secondary endpoints were 3-month mortality and symptomatic intracranial haemorrhage (sICH). Odds ratios for endpoints were pooled using the random effects model and were compared between the two organizational models. Results Overall, 18 studies (n=7,017) were included in quantitative synthesis. MS paradigm was superior to DS model for functional independence (odds ratio, 1.34; 95% confidence interval, 1.16 to 1.55; I2=30%). Meta-regression analysis revealed association between onset-to-needle time and good functional outcome, with longer onset-to-needle time being detrimental. Similar rates of recanalization, sICH and mortality at 90 days were documented between MS and DS. Conclusions Patients with acute ischemic stroke eligible for reperfusion strategies might benefit more from MS paradigm as compared to DS. RCTs are needed to further refine best management taking into account logistics, facilities and resources.

Correction: Quarantine and Appendicitis: A Macro-Area Experience

Zampieri, Nicola,Murri, Virginia,Cinquetti, Mauro,Elio, Amedeo,Camoglio, Francesco Saverio The Korean Society of Pediatric Gastroenterology 2021 Pediatric gastroenterology, hepatology & nutrition Vol.24 No.2

Quarantine and Appendicitis: A Macro-Area Experience

Nicola, Zampieri,Virginia, Murri,Mauro, Cinquetti,Amedeo, Elio,Saverio, Camoglio Francesco The Korean Society of Pediatric Gastroenterology 2021 Pediatric gastroenterology, hepatology & nutrition Vol.24 No.1

Purpose: Appendicitis is the most frequent urgency in pediatric age; the aim of this study was to investigate the association of quarantine for severe acute respiratory syndrome coronavirus 2 pandemic and the incidence of pediatric appendicitis in a specific macro area. Methods: We retrospectively analyzed the medical records of consecutive patients who underwent surgical exploration for acute appendicitis in the period March-April since 2014. This specific quarantine period was divided into two phases as indicated by National government. Patient data, demographics, characteristics and outcomes were studied and evaluated comparing patients treated during quarantine especially phase 1 vs. phase 2 (March-April 2020). Results: After reviewing medical charts following the inclusion and exclusion criteria, 155 patients were studied; focusing on the final outcome, it is possible to show a decreased amount of appendicitis during phase 1 and a progressive increase during phase 2; respect to previous years, there was a statistical increase in severity of appendicitis during quarantine (gangrenous vs. phlegmonous appendicitis). Conclusion: During this specific quarantine there was a reduction in appendicitis and a progressive increase during phase 2. These results offer new perspective among disease incidences during lockdown.

Mechanical Thrombectomy in Strokes with Large-Vessel Occlusion Beyond 6 Hours: A Pooled Analysis of Randomized Trials

Simone Vidale,Marco Longoni,Luca Valvassori,Elio Agostoni 대한신경과학회 2018 Journal of Clinical Neurology Vol.14 No.3

Background and Purpose Mechanical thrombectomy with or without intravenous thrombolysis is indicated in the acute treatment of ischemic strokes caused by an emergent largevessel occlusion (ELVO) within 6 hours from symptom onset. However, a significant proportion of patients are referred to comprehensive stroke centers beyond this therapeutic time window. This study performed a pooled analysis of data from trials in which mechanical thrombectomy was performed beyond 6 hours from symptom onset. Methods We searched for randomized controlled trials that compared mechanical thrombectomy with the best medical treatment beyond 6 hours for ischemic strokes due to ELVO and reported on between 1990 and April 2018. The intervention group comprised patients treated with mechanical thrombectomy. Statistical analysis was conducted while pooling data and analyzing fixed- or random-effects models as appropriate. Results Four trials involving 518 stroke patients met the eligibility criteria. There were 267 strokes treated with mechanical thrombectomy, with a median time of 10.8 hours between when the patient was last known to be well to randomization. We observed a significant difference between groups concerning the rate of functional independence at 90 days from stroke, with an absolute difference of 27.5% (odds ratio=3.33, 95% CI=1.81–6.12, p<0.001) and good recanalization (odds ratio=13.17, 95% CI=4.17–41.60, p<0.001) favoring the intervention group. Conclusions This meta-analysis confirms the efficacy of mechanical thrombectomy in selected ischemic stroke patients beyond 6 hours from symptom onset. The selection is mainly based on the limited core infarct detected by emergent assessment using neuroimaging techniques.