Pharmacist-Facilitated Interactive E-Learning for Patients Newly Initiated on Warfarin: A Randomised Controlled Study

It is not known whether electronic-learning (e-learning) is effective for educating hospital inpatients about complex medications such as warfarin. This prospective randomised controlled study compared pharmacist-facilitated e-learning with standard pharmacist-delivered face-to-face education on patients’ or their unpaid carers’ knowledge of warfarin and satisfaction with warfarin education as well as the time that was spent by pharmacists in delivering warfarin education. Adult English-speaking patients (or their carers) who had been prescribed warfarin were randomised to receive standard pharmacist face-to-face education (control) or an e-learning module on a tablet device facilitated by a pharmacist (intervention). All of the participants received written warfarin information and were presented with the opportunity to ask any questions that they may have had to a pharmacist. Fifty-four participants completed the study (27 per group). The participants who received e-learning had median correct Oral Anticoagulation Knowledge (OAK) test scores of 85% compared to 80% for standard education (p = 0.14). The participants in both groups were satisfied with the information that they received. There was a trend towards pharmacists spending less time on warfarin education for the e-learning group than in the standard education group (25.5 vs. 33 min, respectively, p = 0.05). Education delivered via pharmacist-facilitated e-learning was non-inferior in terms of patient or carer warfarin knowledge compared to standard pharmacist-delivered education.

Possibilities of Preparing Pupils for Proof Problems of Synthetic Plane Geometry Solvable by Deductive Methods

Proof problems, especially the ones of the synthetic plane geometry solvable by deductive methods, play a significant role in mathematical education and due to their demanding principle also in the above-standard education including mathematical competitions. Therefore, the issue of preparing pupils for solving the proof problems is very important. This study aimed to find out if the contemporary state of the system of pupils’ preparation for synthetic plane geometry proof problems is sufficient enough for the mentioned purpose. From the full set of schools of the Czech Republic, there were 14 schools identified as the successful ones based on the results of the national round of the Mathematical Olympiad. These schools were asked questions about literature used for pupils’ preparation and the publications named in the answers were then deeply inspected. The results showed a narrow range of the literature used by the schools and the didactic-methodical inspection of stated literature detected considerable space for improvements which led the author to the main theme of his dissertation.

Biosimilar strategic implementation at a large health system

Disclaimer In an effort to expedite the publication of articles , AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose This article highlights one health system’s response to the market influx of biosimilars with the establishment of a process for formulary review and selection of preferred agents and support for therapeutic interchanges. Summary Through assessment of available literature, insurance payor coverage, and manufacturer-anticipated approvals of biosimilars, a strategic stance was developed to guide biosimilar order preparation, review, adoption, and implementation. The electronic medical record (EMR) is prepared for biosimilar implementation at least 6 to 12 months ahead of anticipated formulary review. The review includes assessment of a class (reference product and available biosimilars) after at least 2 biosimilars become available. Key health-system departments and clinicians are enlisted to support review of clinical, safety, and economic implications. Implementation of a preferred product relies on standard education, formulary availability, and staff awareness to address any perceived patient safety concerns and gather provider support. The standard steps developed now apply to all future biosimilar reviews, adoption plans, and ongoing monitoring. Barriers evaluated include changes in payor coverage and challenges in preparation of the EMR for future biosimilars, meeting precertification team education needs, and providing operational support for pharmacy inventory. Conclusion To date, use of 5 preferred biosimilar products has led to significant cost savings to the institution, and the process has been endorsed by providers. The institution’s successes can be attributed to clear communication with stakeholders and the development of a deliberate process, led by a multidisciplinary leadership team, for managing formulary, safety, and operational barriers in a thoughtful and systematic manner.

Reducing Length of Stay and Hospital Readmission for Orthopedic Patients: A Quality Improvement Project

BackgroundTransitioning patients from the hospital to home after a total hip or knee arthroplasty is challenging. Severe pain, comorbidities and complex medication regimes have the potential to delay readiness for discharge, increase length of stay (LOS), and cause readmissions.ObjectiveThe goal of this practice improvement project was to improve patient readiness for discharge after total joint arthroplasty to reduce LOS, prevent emergency department (ED) visits, and prevent hospital readmissions.MethodsThis quality improvement project was guided by the Iowa Model and implemented a prepost program implementation evaluation design. Nurses incorporated the Registered Nurse Assessment of Readiness for Hospital Discharge Scale (RN-RHDS) to guide and evaluate discharge education efforts.ResultsThe focused education cohort demonstrated significantly decreased LOS and decreased readmissions compared to the cohort receiving standard education efforts. ED visits were not significantly different amongst cohorts.ConclusionThis practice improvement project demonstrates successful translation of research into practice.Implications for NursingThe use of focused education and the RN-RHDS tool is recommended for nursing to improve patient readiness for discharge and patient outcomes.

Buerger Exercise Reduces the Risk of Neuropathy in People with Diabetes Mellitus

Introduction: Diabetes mellitus (DM) remains the major global health problem, predicted to exceed half a billion people in 2040. One of the major complications was lower extremity neuropathy leading to foot ulcer and amputation. This study aimed to investigate the effect of routine Buerger exercise on the neuropathy index of people with DM. Methods: A pre-and posttest quasi-experimental study between May and August 2018 involving DM patients in primary health centre was conducted. They were prospectively recruited and either be allocated into the intervention group where the monitored routine Buerger exercise was performed or control group with the standard education on DM. Michigan Neuropathy Screening Instrument (MNSI) with subjective and objective measurement was used to evaluate the neuropathy index. Results: Seventy-seven participants (63 females) with mean age of 58.2±7.2 years completed the study with similar characteristics. Mean pretest MNSI score for intervention and control group were 3.8±1.7 and 3.9±1.6 respectively, and were not different (P = 0.561). At the end of follow up, significant decrease was observed in the intervention group (2.8±2.2, P = 0.011) but not in control group (4.0±1.9, P=0.947). Physical examination according to MNSI guideline showed a significant reduction in the neuropathy score for the intervention group from 1.8±1.4 at the start to 1.3±1.1 at the end of the study (P< 0.001), but this was not seen in the control group. Conclusion: Buerger exercise had a beneficial effect on improving the neuropathy index and symptoms of DM patients with high risk of diabetic foot ulcer.

MODELING METHODS AIMED AT THE FORMATION OF UNIVERSAL TRAINING IN THE INITIAL EDUCATION

Modeling in the form of essentially, organizational and targeted methodological innovations of methodical innovations for primary education. Theory and practice required to systematically update primary education, primary education standard education, was studied.

Manajemen Pembiayaan Pendidikan (Analisis Konsep dan Implikasinya Terhadap Peningkatan Mutu Pendidikan)

This study aims to analyze the basic concepts of education financing and its implications for improving the quality of education. This research uses the Library Research method. The results showed that improving the quality of an educational institution / institution is the hope and desire of the community who use educational services. Therefore, to make this happen, various strategic efforts have been made by the government and the community as managers and education stakeholders. Among them, what the government is doing is designing national education standards. Based on the law national education system Number. 20 of 2003 there are 8 national standards, which aim to improve the quality of an educational institution. Based on government regulations, one of the eight national education standards is a financing standard. education financing is the most important and inseparable thing in education management activities. So, among other things, the government policy is to roll out BOS funds at the school level. Education financing and funding managed by schools / madrasahs must be transparent in order to create accountability. If it is accountable, it will increase the credibility of the educational institution. If it is credible, it will automatically improve the quality of the educational institution. To achieve this, the government regulates the term financing standards

The challenges of modern education – a student with Asperger Syndrome (autism spectrum disorder) in a classroom

Currently, many students in mainstream schools have been diagnosed with Asperger Syndrome or symptoms of Autism Spectrum Disorder (ICD10). Since the term Asperger Syndrome has been adopted in both scientific and colloquial language and is associated with specific dysfunctions in specific spheres, I will use this term for the purposes of this article. Some of these students may have associated difficulties, e.g., in learning or ADHD. In schools, it is not uncommon to also find students who exhibit autism or Asperger syndrome behaviour but without a diagnosis. By participating in the standard education cycle, teaching in elementary schools become a challenge for teachers because they face many challenges themselves. The purpose of the article is to show the difficulties faced by students with Asperger syndrome at school. An indication of how teachers can organize work in the classroom to ensure optimal working conditions for students with AS and to avoid provoking unnecessary tensions and frustration that would disturb work during the lesson will be provided.

Accounting education requirements in Algeria according to the International Standard Education (IESs 6): A comparative study between the standard and the Institute of Education Specialized in the Accounting Profession (IESPC)

This study examines the extent to which the Institute of Education Specialized in the Accounting Profession in Algeria responded to the requirements of the International Standards for Education No. 06 related to the assessment of professional competence. As well as the merits of the institute of education specialized in the accounting profession created in Algeria, and this is for the purpose of comparison and the extent of the latter’s response to the requirements of the standard, and for that we will rely on the descriptive analytical approach by reviewing the international standard for education and explaining in detail the procedures and stages that the stalker goes through to reach a profession, and then adopt The comparative approach by identifying the congruences and differences between the content of the standard and the content, where it was reached in the end that the educational path in the institute responded to most of the requirements of the standard, especially the tests used to evaluate trainees for the purpose of obtaining certificates, but it has not been applied so far, which hinders the evaluation process.

Perancangan Content Authoring Tool Berbasis Scorm (Sharable Content Object Reference Model) Pada Sistem E-Learning SMK Negeri 1 Batipuh

E-learning merupakan bentuk model pembelajaran yang diakomodasi dan disuport dalam teknologi dalam suatu sistem informasi. Dalam lembaga pendidikan tentu dibutuhkan untuk menolong guru dalam peningkatan efesiensi proses belajar. Oleh karena itu tujuan dari adanya e-learning di SMK Negeri 1 Batipuh selaku lembaga pendidikan di masa pandemi Coronavirus Disease-19 harus diberlakukan pembelajaran jarak jauh atau work from home. Perubahan bentuk pelayanan pendidikan berstandar SCORM (Sharable Content Object Reference Model), dalam permodelan SCORM menggunakan metode waterfall dalam membangun sistim yang baik, dimana tenaga pendidik bisa memberikan pembelajaran kepada peserta didik terhadap aktivitas transfer ilmu khususnya dengan menyajikan video dalam bentuk materi ditambah metode diskusi beserta emoticon agar siswa lebih memahami, menarik dan menjadi giat dalam proses belajar. Setelah melakukan riset di sekolah terkait, maka penulis menyimpulkan bahwa dibutuhkan sebuah sistem e-learning yang memudahkan proses belajar dan mengajar. Dengan bahasa pemrograman PHP dan framework CodeIgniter maka dirancanglah sebuah sistem e-learning yang mampu menghubungkan siswa dan guru.Kata Kunci : E-Learning, SCORM, Coronavirus Disease-19, Framework CodeIgniter.. E-learning is a form of learning model that is accommodated and supported in technology in an information system. In educational institutions, of course, it is needed to help teachers in increasing the efficiency of the learning process. Therefore, the purpose of e-learning at SMK Negeri 1 Batipuh as an educational institution during the Coronavirus Disease-19 pandemic, distance learning or work from home should be implemented. Changes in the form of SCORM standard education services (Sharable Content Object Reference Model), in SCORM modeling using the waterfall method in building a good system, where educators can provide learning to students about knowledge transfer activities, especially by presenting videos in the form of materials plus discussion methods along with emoticons so that students better understand, be interesting and become active in the learning process. After conducting research in related schools, the authors conclude that an e-learning system is needed that facilitates the learning and teaching process. With the PHP programming language and the CodeIgniter framework, an e-learning system is designed to connect students and teachers.Keywords: E-Learning, SCORM, Coronavirus Disease-19, CodeIgniter Framework.