Serving an Indigenous community: Exploring the cultural competence of medical students in a rural setting

Since 2013, medical students from the International Medical University (IMU) in Malaysia have been providing primary healthcare services, under the supervision of faculty members, to the indigenous people living in Kampung Sebir. The project has allowed the students to learn experientially within a rural setting. This study aims to examine the cultural competence of IMU medical students through an examination of their perspective of the indigenous people who they serve and the role of this community service in their personal and professional development. Students who participated in the project were required to complete a questionnaire after each community engagement activity to help them reflect on the above areas. We analysed the responses of students from January to December 2015 using a thematic analysis approach to identify overarching themes in the students’ responses. Students had differing perceptions of culture and worldviews when compared to the indigenous people. However, they lacked the self-reflection skills necessary to understand how such differences can affect their relationship with the indigenous people. Because of this, the basis of their engagement with the indigenous community (as demonstrated by their views of community service) is focused on their agenda of promoting health from a student’s perspective rather than connecting and building relationships first. Students also lacked the appreciation that building cultural competency is a continuous process. The results show that the medical students have a developing cultural competence. The project in Kampung Sebir is an experiential learning platform of great value to provide insights into and develop the cultural competency of participating students. This study also reflects on the project itself, and how the relationship with stakeholders, the competence and diversity of academic staff, and the support of the university can contribute toward training in cultural competence

Double-burden of malnutrition among the indigenous peoples (Orang Asli) of Peninsular Malaysia

Background: Double-burden of malnutrition (DBM) is an emerging public health concern among the Orang Asli (indigenous peoples) of Peninsular Malaysia. This study aimed to identify the presence of DBM at the community and household levels in Orang Asli population and its associated demographic and socio-economic factors. Methods: This cross-sectional study was conducted in 11 Orang Asli villages surrounding the Krau Wildlife Reserve, Peninsular of Malaysia from October 2011 to January 2012. Of 438 households, a total of 981 adults and 304 children who met the study criteria agreed to participate. About 160 households were further selected with pairs of children aged 3–59 months and non-pregnant mothers aged 15–55 years. Demographic and socio-economic data were obtained using interviewer-administered questionnaire while weight and height were measured using standard procedures. Double-burden of malnutrition was defined as overweight/obese mother-underweight child (OWOBM/UWC), overweight/obese mother-stunted child (OWOBM/STC) or overweight/obese mother-underweight or/and stunted child (OWOBM/UWSTC). Binary logistic regression identified the demographic and socio-economic factors associated with double-burden households. Results: About 26 % of overweight and obese adults coexisting with high proportions of underweight (49 %) and stunted (64 %) children in these Orang Asli villages. There was a higher prevalence of households with OWOBM/ UWSTC (20 %) and OWOBM/STC (19.4 %) than households with OWOBM/UWC (12.5 %). Boys (P < 0.05), older age mothers (P < 0.05), mothers with higher education (P < 0.05) and households with income per capita less than USD 29.01 (RM 97.00) (P < 0.01) were associated with higher odds of OWOBM/STC. Jah Hut (P < 0.05) and higher number of children (P < 0.05) were significantly associated with lower odds of OWOBM/UWC. Conclusions: The occurrence of double-burden of malnutrition in Orang Asli population deserves attention. Poverty reduction, access to quality diet and improved health and nutrition literacy are among strategies that could address the coexistence of DBM in this population

Your perception may predict your anxiety level: a preliminary study in primary care in Singapore

Background: Patients’ perception of their medical illness has been shown to associate with not only their responses to the illness but under certain conditions even outcomes of their illness. While anxiety is prevalent among primary care patients, illness perception studies relating to anxiety in this population are scarce. This study aimed to fill this gap and explore clues for perceptual elements of primary care patients’ effective management of their own anxiety. Methods: Ninety-five adult participants (65% female and 35% male) were recruited in two primary care clinics in this cross-sectional study. The questionnaires administered were Generalized Anxiety Disorder-7 (GAD-7) and Illness Perception Questionnaire Mental Health (IPQ-MH) were used to assess anxiety and illness perception respectively. Data analysis was conducted using Spearman’s rho correlation coefficients and linear regression. Results: Four specific dimensions of the participants’ illness perception (i.e., consequences, personal control, coherence and biology) were found to be significantly correlated with their severity of anxiety. In other words, the participants experienced higher anxiety when they perceived a serious impact of anxiety in their lives, experienced a diminished sense of self-efficacy, had trouble understanding their condition and attributed their anxiety to biological causes (which could presumably be ameliorated only with medication). Conclusion: Attribution to biological factors and personal control were highly significant predictors of severity of anxiety. Clinicians should consider psychological interventions that target patients’ medication adherence as well as their physiological responses to anxiety (e.g., breathing skills). Further, anxiety patients’ experience of personal control should be enhanced which could be facilitated through deliberate assessment and reinforcement of the strengths and resources in the patients’ psychosocial spheres

Proceedings of The HKIE Geotechnical Division 44th Annual Seminar - Elevating Geotechnical Excellence: Novel Practices & Innovative Solutions

This seminar proceedings contain articles on the various research ideas of the academic community and practitioners presented at The HKIE Geotechnical Division 44th Annual Seminar (GDAS2024). This seminar provides a platform for policymakers, practitioners, and academia to share their insights and brainstorm ideas with a view to seizing future opportunities and shaping the new future of Hong Kong. GDAS2024 was organized by the Geotechnical Division, The Hong Kong Institution of Engineers on 31st May 2024. Seminar Title: The HKIE Geotechnical Division 44th Annual SeminarSeminar Acronym: GDAS2024Seminar Date: 31 May 2024Seminar Location:  Hong KongSeminar Organizers: Geotechnical Division, The Hong Kong Institution of Engineers Link to the GDAS2021 Proceedings: Proceedings of The HKIE Geotechnical Division 41st Annual Seminar Link to the GDAS2022 Proceedings: Proceedings of The HKIE Geotechnical Division 42nd Annual Seminar Link to the GDAS2023 Proceedings: Proceedings of The HKIE Geotechnical Division 43rd Annual Semina

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

Background Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. Methods We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). Findings In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683–0·717]). Interpretation In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. Funding British Journal of Surgery Society

Cooperative learning

The purpose of this study is to assess whether small group learning and tutor’s participation in NTU helps in the student performance. There has been extensive research in the area of cooperative learning. This is due to the growing emphasis on participatory educational methods rather than the traditional method of mere dictation by the teacher and acceptance by the student. The research done in the past on effectiveness of cooperative learning indicated that students achieved better academic results in cooperative learning situations than individualistic ones.ACCOUNTANC

Dynamic Changes in the Quantitative Electroencephalographic Spectrum During Attention Tasks in Patients With Prader–Willi Syndrome

Introduction: Attention problems are frequently observed in patients with Prader–Willi syndrome (PWS); however, only few studies have investigated the severity and mechanisms of attention problems in them. In this study, we aim to evaluate dynamic changes in the quantitative electroencephalographic (EEG) spectrum during attention tasks in patients with PWS.Method: From January to June 2019, 10 patients with PWS and 10 age-matched neurotypical control participants were recruited at Taipei Tzu Chi Hospital. Each participant completed Conners’ continuous performance test, third edition (CPT-3), tasks with simultaneous EEG monitoring. The dynamic changes in the quantitative EEG spectrum between the resting state and during CPT-3 tasks were compared.Results: Behaviorally, patients with PWS experienced significant attention problems, indicated by the high scores for several CPT-3 variables. The theta/beta ratio of the resting-state EEG spectrum revealed no significant differences between the control participants and patients with PWS. During CPT-3 tasks, a significant decrease in the alpha power was noted in controls compared with that in patients with PWS. The attention-to-resting alpha power ratio was positively correlated with many CPT-3 variables. After adjusting for genotype, age, intelligence, and body mass index, the attention-to-resting alpha power ratio was still significantly correlated with participants’ commission errors.Conclusion: This study provides evidence that attention problems are frequently observed in patients with PWS, while attention impairment can be demonstrated by dynamic changes in the quantitative EEG spectrum.</jats:p

FPGA Implementation of Real Time String Colour Detection

A Machine vision for string detection is useful technologies which benefit to the industries such as food production. It reduces the risk that can harmful to our health and it can do work more accurate and efficient. The algorithm used is a colour detection which determines the colour of string and background subtraction for filter process by using the threshold range values. The target of detection focuses on plastic string with two different colours; pink and yellow strings. The threshold values used in hardware detection are ranged from 158 to 175 and 3 to 35 for pink and yellow string colours, respectively. The result shows that an object tied with strings is able to be detected and captured by using this system. Overall, this project is successfully developed and achieved the goal for real time detecting a string which is implemented on FPGA