Assessment of Readiness of Newly Graduated Health Professionals to Communicate with Patients in Duhok, Kurdistan Region, Iraq

Communication Skills (CS) are essential to health workforce to conduct effective professional-patient interaction. In Iraq, majority of newly graduated health professionals are engaged in provision of direct health services. However, undergraduate curricula preparing these professionals include no distinct component to train them on CS. This study aims at assessing the status of CS among Health Professions Education (HPE) graduates of University of Duhok (UoD) and estimating the perception of their patients toward those skills. This cross-sectional study was conducted in 2014. Data on communication skills was obtained, from samples of different health professionals which included: medical doctors (junior residents, nurses, dentists and pharmacists) who recently graduated from different colleges at the UoD. Also, data from was obtained, their patients, to assess their satisfaction of the professionals’ CS. For assessing core CS, a specially designed checklist was adopted from Calgary-Cambridge Guide. Also, senior clinicians were asked on CS performed by their junior residents. Results show that 88% of the senior academic staff regarded CS as “highly essential” and 66% of them were not satisfied with interns’ conduct and suggested that CS should clearly be included in the medical curricula. The basic CS were perceived by patients as either not practiced or wrongly practiced. Patients were unsatisfied with the CS of their attending HPs during observed consultation sessions. The study shows obvious lack of CS among HPE graduates of UoD with patients’ dissatisfaction of their CSs. It seems legitimate to propose that relevant training elements to be designed and incorporated within training modules are needed to realize as a core element of the curriculum of all HPE colleges at the UoD. Keywords: Communication, skills, perception, graduates, Kurdistan-Iraq. DOI: 10.7176/JHMN/73-02 Publication date: April 30th 202

Construction Firm Readiness towards Implementing Integrated Project Delivery (IPD)

The Malaysian government has taken the initiative of implementing Industrialised Building System (IBS) in which components are manufactured in mass production under a controlled environment (on or off site), transported, positioned and assembled into a structure with minimal additional site works. It is hope that IBS can improve the performance of construction industry. However, one of the main barriers in Malaysian IBS implementation is lack of integration among stakeholder involved during the project delivery stage. In order to overcome this barrier, a new collaborative procurement or project delivery namely as Integrated Project Delivery (IPD) which is using a multi-party contract (more than two parties selected) has been introduced. Integrated Project Delivery (IPD) is defined as a project delivery approach that integrates people, systems, business structures and practices into a process that collaboratively harnesses the talents and insights of all project participants to optimise the results, increase value to the owner, reduce waste, and maximize efficiency through all phases of design, fabrication and construction. Although, many researchers have argue the importance of IPD in project delivery process, but the readiness of construction industries must be established. This research has used a quantitative research process that involved a few phases including literature review stage, data collection stage, framework development stage, validation and recommendation stage. This research is to obtain data based on multidisciplinary IBS stakeholders perspectives, respondent include project managers, resident engineers, architects and contractors are among the potential candidates. Respondents that directly involved in the construction industry mentioned that their firms are willing to change and implement IPD. The firms readiness recorded at the moderate mean value. It can be noted that each firm involved as respondents are ready to implement

Mutaba'ah - Mother and Child Health Study:Protocol for a prospective cohort study investigating the maternal and early life determinants of infant, child, adolescent and maternal health in the United Arab Emirates

Introduction: Early life exposures, particularly environmental and parental lifestyle factors, have a major influence on children's health and development. Due to increasing interest in the early life developmental origins of diseases, many birth cohorts have been established. These studies constitute a repository of data which researchers use over many years to investigate emerging research questions. However, no such databank or cohort study is available in the United Arab Emirates (UAE). This project aims to establish a prospective mother and child cohort study in Al Ain (Abu Dhabi, UAE) to investigate the maternal and early life determinants of infant, child, adolescent and maternal health of the Emirati population. Methods and analysis: During the period 2017-2021, this study aims to recruit 10 000 pregnancies at approximately 12 weeks of gestation from hospitals and clinics in Al Ain city. For each mother/newborn pair, an initial dataset will be collected including anthropometric, physiological and biochemical measurements, medical interventions, circumstances of pregnancy, delivery details and neonatal and perinatal growth and health using a combination of questionnaires, interviews and medical record extractions. Baseline data will act as the starting point from which the children will be followed up and re-surveyed at intervals throughout their life course until the age of 16 years, to explore how familial, socioeconomic and lifestyle factors interact with genetic and environmental factors to influence health outcomes and achievements later in life. Ethics and dissemination: Ethical approval has been granted by the United Arab Emirates University Human Research Ethics Committee and the ethical committees of the participating institutions. Results: will be widely disseminated via peer-reviewed manuscripts, conference presentations, media outlets and reports to relevant authorities.</p

Selectivity of mass extinctions: Patterns, processes, and future directions

A central question in the study of mass extinction is whether these events simply intensify background extinction processes and patterns versus change the driving mechanisms and associated patterns of selectivity. Over the past two decades, aided by the development of new fossil occurrence databases, selectivity patterns associated with mass extinction have become increasingly well quantified and their differences from background patterns established. In general, differences in geographic range matter less during mass extinction than during background intervals, while differences in respiratory and circulatory anatomy that may correlate with tolerance to rapid change in oxygen availability, temperature, and pH show greater evidence of selectivity during mass extinction. The recent expansion of physiological experiments on living representatives of diverse clades and the development of simple, quantitative theories linking temperature and oxygen availability to the extent of viable habitat in the oceans have enabled the use of Earth system models to link geochemical proxy constraints on environmental change with quantitative predictions of the amount and biogeography of habitat loss. Early indications are that the interaction between physiological traits and environmental change can explain substantial proportions of observed extinction selectivity for at least some mass extinction events. A remaining challenge is quantifying the effects of primary extinction resulting from the limits of physiological tolerance versus secondary extinction resulting from the loss of taxa on which a given species depended ecologically. The calibration of physiology-based models to past extinction events will enhance their value in prediction and mitigation efforts related to the current biodiversity crisis

Evolutionary history of endogenous Human Herpesvirus 6 reflects human migration out of Africa

Human herpesvirus 6A and 6B (HHV-6) can integrate into the germline, and as a result, ∼70 million people harbor the genome of one of these viruses in every cell of their body. Until now, it has been largely unknown if 1) these integrations are ancient, 2) if they still occur, and 3) whether circulating virus strains differ from integrated ones. Here, we used next-generation sequencing and mining of public human genome data sets to generate the largest and most diverse collection of circulating and integrated HHV-6 genomes studied to date. In genomes of geographically dispersed, only distantly related people, we identified clades of integrated viruses that originated from a single ancestral event, confirming this with fluorescent in situ hybridization to directly observe the integration locus. In contrast to HHV-6B, circulating and integrated HHV-6A sequences form distinct clades, arguing against ongoing integration of circulating HHV-6A or “reactivation” of integrated HHV-6A. Taken together, our study provides the first comprehensive picture of the evolution of HHV-6, and reveals that integration of heritable HHV-6 has occurred since the time of, if not before, human migrations out of Africa

Early Ahmed Glaucoma Valve Implantation after Penetrating Keratoplasty Leads to Better Outcomes in an Asian Population with Preexisting Glaucoma

To evaluate the efficacy of Ahmed Glaucoma Valve (AGV) surgery and the optimal interval between penetrating keratoplasty (PKP) and AGV implantation in a population of Asian patients with preexisting glaucoma who underwent PKP.In total, 45 eyes of 45 patients were included in this retrospective chart review. The final intraocular pressures (IOPs), graft survival rate, and changes in visual acuity were assessed to evaluate the outcomes of AGV implantations in eyes in which AGV implantation occurred within 1 month of post-PKP IOP elevation (Group 1) and in eyes in which AGV implantation took place more than 1 month after the post-PKP IOP evaluation (Group 2). Factors that were associated with graft failure were analyzed, and the overall patterns of complications were reviewed. By their final follow-up visits, 58% of the patients had been successfully treated for glaucoma. After the operation, there were no statistically significant differences between the groups with respect to graft survival (p = 0.98), but significant differences for IOP control (p = 0.049) and the maintenance of visual acuity (VA) (p<0.05) were observed. One year after surgery, the success rates of IOP control in Group 1 and Group 2 were 80% and 46.7%, respectively, and these rates fell to 70% and 37.3%, respectively, by 2 years. Factors that were associated with a high risk of AGV failure were a diagnosis of preexisting angle-closure glaucoma, a history of previous PKP, and a preoperative IOP that was >21 mm Hg. The most common surgical complication, aside from graft failure, was hyphema.Early AGV implantation results in a higher probability of AGV survival and a better VA outcome without increasing the risk of corneal graft failure as a result of post-PKP glaucoma drainage tube implantation

Diasporic virginities: social representations of virginity and identity formation amongst British arab muslim women

This study compares how practising and non-practising British Arab Muslim women position themselves in relation to representations of virginity. Overall, in our qualitative study, we found that representations of culture and religion influenced social practices and social beliefs in different ways: non-practising Muslim women felt bound by culture to remain virgins, while practising Muslim women saw it as a religious obligation but were still governed by culture regarding the consequences of engaging in premarital sex. Interestingly, some practising Muslim participants used Mut’a (a form of temporary ‘marriage’) to justify premarital sex. This, however, did not diminish the importance of virginity in their understanding and identification as Arab women. In fact, this study found that virginity, for the British Arabs interviewed, embodied a sense of ‘Arabness’ in British society. Positioning themselves as virgins went beyond simply honour; it was a significant cultural symbol that secured their sense of cultural identity. In fact this cultural identity was often so powerful that it overrode their Islamic identities, prescribing their behaviour even if religion was seen as more ‘forgiving’

The Experience of Quality in Higher Education in the United Arab Emirates: In Times of Rapid Change and Complexities

In less than five decades, from offering formal education only in a few schools to a small tribal community to providing a selection of three public and approximately 100 private higher education institutions to the citizens of seven emirates creates a unique context in the United Arab Emirates (UAE). It is an evolution that corresponds with its remarkable economic growth. Quality assurance of diverse higher educational institutions requires complex schemes to ensure their fitness for purpose, while perhaps development and enhancement aspects need time to mature. The quality of the education is especially important because the UAE yearns for the diversified and knowledge-based economy; one that is led by its own citizens whose contribution to the workforce is currently less than 10%. This chapter highlights contextual complexities in the UAE that might have direct and/or indirect impacts on the quality experiences in the higher education sector, with proposed recommendations

Apoptosis of CD4+CD25high T Cells in Type 1 Diabetes May Be Partially Mediated by IL-2 Deprivation

from T1D subjects. in T1D may be caught up in a relatively deficient cytokine milieu. function in subjects predisposed to T1D

Cytotoxic drug sensitivity of Epstein-Barr virus transformed lymphoblastoid B-cells

BACKGROUND: Epstein-Barr virus (EBV) is the causative agent of immunosuppression associated lymphoproliferations such as post-transplant lymphoproliferative disorder (PTLD), AIDS related immunoblastic lymphomas (ARL) and immunoblastic lymphomas in X-linked lymphoproliferative syndrome (XLP). The reported overall mortality for PTLD often exceeds 50%. Reducing the immunosuppression in recipients of solid organ transplants (SOT) or using highly active antiretroviral therapy in AIDS patients leads to complete remission in 23–50% of the PTLD/ARL cases but will not suffice for recipients of bone marrow grafts. An additional therapeutic alternative is the treatment with anti-CD20 antibodies (Rituximab) or EBV-specific cytotoxic T-cells. Chemotherapy is used for the non-responding cases only as the second or third line of treatment. The most frequently used chemotherapy regimens originate from the non-Hodgkin lymphoma protocols and there are no cytotoxic drugs that have been specifically selected against EBV induced lymphoproliferative disorders. METHODS: As lymphoblastoid cell lines (LCLs) are well established in vitro models for PTLD, we have assessed 17 LCLs for cytotoxic drug sensitivity. After three days of incubation, live and dead cells were differentially stained using fluorescent dyes. The precise numbers of live and dead cells were determined using a custom designed automated laser confocal fluorescent microscope. RESULTS: Independently of their origin, LCLs showed very similar drug sensitivity patterns against 29 frequently used cytostatic drugs. LCLs were highly sensitive for vincristine, methotrexate, epirubicin and paclitaxel. CONCLUSION: Our data shows that the inclusion of epirubicin and paclitaxel into chemotherapy protocols against PTLD may be justified