A modified systematic review of research evidence about education for pre-registration nurses in palliative care

Background: We undertook a modified systematic review of research regarding educational approaches to and effectiveness of pre-registration palliative care nursing, to inform the development of a short course in palliative care for pre-registration nursing students in Cameroon. The aim of this review was to examine educational approaches applied to pre-registration palliative care nursing education and their effectiveness, and to discuss implications for the development of palliative care curricula in resource-poor countries. Method: A modified systematic review of research on palliative care educational interventions, conducted with pre-registration student nurses was undertaken. Relevant literature was gathered from CINAHL, EMBASE, MEDLINE and PsychINFO databases for the period 2000–2013. Inclusion was limited to studies of educational interventions evaluating the effectiveness and outcomes of palliative and end of life care education with pre-registration student nurses. Results: 17 studies were found, all of which were conducted in resource-rich countries: United States of America, Canada, Australia, and United Kingdom. Palliative care nursing education at pre-registration level is either delivered as a discrete course within the curriculum or palliative care content is embedded into other nursing specialty courses throughout the wider curriculum. Palliative care education is delivered to students at a variety of stages in their nursing program, using a mix of both didactic and experiential educational strategies. Course facilitators span palliative care specialists, educators who have attended ‘train-the-trainer’ courses in palliative care, and nurses with hospice experience. Education is underpinned by transformative and experiential learning theories and reported as effective in improving students’ attitudes towards care of the dying. Conclusion: The educational strategies identified in this review may be applicable to resource-poor countries. However, there are challenges in transferability because of the lack of availability of specialist palliative care practitioners who can serve as educators, specialist palliative care units/institutions for experiential learning, funds to design and use high fidelity simulations, and palliative care textbooks and other educational materials. There is thus a need for innovative educational strategies that can bridge these barriers in resource-poor countries. There is also a need for further research into how palliative care education impacts on pre-registration student nurses’ knowledge and practice

Employability Skills Needed for TVET Graduates in Malaysia: Perspective of Industry Expert

Employability skills are a very significant attribute especially to TVET graduates as it is closely related to career readiness. Nevertheless, many studies have found the gap between TVET graduates’ employability skills with industry needs. Their study found that industries need TVET graduates who possess communication skills, interpersonal skills, critical thinking, problem solving and entrepreneurial skills. However, many studies have found that TVET graduates have problems communicating effectively and lack of self-confidence. Therefore, this qualitative study was conducted to identify the employability skills required by the industry through the perspective of industry experts themselves. The findings of the study found that employability skills needed for TVET graduates are social and communication, technological literacy, teamwork and leadership. Therefore, stakeholders in TVET need to pay attention to this matter by producing TVET graduates who possess employability as required by the industry. Concurrently, the success of this collaboration depends on the strategic and tactical approaches made by TVET institutions and industries

Education that makes a difference to palliative and end of life care at the bedside in a resource-poor context: the situation of Cameroon

Background Current demographic trends giving rise to an ageing population worldwide, and changes in disease patterns, are increasing demands for palliative and end of life care. Nurses play a fundamental role in the care of patients with chronic and life-threatening illnesses, making it critical that nurses entering the profession should be competent and confident to provide palliative care. However, some preregistration nursing curricula, particularly those in resource-poor settings, do not include any palliative care content. Existing research identifies a lack of palliative care competencies among practising nurses, both newly graduated and student nurses. Aim The aim of this study was to develop, pilot and evaluate the impact of a palliative care course on Cameroonian preregistration nursing students’ palliative care knowledge and self-perceived competence and confidence in palliative care provision, using Kirkpatrick’s (1967) framework for training programme evaluation. Design This study is situated within the World Health Organisation’s public health model for palliative care as an overarching theoretical framework. It employed a longitudinal quasi-experimental pretest/posttest design, using both quantitative and qualitative methods. It was conducted in 3 phases. In the first phase, a 30 hours classroom based palliative care course, underpinned by experiential learning theory, was developed. In the second phase, the course was delivered to second and third year nursing students in one University in Cameroon, by nurse educators, a chaplain and palliative care trained nurses in Cameroon. In the third phase, an evaluation of the impact of the course on students’ palliative care knowledge, self-perceived competence and confidence in palliative care, and transfer of learning to practice was conducted. Course evaluation data was collected via a pretest/posttest survey, 3 focus groups and 10 individual critical incident interviews. Both descriptive and inferential statistics were used to analyse the quantitative data. The qualitative data was analysed thematically using the framework approach. Findings This study revealed a deficiency in the palliative care content of the pilot University’s preregistration nurse training curriculum, and very poor palliative care knowledge and self-perceived competence and confidence in palliative care provision, among preregistration nursing students of this University.A 30 hour classroom based palliative care course, delivered by nurse educators, palliative care nurses and a chaplain in Cameroon was found to statistically significantly improve students’ overall palliative care knowledge. In this study students’ also had improvements in their self-perceived competence and confidence in palliative care provision, though this was not statistically significant.Student nurses in receipt of palliative care education were able to transfer their learning to practice. They reported recognizing patients with palliative care needs, providing patients with physical, psychosocial and spiritual support and communicating patient information to the wider care team. Notwithstanding this positive finding, some factors, related to the student themselves, the qualified nurses, the practice setting or the patient and family, were found to negatively impact on the learning transfer process. The students generally felt that the course was an ‘eye opener’ and met with their expectations. They perceived the major strength of the course was the use of interactive and stimulating educational strategies, but felt that the absence of a supervised clinical practice component with dying patients was a major weakness of this course. Conclusion There is a need for a curriculum revision to include palliative care content in the preregistration nurse training curricula of the pilot University. This seems to reflect a general need by all preregistration nursing students in this country. This study’s findings reveal the need to advocate for palliative care education and practice policies, and for adequately preparing clinical placement sites for nursing students’ palliative care learning and transfer of learning in Cameroon, and possibly other resource poor settings

Climate change and lake water resources in Sub-Saharan Africa: case study of lake Chad and lake Victoria

This review assesses the impact of climate change on lake water resources in Sub-Saharan Africa(SSA). Two significant global water features with immense contribution to agriculture and socio-economic development of the region were analysed. Lake Victoria is the world second largest freshwater lake and Lake Chad the largest endoreic basin. These two great water bodies have been affected drastically by climate change and human influence. A significant shrinkage on Lake Chad was experienced with a decrease in water stored from in 1960s to less than in 2005. This effect abruptly receded Lake Chad from 25,000Km2 in the 1960s to 1350Km2 in 2005; while Lake Victoria experienced continual fluctuations from over a century; with evaporation rates varying between 1370mm to 1600mm, 90% of water loss which leads to peak fluctuation occurring in 1961.Keywords: Water Resource, Climate Change, Sub-Saharan Africa, Lake Chad, Lake Victori

Thermo-Hygrometric Comfort of Naturally Ventilated Classroom Building as a Function of the Openings Positioning and Orientation

The basic functional requirement of a classroom environment suggests a safe, delightful and relaxing place for the learners’ physical and psychological well-being and vigor such that there will be an aligned expression of satisfaction with the thermal environment. This study assessed the operational thermal comfort of naturally ventilated one-side-window oriented classroom building in Abeokuta, Ogun state, Nigeria using objective and subjective research approaches. The objective research technique involved the use of standardized measurement devices in the assessment of associated environmental factors which were relative humidity, airflow rate, ambient and mean radiant temperatures. The human factor aspect of thermal comfort was subjectively assessed using a questionnaire structured on ASHRAE scale. The measurements were taken at the height of 130 cm at the time intervals of 7:50 – 8:30 am (morning session) and 2:20 – 3:00 pm (Afternoon session) from the month of March 2016 through to February 2017, Mondays to Fridays, excluding days of any form of holidays. The descriptive statistics of the environmental factors data obtained showed that the indoor environment of the assessed classrooms was warm and stale with an average ambient temperature range of 29.37 - 30.08 ℃,  mean radiant temperature 29.24 - 31.28 ℃, relative humidity 67.81 - 68.99 % and wind speed 0.022 - 0.037 m/s. The multiple linear regression analysis gave an R-value of .943 with .889 chances that the average ambient temperature of the classrooms will be affected by time-invariants and microclimate variables which was an indication of good level of prediction. The human factors of the thermal comfort observed a variation between the perceived and the preferred thermal sensation with respect to the time of the day and seasons which was unsatisfactory for the teaching and learning process

Current antibiotic susceptibility profile of the bacteria associated with Surgical wound infections in the Buea health district in Cameroon

Background: Most surgical wounds seen in clinical practice in the Buea Health District, Cameroon are infected prior to arrival or while they are in the hospital. Sometimes the infection necessitates a combination of local wound site measures and systemic antibiotherapy to properly manage the patient.Objective: To identify the current antibiotic susceptibility profile of the common germs that cause surgical wound infections in the Buea Health District of Cameroon.Methods: A total of 2120 specimens comprising swabs from burns, ulcers, open or post-operative wounds were collected from hospitalized patients attending health institutions in Buea. The samples were collected from different anatomic sites of the patients. Cultures were effected from the specimens and bacteria isolated from infected wounds using standard microbiological techniques. Antibiotic susceptibility of the different isolates was determined.Results: Majority (79.8%) of the wounds were infected with pathogenic bacteria. The germs globally showed multi resistant patterns to commonly used antibiotics in the study area, especially to co-trimoxazol, doxycycline, chloramphemicol, ampicilline and aztreonam. However appreciable sensitivity was noted to ofloxacillin, perflacin, and ceftriazone.Conclusion: This study has revealed ofloxacin as the only antibiotic to which all the isolated bacteria from infected wounds were sensitive in the study area.Keywords: Wound infection, Antibiotic susceptibility profile, Buea Health District, Cameroo

A qualitative evaluation of the impact of a palliative care course on preregistration nursing students' practice in Cameroon

Background Current evidence suggests that palliative care education can improve preregistration nursing students’ competencies in palliative care. However, it is not known whether these competencies are translated into students’ practice in the care of patients who are approaching the end of life. This paper seeks to contribute to the palliative care evidence base by examining how nursing students in receipt of education report transfer of learning to practice, and what the barriers and facilitators may be, in a resource-poor country. Methods We utilised focus groups and individual critical incident interviews to explore nursing students’ palliative care learning transfer. Three focus groups, consisting of 23 participants and 10 individual critical incident interviews were conducted with preregistration nursing student who had attended a palliative care course in Cameroon and had experience caring for a patient approaching the end of life. Data was analysed thematically, using the framework approach. Results The results suggest that nursing students in receipt of palliative care education can transfer their learning to practice. Students reported recognizing patients with palliative care needs, providing patients with physical, psychosocial and spiritual support and communicating patient information to the wider care team. They did however perceive some barriers to this transfer which were either related to themselves, qualified nurses, the practice setting or family caregivers and patients. Conclusion The findings from this study suggest that nursing student in receipt of palliative care education can use their learning in practice to provide care to patients and their families approaching the end of life. Nevertheless, these findings need to be treated with some caution given the self-reported nature of the data. Demonstrating the link between preregistration palliative care education and patient care is vital to ensuring that newly acquired knowledge and skills are translated and embedded into clinical practice. This study also has implications for advocating for palliative care policies and adequately preparing clinical placement sites for students’ learning and transfer of learning

Education that makes a difference to palliative and end of life care at the bedside in a resource-poor context: the situation of Cameroon

Background Current demographic trends giving rise to an ageing population worldwide, and changes in disease patterns, are increasing demands for palliative and end of life care. Nurses play a fundamental role in the care of patients with chronic and life-threatening illnesses, making it critical that nurses entering the profession should be competent and confident to provide palliative care. However, some preregistration nursing curricula, particularly those in resource-poor settings, do not include any palliative care content. Existing research identifies a lack of palliative care competencies among practising nurses, both newly graduated and student nurses. Aim The aim of this study was to develop, pilot and evaluate the impact of a palliative care course on Cameroonian preregistration nursing students’ palliative care knowledge and self-perceived competence and confidence in palliative care provision, using Kirkpatrick’s (1967) framework for training programme evaluation. Design This study is situated within the World Health Organisation’s public health model for palliative care as an overarching theoretical framework. It employed a longitudinal quasi-experimental pretest/posttest design, using both quantitative and qualitative methods. It was conducted in 3 phases. In the first phase, a 30 hours classroom based palliative care course, underpinned by experiential learning theory, was developed. In the second phase, the course was delivered to second and third year nursing students in one University in Cameroon, by nurse educators, a chaplain and palliative care trained nurses in Cameroon. In the third phase, an evaluation of the impact of the course on students’ palliative care knowledge, self-perceived competence and confidence in palliative care, and transfer of learning to practice was conducted. Course evaluation data was collected via a pretest/posttest survey, 3 focus groups and 10 individual critical incident interviews. Both descriptive and inferential statistics were used to analyse the quantitative data. The qualitative data was analysed thematically using the framework approach. Findings This study revealed a deficiency in the palliative care content of the pilot University’s preregistration nurse training curriculum, and very poor palliative care knowledge and self-perceived competence and confidence in palliative care provision, among preregistration nursing students of this University.A 30 hour classroom based palliative care course, delivered by nurse educators, palliative care nurses and a chaplain in Cameroon was found to statistically significantly improve students’ overall palliative care knowledge. In this study students’ also had improvements in their self-perceived competence and confidence in palliative care provision, though this was not statistically significant.Student nurses in receipt of palliative care education were able to transfer their learning to practice. They reported recognizing patients with palliative care needs, providing patients with physical, psychosocial and spiritual support and communicating patient information to the wider care team. Notwithstanding this positive finding, some factors, related to the student themselves, the qualified nurses, the practice setting or the patient and family, were found to negatively impact on the learning transfer process. The students generally felt that the course was an ‘eye opener’ and met with their expectations. They perceived the major strength of the course was the use of interactive and stimulating educational strategies, but felt that the absence of a supervised clinical practice component with dying patients was a major weakness of this course. Conclusion There is a need for a curriculum revision to include palliative care content in the preregistration nurse training curricula of the pilot University. This seems to reflect a general need by all preregistration nursing students in this country. This study’s findings reveal the need to advocate for palliative care education and practice policies, and for adequately preparing clinical placement sites for nursing students’ palliative care learning and transfer of learning in Cameroon, and possibly other resource poor settings

Research on the legitimacy of the United Nations Human Rights Committee and the effectiveness of its function

La recherche sur la légitimité et l’effectivité du CDH vient du constat de la méconnaissance générale de la portée de sa mission, laquelle produit des effets néfastes sur celui-ci. Cette étude montre que malgré les limites imposées à cet organe par le PIDCP, son œuvre déployée a une portée considérable dans la protection internationale des droits de l’homme. Pour parvenir à cette fin, le CDH à adopter des techniques d’interprétation qui lui ont valu l’attention des organes tiers renforçant, par là même, sa légitimité. Poursuivant cette même finalité, afin de pallier l’absence de force obligatoire de ses décisions, il s’emploie à conférer à son activité une nature comparable à celle d’une juridiction formellement instituée afin d’attirer l’attention des États sur le degré d’autorité dont elles sont revêtues. Toutefois, nous proposons qu’à défaut que les États franchissent un nouveau cap en mettant en place une juridiction unique en la matière, il urge que le système soit rationalisé au nom de l’intérêt individuel. L’effectivité des droits de l’homme étant tributaire de leur volonté, la solution contre les écueils actuels nécessite un projet politique d’envergure de leur part.The research on the legitimacy and effectiveness of the HRC stems from the observation that there is a deep lack of knowledge regarding the scope of its mission, which has a negative impact on it. This study shows that despite the limits imposed on this body by the ICCPR, its work has a very significant impact on the international human rights protection. To achieve this end, the HRC adopted interpretation methods that have earned it the attention of others bodies, strengthening by the way its legitimacy. Pursuing the same goal, in order to overcome the non-binding nature of its decisions, it endeavors to give its activity the impression of that of a formally court-like function with the purpose to facilitate States’ compliance by the degree of authority with which they are endowed. However, we propose that if States do not take a new step by setting up a single international court in human rights field, it is an urgent that the UN treaties bodies system, as it known today, be rationalized for the individual’s interests. As the effectiveness of human rights dependent on States willingness, the solution against the current pitfalls requires a large-scale political project supported by them

Inequities in access to palliative and end-of-life care in the black population in Canada: a scoping review

Abstract Background Improving equity and early access to palliative care for underserved populations in Canada is a priority. Little is known regarding access to palliative and end-of-life care in the Black population. Methods We undertook a scoping review using the framework by Arksey and O’Malley to identify knowledge, access gaps, and experiences of palliative and end-of-life care among Blacks living with life-limiting illnesses in Canada. Primary studies, discussion papers, books, and reports were considered eligible. We followed a comprehensive search strategy developed by an information scientist. Searches were performed in the following bibliographic databases: Medline, EMBASE, PsycINFO via OVID, CINAHL via EBSCOhost, Scopus and Cochrane Library via Wiley. The search strategy was derived from three main concepts: (1) Black people; (2) Canada and Canadian provinces; (3) Palliative, hospice, or end-of-life care. No publication date or language limits were applied. Titles and abstracts were screened for eligibility by one reviewer and full text by two independent reviewers. Results The search yielded 233 articles. Nineteen articles were selected for full-text review, and 7 articles met the inclusion criteria. These studies were published between 2010 and 2021, and conducted in the provinces of Ontario and Nova Scotia only. Studies used both quantitative and qualitative methods and included cancer decedents, next of kin, family caregivers and religious leaders. Sample sizes in various studies ranged from 6 − 2,606 participants. Included studies reported a general lack of understanding about palliative and end-of-life care, positive and negative experiences, and limited access to palliative and end-of-life care for Blacks, across all care settings. Conclusion Findings suggest limited knowledge of palliative care and inequities in access to palliative and end-of-life care for Blacks living with life-limiting illnesses in 2 Canadian provinces. There is an urgent need for research to inform tailored and culturally acceptable strategies to improve understanding and access to palliative care and end-of-life care among Blacks in Canada