Teaching and Learning Interventions Designed to Improve Cultural Competence in Health Profession Students: A Systematic Review

Purpose: Developing healthcare profession students’ cultural competency knowledge, skills and attributes is critical to meet the needs of culturally and linguistically diverse healthcare service consumers. The purpose of this systematic review was to identify effective cultural competence interventions for healthcare profession students. Methods: A systematic review of peer reviewed articles published from 2010-2021 using PRISMA guidelines was conducted by searching CINAHL, EMBASE, ERIC, PubMed, and Psych INFO databases. Article quality was assessed using the Evaluation Tool for Quantitative Research and Mixed Method Appraisal Tool. Results: The initial search identified 2,261 potentially relevant studies, 41 studies met the inclusion criteria in which intervention effectiveness was evaluated using a validated outcome measure pre- and post- intervention. Only one study used a non-self-report outcome measure. Out of the 41 studies, only eight studies employed randomisation in the method. Conclusion/Recommendations: This review evaluated effectiveness of cultural competence interventions and evaluation of the intervention using either self-report or non-self-report validated outcome measures at pre- and post-intervention exposure. Combining cultural competence teaching methods such as lectures with simulations, role-playing and community engagement with diverse populations enhanced cultural competence. Further studies are required to compare effective cultural competence teaching models and identify reliable non-self-report outcome measures to assess the effectiveness of interventions post-exposure. Comparing effective cultural competence teaching models that utilise reliable non-self-report outcome measures will be valuable for guiding the design of teaching and learning interventions directed towards cultural competence. Further research is also required to examine the duration of intervention efficacy and how to maintain efficacy post-intervention exposure. Findings from this review are important for designing and structuring of cultural competence curriculum for healthcare profession students and informing future research on cultural competence teaching. This review has identified that most evaluation tools and studies have been designed for the nursing discipline. There is need to design more cultural competence evaluation tools and studies for other healthcare disciplines such as pharmacy and physical therapy

A Drosophila Model to Image Phagosome Maturation

Phagocytosis involves the internalization of extracellular material by invagination of the plasma membrane to form intracellular vesicles called phagosomes, which have functions that include pathogen degradation. The degradative properties of phagosomes are thought to be conferred by sequential fusion with endosomes and lysosomes; however, this maturation process has not been studied in vivo. We employed Drosophila hemocytes, which are similar to mammalian professional macrophages, to establish a model of phagosome maturation. Adult Drosophila females, carrying transgenic Rab7-GFP endosome and Lamp1-GFP lysosome markers, were injected with E. coli DH5α and the hemocytes were collected at 15, 30, 45 and 60 minutes after infection. In wild-type females, E. coli were detected within enlarged Rab7-GFP positive phagosomes at 15 to 45 minutes after infection; and were also observed in enlarged Lamp1-GFP positive phagolysosomes at 45 minutes.

Test Miniaturized and Portable Home-Based Vital Sign Monitor Design with Android Mobile Application

Frequent or continuous vital sign monitoring could help to decrease mortality rate as early detection of vital sign abnormality allow prompt medical action to be taken for early prevention measurement, especially to elderly people and patients who suffer from chronic disease or infectious disease. However, most of the vital sign monitor are designed for hospital usage and operated by healthcare professionals, which the devices are generally heavy duty, cost-expensive, and complicated user interface for home user. This paper proposes a miniaturized and portable home-based vital sign monitor, named myVitalGear, which can accurately measure heart rate using electrocardiogram (ECG), body temperature and blood oxygen saturation (SpO2), based on Arduino Nano technology. This device aims to enable frequent vital sign monitoring at home by reducing long distance travel to hospital and long waiting hour at hospital. The device consists of an AD8232 chip to acquire ECG for heart rate measurement and further heart rhythm abnormality detection, a high precision DS18B20 temperature sensor for body temperature measurement, and a MAX30100 pulse sensor for SpO2 monitoring. In this device, the Arduino Nano microcontroller acts as the master controller to control all the system peripherals and biomedical sensors to acquire and process all the vital signs.  The device also equipped with simple interface like light emitting diode (LED), liquid crystal display (LCD) and buzzer as the status indicator for layman user.  A mobile application which targeted to Android-based smart phone is also developed to communicate with myVitalGear through Bluetooth wireless communication. The mobile app support the functionalities of displaying the vital sign measurement result, automated short message service (SMS) notification message and user location sending to the healthcare provider or guardian, in case of any vital sign abnormality is detected.  Validation result has shown that the system able to measure vital sign with accuracy of 99.4%, 99.7% and 98.1% for heart rate, body temperature, and SpO2 respectively

Dosage Form Modification, a Simulation Activity between Nursing and Pharmacy Students

Background: The aim of this exploratory pilot study was to evaluate student perceptions of a simulation activity involving undergraduate nursing and pharmacy students. The key question was “how do nursing and pharmacy students respond in an immersive collaborative simulation activity which involves medication dosage form modification?” Methods: One hundred nursing students participated in a simulated exercise where patients required medications for which there were barriers to administration. Fourteen pharmacy students were also present in the simulated health environment, observing the work of the nursing students and being available to provide advice regarding medication administration to the nursing students. A mixed methods approach was employed for this exploratory pilot study, where both nursing and pharmacy students were invited to complete a survey regarding the experience at the end of the simulation exercise and pharmacy students completed a reflection. Both surveys and reflections were analyzed. Results: Survey results indicated very high satisfaction regarding the exercise for both pharmacy and nursing students. Analysis of pharmacy student reflections also indicated apprehension regarding their preparedness to contribute to the exercise, enjoyment in participation, their understanding of the value of collaboration between the two groups of students, and also recognition of their need to be more prepared for such situations. Conclusion: This study assessed student perceptions and did not formally evaluate learning outcomes. The interprofessional immersive simulated learning opportunity was viewed as valuable by both nursing and pharmacy students. The immersive simulation provided teaching staff with the opportunity to develop a new approach for the teaching of dosage form modification to both nursing and pharmacy students in an interprofessional setting

Functional Effects of Epilepsy Associated <i>KCNT1</i> Mutations Suggest Pathogenesis via Aberrant Inhibitory Neuronal Activity

KCNT1 (K+ channel subfamily T member 1) is a sodium-activated potassium channel highly expressed in the nervous system which regulates neuronal excitability by contributing to the resting membrane potential and hyperpolarisation following a train of action potentials. Gain of function mutations in the KCNT1 gene are the cause of neurological disorders associated with different forms of epilepsy. To gain insights into the underlying pathobiology we investigated the functional effects of 9 recently published KCNT1 mutations, 4 previously studied KCNT1 mutations, and one previously unpublished KCNT1 variant of unknown significance. We analysed the properties of KCNT1 potassium currents and attempted to find a correlation between the changes in KCNT1 characteristics due to the mutations and severity of the neurological disorder they cause. KCNT1 mutations identified in patients with epilepsy were introduced into the full length human KCNT1 cDNA using quick-change site-directed mutagenesis protocol. Electrophysiological properties of different KCNT1 constructs were investigated using a heterologous expression system (HEK293T cells) and patch clamping. All mutations studied, except T314A, increased the amplitude of KCNT1 currents, and some mutations shifted the voltage dependence of KCNT1 open probability, increasing the proportion of channels open at the resting membrane potential. The T314A mutation did not affect KCNT1 current amplitude but abolished its voltage dependence. We observed a positive correlation between the severity of the neurological disorder and the KCNT1 channel open probability at resting membrane potential. This suggests that gain of function KCNT1 mutations cause epilepsy by increasing resting potassium conductance and suppressing the activity of inhibitory neurons. A reduction in action potential firing in inhibitory neurons due to excessively high resting potassium conductance leads to disinhibition of neural circuits, hyperexcitability and seizures

Mutations in KCNT1 cause a spectrum of focal epilepsies

Summary Autosomal dominant mutations in the sodium-gated potassium channel subunit gene KCNT1 have been associated with two distinct seizure syndromes, nocturnal frontal lobe epilepsy (NFLE) and malignant migrating focal seizures of infancy (MMFSI). To further explore the phenotypic spectrum associated with KCNT1, we examined individuals affected with focal epilepsy or an epileptic encephalopathy for mutations in the gene. We identified KCNT1 mutations in 12 previously unreported patients with focal epilepsy, multifocal epilepsy, cardiac arrhythmia, and in a family with sudden unexpected death in epilepsy (SUDEP), in addition to patients with NFLE and MMFSI. In contrast to the 100% penetrance so far reported for KCNT1 mutations, we observed incomplete penetrance. It is notable that we report that the one KCNT1 mutation, p.Arg398Gln, can lead to either of the two distinct phenotypes, ADNFLE or MMFSI, even within the same family. This indicates that genotype-phenotype relationships for KCNT1 mutations are not straightforward. We demonstrate that KCNT1 mutations are highly pleiotropic and are associated with phenotypes other than ADNFLE and MMFSI. KCNT1 mutations are now associated with Ohtahara syndrome, MMFSI, and nocturnal focal epilepsy. They may also be associated with multifocal epilepsy and cardiac disturbances