Conversion of carbon black recovered from waste tires into activated carbon via chemical/microwave methods for efficient removal of heavy metal ions from wastewater

In this research study, recovered carbon black (rCB) was obtained via pyrolysis of waste tires. The obtained rCB was then converted into activated carbon species through both chemical treatment and microwave coupled with chemical treatment as a two-step activation process. The activated carbon obtained from chemical activation was denoted as C-AC, while that obtained from exposure to microwave followed by chemical activation was labeled as MC-AC. These two structures were consequently introduced as sorbents for the removal of cadmium ions from an aqueous solution. The structural characteristics of the introduced adsorbents were confirmed using various techniques, namely X-ray diffraction (XRD), Fourier-transform infrared (FTIR) spectroscopy, and energy-dispersive X-ray (EDX) spectroscopy. Additionally, textual features of these adsorbents were acquired via both scanning electron microscopy (SEM) and N2 adsorption-desorption BET surface area analyses. These two structures were then introduced for Cd ion adsorption under different operating conditions. Particularly, the effect of pH, contact time, adsorbent dose, and metal ion concentration on the efficiency of adsorption was investigated. The 1maximum adsorption capacity was detected at a pH value of 5.0, a contact time of 30 min, a sorbent dose of 0.4 g L-1, and an initial metal concentration of 50 mg L-1 using MC-AC, which exhibited nearly double the sorption capacity detected for C-AC. Kinetic studies indicated that the process of Cd(ii) adsorption is perfectly described and fitted by the pseudo-second-order model. However, adsorption isotherms for the two adsorbents were found to match the Langmuir model, referring to the occurrence of uniform monolayer adsorption for the metal ions. Thermodynamic analysis demonstrated that the adsorption process was spontaneous and endothermic.

Nickel-hydroxide-encapsulated polyacrylamide as a novel adsorptive composite for the capture of methylene blue from wastewater

The wastewater released from different industries is a major environmental issue that has grabbed significant attention lately. Thus, the implementation of suitable routes for the treatment of such water is strongly recommended to reach the level of possible reuse for either industrial or agricultural purposes. In line with such a concept, this research work introduces a new composite structure made via the coating of polyacrylamide by loading nickel hydroxide nanoparticles for use as an absorbent for the purification of wastewater from dye contaminants. High internal phase emulation (HIPE) polymerization was utilized to first prepare particles of polyacrylamide followed by their coating with particles of nickel hydroxide to ultimately obtain the designated adsorbent. The structural features and chemical composition of the synthesized composite were confirmed by X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, and energetic dispersive X-ray (EDX) spectroscopy. Additionally, scanning electron microscopy (SEM) and N2 adsorption-desorption surface area analysis were employed to detect the textural characteristics of the composite. Subsequently, the efficiency of this structure, as an adsorbent for the disposal of methylene blue dye species from a wastewater sample, was studied. During the water purification process, several operating parameters, namely, retention time, solution pH, initial concentration, and absorbent dose, were investigated. The presented Ni-polyacrylamide composite achieved the promising removal of methylene blue dye. An increased adsorption capacity of 14.3 mg g-1 toward methylene blue was achieved by the composite, thanks to the presence of both organic and inorganic functional groups within its structure. Kinetic and isotherm studies for the adsorption of methylene blue species were found to fit pseudo-second-order and Langmuir models. Additionally, thermodynamic measurements indicated that the adsorption process of methylene blue is feasible, spontaneous, involves physisorption, and is endothermic.

Decoration of polystyrene with nanoparticles of cobalt hydroxide as new composites for the removal of Fe(iii) and methylene blue from industrial wastewater

Effluent water from different industries is considered one of the most serious environmental pollutants due to its non-safe disposal. Therefore, proper treatment methods for such wastewater are strongly stimulated for its potential reuse in industries or agriculture. This study introduces a composite fabricated via doping of polystyrene with nanoparticles of cobalt hydroxide as a novel adsorbent for dye and heavy metal decontamination from wastewater. The adsorbent fabrication involves the preparation of polystyrene via high-internal phase emulation (HIPE) polymerization followed by its intercalation with particles of alkali cobalt. The chemical composition and structural properties of the synthesized composite were confirmed by X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, and energy-dispersive X-ray spectroscopy (EDX). Moreover, scanning electron microscopy (SEM) and N2 adsorption-desorption surface area analysis were performed to identify the surface and morphological characteristics of the composite. Then, the ability of this structure toward the removal of methylene blue dye (MB) and heavy metal (iron iii) species from waste aqueous solutions was investigated. Successful elimination for both MB and Fe(iii) was achieved by the presented composite. Elevated adsorption capacities of 75.2 and 112.3 mg g-1, toward MB and Fe(iii) respectively, were detected for the presented polymer-metal hydroxide composite. The increased values of the composite are attributed to the presence of both organic and inorganic functional groups within its structure. Kinetic and isotherm studies for the removal of both cationic species revealed that adsorption processes fit the pseudo-second-order kinetic model and Langmuir isotherm model. Additionally, thermodynamics measurements indicated that the adsorption process of methylene blue and Fe ions is feasible, spontaneous, physisorption, and endothermic.

Soya bean derived activated carbon as an efficient adsorbent for capture of valuable heavy metals from waste aqueous solution

The removal of hazardous metal ions from liquid waste effluents is very important for water as well as environmental safety. In this regard, this article discusses in detail the U(VI) uptake from aquatic environment using biomass-based Soya Bean activated carbon (labeled as AC-SB). XRD, SEM, FTIR, Raman, and BET analysis were used to characterize the synthesized AC-SB sorbent. Batch-type experiments were used to investigate the effect of various parameters on adsorption efficiency, including pH, metal-ion concentration, temperature, and contact time. The sorption experimental data have been described well with pseudo-second-order kinetic mathematical equations. The equilibrium state of the uptake reaction was 120 min. The Langmuir isotherm model accurately described the equilibrium process which declares that the uranium sorption is a monolayer and homogeneous process. The sorption capacity of the prepared AC was 32.7 mg g−1. Thermodynamic analysis explore that the U(VI) uptake process is endothermic, feasible and spontenous process. The displayed results demonstrate that the prepared AC-SB sorbent could be used as the proper material for uranium sorption from real matrix samples.

Promoting more future-ready anatomy education after the Covid-19 pandemic: A scoping review

The coronavirus disease 2019 (Covid-19) pandemic caused an abrupt transition from face-to-face to online anatomy teaching, learning, and assessment. Although online education has ensured the continuity of anatomy education during the pandemic, its implementation has been challenging, and its effectiveness has been questioned. Therefore, literature pertinent to online anatomy education during the pandemic is crucial to explain Covid-19's disruptions to this field. Accordingly, this scoping review explored changes, disruptions, and gaps in anatomy teaching and assessment during Covid-19 using an enhanced version of Arksey and O'Malley's six-stage protocol. Five online databases were searched for articles that described changes and disruptions in anatomy education. Three independent researchers were involved in titles, abstracts, and full texts screening, while another four researchers were independently involved in data extraction, charting, and synthesis. This review revealed six themes: immediate strategic plans and actions, teaching and learning changes, online assessment practice, students' and educators' receptivity and adaptability, online learning and assessment effects, and future directions. It also revealed four gaps: non-future-ready curricula, learning obstacles, administrative and teaching challenges, and online education ethical issues. The results were reported in tabular and narrative forms, following the PRISMA Extension for Scoping Reviews (PRISMA-ScR guidelines). Understanding the evolution and gaps in anatomy education during the Covid-19 pandemic will help anatomists design future-ready, adaptable curricula.

Evaluation of the integration of social accountability values into medical education using a problem-based learning curriculum

BACKGROUND

Medical schools have the obligation to direct their education toward addressing the priority health concerns of the societies that they serve. The purpose of this study was to evaluate the integration of the concepts and values of social accountability into the case scenarios that are used in a problem-based learning (PBL) curriculum at a medical school in the United Arab Emirates (UAE).

METHODS

A validated "social accountability inventory for PBL" was used for examining 70 case scenarios in a problem-based learning (PBL) medical curriculum.

RESULTS

The findings of the study showed that patient gender and age were included in all the 70 case scenarios. Vast majority of the case scenarios had successfully integrated the social accountably values in addressing the following: the major health problems or social health concerns of the UAE (73%), the social determinants of health (70%), the contextual integration of medical professionalism (87%), the evolving roles of doctors in the health system (79%), the healthcare referral system based on the case complexity (73%), the involvement of different stakeholders in healthcare (87%), psychosocial issues rather than only the disease-oriented issues (80%) and the values of health promotion/prevention (59%) cases. On the other hand, the case scenarios were deficient in integrating other social accountability values that related to the importance of treatment cost-effectiveness (91%), consideration of the underserved, disadvantaged or vulnerable populations in the society (89%), patient's ethnicity (77%), multidisciplinary approach to patient management (67%), the socioeconomic statuses of patients (53%), the issues regarding the management of the health system (39%) respectively. There was variability in integrating the social accountability values in case scenarios across different units which are based on organ system.

CONCLUSION

Medical educators and healthcare leaders can use this valuable data to calibrate the curriculum content, especially when using a problem-based learning curriculum to integrate the values of social accountability such as relevance, quality, equity and cost-effectiveness to train the future generation of healthcare providers to be ready to address the ever-changing and diverse needs of the societies.

Factors that affect student engagement in online learning in health professions education

BACKGROUND

Student engagement is vital in achieving learning outcomes and improving students' motivation, involvement, and attitudes toward learning. The aim of this study was to identify the factors that affect student engagement in online learning in medical and health science colleges.

METHODS

A cross-sectional study was conducted among medical and health science students and faculty in May 2020. The Online Engagement Strategies Questionnaire was e-mailed to 370 students and 102 faculty members. The SPSS statistical software was used for the statistical analysis. Exploratory factor analysis was performed to identify the factors that affected the students' engagement in online learning. Composite scores were calculated for factors, separately for the student and faculty responses. Descriptive statistical analysis was performed for the student and faculty responses.

RESULTS

The response rates of the students and faculty were 85.1% and 74.1%, respectively. The mean ages of the students and faculty were 20.6 and 44.6 years, respectively. Eighty-five percent of the faculty (n = 51) and 88.3% (n = 278) of the students found that the use of technology in proper communication was an important strategy to engage students in online learning. The factor analysis revealed agreement between the students and faculty regarding the factors that support student engagement in online learning. Techno-pedagogical skills were considered very important for faculty and important for students. For both faculty and students, self-directed learning skills were important, and peer-assisted learning (PAL) was fair symmetry. Nevertheless, collaborative learning (CL) was fairly symmetry to students and important to faculty.

CONCLUSION

To enhance student engagement in online learning, faculty members should consider improving their techno-pedagogical skills. Moreover, by incorporating self-directed learning, CL and PAL will support student engagement. Finally, faculty development, updating of course design, and institutional policies are all required to support online learning.

What makes a medical school socially accountable? A qualitative thematic review of the evaluation of social accountability in medical schools in the Eastern Mediterranean Region

Background: The World Health Organization Regional Office for the Eastern Mediterranean established social accountability (SA) as one of its strategic directions for medical education in 2015, and individual countries have been contributing to ongoing SA endeavors. Aim: This study aimed to identify compliance with SA concepts in the Eastern Mediterranean Region (EMR) based on the published evaluation results of SA using different frameworks. Methods: Thematic analysis of qualitative studies was done following a scoping review of published papers in the EMR over the period 1995–2021. CINAHL, Google Scholar, PubMed, Scopus, and Web of Sciences were searched along with a manual search for articles from reference lists. The Enhancing Transparency in Reporting the Synthesis of Qualitative Research ENTREQ statement guided the review. Results: The reviewed studies (n = 3) were from 3 countries in the EMR: Egypt, Saudi Arabia, and Sudan. These studies identified 7 key themes: mission and governance, communication with stakeholders, a community-oriented and community-based curriculum, provision of health services, responding to emerging community health needs, impactful faculty and student research and gaps to be addressed. Conclusions: Despite the call to reorient health profession schools to be responsive to the community and health system needs, only 3 countries in the EMR reported their efforts to move towards SA. Urgent action needs to be taken by medical education leaders in the Region to support colleges in their compliance with SA concepts.

Bridging the Gap in Online Learning Anxiety Among Different Generations in Health Professions Education

Objectives

This study aimed to examine the effects of an individual’s generation group on anxiety related to online learning among students and online learning and teaching activities among faculty.

Methods

This cross-sectional study was conducted at the University of Sharjah, Sharjah, United Arab Emirates, in April 2020 using the Online Course Anxiety Scale. The questionnaires were sent to 370 undergraduate students and 81 faculty members via email and the responses were stratified by generation. Descriptive statistics and an independent sample t-test was used to compare the mean scores of online learning anxiety with gender and previous experience among faculty and students.

Results

A total of 358 students and 70 faculty members completed the questionnaire (response rate: 96.8% and 86.4%, respectively). Only 5.7% of the faculty (compared to 54.7% of the students) enjoyed browsing internet resources during online learning. Among the faculty, 75.7% experienced anxiety during online teaching compared to 37.7% of students. Of the faculty, 92.3% of baby boomers felt anxious compared to 70.5% and 76.9% of X and Y generations, respectively.

Conclusion

While students of Generations Z and Y enjoyed browsing the internet during online learning, the Generation Z students were anxious during online discussions and concerned about the misinterpretation of their written communication. Anxiety among faculty members was related to confusion regarding the use of the internet and computers and misinterpretations of text-based messages.

Stress and its correlates among medical students in six medical colleges: an attempt to understand the current situation

Abstract

Background

Medical students encounter various stressors during their studies. The study aimed to assess stress levels, sources, and associated determinants among Sudanese medical students. An online questionnaire-based study was conducted among 617 undergraduate medical students of 6 different universities in Sudan. A 19-item questionnaire was utilized to assess stress sources, in addition to demographics, stress manifestations, and coping strategies.

Results

The overall prevalence of stress was 31.7% (p < 0.01). The main sources of stress were time pressure, heavy workload, fear of failure, and examination frequency. One-third of students indicated that they experienced at least one source of psychosocial- and teaching-related stress. Female medical students were more significantly stressed due to academics than males. Also, fourth- and fifth-year students were academically more stressed in comparison to the first-year students. Poisson regression analysis model showed that first-year students were less stressed than the final-year students in relation to academics (odds = 0.888, P = 0.003). Male medical students, across all study years, were far less stressed than females (odds = 0.901, P = 0.000153). Expectedly, ‘studying medicine by choice’ was associated with decreased odds for psychosocial stressors (odds = 0.885, P = 0.00781), and improved model-fit (chi-squared = 6.8952, P = 0.008643). Also, the year of study was a predictor of teaching-related stress development.

Conclusions

Female medical students were more stressed due to academics than males. On the other hand, final-year students were more academically stressed than first-year students. Female medical students were likely having stress related to academic stress development, while being first-year medical student was a predictor of not developing academic stress. Studying medicine by choice’ was associated with ability to cope against stress.

Satisfaction with online learning in the new normal: perspective of students and faculty at medical and health sciences colleges

Online learning has become the new normal in many medical and health science schools worldwide, courtesy of COVID-19. Satisfaction with online learning is a significant aspect of promoting successful educational processes. This study aimed to identify factors affecting student and faculty satisfaction with online learning during the new normal. Online questionnaires were emailed to students (n = 370) and faculty (n = 81) involved in online learning during the pandemic. The questionnaires included closed- and open-ended questions and were organised into two parts: socio-demographic information and satisfaction with online learning. Descriptive statistics were used to analyse the responses to the satisfaction scales. Students' and faculty responses to the open-ended questions were analysed using the thematic analysis method. The response rate was 97.8% for students and 86.4% for faculty. Overall satisfaction among students was 41.3% compared to 74.3% for faculty. The highest areas of satisfaction for students were communication and flexibility, whereas 92.9% of faculty were satisfied with students' enthusiasm for online learning. Technical problems led to reduced student satisfaction, while faculty were hampered by the higher workload and the required time to prepare the teaching and assessment materials. Study-load and workload, enhancing engagement, and technical issues (SWEET) were the themes that emerged from the thematic analysis as affecting student and faculty satisfaction. Adopting a combination synchronous and asynchronous approach, incorporating different applications to engage students, and timely feedback are imperative to increasing student satisfaction, while institutional support and organisational policy could enhance faculty satisfaction.

Development and validation of inventory tool to evaluate social accountability principles in case scenarios used in problem-based curriculum (Social accountability inventory for PBL)

Social accountability (SA) is an obligation for medical schools in meeting the priority health concerns of the communities they serve. To measure the integration of SA principles into medical curricula, suitable tools are needed. This study developed and validated an inventory to assess SA values within the existing case scenarios used in problem-based learning (PBL) curricula. The Delphi technique was employed to develop and validate the new inventory. The validation used expert opinion and calculated the content validity using content validity indices (CVIs). The initial draft (Draft 0) was formulated with 25 open-ended questions. Following expert evaluation, Draft 1 had 22 closed-ended questions and the mean ratings, according to the experts, were as follows: relevance, 3.33-4.83; importance (3.5-4.8); clarity (3.33-4.83); and simplicity (3:00-4.67). Draft 2 had 19 questions. After a further round of rating and analysis, a final draft was prepared, consisting of 17 items, with CVI scores ≥ 0.8 and 100% overall satisfaction. Using this inventory tool will help health professions schools to translate SA indicators into curricular activities by identifying the gaps in their PBL curricula. Deficiencies can be either in the type of case scenarios used or the triggers embedded in the individual case scenarios, subsequently leading to the development of PBL case scenarios that address real health social needs. A revision and rewriting of the problem case scenarios to incorporate SA will be the next step.

Twelve tips for introducing the concept of validity argument in assessment to novice medical teachers in a workshop

This article was migrated. The article was marked as recommended. Background: Misconceptions have been observed in the application of validity by faculty and in the reporting of validity in a significant amount of published work in the field of students' assessment. As a result, actions concerning the dissemination of information about the concept of validity in relation to assessments, especially among novice medical teachers, is needed. Aim: This work aims to guide how the concept of validity argument in assessments is delivered to novice medical teachers in a workshop. Methods: Critical reflection and a careful review of relevant literature were used to develop these tips. Results and Conclusion: Twelve tips were introduced to support instructors conducting workshops on introducing the concept of validity, especially to novice medical teachers.

On Steel Surface Modification via Embedment of ZnNPs@polystyrene Composite as Anti-corrosive Template.. [DOI: 10.21203/rs.3.rs-532908/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Corrosion is one of the serious problems countered in different industries as it dramatically causes strong impacting on the infrastructures. As an attempt for sorting out such problem, this approach investigated an innovative strategy for synthesis of corrosion inhibitor for steel surfaces based on composite of polystyrene and zinc nanoparticles (ZnNPs@polystyrene composite). The successive immobilization of ZnNPs (size average of 4-50 nm) within polystyrene matrix (Mwt of 372.587 g/ mole and degree of polymerization equals 3582 repeat unit/ molecule) for clustering of the desirable ZnNPs@polystyrene composite (surface area of 33.62 m2/g, average pore diameter of 9 nm) was approved via several instrumental analyses of FT-IR, XRD, SEM, HRSEM, EDX, TEM and BET with estimation of total pore volume and average pore diameter for the prepared composite. Thermal stability of the prepared composite was affirmed via TGA analysis. Corrosion percentage via weight loss percent in three media of water, H2SO4 and diesel fuel was estimated to reach maximally to 25 % in case of H2SO4, while, corrosion inhibition efficiency (CIE) percentage estimated according to weight loss to reach 94.27, 88.18 and 85.05 % after 10 days of soaking the steel samples coated with the synthesized ZnNPs@polystyrene composite (800 ppm) at 25 ℃, while, elevation of temperature up to 45 ℃, resulted in non-significant effect on the estimated CIE to be diminished to 91.8, 85.2 and 81.1% after soaking in water, diesel fuel and sulfuric acid as corrosion media, respectively. CIE was estimated to be near 30% in case of coating steel samples with polystyrene polymer, to be significantly increased to near 80 % and formidably jumped to near 100% by coating with ZnNPs@polystyrene composite, with weight percent of 30 & 50% of ZnNPs, respectively. In addition to, Zeta potential was also detected to be - 9.67 in case of untreated steel samples, while, it became - 4.98 after coating of sample with ZnNPs@polystyrene composite. Eventually, from Arrhenius plots, activation energies and thermodynamic parameters of rate constant, enthalpy (ΔH) and entropy (ΔS) confirmed that the interaction is more taking place between the corrosion species and ZnNPs@polystyrene composite as corrosion inhibitor rather than with steel surface. Postulation of the reaction mechanism for the anticorrosive action of the synthesized ZnNPs@polystyrene composite was presented according to the illustrated instrumental analyses.

Sorption of U(VI), Mn (II), Cu(II), Zn(II), and Cd(II) from multi-component phosphoric acid solutions using MARATHON C resin

Crude phosphoric acid is a vital component used in making phosphate fertilizers. Depending on the processes used in producing the crude phosphoric acid, it usually contains organic and inorganic contaminants. To make environmentally friendly phosphate fertilizers, these contaminants must be removed from the crude phosphoric acid stock used in making fertilizers. In this paper, commercially available strong cation exchange resin, Marathon C, was used to study the adsorptive removal of U(IV), Mn(II), Cd(II), Zn(II), and Cu(II) from synthetic multi-component phosphoric acid solutions and commercial crude phosphoric acid. Important parameters on the adsorption process such as the effects of contact time, initial metal ion concentration, sorbent dose, and concentration of phosphoric acid were investigated. The results suggested that the adsorption process reached equilibrium within 240 min for the five metal ions studied and the resin had adsorptive affinity for the metal ions in the order of U(IV) > Zn(II) > Cu(II) > Mn(II) > Cd(II). The results from the kinetics and isotherm models from the studies are very consistent with pseudo-second-order kinetic and Langmuir isotherm models. Simultaneous adsorptive removal of metal ions from the crude phosphoric acid strongly suggests that the Marathon C resin could be used in removing toxic metal ions from crude phosphoric acids used in making phosphate fertilizer.

Commitment towards a better future for medical education in Saudi Arabia: the efforts of the college of medicine at Qassim University to become socially accountable

Background: The College of Medicine at Qassim University (COMQU) was founded in 2001 as a problem-based learning and community-oriented medical school in order to strengthen the health system not only in the Qassim region but also in the whole of Saudi Arabia. The aim of the current study was to assess whether the COMQU is a socially accountable medical school and the steps taken to achieve that target.Materials and methods: The study used the social accountability grid published by the World Health Organization (WHO) as a framework to assess the social accountability efforts in the context of three functions of medical schools: education, service and research. Data were collected through the analysis of college documents (2001-2017) and interviews with key informants.Results: The COMQU shows compliance towards social accountability in the three domains of the grid. The indicators related to the education domain demonstrate more compliance than those of research and community service in the grid.Conclusion: The COMQU is based on community-oriented medical education (COME) with strong commitment towards social accountability (socially responsible going towards social responsiveness). More research is needed in order to pave the way to achieve social accountability status.Abbreviations: COMQU: College of Medicine at Qassim University; COME: Community-oriented medical education; WHO: The World Health Organization; MOH: Ministry of Health; SCFHS: Saudi Commission of Health Specialties; PHC: Primary Health Care; HYMS: Hull York Medical School; WFME: World Federation for Medical Education; NCAAA: National Commission for Academic Accreditation and Assessment.

Knowledge, Anxiety, Fear, and Psychological Distress About COVID-19 Among University Students in the United Arab Emirates

Background: Fear of infection, the epidemic situation, unexpected lockdown, and implementation of online classes are most likely affecting the psychological well-being of students during the COVID-19 pandemic. Therefore, this study aims to assess the level of knowledge, anxiety, and psychological distress concerning COVID-19 and their association with fear, gender, age, history of mental illness, time spent reading about COVID-19, program of study, and type of dwelling among students in the United Arab Emirates (UAE). Methods and Materials: In this cross-sectional study, 433 students participated in a web-based survey. These were students at the University of Sharjah, coming from all the emirates of the UAE. Demographic scale, COVID-19 knowledge, anxiety, fear, and psychological distress scales were used to screen these problems. Results: Of the 433 students, 278 (64.2%) were male and 155 (35.8%) were female. Overall, 353 (81.5%) exhibited adequate knowledge of COVID-19. Sixty-nine (15.9%) of students were anxious and 221 (51%) were in psychological distress. Students who exhibited anxiety concerning COVID-19 anxiety (odds ratio [OR]: 2.98) and fear (OR: 1.27), and who spent more than 4 h reading about COVID-19 (OR: 11.20) were more psychologically distressed. Students with a history of mental illness showed adequate knowledge of COVID-19; however, they were more psychologically distressed (OR: 5.93). Older students were less likely to have psychological distress (OR: 0.87). Conclusion: Students possess adequate knowledge concerning COVID-19; however, they are psychologically distressed. Age, dwelling status, history of mental illness, anxiety, and fear significantly predicted psychological distress. Frequent web-based workshops that include insight, guidance, online counseling, scheduled activity, and coping mechanisms for COVID-19 are highly recommended. The authors discuss the implications for future research and provide recommendations for students and educational institutions.

Breaking bad news: Awareness and practice among Sudanese doctors

Background

Breaking bad news is an important task for doctors in different specialties. The aim of the study was to assess adherence of Sudanese doctors to the SPIKES protocol in breaking bad news.

Methods

A descriptive cross-sectional study recruited 192 doctors, at Wad Medani teaching hospital, Sudan. A questionnaire-based on SPIKES protocol was distributed among 10 departments in our hospital. Data were analyzed using SPSS and Microsoft excel.

Results

There were (n = 101, 52.6%) females and (n = 91, 47.4%) males among the participants. 95.3% have been involved in breaking bad news, but only 56.3 received education and training about this issue. 43% admitted bad experience in breaking bad news, while 65.6% mentioned that bad news should be delivered directly to patients. The majority (>90%) agreed training is needed in the area of breaking bad news. Usual adherence to the SPIKES protocol was reported in a range of 35–79%, sometimes adherence was reported in a range of 20–44% while never adherence was reported in a range of zero–13.5%. Consultants, registrars, obstetrician and gynecologists and surgeons achieved high scores in breaking bad news. Training is an important factor in achieving high score in SPIKES protocol. The unadjusted effect of background factors on SPIKES score, showed that only training has significant impact on protocol adherence (P = 0.034, unadjusted; and P = 0.038 adjusted).

Conclusion

Large number of Sudanese doctors will try to adhere to SPIKES protocol. Training is an important factor in the success of breaking bad news.

Cadmium and iron removal from phosphoric acid using commercial resins for purification purpose

Three commercial resins bearing sulfonic, amino phosphonic, or phosphonic/sulfonic reactive groups have been tested for the removal of iron and cadmium from phosphoric acid solutions. The sorption properties are compared for different experimental conditions such as sorbent dosage (0.5-2.5 g L-1), phosphoric acid concentration (from bi-component solutions, 0.25-2 M), and metal concentrations (i.e., in the range 0.27-2.7 mmol Cd L-1 and 0.54 mmol Fe L-1) with a special attention paid to the impact of the type of reactive groups held on the resins. The sulfonic-based resin (MTC1600H) is more selective for Cd (against Fe), especially at high phosphoric acid concentration and low sorbent dosage, while MTS9500 (aminophosphonic resin) is more selective for Fe removal (regardless of acid concentration and sorbent dosage). Equilibrium is reached within 2-4 h. The resins can be ranked in terms of cumulative sorption capacities according the series: MTC1600H > MTS9570 > MTS 9500. Sulfuric acid (0.5-1 M) can be efficiently used for the desorption of both iron and cadmium for MTC1600H, while for MTS9570 (phosphonic/sulfonic resin) sulfuric acid correctly desorbs Cd (above 96% at 1 M concentration), contrary to Fe (less than 30%). The aminophosphonic resin shows much poorer efficiency in terms of desorption. The sulfonic resin (i.e., MTC1600H) shows much higher sorption capacity, better selectivity, comparable uptake kinetics (about 2 h equilibrium time), and better metal desorption ability (higher than 98% with 1 M acid concentration, regardless of the type of acid). This conclusion is confirmed by the comparison of removal properties in the treatment of different types of industrial phosphoric acid solutions (crude, and pre-treated H3PO4 solutions). The three resins are inefficient for the treatment of crude phosphoric acid, and activated charcoal pre-treatment (MTC1600H reduced cadmium content by 77%). However, MTC1600H allows removing over 93% of Fe and Cd for H3PO4 pre-treated by TBP solvent extraction, while the others show much lower efficiencies (< 53%).

Why social accountability of medical schools in Sudan can lead to better primary healthcare and excellence in medical education?

Introduction:

Medical education in Sudan continues to evolve and progress with proliferation in the number of medical schools after 1990. Social factors and the geographical location of Sudan will increase the opportunity of success of medical schools to be socially accountable. In this analysis, we explained why social accountability is needed in Sudan and how this can enhance both excellence in medical education and primary health care, especially in rural areas.

Methodology:

PubMed, scopus Medline, and Google Scholar were searched for published-English literature concerning social accountability of medical schools in Sudan and worldwide were reviewed regardless of the time limit. We have also included examples of medical schools from Sudan and the Middle East to reflect on their experience in social accountability.

Results:

In this critical review, we have shown that social accountability will come with benefits for medical schools and the community. Implementation of social accountability in medical schools in Sudan will increase the effectiveness of medical schools' productivity, research output, and health service in urban and rural areas. There is an urgent need for social accountability alliance in Sudan to increase collaboration between medical schools. This will increase the benefits of social accountability for all stakeholders and also increases the competency in social medicine within the medical school curriculum.

Conclusion:

Social accountability is regarded as a sign of excellence in medical education. Primary care physicians in Sudan are expected to be the leaders in the implementation of social accountability. This analysis answered two important questions about why medical schools in Sudan should be socially accountable? And do we need a special structure of social accountability in Sudan?

The assessment clock: A model to prioritize the principles of the utility of assessment formula in emergency situations, such as the COVID-19 pandemic

This article was migrated. The article was marked as recommended. Many concerns have been raised regarding the impact of the changes to medical education as a result of the coronavirus disease 2019 (COVID-19) pandemic, particularly the impact of these changes on student assessments. This paper suggests an assessment clock as a conceptual model to enable medical educators to decide which assessment method is suitable under challenging circumstances, such as the COVID-19 pandemic. The assessment clock has five numbers, representing the five principles of the utility of assessment formula, which are arranged from the principle with the lowest weight (cost = 1) to the principle with the highest weight (validity = 5). The numbers are repeated in each half of the clock, and the clock is placed in the middle of two overlapping axes. The vertical axis is related to exam stakes (high or low). The low stakes condition, which represents the normal situation of running assessments at the beginning of each academic year, is placed at the top of the clock. The horizontal axis is related to the type of situation (normal or crisis). The high stakes condition is placed at the bottom of the clock. The right half of the clock represents the normal situation of planning and conducting assessments, while the left half represents an emergency situation, such as the current COVID-19 pandemic. The assessment clock offers assessment planners insights into how to determine the most important assessment principles on which they should focus during a crisis situation. Moreover, it provides practical guidance for educators to help them decide which assessment tool is suitable for use in which situation.

Curriculum delivery in Medical Education during an emergency: A guide based on the responses to the COVID-19 pandemic

This article was migrated. The article was marked as recommended. The spread of coronavirus (COVID-19) has led the majority of countries worldwide to implement emergency lockdown plans to limit the spread of the virus; this has resulted in the interruption of on-campus school and university instruction. Responses to the COVID-19 pandemic in medical education have varied from country to country, from closures of medical schools to online/distance learning approaches to abiding by country-specific measures such as social distancing to stop the spread of the disease. The sudden transition from on-campus learning to exclusively distance learning is challenging for both faculty and students and has required a lot of preparation and other efforts in a short time. This paper aims to share the experiences of four authors in the middle east that have dealt with the sudden transition from ordinary teaching and learning to fully online teaching. The process of Curriculum delivery in Medical Education during an emergency has included; establishing a sense of urgency, establishing working teams, conducting needs assessments, developing implementation plans, communicating the curriculum content, capacity building, managing students' stress, finding tools to be used, managing student engagement and motivation, student assessment, anticipating challenges and planning for how to overcome them, and monitoring and evaluation of curriculum implementation and continuous improvement. The proposed process will hopefully assist the medical schools in response to the current pandemic (COVID-19) and when facing similar situations.

Internet Use and Addiction Among Medical Students in Qassim University, Saudi Arabia

Objectives

This study aimed to measure the prevalence of Internet use and addiction and determine its association with gender, academic performance and health among medical students.

Methods

This cross-sectional study was conducted between December 2017 and April 2018 at the College of Medicine, Qassim University, Buraydah, Saudi Arabia. The validated Internet Addiction Test questionnaire was distributed by simple random methods to medical students (N = 216) in the pre-clinical phase (first-, second- and third-years). A chi-square test was used to determine significant relationships between Internet use and addiction and gender, academic performance and health.

Results

A total of 209 student completed the questionnaire (response rate: 96.8%) and the majority (57.9%) were male. In total, 12.4% were addicted to the Internet and 57.9 had the potential to become addicted. Females were more frequent Internet users than males (w = 0.006). Academic performance was affected in 63.1% of students and 71.8% lost sleep due to late-night Internet use, which affected their attendance to morning activities. The majority (59.7%) expressed feeling depressed, moody or nervous when they were offline.

Conclusion

Internet addiction among medical students at Qassim University was very high, with addiction affecting academic performance and psychological well-being. Suitable interventional and preventive measures are needed for proper Internet use to protect students’ mental and physical health.

Students' perception of the learning environment and its relation to their study year and performance in Sudan

OBJECTIVES

To evaluate students' perceptions of the learning environment and to assess any differences in perception related to students' performance and their year of study.

METHODS

A descriptive cross-sectional study was performed of 638 students from the second, sixth and tenth semesters at the Faculty of Medicine at Gezira University, Sudan. This study employed the Arabic-translated Dundee Ready Education Environment Measure. The main predictor variables were the study year and academic performance. Descriptive statistics and one-way analysis of variance with a post hoc Tukey-Kramer multiple comparisons test were used for data analysis.

RESULTS

The overall score for this study was 122/200 (SD=16.6), indicating a positive perception of the learning environment. The overall mean score was 109.94/200 (SD=21.2) for Semester 2 students, 122.9/200 (SD=20.29) for Semester 6 students, and 116.53 (SD=20.12) for Semester 10 students, reflecting a significant difference in students' perceptions in different years of study (F (2,2422) = 3.21, p=0.04). There was also a significant difference between the mean overall scores with respect to academic performance. High-achieving students' mean DREEM score was 126 (SD=24.4); while low-achieving students' mean DREEM score was 102 (SD=26.25) (F(2,2453) = 3.53, p=0.029).

CONCLUSIONS

High achievers' perceptions of the learning environment are significantly better than those of low achievers. A significant difference was observed between students in different years of study. The differences in students' academic performance should be further investigated, targeting specific domains. A large-scale study is required to differentiate between the weakness and the strength of each academic level.

Combined Anterior and Posterior Lumbar Rhizotomy for Treatment of Mixed Dystonia and Spasticity in Children With Cerebral Palsy

BACKGROUND

Children with cerebral palsy (CP) can present with severe secondary dystonia with or without associated spasticity of their extremities.

OBJECTIVE

To assess the outcomes of combined anterior and posterior lumbar rhizotomy for the treatment of mixed hypertonia in the lower extremities of children with CP.

METHODS

Fifty children with CP were subjected to combined anterior and posterior lumbar rhizotomies in a prospective study. Clinical outcome measurements were recorded preoperatively and were evaluated at 2, 6, and 12 months postoperatively. The operative techniques were performed by laminotomy from L1-S1, and intraoperative monitoring was used in all cases. All patients underwent intensive postoperative physiotherapy programs.

RESULTS

Changes in muscle tone, joint range of motion, and dystonia were significant (P = .000) at postoperative assessment visits.

CONCLUSION

This study demonstrated the potential of combined anterior and posterior lumbar rhizotomies to improve activities of daily living in children with CP and with mixed spasticity and dystonia.

ABBREVIATIONS

BAD, Barry-Albright Dystonia ScaleCAPR, combined anterior and posterior lumbar rhizotomyCP, cerebral palsyITB, intrathecal baclofenMAS, modified Ashworth ScaleROM, range of motionSDR, selective dorsal rhizotomy.