Browsing by Subject "Training"

The scope of my dissertation project was to investigate the training of community leaders, including religious leaders, in the delivery of individual cognitive-behavioral support for depression in the community from Burma in NC. My research aims were to train community leaders a) to recognize the signs and symptoms of depression and associated problems, including intergenerational conflict, substance abuse, domestic violence and suicide; b) to use reflective listening and cognitive-behavioral therapy (CBT) skills, and c) to increase awareness of stigma toward treatment-seeking for depression and its related problems. Positive training outcomes were found for knowledge of depression and CBT strategies, and for attitudes toward treatment-seeking for depression; suggesting community leaders could be a valuable resource for expanding evidence-based mental health services delivery within the community from Burma and potentially within Burma as well, where there is a scarcity of mental health professionals. This study extends existing research on training paraprofessionals and religious leaders in the use of CBT. In particular, it adds to the knowledge base on providing mental health services within the community from Burma, which may extend to other refugee and immigrant communities in the U.S.

Background/ObjectivesAfrica has only 1% of the global neurosurgery workforce, despite having 14% of the global population and 15% of the global neurosurgical disease burden. Also, neurosurgical training is hampered by paucity of training institutions, dearth of training faculty, and deficiency of optimal training resources. The study appraises the current specialist neurosurgical workforce in Africa, evaluates the major neurosurgery training programs, and projects the 2030 workforce capacity using current growth trends. Methods The study involved systematic and gray literature search, with quantitative analysis of retrospective data on the neurosurgery workforce, qualitative evaluation of the major neurosurgery training programs for their strength, weaknesses, opportunities, and threats, and projection modeling of the workforce capacity up to year 2030. Results 1,974 neurosurgeons serve 1.3 billion people (density 0.15/100,000; ratio 1:678,740), in Africa, with the majority (1,271; 64.39%) in North Africa. There are 106 specialist neurosurgery training institutions in 26 African countries, with North Africa having 52 (49.05%) of the training centers. Training is heterogenous, with the major programs being the West African College of Surgeons (WACS) - 24 centers across 7 countries, and the College of Surgeons of East, Central and Southern Africa (COSECSA) - 17 centers in 8 countries. At the current linear growth rate of 74.2 neurosurgeons/year or exponential growth rate of 6.81% per annum, Africa will have 2,716 - 3,813 neurosurgeons by 2030, with a deficit of 4,795 - 11,953 neurosurgeons. The continent requires a scale-up of its linear growth rate to 663.4 - 1269.5 neurosurgeons/year, or exponential growth rate to 15.87% - 22.21% per annum to meet its needs. While North African countries will likely meet their 2030 workforce requirements, sub-Saharan African countries will have significant workforce deficits. Conclusion Despite a recent surge in neurosurgery residency training, the current state of Africa’s neurosurgery workforce is dire, and many countries will be unable to meet their workforce requirements by 2030 at current growth trends. A significant scale-up of the neurosurgery workforce is required in order to meet these targets.

There is little information regarding the knowledge, attitudes and practices of obstetric care providers in Rwanda, who are a crucial component for providing quality Safe Motherhood care. Despite investments in the structural capacity needed to deliver these services, little has been directed towards understanding the current competency of skilled providers on the front lines of maternal mortality and morbidity prevention. This study surveyed 87% of all obstetric care providers in the Bugesera District of Rwanda to determine their demographic characteristics, competency in Safe Motherhood knowledge, obstetric practices, and attitudes towards patients and training approaches. The study identified the majority of providers to be A2 level nurses (82%) who have received one year of health education in secondary school. In addition, the majority of providers expressed that both their knowledge (60.6%) and skills confidence (72.2%) across fundamental topics of Safe Motherhood care need improvement. There was a low level of demonstrated knowledge in Safe Motherhood services with a mean of 46.4% of 50 questions answered correctly. Performance of knowledge in normal labor (39.3% correct) and obstetric complications (37.1% correct) were the weakest areas identified. A high percentage of providers (60.8%) engage in the potentially harmful practice of fundal pressure during vaginal delivery, while only 15.9% of providers practice steps of the active management of the third stage of labor in 100% of their deliveries. Providers view additional education and training in emergency obstetric care (EMOC) to be very useful, with 89.3% reporting an enthusiastic willingness for participation in a two-day workshop even if it was their day off. Improving knowledge, skills and practices of obstetric providers is an essential step in improving the quality of emergency obstetric care.

Given their low operating costs and flight capabilities, Unmanned Aircraft Vehicles(UAVs), especially small size UAVs, have a wide range of applications, from civilian rescue missions to military surveillance. Easy control from a highly automated system has made these compact UAVs particularly efficient and effective devices by alleviating human operator workload. However, whether or not automation can lead to increased performance is not just a matter of system design but requires operators’ thorough understanding of the behavior of the system. Then, a question arises: which type of training and level of automation can help UAV operators perform the best?

To address this problem, an experiment was designed and conducted to compare the differences in performance between 3 groups of UAV operators. For this experiment, 2 different interfaces were first developed - Manual Control, which represents low LOA interface, and Supervisory Control, which represents high LOA interface - and people were recruited and randomly divided into 3 groups. Group 1 was trained using Manual Control, and Group 3 was trained using Supervisory Control while Group 2 was trained using both Manual and Supervisory Control. Participants then flew a drone in the Test Mission stage to compare performance.

The results of the experiment were rather surprising. Although group 3 outperformed group 1, as expected, the poor performance of group 2 was unexpected and gave us new perspectives on additional training. That is, additional training could lead not just to a mere surplus of extra skills but also a degradation of existing skills. An extended work using a more mathematical approach should allow for a more precise, quantitative description on the relation between extra training and performance.