An Online Pediatric Palliative Care Education and Mentoring (Project ECHO) in Nepal: A Program Implementation Case Study and Assessment of Changes in Healthcare Providers’ Knowledge, Confidence, and Attitudes

OBJECTIVES The goal of this implementation study was to describe the implementation and evaluation of the impact of an online pediatric palliative care training program in Nepal, using the Project ECHO model. METHODS The study used mixed methods, including a program case study describing the online learning program and before-and-after surveys of program participants, assessing learning through changes in knowledge, comfort, and attitudes. An end-of-program survey was used to evaluate participants’ overall experiences with the learning program and use of the learning resources. RESULTS A literature review, stakeholder surveys, and expert input informed the design of the intervention. The course used the Project ECHO model of online education, with modifications based on the leadership team's previous ECHO experiences and local stakeholder input. The intervention occurred over 9 months, with 22 online teaching sessions. Each session consisted of a didactic lecture, case presentation, and interactive discussion with expert clinical teachers. Fifty-five clinicians in Nepal participated, including physicians (47%), nurses (44%), and psychotherapists (5%). Clinicians reported improvements in knowledge, skills, and attitudes after program participation. Program acceptability scores were high, with 93% of participants reporting that the course provided effective learning. CONCLUSIONS Project ECHO can be successfully implemented to deliver continuing professional development in Nepal. Delivering palliative care education online using the Project ECHO model, leads to improved knowledge, skills, and attitudes for clinicians. Project ECHO suggests an innovative solution which can provide training and support to clinicians in settings where educational opportunities in palliative care are limited

Modeling and Mapping of Aboveground Biomass and Carbon Stock Using Sentinel-2 Imagery in Chure Region, Nepal

The concerns about climate change in recent decades have heightened the need for effective methods for assessing and reporting forest biomass and Carbon Stocks (CS) at local, national, continental, and global scales. Accurate assessment of Aboveground Biomass (AGB) is critical for the sustainable management of forests, especially in the Chure region, a fragile and young mountainous in the lesser Himalaya of Nepal. This paper presents the modeling and mapping approach and shows how medium-resolution Sentinel-2 multispectral instrument (MSI) data can be used instead of hyperspectral data in inaccessible areas of the Chure region. The data were collected and analyzed from 72 circular sample plots. 60% (43 random sample plots) were used to create the model, while the remaining 40% (29 plots) were used for model validation. This study involved calculating 12 different vegetation indices and correlating them with plot-level AGB. Five models, including linear, logarithmic, quadratic, power, and exponential, were created, but the best model was found to be the quadratic model using normalized difference vegetation indices (NDVIs) with an R2 value of 0.777 and a correlation coefficient of 0.881. The model’s AIC and BIC values were 313.60 and 320.65, respectively. The validity of the model was performed using observed and predicted AGB values, resulting in an r value of 0.9128, an R2 value of 0.8332, and an RMSE value of 10.7657 t·h−1. Finally, the developed regression equation was used to map AGB in the study area. The AGB per pixel ranges from 0 to 129.18 t·h−1, whereas the amount of CS ranges from 0 to 61.01 t·h−1. Among the different vegetation indices used in the study, NDVI was found to be more precise in estimating and mapping biomass and carbon stocks in this study. Therefore, the study recommends using the quadratic model of NDVI for accurate estimation of AGB and CS in the Chure region of Sainamaina municipality

sj-docx-1-mde-10.1177_23821205241234541 - Supplemental material for An Online Pediatric Palliative Care Education and Mentoring (Project ECHO) in Nepal: A Program Implementation Case Study and Assessment of Changes in Healthcare Providers’ Knowledge, Confidence, and Attitudes

Supplemental material, sj-docx-1-mde-10.1177_23821205241234541 for An Online Pediatric Palliative Care Education and Mentoring (Project ECHO) in Nepal: A Program Implementation Case Study and Assessment of Changes in Healthcare Providers’ Knowledge, Confidence, and Attitudes by Anisha Lynch-Godrei, Sudhir Sapkota, Jennifer Rowe, Bishnu Dutta Paudel, Garima Aryal and Megan Doherty in Journal of Medical Education and Curricular Development</p

sj-docx-2-mde-10.1177_23821205241234541 - Supplemental material for An Online Pediatric Palliative Care Education and Mentoring (Project ECHO) in Nepal: A Program Implementation Case Study and Assessment of Changes in Healthcare Providers’ Knowledge, Confidence, and Attitudes

Supplemental material, sj-docx-2-mde-10.1177_23821205241234541 for An Online Pediatric Palliative Care Education and Mentoring (Project ECHO) in Nepal: A Program Implementation Case Study and Assessment of Changes in Healthcare Providers’ Knowledge, Confidence, and Attitudes by Anisha Lynch-Godrei, Sudhir Sapkota, Jennifer Rowe, Bishnu Dutta Paudel, Garima Aryal and Megan Doherty in Journal of Medical Education and Curricular Development</p

sj-docx-3-mde-10.1177_23821205241234541 - Supplemental material for An Online Pediatric Palliative Care Education and Mentoring (Project ECHO) in Nepal: A Program Implementation Case Study and Assessment of Changes in Healthcare Providers’ Knowledge, Confidence, and Attitudes

Supplemental material, sj-docx-3-mde-10.1177_23821205241234541 for An Online Pediatric Palliative Care Education and Mentoring (Project ECHO) in Nepal: A Program Implementation Case Study and Assessment of Changes in Healthcare Providers’ Knowledge, Confidence, and Attitudes by Anisha Lynch-Godrei, Sudhir Sapkota, Jennifer Rowe, Bishnu Dutta Paudel, Garima Aryal and Megan Doherty in Journal of Medical Education and Curricular Development</p

Logistic Regression With Machine Learning Sheds Light on the Problematic Sexual Behavior Phenotype

Objectives: There has been a longstanding debate about whether the mechanisms involved in problematic sexual behavior (PSB) are similar to those observed in addictive disorders, or related to impulse control or to compulsivity. The aim of this report was to contribute to this debate by investigating the association between PSB, addictive disorders (internet addiction, compulsive buying), measures associated with the construct known as reward deficiency (RDS), and obsessive-compulsive disorder (OCD). Methods: A Canadian university Office of the Registrar invited 68,846 eligible students and postdoctoral fellows. Of 4710 expressing interest in participating, 3359 completed online questionnaires, and 1801 completed the Mini-International Neuropsychiatric Interview. PSB was measured by combining those screening positive (score at least 6) on the Sexual Addiction Screening Test—Revised Core with those self-reporting PSB. Current mental health condition(s) and childhood trauma were measured by self-report. OCD was assessed by a combination of self-report and Mini-International Neuropsychiatric Interview data. Results: Of 3341 participants, 407 (12.18%) screened positive on the Sexual Addiction Screening Test—Revised Core. On logistic regression, OCD, attention deficit, internet addiction, a family history of PSB, childhood trauma, compulsive buying, and male gender were associated with PSB. On multiple correspondence analysis, OCD appeared to cluster separately from the other measures, and the pattern of data differed by gender. Conclusions: In our sample, factors that have previously been associated with RDS and OCD are both associated with increased odds of PSB. The factors associated with RDS appear to contribute to a separate data cluster from OCD and to lie closer to PSB