Iris Publishers-Open access Journal of Biomedical Engineering & Biotechnology | Role of CT Angiography in Detection Left Main disease in Asymptomatic Patients

 

Authored by Mosaab Akram Elshaer*,

Abstract

Background
For decades, many investigators have been trying to find the “factors” that increase the risk of coronary artery disease , A lot of cases reported for Asymptomatic patients or very mild symptoms and tendence to be coronary artery disease and in many cases, it could be critical situation.
Despite these massive efforts and findings, still some young individuals suffer from myocardial infarction without any “traditional” risk factors.
Coronary calcium score has emerged as a reliable tool to add to the already known mix of the risk factors to assess someone’s future risk of acute coronary syndromes by identifying atherosclerosis. Atherosclerosis, an inflammatory process in the arterial wall, starts at young ages and results in the formation of “plaques” in the arterial wall. As we age, the process of calcification begins in these plaques. We can identify the calcium in x-ray images, which confirms the underlying plaque in the arterial wall. These “plaques” are the main precursors of myocardial infarction. The CT can play important role in detection the coronary artery disease and evaluate the severity of the stenosis and its location.

Case Presentation

• Male patient, 50 years old, Mediterranean background, not diabetic, not hypertensive, nor hyperlipidemic, no significant medical history and takes no medications. He does not use tobacco, alcohol, or illicit drugs. No family history of medical disease.
• The patient has very mild occasional chest discomfort that’s not related to activities and has no precipitating factors. No dyspnea, no orthopnea.
• On physical examination: Temperature is 37c (99.5F) Blood pressure 120/80 mm, pulse is 90/m and respiration are 16/min. On Auscultation no heart sounds, no murmurs, The Lungs are clear. There is no peripheral edema.
• Electrocardiogram shows no significant changes. Echo shows Ejection fraction 56%, No resting wall motion abnormalities.

C.T Coronary angiography Findings

Left main coronary artery (L.M): is an average caliber atherosclerotic vessel showing an ostial non calcified plaque causing critical lumen narrowing; the LM is seen originating normally from the left coronary cusp, it ends by bifurcating into LAD and LCX. Left anterior descending coronary artery (LAD): is an average caliber atherosclerotic long vessel showing several noncalcified plaques throughout its course with no significant stenoses. It gives origin to three average caliber normal diagonals; the LAD ends by wrapping around the apex. Left circumflex coronary artery (LCX): is an average caliber non-dominant atherosclerotic vessel, giving origin to an average caliber long OM branch then the LCX continues as a small caliber vessel, the LCX and its OM branch are free of significant lesions. Right coronary artery (RCA): is a dominant average caliber atherosclerotic vessel, it gives origin to a small conal and RV branches and ends by bifurcating into average caliber PDA and PLB; the RCA and its branches show several nonocclusive plaques. Coronary Impression: Atherosclerotic CAD. Critical ostial LM stenosis with no other significant lesions.

C.T coronary calcium score report

(Table 1) This is the total amalgamation of a calcium score of 37 in the left main coronary artery, 8 in the right coronary artery, 0 in the left anterior descending coronary artery, 0 in the circumflex artery and 0 in the posterior descending artery.

Table 1: Calcium Plaque Burden.

Calcium Percentile Score

Total calcium score of 53 is between the 50th and 75th percentile for men between the ages of 55 and 59

This means that 50 percent of people this age and gender had less calcium than was detected in this study. The following graph shows the distribution of total calcium scores for each age group by percentiles. Your calcium score, relative to other age groups, is indicated by the highlighted square in the graph (Figure 1). [1] Callister TQ et. al., Coronary Artery Calcium Scores on Electron Beam Computed Tomography: JACC 1999. 33 (Supl.): 415A [1,2].

Translation Of Calcium Score

(Table 2) [2] Mayo Clinic Proceedings, March 1999, Vol. 74. Findings based on EBCT data. [3] Carr JJ, et. al., Evaluation of Subsecond Gated Helical CT for Quantification of Coronary Artery Calcium and Comparison with Electron Beam CT.; AJR 2000; 174: 915- 921

Table 2:

CT Cardiac Functional Analysis Report

Table 3:

(Table 3) Normal left ventricular systolic function with no resting SWMA. There are no calcifications within mitral and aortic annuli, including valves. There is no pericardial or pleural effusion. There is no aneurysm or dissection of the thoracic aorta [3,4]. Impression: Atherosclerotic CAD. Critical ostial LM stenosis with no other significant lesions.

• Calcium Score is calculated to be 53 by Agatston Score. Normal LV EF (56%) with no resting SWMA’s (Figures 2-8).

Conclusion

C.T angiography is having a good diagnostic value in detection of the left Main coronary artery disease.

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Iris Publishers-Open access Journal of Civil & Structural Engineering | Project Monitoring and Early Warning of Time-Cost Overruns in Earned Value Management

 

Authored by Mohammad Azim Eirgash*,

Abstract

Project monitoring and control processes are crucial aspects of project management. To perform an appropriate project tracking, Earned Value Analysis (EVA) has to be implemented to help the project managers to measure project performances. A tool to monitor and control the cost, time and work done of a construction project. Furthermore, it also provides an “Early Warning” signal for immediate corrective action. Thereby, in this study, some work items related to a completed real life construction project were evaluated according to the method of Earned Value and the result implies that the analysis can be very useful in project forecasting and decision making relevant to early warnings.

Keywords: Project management; Earned value analysis; Performance indices; Scheduling; Variances

Introduction

The main objective of project management is to meet all project requirements within budget forecasts and the planned time-line. To achieve this goal, it is necessary to put substantial managerial efforts for which project stakeholders are responsible. Creating the effective performance monitoring system plays vital rule in this managerial process. Irrespective of the having project careful planning, without timely and proper performance control, to evaluate the project progress and execution efficiency of the construction project is a nightmare. Monitoring and control system also helps in providing feedbacks to management on the different schedules prepared earlier, in order to ensure that the project is progressing as per schedule. It compares the planned amount of work with what has actually been completed, to determine if cost, schedule, and work, accomplished are progressing as planned. It also provides data for preparing reports for management information system. In today‘s high computational world a construction project works in a dynamic environment and situations, constraints, etc., keep on changing. Hence, it is absolutely necessary to monitor the project at regular intervals and adopt suitable controlling measures in order to keep the project on track. For this purpose, construction organizations have project monitoring and control systems in place.

Efficiency of EVA application to meet project criterion elaborated by several researches e.g. De Marco [1], Souza [2], Chou [3] and Joby [4]. In addition to this earned values analysis has used triangular fuzzy time by utilizing triangular fuzzy number as well as bottom-up hierarch guess procedure considering the design control mechanism to tackle multi-product planning problems. Furthermore, there is no precise control system for measuring the quality of work-done on individual tasks in addition to variation in cumulative earned value appears to be a weakness point of this method. Long Chena [5] proposed a fundamental methodology to enhance the performance prediction of planned value by advanced modelling PV obtaining a trustworthy forecasted results about earned value. In a literature search, identified Earned Value Analysis as a good method for better project management. With this method, cost, timeline and scope are combined and progress performance and it is stated that it can be used to estimate project completion dates. Agata [6] explained that if Earned Value Analysis is applied, this method should be used appropriately; He stated that it makes it easier to monitor progress on the project, determine the status of the project (on time and budget), to roughly estimate their overall impact on the outcome of the project. In another study by Shaik et al. [7], focused on the timely completion of a construction project, the monitoring and control role offered by Earned Value Analysis was examined throughout the project. Eirgash et al. [8] has presented performance scale of an example problem suing the theoretical and practical dimension the earned value analysis, and therefore helped in practical application of the current construction project. Lipke [9] has demonstrated a defined system by which total project cost as well as time duration of a project is likely to be determined to assist the project managers to make intelligent decisions. Figure 1 clearly describes the earned value analysis chart (Figure 1).

Following is the paper arrangement: Firstly basic concept, straightaway the importance of the construction project relevant to the Earned value analysis is given in well-figured explanations. A small scale example problem is considered to exhibit the effectiveness of earned value analysis in construction projects. Ultimately, discussion and conclusion are presented in order [10- 12].

Basic Concepts of Earned Value Method

In this section, explanation about the earned value analysis terms is illustrated in Table 1. Basic concepts of the EVM are given in Figures 2-4 (Table 1) (Figures 2-4).

Table 1: Earned value terms.

where ρ is the mass density, v is the velocity, T is the symmetric Cauchy stress tensor, b is the body force. The balance of energy is written in the form

Application

During the summer of 2009 in the building of the closed sports hall faced a big problem in the construction phase, and specifically the problem was in the rebar. This problem was discovered later on, after the completion of the process of pouring the foundations and Ground beams. The project area 1744 m2, according to the contract for Project 340 day, every day of delay will be paid 600$. In the initial planning phase was the work of a timetable for the project using Primavera 6.0 were created for the project (330 days), but the maximum duration of the contract 340 days within any period allowed by. The cost of the project 2,828,241$. (Table 2) (Figure 5)

Table 2: Represents the status report of the project.

Results and Discussion

Update process of project with earned value analysis

Table 3: Obtained values of status report of the project.

After the work schedule and start the implementation, we need to update the project data into compare the project actually and the planned project and the impact on the schedule. Will now be an update of the project data and follow-up activities during the 3 months from 1 \ 3 \ 2009 to 1 \ 6 \ 2009 using the theory of earned value. As we can by using this value follow-up project in terms of time and cost, sometimes called financial values gained with time and which we can make the right decisions to return the original project if there is a deviation from the previously planned. Estimate to complete as well as estimate at completion are considering the data in Table 1, indices and relevant comments are stated using the plotted graphics (Table 3) (Figure 6).

Based on the analysis of the status report and graphical representation in Figure 6, the estimated cost of the project at completion for the 7th month of the updating (after 40% of the project execution) is estimated to have a considerable cost overrun and schedule lagging behind (Figure 7).

Based on the Figure 7 and 8 which are interconnected to each other, the earned value of the project for the 7th month of the updating explains that both the CV and SV are smaller than zero which express that the project is behind schedule and having cost overrun. In case of 9th month updating both the CV and SV are greater than zero which implies that the project is ahead of the schedule and making profit. By analyzing the graphical representation of CPI and SPI indices in Figure 9, the following comments can be stated.

Review of the project on the 7th month

Based on the Figure 9 representation, CPI and SPI both are less than 1.0, CPI<1 indicates a weak cost performance. That earned value is short of what the real costs for this reporting period. Cost performance index (CPI) between 0.95-0.96 indicate cost overrun and behind schedule (Figures 8,9).

9th month review project

It is clear that values of CPI and SPI are greater than 1.0 reveal a good project performance. Also, the project is ahead of schedule, which is a bit better than the previous status report and CPI >1 the project is making loss. According to the graphical indication of CPI and SPI in Figure10. The following remarks can be stated (Figure10).

Summary and Conclusion

As it is clear that to provide information on performance of the construction projects, earned value is found to be effective technique. Project stakeholders are likely to get to know timely regarding the scope, schedule, and cost status information of the relevant project. Accomplishment of the projects with a success is associated with the significant factors e.g. .application of earned value analysis with its means at the right time and right manager. The main reason behind the utilizing this method is to stay far away from schedule delay and over budgeting. Therefore, analyzing the indices it can be concluded that each day one of the actual duration was obtained only 0.96 of the value of planned, in other words that the productivity of the project is only 0.96 of the planned. And this also means that each and every one $ of the actual cost was obtained only 0.88 of the value of planned.

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Iris Publishers-Open access Journal of Biology & Life Sciences | Climate Change and its Impact on the Agricultural Sector

 

Authored by Zakaria Fouad Fawzy*,

Abstract

The agricultural sector is one of the sectors that will be negatively affected by this phenomenon. Climate changes are expected to affect the productivity of agricultural land, starting with affecting the natural, chemical, and biological properties of the land, passing through the spread of pests, insects, diseases and other problems, and ending with affecting the produced crop.

Keywords: Climate change; Agriculture sector; Food security; Health; Fisheries; soil; Water resources

Introduction

Problem statement climate change can lead to serious impacts including but not limited to: agricultural production, soil, water resources, livestock, food security, health, fisheries, tourism, social and broad economic impact. The vision of this agreement is to assess and identify the determinants of users for knowledge, attitudes, and practices related to climate change.

Importance of the study climate change is one of the most serious problems that confront the world. There is plenty evidence that climate change might negatively affect many aspects of life for all people around the world, such as impact on agricultural production, soil, water resources, droughts, livestock, food security, industry, diseases and pests, economic consequences, flooding, human health, fisheries, ecosystems, and biodiversity.

Climate change, and increasing climate variability, as well as other global environmental issues such as land degradation, loss of biological diversity and stratospheric ozone depletion, threatens our ability to meet the basic human needs of adequate food, water and energy, safe shelter, and a healthy environment.

The vulnerability of agriculture to natural climate variability and climate change can be somewhat decreased through more informed policy choices, practices, and technologies. Negative impacts of climate change on agriculture can be further reduced by increasing climate knowledge and improving prediction capabilities, which will lead to the development of relevant information and prediction products for applications in agriculture. However, while farmers are heavily dependent on the climate, farmers can exploit weather and climate services to minimize the impact of these hazards, either by planning to avoid the risk in the first place or by taking precautionary measures when there is warning that a hazard may arise.

Among the most important suggested regionalization strategies in this regard are the following:
• Developing new varieties that can withstand high temperatures, salinity, and drought, which are the conditions that will prevail under the conditions of climatic changes.
• Developing new varieties with a short growing season to reduce the water requirements needed for them. • Changing the planting dates to suit the new weather conditions, as well as planting the appropriate varieties in the appropriate climatic zones to increase the crop yield from the unit of water for each crop.
• Reducing the area of crops that are wasteful in their water consumption, or at least not increasing the area designated for them (such as rice and sugar cane).
• Cultivation of alternative crops that give the same purpose and have less water consumption and growing season, such as planting sugar beets instead of sugar cane (and in this strategy we must consider that this crop is a major crop in developing countries in addition to factories, secondary industries and employment based on this crop).
• Irrigation at the appropriate times and with the appropriate amount of water in each irrigation to preserve every drop of water, which we will be in dire need of under the conditions of climatic changes.

The national program for climate change research and reducing its effects on agriculture

Basic goals: Preparing a future for the impact of current and expected climatic changes and problems on the agricultural system to formulate a vision for ways to confront these pressures and limit their effects.
• assessing and minimizing the negative impact of agricultural activities on the climate system.
• Increasing the agricultural sector’s ability to adapt to face climate changes, with a focus on the most vulnerable agricultural areas.

Climate Changes and Agriculture Sector

Vision and mission

Adaptation to climate change in agriculture:

a) Objectives: Develop and disseminate affordable climate change adaptation technologies and practices in the agricultural sector, by conducting comprehensive public awareness and outreach campaigns combined with capacity building programs tailored to the needs of farming operations.

Components:

• Develop, test, demonstrate, and disseminate innovative climate change-related adaptive agricultural practices to minimize the adverse impacts of global warming on the prevailing highvalue crops in the targeted regions.
• Public awareness and civil society capacity building to raise awareness of the forthcoming challenges of climate change and the necessity for joint community-level responses and action

b) Vision: Building up a climate change center as an excellence focusing to scientific role in the studies of vulnerability, mitigation, and adaptation in agriculture sector in the developing countries.

c) Mission:

• To survey, collect and evaluate the demands of technology of developing countries to address the climate change and taking the technology demand information for sharing.
• Studying methods of mitigation and/ or adaptation to the ongoing climate changes issues in the developing countries about agriculture sector.
• To recommend and send technical and management personnel from developing countries to attend technical training, international workshop, technical exhibition, and other activities.
• Full and fruitful cooperation with various sectors and ministries in the field of climate change issue in the specialty of Agriculture and Irrigation sectors.
• Activating the role of projects related to the issues of climate change at the local and international level
• Expansion in the field of organic farming and climate smart agriculture which reduces the use of fertilizers, and therefore reduces the use of energy sources used in the production of fertilizers.

Climate Change and its Impact on Agriculture

Driven mainly by population and economic growth, total global food consumption is expected to increase by more than 50% by 2030 and may double by 2050. Most of the increase in food production in the coming decades is expected to occur through further intensification of existing cropping systems rather than opening new land in agricultural production. Intensification of cropping systems has been a very successful strategy for increasing food production. The best example of this is the well-known success of the Green Revolution, where the adoption of modern varieties, irrigation, fertilizers, and agrochemicals led to significant increases in food production. However, this strategy has also led to unexpected environmental consequences, among them greenhouse gas emissions into the atmosphere. Therefore, future strategies that promote further intensification of agriculture should aim at developing sustainable cropping systems that consider not only increased food production but also reduced environmental impact [1].

At present, 40% of the Earth’s surface is managed for farmland and pasture [Foley et al., 2005]. The most important crop systems globally, in terms of meeting future food demand, are those based on staple crops, rice, wheat and maize. Both rice and maize are grown on an area of more than 155 million hectares [2]. In addition, rice is the staple food for the largest number of people on Earth. The geographical distribution of rice production gives particular importance to Asia where 90% of the world’s rice is produced and consumed. Corn is mainly produced in the Americas, followed by Asia and then Africa. Maize is important as a staple crop (mainly in developing countries) but is also important as animal feed, and increasingly as a biofuel. Wheat is the most widely cultivated crop, covering more than 215 million hectares worldwide, and Asia covers nearly 50% of the world’s wheat [2].

It is important to promote agricultural practices that mitigate climate change by reducing greenhouse gas emissions, but these same practices must also improve farmers’ production and incomes and protect the production system from the effects of changes in climate. The overall impact predicted by climate change models varies, but we are now caught up in global warming and inevitable changes in climate patterns that are likely to exacerbate current precipitation variability and increase the frequency of extreme weather events. In the event of heavy rains, intense rainfall events will increase resulting in flooding and soil erosion. In regions of low precipitation, and regions prone to drought, there is general acceptance in the scientific community of recurrent moisture stress due to failure of precipitation patterns and increased evaporation caused by higher temperatures [3]. In Africa specifically, the projected combined effects of climate change and population growth point to an alarming increase in water scarcity in many countries, with 22 out of 28 countries believed to be likely to face water scarcity or water stress by 2025. This, in turn, will limit of the capacity of irrigated agriculture to respond to the growing food needs of tomorrow’s Africa [4].

Agriculture as a Solution to Climate Change

The agricultural sector has great potential to mitigate the effects of climate change by reducing greenhouse gas emissions and enhancing agricultural sequestration. In addition, it also has an important role in adaptation to climate change. Adaptation alone is not sufficient to offset the effects of climate change, and thus remains to be complemented by concerted mitigation efforts. Vuuren et al., [5]. Various land use departments (soil and water conservation measures, manure, and fertilizer management) in the agricultural field will help us sequester a large amount of carbon in the field and reduce the emissions of methane and nitrous oxide which are the main means of greenhouse gas emissions.

Change in Cropping Style

Apply changes in how crops are rotated during the season. Farmers in drought-prone semi-arid regions of Brazil have realized that several varieties of a single crop species can occupy a common land area, which includes many varieties of beans, maize, and sorghum, among others, to increase harvest potential due to Kemba’s dry climate and arid climatic pressures. Muzangwa L, et al. [6] similarly, farmers in Ethiopia are trying to adapt CC by growing diversified crops (home maize and other farm management practices).

A change in current farm management practices such as the practice of organic farming to maintain diversified farming systems (i.e., growing different types of crops) also helps diversify potential sources of income for farmers, making the farm family more resilient to the negative effects of climate on agricultural production. According to Rhodes et al., [7] also considers the practice of crop residue management to be one of the best climate-smart measures.

Conclusion

From this extensive review, it is concluded that globally, climate change has relationship with agriculture in one or another way. This relationship becomes strong in developing countries because their livelihood depends on agricultural activities and these activities mostly depend on climatic condition.

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Iris Publishers-Open access Journal of Complementary & Alternative Medicine | Fearing the Future: A Call to Teach Hope

 

Authored by Karin Richards*,

Abstract

Evaluation of the level of hope in interprofessional students, before the COVID-19 pandemic hit, included: temporality and future; positive readiness and expectancy; and interconnectedness with self and others as well as an overall score of hope. With a total possible score of 48, indicating the maximum level of hope, scores ranged from 30-41. This study identified that while 85% of the participants indicated that had both short and long-term goals, 39% of the participants still felt all alone. Schools cannot neglect the vital component of hope. All higher education healthcare professionals can deviate to developing interventions and curriculum to address hope, specifically the fear of the future and lack of inner strength among our students.

Keywords:Hope, future, fear, alone

Introduction

In spring 2019, the American College of Health Association suggested 67% of college students surveyed (n= 67,972) indicated feeling very lonely and 56% of college students experiencing a lack of hope at least once during the last 12 months [1]. This finding is not unique in previous research [2-4]. Theorizes that the colder months such as after winter break may be particularly disheartening to students due to the leaving of the comforts of home and returning to the assumption of already formed social ties among peers at their respective academic institution [5]. Loneliness and hopelessness may also contribute to concerning mental health challenges such as depression, anxiety and suicide [6-9].

Hopelessness can be defined as having low motivation and disbelief in the ability of oneself to meet desired goals [10]. Having hope, therefore, can be further described as “creating positive feelings and applying inspired action” on a daily basis and especially through challenging, uncertain times [15]. Hope can be a valuable skill to teach especially among future healthcare professionals both for the clinician and the patients with whom the practitioner interacts [9,11]. Hope offers an alternative from feeling a lack of control and from the unknown which may also further improve lifestyle choices and overall well-being [11-13]. Limited research exists on the hope of Gen Z future healthcare students. Now is the time they may need it most.

Materials and Methods

A convenience sample was used consisting of all students (n=18) enrolled in the spring 2020 semester of PE 102-02. No student who chose to participate was eliminated from the study. All questionnaires were completed in their entirety.

The level of hope was rated through the 12-item, previously validated, 1999 Hope Herth Index Likert scale quantitative assessment tool [14]. Each item on the Herth Index tool is rated between 1-4, (Strongly Disagree, Disagree, Agree, Strongly Disagree), with possible overall scores ranging from 12-48 [14]. Items number three and six on the tool, however, are reversed scored due to the type of negative affirmation utilized in the assessment [14]. Summing all variables results in a degree of hope with higher scores suggesting elevated levels [14]. The individual variables of hope are also grouped into three categories: temporality and future; positive readiness and expectancy; and interconnectedness with self and others [14].

Descriptive statistics were used to report central tendencies and sample standard deviation of variables. All statistical analyses were conducted using the Statistical Package for Social Sciences (SPSS Version 26).

Results and Discussion

The majority of participants (94%) rated themselves as having a positive outlook on life, having a high sense of life’s worth and the ability to see potential in each day. Yet 89% were scared of their future and 39% of students reported feeling all alone.

Among the three categories of hope, interconnectedness with self and others was suggested to be the strongest (85%) followed by positive readiness and expectancy (79%); and temporality and future (68%). The average standard deviation among variables was .69, thus indicating little variability.

Research has consistently indicated that hope is a key component of lifelong wellness [8,9,13]. Yet university curriculums lack a focus upon teaching the concepts of hope to its students. Berg et al., (2011) suggest that engagement in healthy behaviors correlate favorably with levels of hope [13]. Ample research exists on the lifestyle choices of college students most notably which is assessed on a seasonal semester basis [1-4]. Teaching and encouraging grit, however, has been suggested to be a more acceptable measure among the academic community [15-17]. Grit has been suggested as resolution and drive towards goals, which is suggested to improve academic achievement, well-being, and personal accomplishment [15-17]. These traits, however, will not help a patient power through the latest experimental drug or cognitive speedbump when all medical effort has been exhausted. Nor will grit provide the connection needed between the healthcare provider and patient. Stitzlein (2020) theorizes that grit is more an individualistic approach to effort-focused goals whereas a hope approach is towards a communal outcome [15]. Additionally, hope has been suggested to be a bonding factor between patient and provider and facilitator of coping mechanisms [18]. Improving patient experiences starts with the healthcare provider, thus teaching how to cultivate hope first to healthcare students could be an opportunity to instill this positive trait within the future practitioner and the ability to transmit hope to the patient. The level of hope has been regularly assessed in patients, yet limited research exists on the hope in students who will one day treat these patients [18,21-23].

Table 1: Standard deviations among Herth Hope Index variables.

Academic institutions could be an ideal setting to enhancing student connection and overall wellbeing [7,8,15,24,25]. Various techniques to cultivate hope have been presented in the literature: positive affirmations, breathing techniques, mindfulness, visualization, journaling, gratitude, giving back, establishing connection among peers, promoting spiritual growth, and creating, as well as developing specific, measurable, attainable, realistic and time-bound (SMART) goals and finding encouragement through action [8,19,20,22,24,25]. Hopeful Minds, for example, is an evidenced-based curriculum designed to teach hope to elementary and middle school students [8,24,25]. Their research suggests that teaching hope is possible and results in an increase in “emotional intelligence, leadership, resiliency, self-esteem, mental health, and the prevention of suicide.” [8,24-26]. This curriculum could be adapted and implemented into higher education courses as well.

Evaluation of the role of hope offers an opportunity to assess university students’ current and future perceptions. Interventions to alleviate anxiety can instill future coping skills as well as professional interactions and realistic encouragement with patients [8,21-23]. Based on the current pilot study, students are fearful of the future. Addressing this trepidation can be integrated into the university curriculum. If academia can instruct how to power through challenges, hope can be taught to find encouraged emotion and action [8,15-17]. Teaching hope may instill the skill and belief in our students, our future healthcare practitioners, that optimism over struggle may play more of a key role in patient and personal outcomes [8,24,25].

Primary limitations of the study include the potential for random error on the part of the observer; the non-coverage bias of the segment sample; and type of sampling frame and segment participants, which limit external validity. Small sample size and sample validity are also limitations of the investigation due to the geographical locations of the university and may not be generalizable to the population. A final limitation of the study is that the study is an observational study rather than an experimental design with researcher intervention [27].

Future research should include the assessment of hope on a larger scale among future healthcare professionals, identification of specific fears of the future as well as interventions to examine the changes of perceptions of hope among students.

Conclusion

Assessing hope can provide valuable insight into students’ current and future perceptions of personal and professional life. Teaching students how to develop a stronger outlook and active skills while lessening anxiety and depression may alleviate the fear of the future and feelings of loneliness while strengthening self-efficacy. While teaching the application of hope is not a typical course in a rigorous university healthcare curriculum, maybe it should be.

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