This paper outlines evidence-based practice in the context of professionalism, and highlights the contribution evidence-based practice can make to the professional practice of higher education course managers. Implications of the changing HE landscape for the status of academics as professionals are reviewed, and evidence-based practice is proposed as a solution for both enhanced course management and to remedy perceived deprofessionalisation. Finally, questions regarding researching professional practice within one’s own institution are addressed.

The aim of this study was to develop a valid and reliable questionnaire to assess vitamin D-related knowledge, attitude and practice (KAP) in Iranian adults who may be at increased risk of vitamin D deficiency. This study was conducted on 527 subjects, aged ≥20 years from Public health care centers in Tehran, Iran. Based on results of literature review and in-depth interviews, the 38-item vitamin D-related KAP questionnaire with four subscale was developed: 1) general knowledge; 2) nutritional knowledge; 3) attitudes; 4) behaviors. Validity of the developed vitamin D-KAP questionnaire was assessed, utilizing face, content, and construct validity methods. Internal consistency was calculated to assess reliability of the current developed questionnaire. A total of 572 (54.1% female) adults, aged 30.2±7.9 years, participated in the study. All items were perceived as relevant and comprehendible by participants. Content validity was confirmed by the panel of experts. The internal consistency, as measured by Cronbach’s alpha coefficients, exceeded the minimum reliability standard of 0.60 for four subscales. The EFA suggested a four-factor construct and the results of the CFA indicated acceptable fit indices for the proposed model. No ceiling effects were observed except for general knowledge (1.2%). Floor effects detected were 0, 1.1, 2.4, and 8.7% for practice, attitude, general knowledge, and nutrition knowledge, respectively. General knowledge had the highest score (79.59±14.52) and nutrition knowledge, the lowest score (42.58±20.40) among the four sub-scales. Results confirm the initial validity and reliability of the vitamin D-related knowledge, attitude and practice questionnaire. Further investigations in different urban and rural population are recommended.

A capacity to reflect on experience and learn through it (reflective and reflexive practice) is deemed an essential part of ethical practice and research. Challenging traditional research approaches this arts-based, inter-disciplinary, Ph.D. project explores artistic practice as a research methodology, and how learning through experiences of ‘making’ things may enhance and amplify our understanding of the more affective aspects of human situations and experience. Grounded in the author’s artistic practice and learning through experiences of ‘making’, the author assembles and adapts frames from psychoanalysis, art (psycho)therapy, and the arts with/through which to observe and document their experience of an organisational situation. Describing the development of their method in three phases, analysis takes place through returning to revisit and rework artistic material produced, and engaging in conversation with the emergent material and others in response. Results take the form of artworks and artistic projects, including documentation of process. Emergent threads draw attention to the speculative, entangled, and affective nature of the research process, the reflexivity generated through moving and handling material, and the reflexive work of undergoing, foregrounding an ethics of responsibility, attention, and care for/of the body. As a space for imaginative encounter and performative enactment, and a site for reflexivity through which one may be pressed to notice and feel more acutely, the author argues that the research value resides in the capacity of this method to embrace complex relationalities, and engage our affective, ethical sensibilities in ways that may not emerge through more traditional approaches to reflective/reflexive practice(s). This has implications for both art therapy practice and research, amplifying the learning opportunities afforded by moving, modifying, and assembling things differently, the embodied ‘work’ of art as a method of enquiry, the cultural sensitivity of documentary fragments captured in/through various media and voices, and the value of collaborative endeavours where meaning is co-constructed in conversation.

Abstract: Background: Dental fear and uncooperative behavior can hinder dental treatment quality. Pediatric Procedural Sedation and Analgesia (PPSA) is used to facilitate treatment when coping capacity is exceeded. Out-of-hospital PPSA has been associated with more adverse outcomes compared to hospital-based settings. Updated Dutch PPSA guidelines recommending two anesthesiologists and a ventilator during out-of-hospital PPSA have increased costs and raised concerns about the accessibility to specialized high quality dental care for children in the Netherlands. Aim: This study aims to investigate the impact of the updated 2017 guideline on the occurrence rate of adverse events during PPSA, as recorded in the anesthesia complication database of twelve participating Dutch dental clinics, with adjustments made for age, weight, and duration of treatment. Method: Data of 25,872 children treated at 12 dental clinics performing out-of-hospital PPSA between 1997 and 2019 were analyzed. Eligible children were aged 2-18 with ASA classification I and II. A logistic two-level mixed-effects model is used to estimate the updated guideline’s impact on adverse events. Results: In the final model we analyzed the data of 21,759 children in nine dental clinics. The OR of the occurrence rate of an adverse event adjusted for age, weight, and duration of treatment was 0.75 (95% CI 0.64 – 0.89) after the implementation of the updated guideline, compared to before the updated guideline. This outcome was significant with a P=0.001, indicating a protective effect. The average odds per clinic of having an adverse event was 0.04 with a 3.81% chance. Conclusion: Our findings demonstrate a significant reduction in adverse events after the implementation of the updated guideline and highlight the importance of adherence to evidence-based guidelines in improving patient safety and the quality of care provided during pediatric procedural sedation and analgesia in out-of-hospital dental clinics. Our study underlines the necessity of considering the complex underlying mechanisms that play a role in the development and implementation of evidence-based practice and safety initiatives on the occurrence of adverse events.

Energy use is of crucial importance for the global challenge of climate change but also an essential part of daily life. Hence, research on energy needs to be robust and valid. Other scientific disciplines have experienced a reproducibility crisis, that is, existing findings could not be reproduced in new studies, and energy research might be impacted as well. In this paper, we suggest the ‘TReQ’ approach to improve the research practices in the energy field and arrive at greater Transparency, Reproducibility, and Quality. We acknowledge the specific challenges of energy research and suggest a highly adaptable suite of tools that can be applied to research approaches across this multi-disciplinary and fast-changing field. In particular, we introduce preregistration of studies, making data and code publicly available, using preprints, and employing reporting guidelines to heighten the standard of research practices within the energy field. We argue that through wider adoption of these tools, we will be able to have greater trust in the findings of research used to inform evidence-based policy and practice in the energy field.

Nurses’ competency towards Evidence-based Practice (EBP) has been extensively investigated by several studies worldwide. However, factors affecting the competence of Greek nurses working in the NHS have not been fully investigated in terms of EBP. Thus, this study aimed to explore the impact of individual qualifications of nurses on their competence towards EBP. Data from 473 registered nurses working in 10 hospitals of in the Greek National Health Service (NHS) were collected between October and December 2022 using a convenience-sampling method in a cross-section design. The Greek version of the 35-item (5-point Likert scale) Evidence-Based Practice Competency Questionnaire for Professional Registered Nurses (EBP-COQ Prof) was used to assess the competence level of nurses focusing on the attitudes, skills, and knowledge as well as the utilization of EBP in clinical practice. One-way ANOVA and Pearson coefficient tests were applied to compare possible differences among variables (two or more groups) as appropriate. A multi-factorial regression model was applied to explore participants’ qualifications, including demographics (MSc degree, gender, English language knowledge, etc.) as independent variables, and to control for potential confounding effects toward EBP competency. P-values <0.05 were considered statistically significant. The mean age of 473 participants (402 women and 71 men) was 44.7 ± 9.2 years old. The mean value of competence subscales was found as follows: attitudes 3.9±0.6, knowledge 3.7±0.6, skills 3.1±0.8, and utilization 3.4±0.7. A multivariate regression analysis revealed that associates of “Master's degree” (t=3.039, p=0.003), “Writing an academic article” (3.409, p=0.001), “Working in a University clinic” (2.203, p=0.028) and, “Computer Skills” (2.404, p=0.017) are positively affecting ‘Attitudes’, ‘Knowledge’, ‘Skills’ and ‘Utilization’. Respectively. The research data suggest that nurses working in Greek NHS are limited in competence towards EBP in comparison to other European countries. Therefore, Vocational, Educational and Training programs tailored to EBP enhancement are crucially important.

Decision-making using evidence-based practice (EBP) is generally universally accepted by nurses. Such acceptance may affect the personnel’s behaviour towards patients, which is also demonstrated by taking into consideration the patient’s preferences, including the patient’s spiritual needs, in the care plan. The provision of such care requires the development of an attitude of approval and an adequate level of communicative competence, which will enable the actual implementation of the EBP. The purpose of our study was to assess the perception of spirituality and the nurse’s role in providing spiritual care, as well as the perception of the significance of communication skills in the approval of EBP in professional practice. A multi-centre cross-section study was conducted on a population of 1176 participants (459 undergraduate (Bachelor programme, BP) and 717 postgraduate students (Master programme, MP)) from 10 medical universities in Poland. Three tools were used in the study to evaluate the participants’ approach: Evidence-Based Practice Competence Questionnaire (EBP-COQ), The Spirituality and Spiritual Care Rating Scale (SSCRS), and Communication Skills Attitude Scale (CSAS). Structural equation modelling was used for the analysis. An analysis of structural equations revealed the presence of positive relationships of the attitude to spiritual care and the role of communicative competences with the approach to EBP regardless of the cohort. A significant difference was found related to the influence of age on the attitude toward learning communicative competences. The approval in this respect was observed to decrease with age in the MP group. Increasing approval of EBP requires strengthening the approach to activity-centred spiritual care, with the simultaneous development of a positive attitude towards learning communicative competences. The model reveals the need to integrate a humanistic approach with EBP, which can be achieved by planning different interventions in different groups of recipients: nurses, academic teachers and students.

In recent years the study of the teacher-student relationship in the teaching-learning processes in physical education has had great emphasis. Previous studies have shown that the use of the Spectrum of teaching Styles can enhance intrinsic motivation, enjoyment, adherence to physical activity and physical activity levels in children and adolescents. The present study aims to assess if a physical education (PE) intervention based on the variations in teaching styles, with reference to production ones, can also have positive effects on physical fitness. The sample involved 4 primary school classes (n = 124 children, mean age = 8-10 years) recruited from the SBAM (Health, Wellness, Food Education and Movement at School) Project in Apulia, Southern Italy. Classes were randomly assigned to Experimental Group (EG) and Control Group (CG). EG followed a 5months experimental intervention based on the variation of teaching styles, while CG performed regular PE lessons. Physical fitness test was assessed with Standing Long Jump (SLJ), Medicine Ball Throw 1kg (MBT), and 20m sprint (20m), while two validated questionnaires were used to evaluate physical self-perception (PSP) and enjoyment. A 2x2 (intervention group x time) ANOVA was carried out to assess significant difference and interaction effect pre (t0) and post (t1) intervention protocol. Data analysis showed a significant improvement of physical fitness in both EG and CG, while PSP and enjoyment increased only in EG. Moreover, significant interaction (p<. 05) effects were found for 20m sprint, PSP and Enjoyment with low effect size (η2 ~. 20). The results of the present study highlight the effectiveness of a PE intervention based on the variation of teaching styles in improving physical fitness, self-perception, and enjoyment. Moreover, the use of production teaching styles significantly impacts self-perception and enjoyment, that are important mediating factors for guarantee better adherence to physical activity.

Introduction: Dementia is a cognitive decline with patients often exhibit behavioural and psychological symptoms, severely affecting the quality of life and placing a heavy burden on caregivers. Acupressure has reported benefits for dementia. This study aims to critically review the available evidence for its use as a non-pharmacological therapy. Methods: Systematic search of major research databases for human clinical trials using acupressure as an intervention for dementia patients was conducted. Results were synthesised for the effects of acupressure on various outcome measures of interest for dementia.Results: Twelve clinical trials (N=973), including eight randomised control studies, were included in this review. The study sample was predominantly institutionalised residents with moderate to severe dementia. Baihui (GV20), Shenmen (HT7), Fengchi (GB20), Neiguan (PC6), Sanyinjiao (SP6), and Yingtang (EX-HN3) were the most used acupoints for intervention. Acupressure techniques employed in these clinical trials vary greatly with no standardised approach. This review finds inconsistent evidence in the effectiveness of acupressure in reducing agitation and behavioural disturbances. However, the treatment appears to improve their ease of care and reduce physical stress. Affixing acupressure devices on selected acupoints can also potentially improve psychiatric pain, anxiety, and depression. Long-term (6 months) treatment can potentially improve the cognitive function, activities of daily living, and quality of life of patients with mild to moderate dementia. The effect of acupressure on sleep disturbances remains unclear. Conclusion: More high-quality research on acupressure is needed to fill the gaps in knowledge and inform better care for dementia patients in the future.

A critical context is an essential aspect of practice-based research; however, a lack of structure exists to obtain and evaluate criticism from peers. This paper presents a case study of how the ‘silent student’ critique method used in Higher Education settings in the UK (Elkins, 2014) was adapted for a holographic arts research study. A ‘silent researcher’ critique session with nine experts was held in Aveiro, Portugal, June 2018 to evaluate the author’s digital holographic artwork, on display at the City Museum. The experts asked the author critical questions about the artwork while the author remained silent. The session was filmed, transcribed and processed using a general inductive approach for analysing qualitative evaluation data (Thomas, 2006). This paper outlines the benefits and drawbacks of using this new critique method for research. The benefits included; participant’s careful response to the artwork avoiding engagement of egos of critic and researcher, the drawbacks included the difficulty of evaluating against a pre-determined research question when the discussion could not be steered. This paper evaluates the artwork critiqued describing how the work contributes to the aesthetic development of the medium of holography; which used the Z-axis of holographic space to depict a chronological narrative.

Background: Good clinical practice (GCP) training is the industry standard for ensuring the quality conduct of registrational clinical trials. However, concerns have been raised about whether the current structure and delivery of GCP training sufficiently prepares clinical investigators and their delegates to conduct clinical trials. Methods: We conducted qualitative semi-structured interviews with 13 clinical investigators and 10 research sponsors to 1) examine characteristics of the quality conduct of sponsored clinical trials, including critical tasks and concerns perceived as essential for trial quality, 2) identify key knowledge and skills required to perform critical tasks, and 3) identify gaps and redundancies in GCP training and areas of improvement to ensure the quality conduct of clinical trials. We used applied thematic analysis to analyze the data. Results: The top three tasks identified as critical for the quality conduct of clinical trials were obtaining informed consent, ensuring protocol compliance, and protecting participants’ health and safety. Respondents acknowledged that GCP principles address each of these critical tasks; however, they described many challenges and burdens of GCP training, including high training frequency and repetitive content. Respondents suggested moving beyond GCP training as a mere check-box activity by making it more effective, engaging, and interactive. They also emphasized that applying GCP principles in a real-world, skills-based environment would increase the relevance of GCP training to investigators and their delegates. Conclusion: Our findings indicate that although investigators and sponsors recognize that GCP training addresses critical tasks necessary to the quality conduct of clinical trials, they articulated the need for significant improvement in the design, content, and presentation of GCP training.

Recently, interest in STEM education has grown among researchers and educators, also considering the skills required to address the challenges of the 21st century. Supporting learning in STEM subjects is an open challenge, especially during secondary education, which is reflected in the implementation of innovative pedagogical practices, including approaches focused on Game-Based Learning (GBL). This study analyzed the main issues addressed by research on game-based educational approaches applied to STEM teaching and learning in secondary school and their evolving trends. A text analysis of abstracts published in the past decade was conducted using T-lab software. The “Word Analysis” function was used for preliminary visual mapping; then the “Specificity Analysis” and “Thematic Analysis of Elementary Contexts” functions were applied to explore changes in research directions and to map the themes covered by the most recent studies. The results showed that the implementation of games in STEM disciplines is a promising area of inquiry. A shift in research directions also emerged, currently more focused on studying how GBL can foster engagement and the emotional component of learning. Adapting to rapidly changing technology and integrating essential skills such as coding and computational thinking are additional challenges that the research community is facing.

Significant efforts in the past decades to teach evidence-based practice (EBP) implementation has emphasized increasing knowledge of EBP and developing interventions to support adoption to practice. These efforts have resulted in only limited sustained improvements in the daily use of evidence-based interventions in clinical practice in most health professions. Many new interven-tions with limited evidence of effectiveness are readily adopted each year - indicating openness to change is not the problem. The selection of an intervention is the outcome of an elaborate and complex cognitive process which is shaped by how they represent the problem in their mind and is mostly invisible processes to others. Therefore, the complex thinking process which support appropriate adoption of interventions should be taught more explicitly. Making the process visible to clinicians increases the acquisition of the skills required to judiciously select one in-tervention over others. The purpose of this paper is to provide a review of the selection process and the critical analysis that is required to appropriately decide to trial or not trial new intervention strategies with patients.

Background: One way to demonstrate the existence of nursing is to develop a nursing theory model through nursing research which can ultimately be implemented in nursing practice. RAM is one of the most frequently used models in guiding nursing research. Roy's Adaptation Model (RAM) is one of the most useful conceptual frameworks that guide nursing practice, direct research, and influence education. Theory-guided nursing practice is fundamental in providing the framework for developing superior and quality nursing care.Objectives: This systematic review aims to critically analyze recent studies using RAM as a conceptual framework to identify the effectiveness of this model in guiding nursing research.Methods: A literature search was conducted on five databases, namely SCOPUS, PubMed, ProQuest, ScienceDirect, and SAGEPub. There were no population boundaries and diagnoses involved in the study. The study is a quantitative design focused on publication between 2015-2021. The methodological quality of applying the Cochrane and JBI bias tools. The analysis uses narrative synthesis.Results: 20 studies were found out of 1,315 studies. The research population found is very diverse. The given intervention follows the conceptual framework of RAM. RAM-based interventions effectively overcome the problems experienced by patients and reduce the perceived symptoms and improve the patient's quality of life.Conclusion: The conceptual use of RAM theory in nursing research has been widely reported. RAM-based interventions have a significant impact and have strong evidence-based practice in improving patient health status.

We construct a Bayesian estimator for the dilution of a wastewater sample. When wastewater is diluted by rainwater an estimate of the level of dilution is required if we are to normalise sample measurements of disease markers such as SARS-CoV-2 RNA. We consider the situation where flow measurements are available, but will regularly be unreliable because of the action of combined sewer outflows (CSOs) and wastewater storage tanks, which divert wastewater away from treatment plants when the flow is excessive. However, we also have proxies for the flow from various chemical markers (e.g.\ phosphate, ammonium, electrical conductivity), whose level per unit of population is fixed. The new flow estimator has multiple advantages compared to existing procedures: credible intervals for the estimates; optimal weighting of the chemical markers; systematic handling of missing and censored values; and model based smoothing without lags.

Preschoolers with disabilities and their caregivers have been neglected in health and social service provision in most low-income countries and arguably too in low resourced areas of more affluent nations. Yet as this rapid review of published literature identifies, there are low-cost, evidence-based strategies to address their needs that can be implemented in communities by local people. Five key features of the necessary supports are examined. First the leadership functions required to create and implement the support services. Second, the family-centred, home-based support provided to caregivers and the personnel undertaking this form of support. Third, providing opportunities for peer support to flourish and encouraging the formation of advocacy groups across families. Fourth, mobilizing the support of significant groups within the community; notably traditional healers and leaders; health services and poverty alleviation initiatives. Fifth, devising ways in which preschool educational opportunities can be offered to children as a prelude to their inclusion in primary schools. The review serves a further purpose. It provides an example of how public health researchers and academics could achieve more rapid implementation of evidence-based knowledge into existing and new support services through dissemination to community practitioners.

People are increasingly encouraged to reduce animal food consumption and shift towards plant-based diets, however the implications for children’s health are unclear. In this narrative review of research in high-income settings, we summarize evidence on the increasing consump-tion of plant-based diets in children, and update an earlier systematic review regarding their associations with children’s health outcomes. The evidence indicates that vegan but not vege-tarian diets can restrict growth relative to omnivorous children, and increase the risk of being stunted and underweight although the percentage affected is relatively small. Bone mineral content is reduced in vegetarian and especially vegan children, compared to omnivores. Both vegetarian and vegan children who do not use vitamin B12 supplements manifest with B12 defi-ciency, however supplementation rectifies this problem. Both vegetarians and vegans have lower concentrations of 25 (OH)D if unsupplemented, and lower body iron stores, but usually have normal iron metabolism markers. Both groups are at risk of iodine deficiency and this might affect thyroid health. Children consuming a vegan diet have more favorable lipid profile than omniv-orous children, however the results for vegetarian diet are inconsistent and vary by outcome. Based on the same scientific evidence, national and international dietary recommendations are heterogeneous, with some countries supporting plant-based diets among infants, children and adolescents, and others discouraging them. We offer a research roadmap, highlighting what is needed to provide adequate evidence to harmonize dietary recommendations for plant-based diets in children. A number of measures should urgently be introduced at international and na-tional levels to improve the safety of their use in children.

Tropical cyclones devastate large areas, take numerous lives and damage extensive property in Bangladesh. Research on landfalling tropical cyclones affecting Bangladesh has primarily focused on events occurring since AD1960 with limited work examining earlier historical records. We rectify this gap by developing a new tornado catalogue that include present and past records of tornados across Bangladesh maximizing use of available sources. Within this new tornado database, 119 records were captured starting from 1838 till 2020 causing 8,735 deaths and 97,868 injuries leaving more than 1,02,776 people affected in total. Moreover, using this new tornado data, we developed an end-to-end system that allows a user to explore and analyze the full range of tornado data on multiple scenarios. The user of this new system can select a date range or search a particular location, and then, all the tornado information along with Artificial Intelligence (AI) based insights within that selected scope would be dynamically presented in a range of devices including iOS, Android, and Windows. Using a set of interactive maps, charts, graphs, and visualizations the user would have a comprehensive understanding of the historical records of Tornados, Cyclones and associated landfalls with detailed data distributions and statistics.

Diseases in articular cartilages have affected millions of people globally. Although the biochemical and cellular composition of articular cartilages is relatively simple, there is the limitation in self-repair ability of cartilage. Therefore, developing the strategies for cartilage repair is very important. Here, we reported a new manufacturing process of water-based polyurethane based photosensitive materials with hyaluronic acid and applied the materials for 3D printed customized cartilage scaffolds. The scaffold has high cytocompatibility and is one that closely mimics the mechanical properties of articular cartilages. It is suitable for culturing human Wharton's jelly mesenchymal stem cells (hWJMSCs) and the cells showed an excellent chondrogenic differentiation capacity. We consider that the 3D printing hybrid scaffolds may have potential in customized tissue engineering and facilitate the development of cartilage tissue engineering.

The magnetic properties of 0.10 mm ultra-thin grain-oriented (UTGO) silicon steel and Fe-based amorphous (FBA) alloy under sinusoidal excitation were measured experimentally, and the magnetic field strength and iron loss of the two materials under different frequencies and magnetic densities were obtained. Based on the measured data, the magnetization and loss characteristics of the two materials were analyzed and compared. Furthermore, two Epstein square ring models of the same specification and different materials were designed, and the reliability of the models was verified. Then, the electromagnetic characteristics of the two Epstein square ring models at higher and lower frequencies were calculated by using the finite element method, and the iron loss was obtained and compared. The results show that the FBA alloy has good application characteristics at low frequency and low power, and the 0.10 mm UTGO silicon steel has good application characteristics at high frequency and high power. This research can provide important data basis to promote the application of these two materials in new energy equipment.

Approximately 20% of the world's population resides in coastal areas at risk of rising sea levels due to climate change. This could lead to severe weather events and ecological impact on critical infrastructure. To combat the effects of water-based environmental forces on the land, hard engineering methods such as seawalls have been utilized. However, a more sustainable solution is emerging in nature-based engineering, which involves growing vegetation. This approach can help extend the lifespan of existing technology and provide climate change adaptation and resilience for coastal and riverine communities. The following paper will review seaweed farms as an advanced nature-based mitigation approach. The paper also outlines the findings of experiments at RWTH Aachen University's hydraulic laboratory. These tests involved using seaweed as a natural solution to dampen waves in a model system to test a hypothesis. One result involving a system with two lines of seaweed revealed 15 percent wave damping. Using seaweed as a nature-based solution, a gentle engineering approach to designing future vegetated protection systems can extend the design life of existing coastal infrastructure. This can also provide protection against climate-induced sea level rise, promote coastal risk mitigation, restore ecosystems, and foster blue bio-economic development.

A project-based module on Sustainable Development Goal number 5, Gender Equality, was im-plemented on 5 different groups of Business English students consisting of a total number of 62 students in higher education. The main purpose of this project was to raise awareness of this goal by means of a flipped method in which students were required to carry out some research on specific areas of the aforementioned goal and work in teams to elaborate oral presentations. Once their findings were shared in class, students were expected to answer a written questionnaire of open-ended questions which were part of a qualitative analysis. Results of this survey showed that not only 90% of the students gained in depth knowledge of this goal, but also 85% had built a positive attitude to take initiative and 80% were optimistic about future gender equality. Finally, 70% of students suggested further social action to curb the problem of gender discrimination. On the whole, the flipped classroom method of learning combined with project-based group work have proven to be an effective way to raise awareness of this goal, create a more positive attitude, in-crease their willingness to take action as well as widening their English lexical resources.

Artificial intelligence (AI), deep learning (DL) or machine learning (ML) is the ability of computer systems, machines and enginery to work devise procedures like humans. These technologies provide opportunities and possibilities to advance diagnostics and in planning also in the field of human medicine and dentistry. The purpose of this literature review was to ascertain the applicability and significance of AI, as well as to highlight its uses in maxillofacial surgery. The primary inclusion criterion for this publication was an original paper written in English focusing on the use of AI, DL or ML in maxillofacial surgery. The sources of information were PubMed, Scopus and Web of Science, and the queries were made on 31st of December 2023. The search strings used were “artificial intelligence maxillofacial surgery”, “machine learning maxillofacial surgery” and “deep learning maxillofacial surgery”. Following the removal of duplicates, all remaining publications that were returned by the searches and were screened by three independent operators to minimize the risk of bias. The analysis of publications from 1992 to 2023 identified certain records, of which 324 were finally selected. These were calculated according to the year of publication with a continuous increase (excluding 2012 and 2013) of R2 = 0.9295. Generally, in orthognathic dentistry and maxillofacial surgery, artificial intelligence and machine learning have gained popularity over the past few decades. When we included the keywords "planning in maxillofacial surgery" and "planning in orthognathic surgery", the set of published papers significantly increased to the number of 7535 publications. The first publication appeared in 1965, with an increasing trend (excluding 2014-2018), with an R2 value of 0.8642. These tools have been found useful for diagnosis, treatment planning in head and neck surgical oncology, cosmetic and aesthetic surgery, and in oral pathology. In orthognathic surgery, they have been utilised for diagnosis, treatment planning, assessment of treatment needs, cephalometric analyses, and orthognathic surgeries, among other applications. The review confirms that the current use of artificial intelligence and machine learning in maxillofacial surgery is focused mainly on the evaluation of digital diagnostic methods especially radiology, treatment plans and postoperative results. However, as these technologies are integrated in maxillofacial surgery and robotic surgery in head and neck region, it is expected that in the future they will be gradually utilized to plan and comprehensively evaluate the success of maxillofacial surgeries.

We assessed the use of Evidence-Based Practice (EBP) among pharmacists working in community pharmacies in France, and the factors linked to this practice. During 3 months in 2018 an online survey was sent to over 7,000 active pharmacists, and posted on pharmacist social media sites. The 40-item questionnaire described four clinical cases reflecting typical situations (conventional med-icine and Complementary and Alternative Medicine) encountered daily by community pharma-cists. Multiple-choice responses were proposed and scored according to whether they reflected EBP. A high total score indicated behavior in line with EBP. Univariate and multivariate analyses were used to evaluate factors that might explain adherence to EPB (pharmacy’s characteristics, the pharmacist’s status, mode of continuing education and sources of information). 595 pharmacists completed the questionnaire. The majority relied on pharmaceutical industry and other biased and/or non-evidence-based sources, particularly concerning information on homeopathic products. The consultation of independent reviews, health agency recommendations, and peer-reviewed scientific journals, was associated with evidence-based decisions. In contrast, reliance on phar-maceutical industry documents, personal experience and informal handbooks was linked to lower EBP scores. The level of EBP use by French community pharmacists needs to be improved to ensure that good quality scientifically-based advice is given to customers.

Stakeholder input into the decision-making process when developing public health programs and policies is crucial. This article presents an innovative approach, involving online participation with a wide group of stakeholders located in different geographic locations, for policy consensus by research methodology. The results of the project have been used to propose assumptions regarding a strategy for preventing blood-borne diseases in Poland. The research was conducted iteratively using a multi-stage qualitative methodology to explore risk assessment involving blood-borne infections. The final output of the entire project is a list of key problems/challenges and solutions associated with medical and nonmedical services that are connected to the breakage of tissue continuity. Qualitative research is rare in risk assessment as priority is usually given to statistical data and end-points (quantitative studies ). Statistical data on health risk allows to assess the health implications, while the methodology applied also allowed diagnosis of the processes leading to these effects. In addition to policy preparation for blood-borne illnesses, the methodology employed in the study can also be used to successfully explore other areas of public health policy decisions.

Course-based undergraduate research experiences (CUREs) provide students with opportunities for the same gains that apprenticed research with faculty members offer. As their popularity increases, it is important that critical elements of CUREs are supported by thoughtful design. Student experiences in CUREs can provide important insights into why CUREs are so effective. We present evidence from students who participated in CUREs at the introductory, intermediate, and advanced levels, as well as from graduate teaching assistants for an introductory lab course that included a CURE. Students and teaching assistants describe repetition as a valuable element in CUREs and other laboratory experiences. We used student work and open-ended interviews to identify which of five previously described elements of CUREs students found important. Because repetition was particularly salient, we characterized how students described repetition as they experienced it in courses that contained full-length or “micro”-CUREs. In prompted interviews, students described how repetition in CUREs provided cognitive (learning concepts) and practical (learning technical skills) value. Recent graduates who had participated in CUREs at each level of their Biology education were particularly aware that they placed value in repetition and acknowledged it as motivational in their own learning. Many students described repetition in metacognitive terms, which also suggests that as students advance through laboratory and CURE curricula, their understanding of how repetition supports their learning becomes more sophisticated. Finally, we integrated student descriptions to suggest ways in which repetition can be designed into CUREs or other laboratory courses to support scientific learning and enhance students’ sense of scientific identity.

The balance between theory and practice in architectural education is a permanent element of the discussion on teaching architecture. The article discusses the method of implementation of practical knowledge of the architectural profession at Poland’s largest department of architecture – Cracow University of Technology. Showing the subsequent stages of the education process on the way to obtaining authorization to independent design in Poland. Against this background, the didactic methods used in the initially experimental subject and now regular one taught at the Faculty of Architecture of the Technical University of Cracow together with the Chamber of Architects of the Republic of Poland since 2018 are discussed. The results of this collaboration and the didactic effects are discussed. The experience of adapting methods for remote education in connection with the pandemic of Covid-19 is also presented. In conclusion, because of the obtained results in response to the legal changes introduced by the State, the proposed new model of professional practice is discussed which, in the coming years, will cover all architecture universities in Poland.

The purpose of the article is to determine the peculiarities of using of teaching elements of research-based training at the Institute of Human Sciences of Borys Grinchenko Kyiv University. Based on the focus group methodology, the authors identify the key methodological characteristics of research-based training, which have been put into basis of analysis of educational programs for the purpose of determining the application of tasks that contribute to the development of research skills of students. The study used a method of focus group. Its purpose was to obtain the necessary information from the participants to describe the methodological basis and justification of methods, forms, indicators, etc. of research-based training system among people who are competent, have experience in this field. After that, the method of "theoretical sampling" was used, which enabled to formulate generalized characteristics according to the results of focus groups. The practical value of the study is determination of the methodological characteristics of research-based training which is the basis for the application of tasks by university teachers that promote the development of research competence of students. The research is one of the first attempts to determine the methodological characteristics of research-based training in Ukraine.

This survey paper discusses the Cointegrated VAR methodology and how it has evolved over the last 30 years. The first section is a description of major steps in the econometric development of the CVAR model that facilitated serious real world applications. The next three sections are primarily methodological and discuss (i) difficulties and puzzles when confronting theory with the data, (ii) the formulation of a viable link between theory and the data, a so called theory-consistent CVAR scenario, and (iii) how all this was inspired by Trygve Haavelmo and his Nobel prize winning monograph "The Probability Approach to Economics". The next two sections discuss early applications of the Cointegrated VAR model to monetary transmission mechanisms, international transmission mechanisms and wage, price and unemployment dynamics. They report puzzling evidence, discuss the need for new theory, and propose a method for combining partial CVAR analyses into a larger macroeconomic model. The following sections propose a new, empirically-based, approach to macroeconomics in which imperfect knowledge based expectations replace so called rational expectations and in which the financial sector plays a key role for understanding the long persistent movements in the data. The last section argues that the CVAR can act as a "design of experiment for passive observations" and illustrates with several applications including unemployment dynamics under crises periods and aid effectiveness in South Saharan African countries.

The development of plant-based meat analogues has become a significant challenge for the food industry in recent years due to the increasing demand for sustainable and healthier proteins in the context of a global protein transition. Plant-based meat analogues imitate the visual, textural, and chemical properties of traditional meat products and are required to closely resemble meat to appeal to consumers. In addition, consumers demand natural, clean-label, and nutritional and healthy products. To address these challenges, the food industry must develop highly healthy, nutritious, and E-number-free meat analogue products. Understanding the functionality of each ingredient and its role in the food matrix is crucial to being a key player in the innovation of the meat analogues market. This review provides updated information on the primary ingredients utilized for the development of plant-based burger meat alternatives and their functionality. The key components of meat analogue burgers are outlined, including plant proteins, binding agents, fats and oils, flavorings, colorings, preservatives, fortificants, and clean-label considerations.

Background: Dermatophytosis, commonly known as tinea, poses a significant public health concern worldwide, especially in environments with poor hygiene and overcrowding, such as prisons. Despite its prevalence and impact on quality of life, there is a lack of research on the knowledge and hygiene practices regarding dermatophytosis among prisoners, particularly in Nepal. Objective: The study aimed to assess prisoners' knowledge, hygiene practice and infection status regarding dermatophytosis in Central Prison, Nepal. Methods: A descriptive cross-sectional study with a sample size of 184 respondents was designed to collect data using a validated pre-tested questionnaire from September 2023 to January 2024. The collected data was then analysed using IBM SPSS version 21. Knowledge and hygiene practices were measured on an eight and 11-point scale and rated as poor (≤4) and sound (>4), bad (≤6), and good (>6), respectively. Summary data were presented by descriptive, while Chi-square and logistic regression were used for inferential statistics at P < 0.05. Results: The findings revealed moderate knowledge among prisoners regarding dermatophytosis, with significant gaps in understanding its spread and prevention. While most prisoners recognised the importance of treatment, there were misconceptions about the inevitability of contracting dermatophytosis and the role of personal hygiene. Conclusions: Despite good knowledge levels, adherence to recommended hygiene practices was suboptimal, highlighting the need for targeted interventions. The study underscores the importance of addressing knowledge gaps, changing attitudes, and promoting hygienic practices to mitigate the burden of dermatophytosis among prisoners.

Public parks are a community resource with an important role in improving liveability, physical, and mental wellbeing. However, exercise facilities that are suitable for people with disabilities typically have been neglected in public park design. As such, people with disabilities often are unable to independently or safely use the park. To address this shortcoming, the objective of this paper was to employ a pragmatic research through designing process in developing the design for an inclusive park. We used a mixed-methods approach in the research that included review of previous studies, semi-structured interviews, and questionnaire surveys with stakeholders were applied as design integration. Persons with disabilities specifically were consulted to express their views on all matters of inclusive park design.

Community-engaged research is understood as existing on a continuum from less to more community engagement, defined by participation and decision-making authority. It has been widely assumed that more is better than less engagement. However, we argue that what makes for good community engagement is not simply the extent but the fit or alignment between the intended approach and the various contexts shaping the research projects. This article draws on case studies from three Community Engagement Cores (CECs) of NIEHS-funded Environmental Health Science Core Centers (Harvard University, UC Davis and University of Arizona,) to illustrate the ways in which community engagement approaches have been fit to different contexts and the successes and challenges experienced in each case. We analyze the processes through which the CECs work with researchers and community leaders to develop place-based community engagement approaches and find that different strategies are called for to fit distinct contexts. We find that alignment of the scale and scope of the environmental health issue and related research project, the capacities and resources of the researchers and community leaders, and the influences of the socio-political environment are critical for understanding and designing effective and equitable engagement approaches. These cases demonstrate that the types and degrees of alignment in community-engaged research projects are dynamic and evolve over time. Based on this analysis, we recommend that CBPR scholars and practitioners select a range of project planning and management techniques for designing and implementing their collaborative research approaches and both expect and allow for the dynamic and changing nature of alignment.

Introduction: Oral health knowledge, beliefs and attitudes of parents have a direct influence on their child’s oral health maintenance, dietary habits and encourage healthy behaviors. The aim of this study was to assess the knowledge, and attitude of parents with regards to the oral health practice of their children and its associated factors. Methods: A self -administered structured questionnaire was administered to parents or guardians of learners aged 5 to 12 years at a low socio-economic rural primary school in the uGu district, KwaZulu Natal, South Africa to collect demographic variables, knowledge of dental health, use of toothbrush, use of toothpaste, dietary practices and dental visits; practice with respect to dental care and attitudes towards oral health. The questionnaire was translated from English to IsiZulu was used. Bivariate and multivariate logistic regressions were used to assess the association between parent’s sociodemographic factors with their oral health knowledge and practice scores. Results: One hundred and forty four completed survey instruments were received with an eighty percent (118) representation of mothers. Ninety five percent of the parents (136) had a positive attitude towards oral health with 86% (124) of the children brushed their tongue and 89% (128) of the children brushed their teeth happily. The mean knowledge score was 70% with a median of 72%. Children were significantly more likely to brush their tongues (AOR: 3.20 95% CI: 1.06-9.66) and were more likely to be happier when brushing their teeth (AOR: 4.65 95% CI: 1.41-15.38) when the caregivers were their mothers, and when parents had an above average knowledge score (AOR: 1.86 95% CI: 0.72-4.85) and had positive attitudes (AOR: 3.20 95%CI: 0.46-22.00). Conclusion: To reduce the gaps in knowledge, oral health promotion should be integrated into all point of care contact with parents at health facilities, increased community awareness and advertising campaigns as well as a more focused school health oral program that addresses primary prevention, screening and appropriate referrals to health facilities

As belonging to one of the most isolated continents on our planet, the microbial composition of different environments in Antarctica could hold a plethora of undiscovered species with potential for biotechnological applications. This manuscript delineates our discoveries after an expedition to the Bulgarian Antarctic Base "St. Kliment Ohridski" situated on Livingston Island, Antarctica. Amplicon-based metagenomics targeting the 16S rRNA genes and ITS2 region were employed to assess the metagenomes of the bacterial, fungal and archaeal communities across diverse sites within and proximal to the research station. The predominant bacterial assemblages identified included Oxyphotobacteria, Bacteroidia, Gammaprotobacteria and Alphaprotobacteria. A substantial proportion of cyanobacteria reads were attributed to a singular uncultured taxon within the family Leptolyngbyaceae. The bacterial profile of a lagoon near the base exhibited indications of penguin activity, characterized by a higher abundance of Clostridia, similar to lithotelm samples from Hannah Pt. Although most fungal reads in the samples could not be identified at the species level, noteworthy genera, namely Betamyces and Tetracladium, were identified. Archaeal abundance was negligible, with prevalent groups including Woesearchaeales, Nitrosarchaeum, Candidatus Nitrosopumilus and Marine Group II.

To assess the community health workers’ (CHWs) knowledge, attitude, and practices (KAP) in type-2 diabetes (T2D) and hypertension (HTN) management. We thus also sought to assess the potential health system barriers for incorporating CHWs in T2D and HTN management. Mixed-method study comprised (1) a survey among 153 active CHWs to assess their KAP of T2D and HTN, and (2) semi-structured interviews with key informants to understand challenges of the health system and proposed solutions in incorporating CHWs in T2D and HTN management. The majority of CHWs correctly answered general knowledge questions on NCDs, risk factors, and prevention; however, only one-quarter correctly answered questions on smoking, family history, or tobacco use as risk factors. Most respondents appeared to have positive attitudes and have been practicing some activities related to T2D and HTN. Both financial and non-financial resource constraints were cited as challenges of the health system; therefore, re-structuring the role definition of CHWs and task of responsibilities, and assessment the need and workload have been proposed as ways forwards to effectively incorporate CHWs in T2D and HTN care. CHWs in Cambodia have shown their potential in T2D and HTN management; however, a well-designed strategy including technical training, clearly defined roles and responsibilities, and strong supporting structure are important to maximize their potential in the health system.

Introduction: Parents’ behavior and practices affect many aspects of family life, including health, and many studies have proven that children's bad habits are associated with parents’ behavior and practices. Objectives: This study aimed to identify parents’ negative behaviors that might affect their families’ health and social development. Methodology: A descriptive cross-sectional study was conducted to examine the influence of parents’ behavior and practices on their family health, in which 192 respondents participated. Results: The results clarified the influence of parents on family health in several aspects. On the behavioral side, approximately 90% of the participants agreed that the behavior of parents may affect the behavior of their families, and the social and educational side results clarified the relationship between parents' illiteracy and support for the cognitive and social health of the family. Discussion: This study clarified that there is a significant relationship between illiterate parents and their ability to support their families, illustrating that the majority of participants thought that the development of the cognitive and social health of families depends on the presence of supportive parents, which has many implications for family social and psychological health. Conclusion: Parental behaviors and practices have a strong effect on their family’s health, which affects the development of the families’ cognitive and social health. Recommendation: The study recommends the need for supportive, friendly hospitals for family social health and the provision of specialized programs that support the family’s social and psychological health.

This study aims to understand the contents of debriefing performance in simulation education and its results by comprehensively examining the learning performance of the education ac-cording to the difference in the debriefing methods employed in domestic and overseas nursing simulation training. This is a literature review conducted to identify the effect of debriefing of simulation nursing practice education. The existing literature was found in electronic databases using Pubmed, Embase, MEDLINE complete, PsycINFO, Web of Science, CINAHL, the Cochrane Library, KoreaMed, National Discovery for Science Leaders, and Research Information Sharing Service and the key words were “nurse,” “nursing student,” “simulation,” “simulator,” “stand-ardized patient,” “debriefing.” Finally, 32 studies were analyzed. All the studies were conducted from 2012 to 2021. A total of 11 RCT, 17 quasi-experimental studies, 3 mixed method studies and 1 pilot study were identified. The debriefing process used media, structured questionnaires, and a method of teaching or peer-led debriefing. The outcome variables that were statistically significant were skill, performance, knowledge, problem-solving competency, critical thinking disposition, clinical judgement, self-confidence, satisfaction, and debriefing quality evaluation. It is necessary to educate the debriefers who are responsible for strategy development and meeting effective debriefing goals.

Visual Patient technology is a situation awareness–oriented visualization technology that translates numerical and waveform patient monitoring data into a new user-centered visual language. Vital sign values are converted into colors, shapes, and rhythmic movements—a language humans can easily perceive and interpret—on a patient avatar model in real time. In this review, we summarize the current state of the research on the Visual Patient, including the technology, its history, and its scientific context. We also provide a summary of our primary research and a brief overview of research work on similar user-centered visualizations in medicine. In several computer-based studies under various experimental conditions, Visual Patient transferred more information per unit time, increased perceived diagnostic certainty, and lowered perceived workload. Eye tracking showed the technology worked because of the way it synthesizes and transforms vital sign information into new and logical forms corresponding to the real phenomena. The technology could be particularly useful for improving situation awareness in settings with high cognitive demand or when users must make quick decisions. This comprehensive review of Visual Patient research is the foundation for an evaluation of the technology in clinical applications, starting with a high-fidelity simulation study in early 2020.

This study explores the impact of the ‘pre-intervention effects’ of a community-based interventions. This refers to participatory research processes and parallel publicity in the media on changes in alcohol use and relevant mechanisms (rules and norms about alcohol, accessibility of alcohol in a formal setting) among adolescents before any intervention is implemented. In a quasi-experimental study, adolescent data were collected twice by means of self-report among adolescents living in two municipalities (control and experimental condition). Regression analysis showed pre-intervention main effects on adolescents’ perceived accessibility of alcohol in a formal setting. Moreover, among adolescents aged 15 years and older, the normative decline in strictness of rules and norms was less steep in the experimental condition compared to the control condition. Also, adolescents aged 14 years and younger in the experimental condition reported more weekly drinking compared to their peers in the control condition. No differential effects across gender were found. To conclude, applying a co-creational approach in the development of an intervention, not only contributes to more effective interventions in the end, but involvement of and discussions in the community at the start of intervention planning are contributing to changes in targeted factors. This implies that public discussions about the development of intervention strategies should be considered as an essential feature of co-creation in community-based interventions.

Type 2 diabetes (T2DM) presents an enormous global healthcare challenge, especially among rural communities due to limited access. To overcome this, many low- and middle-income countries are resorting to task shifting, using community health workers (CHWs) for diabetes management. However, its successful implementation depends on the practice behaviours and knowledge of these workers. This cross-sectional study from rural South India aimed to evaluate the proficiency of 275 CHWs in diabetes screening and management. A customized questionnaire, developed through experts and government was used to evaluate the practice behaviours and knowledge. Analytical methodologies consisted of descriptive statistics, logistic regression, and mosaic plots for comprehensive data interpretation. Results showed significant deficiencies of mean correct practice behaviours at 48 and 50% respectively. The identified gaps included diabetes diagnosis, HbA1c testing, diet, self-management, complications screening and risk assessment. In several areas, correct practice behaviour was reported by a relatively large number of CHWs despite incorrect answers to the related knowledge questions such as referral to the health centres, self-management and calculation of diabetes risk assessment. Addressing these deficiencies requires a thorough needs assessment and tailored training for improved diabetes management by CHWs. Training of CHWs, should not only identify prior knowledge and/or behaviour but also their interrelationship to help create a robust and flexible set of practice behaviours.

Gene editing tools such as CRISPR-Cas9 have created unprecedented opportunities for genetic studies in plants and animals. We designed a course-based undergraduate research experience (CURE) to train introductory biology students in the concepts and implementation of gene editing technology as well as develop their soft skills in data management and scientific communication. We present two versions of the course that can be implemented with twice-weekly meetings over a five-week period. In the remote-learning version, students perform homology searches, design guide RNAs and primers, and learn the principles of molecular cloning. This version is appropriate when access to laboratory equipment or in-person instruction is limited, such as closures that have occurred in response to the Covid-19 pandemic. In the in-person version, students design guide RNAs, clone CRISPR-Cas9 constructs, and perform genetic transformation of the model plant Arabidopsis thaliana. The highly parallel nature of the CURE makes it possible to target dozens to hundreds of genes, depending on the number of course sections available. Applying this approach in a sensitized mutant background enables focused reverse genetic screens for genetic suppressors or enhancers. The course can be readily adapted to other organisms or projects that employ gene editing.

A significant part of the literature on innovative practice in medicine relates to seizing opportunities and curbing harms for patients in desperate situations. Unfortunately, the term innovation has multiple meanings and a rich rhetorical flourish that adds confusion and misunderstanding to an already difficult debate. This paper aims to enhance the current definition of innovative practice for medicine. First, we replace the term innovation with the more literal of new non-validated practice. To identify this meaning, we analyse the traditional research ethics’ distinction between research, validated practice, and innovation in the Belmont Report. Second, we propose the following explicit definition of new non-validated practice: the first or recent use of diagnostic, therapeutic or preventive interventions that introduce a significant change, with an insufficient level of evidence of safety or efficacy for regular healthcare, and with the main aim to benefit individual patients. This definition is a promising conceptual tool to inform empirical research, ethicists, and the harmonization of its regulation and legislation (e.g. right-to-try laws).

Background Although the management of the majority of patients with IBS is dealt with by General Practitioners, randomized clinical trials and treatment guidelines are developed mostly in academic settings. Probiotics are one of the most investigated treatment modality for this condition. Scarce information is available as regards GPs attitude in this regard. Methods A literature search was performed to identify papers specifically dealing with probiotic treatment of IBS in the general practice setting. Moreover, the preliminary results of a survey on this topic conducted by the authors among general practitioners in a province in northern Italy are reported. Results Five papers specifically addressing probiotic treatment of IBS in general practice were found. The response rate varied from 4 to 100%. The prescription rate of probiotics by GPs in IBS varied from <10 to 46%, regardless of the patients’ bowel habits. Physicians’ satisfaction with this treatment varied from 20 to 93%. The variability of these results probably depends on factors such as differences in the interpretation of the available data on probiotics use in IBS and traditional/ cultural differences. Moreover, compliance with patient satisfaction, may play a role. Conclusions The reported data on the treatment of IBS with probiotics in general practice is scarce and inhomogeneous, thus it does not allow firm conclusions. It is suggested that the involvement in research on the use of probiotics in IBS of physicians working in general practice would be useful in order to pursue more reliable and useful results, since the majority of the IBS population is followed in general practice and may differ from the one represented in academic clinical trials.

Breastmilk is the only recommended source of nutrition for infants below six-months of age. However, a significant proportion of children are either on supplemental breastfeeding(SBF) or weaned due to the early introduction of solid/semi-solid/soft food and liquids(SSF) before 6 months of age. There is good evidence that Exclusive Breastfeeding(EBF) in infants below six-months of age protects them from preventable illnesses, including malnutrition. The relationship between infant feeding practices and coexisting forms of malnutrition(CFM) has not yet been explored. This study examined the association of different feeding indicators(continuation of breastfeeding, predominant feeding, and SSF) and feeding practices(EBF, SBF, and complete weaning) with CFM in infants aged below six-months of age in Pakistan. National and regional datasets of Pakistan from the last ten years were retrieved from the Demographic Health Surveys(DHS) and UNICEF data repositories. In Pakistan, 34.5%(n=6131) of infants have some form of malnutrition. Among malnourished infants, 44.7%(~15.4% of the total sample) had a CFM. Continuation of breastfeeding was observed in more than 85% of infants, but less than a quarter were on EBF, and the rest were either SBF(65.4%) or weaned infants(13.7%). Compared to EBF, complete weaning increased the odds of coexistence of underweight with wasting and underweight with both wasting and stunting by 1.96(1.12-3.47) and 2.25(1.16-4.36), respectively. Overall, breastfed children had lower odds of various forms of CFM (compared to non-breastfed), except for the coexistence of stunting with overweight/obesity. Continuation of any breastfeeding protects infants in Pakistan from various types of CFM during the first six months of life.

The aims of this study were to assess oral health knowledge, attitudes, and practices among orthodontic patients between the ages of 15 and 17 years old compared to adolescents without orthodontic treatment. This cross-sectional study included 392 adolescents drawn from various French teaching hospitals. A closed-ended questionnaire was used to collect data. Adolescents undergoing orthodontic treatment had a higher knowledge of oral health than adolescents without orthodontic treatment. The majority of adolescents for both groups (69%) claimed to brush their teeth twice a day. Regarding complimentary dental material, 81.9% of adolescents without orthodontic treatment never used an interdental brush and 78.8% never used dental floss. For those undergoing orthodontic treatment, 48.5% never used interdental brush. Only 4% of adolescents without and 3% of adolescents with orthodontic treatment never consumed fizzy drinks, 4.9% and 3% never consumed sweets, 4% and 8.4% never ate fast-food. Adolescents without treatment consumed more sodas (p=0.04) and more fast food (p=0.03). Adolescents had insufficient knowledge of oral health. Health education programmes should be implemented to improve adolescents' knowledge and individual oral prophylaxis with interdental brushes.

The treatment of peptides has played an important role in clinical practice since the discovery of insulin therapy in the 1920s. Over 60 peptide drugs are approved in the United States (US and other regional mar-kets, and peptides continue to undergo drug discovery steadily. Peptide research and development has lev-eraged a wider range of structures known from other plant sources, via pharmacology and medicinal molecular biology, beyond its conventional focus on individual endogenous peptides. We build a comprehensive database of peptides that have met scientific studies with more than 150 constantly evolving peptides. Here we provide a simple overview of the peptide-based drug therapy environment, comprising evolutionary points of view, structural properties, operational thresholds, and explanation of the therapeutic area.

The Hennovation project, an EU H2020 funded thematic network, aimed to explore the potential value of practice-led multi-actor innovation networks within the laying hen industry. The project proposed that husbandry solutions can be practice-led and effectively supported to achieve durable gains in sustainability and animal welfare. It encouraged a move away from the traditional model of science providing solutions for practice, towards a collaborative approach where expertise from science and practice were equally valued. During the 32-month project, the team facilitated 19 multi-actor networks in 5 countries through 6 critical steps in the innovation process: problem identification, generation of ideas, planning, small scale trials, implementation and sharing with others. The networks included farmers, processors, veterinarians, technical advisors, market representatives and scientists. The interaction between the farmers and the other network actors, including scientists, was essential for farmer innovation. New relationships emerged between the scientists and farmers, based on experimental learning and the co-production of knowledge for improving laying hen welfare. The project demonstrated that a practice-led approach can be a major stimulus for innovation with several networks generating novel ideas and testing them in their commercial context. The Hennovation innovation networks not only contributed to bridging the science-practice gap by application of existing scientific solutions in practice but more so by jointly finding new solutions. Successful multi-actor, practice-led innovation networks appeared to depend upon the following key factors: active participation from relevant actors, professional facilitation, moderate resource support and access to relevant expertise. Farmers and processors involved in the project were often very enthusiastic about the approach, committing significant time to the network’s activities. It is suggested that the agricultural research community and funding agencies should place greater value on practice-led multi-actor innovation networks alongside technology and advisor focused initiatives to improve animal welfare and embed best practices.

Background: This practice guideline was developed by the Chronic Kidney Disease (CKD) Task Force, which was composed of clinical and methodological experts. The Saudi Arabian Ministry of Health and its Health Holding Company commissioned this guideline project to support the realization of the Vision 2030's healthcare transformation pillar. Methods: The guideline synthesis was guided by the GRADE-ADOLOPMENT methodology. Results: The final adoloped guideline addressed 12 clinical questions on blood pressure management in patients with CKD through a set of recommendations and performance measures. The recommendations included antihypertensive agents in children, non-renin angiotensin system inhibition (Non-RASi) vs RASi in adults, intensive vs standard blood pressure targets, early vs late assessment for kidney replacement therapy (KRT), late vs early preparation strategy for KRT, CKD symptoms during assessment for KRT or conservative management, initiation of KRT in patients with deteriorating CKD, choice of KRT modality or conservative management in certain CKD patient groups, changing or discontinuing KRT modalities, review frequency for KRT or conservative management, and Information, education and support. Conclusions: These conditional recommendations were based on low to very low certainty of evidence that highlights the need for high-quality randomized trials comparing different antihypertensive agents in patients with CKD.

According to Young Minds [1] ‘everyone gets angry sometimes’. Their website offers a number of de-escalating strategies, including staying calm, managing responses and setting limits to help young people who most deem resistive. Yet, Young Minds are not alone because such logical advice is ubiquitous in the literature about challenging behaviour despite the fact that in our experience when faced with high states of arousal, most young people tend to act first and deal with the consequences later. It’s not that they are stupid or non-caring, but they are human capable of great feats as well as stupidity. The same is true for any claims that solution focused (SF) conversations can put right the several decades of psychological theory suggesting resistance requires logic and better cognition. By giving the correct thinking skills, young people will walk away from risk, avoid physical confrontation, handle challenging situations like logical thinkers, and generally discount that the process of growing up is part of the challenge. It is with this in mind that over recent years in our current SF practice (with staff group supervision) we have examined the concept of ‘resistance’ and how it can be put to use as a process of collaboration. To do this, we have revisited SF theory that preoccupied many of its pioneers during the 1980’s and 1990’s and attempted to make it useful for the early 2020’s for professionals having conversations with young people, who, in traditional models, are labelled challenging. We want to introduce key differences of solution focused practice and how Anita started to formulate a 6D-SF model (details, dynamics, dimensions, dispositions, dislocations, descriptions) for contemplating how groups of professionals relate to each other and are triggered by challenging behaviour. We do not claim to have proof, logic or exactness on our side, but we’re happy to suggest how our resistance mirrors what many of the staff teams feel and describe when working through their work.

In order to create a smart mine, it is necessary to digitize the existing emulsion pumping station. Existing research does not achieve this task, this paper designs and manufactures a high-pressure, high-flow, high-water-based mining digital controlled unloading valve (abbreviated as HLHMDCUV), which achieves good results in both theoretical analysis and experimental testing. In order to obtain the accurate dynamic characteristics, this valve was analyzed by simulation using AMESim. Based on the dynamic performance analysis and the flow field analysis inside the valve body, the structure has been optimized to improve the performance of HLHMDCUV. The results show that the HLHMDCUV has a better dynamic characteristics, which were also demonstrated in the experiment. At the same time, the HLHMDCUV is easy to disassemble and maintain. This paper provides a theoretical basis for the design of such valves, which is conducive to the subsequent promotion of intelligent mine transformation.

This research aims to explore factors that influence sustainable music education from a psychological perspective, and innovatively constructs a combination of qualitative and quantitative approaches. For first time, combines stochastic nonlinear system of control theory and identifies relevant factors affecting sustainable music learning by establishing a data system for questionnaire answering and a quantitative model for actual academic performance. Existing research mainly looks at several factors that affect fragmented music education from perspective of teachers' teaching rules, emphasizing phased teaching state and learning goals of teachers as main body, thus ignoring sustainable music education and students, who are a large group of music learning objects. The research fills gap in this type of research object, focusing on sustainable music education from an emotional perspective and students who occupy a dominant position in music learning, so as to more accurately explore impact of their emotional influencing factors on sustainable music learning. The most prominent innovation of this study lies in construction of stochastic nonlinear system for psychological influencing factors of sustainable student music learning and a quantitative model for actual learning effect. Through analysis of nonlinear system, weight values of several negative emotions on sustainable music learning are obtained.

The application of smartphone-based color evaluation of passive sampling devices for gases has only been sparsely reported. The present review aims to compile available publications with respect to the configuration of the passive samplers, conditions of smartphone photographing, analytical procedure for color detection and quantification (including calibration processes), and their application to different target gases. The performance of the methods - whenever available - is presented regarding the analytical specifications selectivity, sensitivity, and limit of detection in comparison with other color evaluation methods of passive samplers. Practical aspects like requirements of instrumentation and ease of use will be outlined in view of the potential employment in education and citizen science projects. In one section of the review the inconsistent terminology of passive and diffusive sampling is discussed in order to clarify the distinction of information obtained from the uptake of the passive samplers between gas-phase concentration and the accumulated deposition flux of gaseous analytes. Colorimetric gas sensors are included in the review when applied in passive sampling configurations and evaluation is performed with smartphone-based color evaluation. Differences in the analytical procedures employed after the passive sampling step and prior to the detection of the colored compounds are also presented.

Longitudinal studies tracing high-risk samples over decades have illuminated powerful pathways of resilient adaptation among individuals who overcome adversities faced early in life. This research demonstrates resilience is a common phenomenon driven by dynamic interactions between individual traits and environmental resources that enable positive adjustment despite adversity exposure. For clinical social workers supporting clients impacted by childhood trauma, abuse, violence and other adversities, understanding these resilience processes is vital for developing strengths-based, trauma -informed interventions that enhance positive adaptation. This paper synthesizes key findings from landmark longitudinal resilience studies and explores specific practice implications for resilience-oriented clinical assessment, intervention planning, prevention efforts, and social worker training. By integrating resilience research insights, social workers can more effectively identify and cultivate clients' innate capacities for resilience, facilitating a journey towards posttraumatic growth.

Cash crops are agricultural crops intended to be sold for profit as opposed to subsistence crops, meant to support the producer, or to support livestock. Since cash crops are intended for future sale, they translate into large financial value when considered on a wide geographical scale, so their production directly involves financial risk. At a national level, extreme weather events including destructive rain or hail, as well as drought, can have a significant impact on the overall economic balance. It is thus important to map such crops in order to set up insurance and mitigation strategies. Using locally generated data -such as municipality-level records of crop seeding- for mapping purposes implies facing a series of issues like data availability, quality, homogeneity etc. We thus opted for a different approach relying on global datasets. Global datasets ensure homogeneity and availability of data, although sometimes at the expense of precision and accuracy. A typical global approach makes use of spaceborne remote sensing, for which different land cover classification strategies are available in literature at different levels of cost and accuracy. We selected the optimal strategy in the perspective of a global processing chain. Thanks to a specifically developed strategy for fusing unsupervised classification results with environmental constraints and other geospatial inputs including ground-based data, we managed to obtain good classification results despite the constraints placed. The overall production process was composed using ``good-enough" algorithms at each step, ensuring that the precision, accuracy, and data-hunger of each algorithm was commensurate to the precision, accuracy, and amount of data available. This paper describes the tailored strategy developed on the occasion as a cooperation among different groups with diverse backgrounds, a strategy which is believed to be profitably reusable in other, similar contexts. The paper presents the problem, the constraints and the adopted solutions; it then summarizes the main findings including that efforts and costs can be saved on the side of Earth Observation data processing when additional ground-based data are available to support the mapping task.

Nature-based solutions (NbS) rapidly develop globally to address societal challenges and provide human well-being and biodiversity. Watershed restoration plays an essential role in enhancing the ecological and socio-economic benefits of the region. The design and implementation of watershed restoration projects play a crucial role in their effectiveness, and NbS has been applied as a concept in ecosystem-related projects. This paper provides an idea to evaluate the design or implementation of watershed restoration projects based on the eight criteria proposed by the IUCN Global Standard for Nature-Based Solutions and to adjust the projects based on the evaluation results. The aim is to standardize the implementation process of watershed restoration projects to achieve more significant benefits and practically apply the concept of NbS in watershed restoration. implementation scheme of the Shan-Shui Initiative in the Jiulong River Watershed and concludes that the method is feasible in evaluating and improving the design and implementation scheme of ecological restoration projects in the actual basin. According to the assessment results, the degree of matching based on NbS for the implementation scheme of the Jiulong River Watershed Shan-Shui Initiative is 73%, which meets the criteria of NbS but needs to be improved in terms of monitoring and assessment, synergistic management, and benefit trade-offs.

Introduction Paramedic practice is highly variable, occurs in diverse contexts, and involves the assessment and management of a range of presentations of varying acuity across the lifespan. As a result, attempts to define paramedic practice have been challenging and incomplete. This has led to inaccurate or under-representations of practice that can ultimately affect education, assessment, and the delivery of care. In this study, we outline our efforts to better identify, explore, and represent professional practice when revising a national competency framework for paramedics in Canada. Methods We used a systems thinking approach to identify the settings, contexts, features, and influences on paramedic practice in Canada. This approach makes use of the role and influence of system features at the microsystem, mesosystem, exosystem, macrosystem, supra-macro system, and chronosystem levels in ways that can provide new insights. We used methods such as rich pictures, diagramming, and systems mapping to explore relationships between these contexts and features. Findings When we examine the system of practice in paramedicine, multiple layers become evident and within them we start to see details of features that ought to be considered in any future competency development work. Our exploration of the system highlights that paramedic practice considers the person-receiving care, caregivers, and paramedics. It involves collaboration within co-located and dispersed teams that are composed of other health and social care professionals, public safety personnel, and others. Practice is enacted across varying geographical, cultural, social, and technical contexts, and is subject to multiple levels of policy, regulatory, and legislative influence. Conclusion Using a systems thinking approach, we developed a detailed systems map of paramedic practice in Canada. This map can be used to inform the initial stages of a more representative, comprehensive, and contemporary national competency framework for paramedics in Canada.

Among natural disasters, earthquakes have a considerable impact and are among the ten deadliest, with an extreme impact on the healthcare sector. This study aimed to analyze best practices in nursing care for earthquake victims. An in-depth analysis was carried out by using a scoping review, a method used in accordance with the PRISMA-ScR recommendations to identify best nursing practice in these circumstances based on searches of eight databases: MEDLINE via PubMed; Cochrane Library; Embase; VHL; PDQ-Evidence; Scopus; ProQuest; Google Scholar. Twenty-one studies were selected. The nursing practices identified were grouped into two distinct dimensions, each subdivided into four subcategories: (i) care practices: a) immediate care, b) intermediate care, psychosocial care and d) ethical care; (ii) care management and coordination practices, which cover (a) care coordination, (b) victim care network organization, (c) teamwork and (d) training. By analyzing these nursing practices during care and relief operations for earthquake victims, this study identified the various actions carried out, the nursing skills to be developed and the reinforcement of these advanced practices through the systematization of nurses’ skills, in order to promote victims’ rehabilitation, minimize their suffering and improving their quality of life during and after an earthquake.

Background: Annual influenza epidemics are a serious public health problem, causing particularly severe morbidity and mortality in high-risk groups. The study aimed to understand Poles' attitudes and beliefs towards influenza vaccinations in the flu season of 2022–2023, analyze preferences and unmet needs regarding influenza vaccinations, and examine the perception and acceptance of the influenza vaccine among individuals at risk of flu complications. Methods: A cross-sectional survey-based study was carried out on a sample of 1446 respondents. The Google Forms questionnaire was created and disseminated electronically using social media and e-mail. The pre-test was performed at the beginning of the project. Results: The majority of respondents (71%) could identify "high-risk groups" recommended for influenza vaccination. Furthermore, it was observed that individuals aged 21 to 59 demonstrated a higher level of knowledge in this regard compared to those below 20 and above 65 years old, and individuals with higher and medium education levels were much better at identifying risk groups for influenza virus infection. The majority of respondents (52.01%) reported receiving influenza vaccination at some point in the past, with 32.12% receiving it in the 2022–2023 flu season and 41.09% in the 2021–2022 season. The majority of respondents declaring acceptance of the vaccine for the 2022-2023 season were in the high-risk group. Only 17.28% of respondents declared receiving both influenza and SARS-CoV-2 vaccines in the 2022-2023 season, with the vast majority being respondents from the "high-risk group" (p

The purpose of this scoping review was to comprehensively clarify the methodology of Mental practice (MP) to date by systematically mapping studies that have performed MP on post-stroke paralytic upper extremity function. Specifically, (1) When is the most common timing of MP in-tervention after stroke onset? (2) What is the MP load (intervention time, number of interven-tion days, and intervention period)? (3) What are the most common methods of Motor Imagery (MI) recall and MI tasks during MP? (4) Is MP often used in conjunction with individual rehabili-tative therapies? (5) What is the paralyzed side's upper limb and cognitive function level at the start of MP intervention? Our scoping review was performed ac-cording to PRISMA-ScR to iden-tify research questions. Then, the PubMed, Scopus, Medline, and Cochrane Library databases were used to screen articles published by July 19, 2022. Eligible articles were selected all study designs were included, including studies involving the use of MP for post-stroke paralytic upper extremity function. Selection of eligible papers was done by two or more independent persons. Data were extracted from the eligible papers for items necessary to identify the research ques-tions. English-language articles identified for this study were 694, of which 62 were accepted. The most common intervention time was 30 minutes or less and the duration of the intervention was 5 times a week in MP. The most common method of recalling MI during MP was using an audio guide. In the future, it will be important to conduct accumulation of research to unify the varied widely MP methodologies identified in this study.

Inclusive education recognizes the diverse needs of students and ensures that each student is pro-vided with equal opportunities to learn and succeed. The Dubai government has implemented an inclusive education policy aimed at promoting equity and inclusivity in schools. This study aimed to investigate school leaders' understanding, implementation, and perspectives on the Dubai Inclusive Education Policy Framework (DIEPF). To gather data, a qualitative research study was conducted using semi-structured interviews with ten school leaders from private schools located in Dubai, United Arab Emirates (UAE). The findings show that school leaders have a strong understanding of the policy and deem it to be significant. The study also found evidence of effective strategies implemented by school leaders to promote inclusive education. However, there are challenges in the UAE that resonate with those worldwide such as inadequate funding, high student-teacher ratios, shortage of specialized staff, and limited training opportunities for teachers. These findings emphasize the significance of ongoing professional development and training of educators who are involved in inclusive education. Implications for practice and suggestions for future research are provided.

Asthma causes chronic coughing, wheezing, dyspnea, and chest pressure. This study assessed asthmatic patients' knowledge, attitudes and awareness of bronchial asthma and proper education on its meaning, risk factors, symptoms, diagnosis, management, and prevention practice. We performed a cross-sectional interventional asthma KAP survey in Erbil, Iraq. We adapted a validated study questionnaire from KAP studies in other nations to the Erbil situation and culture. In Erbil, Kurdistan, Iraq, two major hospitals' asthma clinics were studied. We chose 250 asthmatic ICU patients from October 2018 to July 2019. Health education was comprehensive. The health education program used a Kurdish PowerPoint with a printout. 25 groups got two-weeks of one-hour health education pre-intervention. Each group was questioned before, 2 and 12 weeks after health education. All data were analyzed by SPSS v26. The mean age of the respondent was 37.52±15.16 with 48.7 % respondent having a positive family history of asthma. After 2weeks of health education intervention, respondent have a higher knowledge score, positive attitudes compared to pre-education and after 12 weeks of education with a significant difference (P < 0.001) with improvised prevention practice. Health education programs led to considerable improvements in asthmatic patients' knowledge, attitudes, and practices regarding their condition. After receiving health education for a period of two weeks, the majority of the participants answered correctly regarding asthma, its causes, and the elements that trigger asthma attacks.

The World Health Organization estimated that around 66 thousand HBV are caused by needlestick injuries annually. Healthcare students should be aware of HBV transmission route and preventive measures. This study assessed the knowledge, attitudes, and practices toward HBV among Jordanian healthcare students and its associated factor. A cross-national study conducted from March to August. The participants were asked to complete the questionnaire. It had four sections: participants' sociodemographic, knowledge, attitudes, and practices about HBV. 2322 participants were enrolled, 67.9% were females, 26.4% were medical student, 35.9% were in the 3rd year. 40% of the participants held a high level of knowledge and attitude. 63.9% of participants had good practices toward HBV. Medical students in the last year of study, encountered HBV patients , had better knowledge. Male students from medicine college, encountered HBV patients and had extra HBV courses showed better attitude. High practice level was associated with being dentistry student, at 5th year, encountered HBV patient and extras HBV courses. This study demonstrated insufficient knowledge and attitudes toward HBV, the practices level toward HBV among healthcare students was promising. Subsequently, public health efforts should modify the knowledge and attitude gaps to reinforce awareness and minimizing risks of the infection.

Questionnaires are useful instruments for gathering responses to specific factual questions. However, the problems of questionnaire responses impede the effective use of the questionnaire. Some of these problems including non-responses, non-completion, issues of judgement, and social desirability such as information that the respondent is not willing to disclose need to be dealt with. The situation is more compounded in a scenario where an information security practice study in a typical hospital consists of broad categories of respondents and the survey findings are to be relied on to actually address information security compliance issues. This study, therefore, shares "pitfalls" to watch when preparing a questionnaire to measure the information security practice level in a hospital which is characterized by different respondents with varying domain knowledge such as knowledge in information security, information communication technology, and that of the domain knowledge of healthcare. A synergy of a conventional pretesting method and behaviour coding were therefore used to pretest the questionnaire. Questionnaire problems including a lack of understanding of the healthcare information systems’ structure of all hospitals, unclear questions, the insignificant difference between questions, problematic questions, inadequate questions, and complex terms were among the identified pitfalls to watch. Out of a total of 118 questionnaire items that were used in the pretesting, a total of 50 questionnaire items (representing 42%) were identified to have problems after the pretesting was conducted with a total of 36 respondents in behavior coding and 21 respondents in conventional pretesting.

Background: COVID-19, caused by SARS-CoV-2, is still a global public health concern due to the absence of effective antiviral treatment against different strains. Studies have shown that pregnant women are more susceptible to COVID-19 due to altered physiology and immunological features. Therefore, this study was designed to investigate pregnant women's knowledge, attitudes, and practice (KAP) to prevent COVID-19 and determine the factors associated with KAP. Methods: A community-based cross-sectional study was conducted among 425 pregnant women in Northern Bangladesh. The samples were obtained using a simple random sampling technique from April 5 to June 15, 2020. The data were collected by face-to-face survey with a structured and pre-tested questionnaire and analyzed using SPSS version 25. Bivariable and multivariable logistic regression analyses were performed, and p-values < 0.05 at 95% CI were considered statistically significant. Results: Overall, the score of KAP among the respondents was 47.76%, 49.41%, and 56.24%, respectively. Participants' area of residence, educational status of the husband, and antenatal care (ANC) visit were significantly associated with the level of knowledge, whereas age, educational status of the husband, number of living children, and knowledge were significant predictors of attitude. The knowledge of COVID-19 was the only predictor associated with the practice. Conclusion: Our study shows that almost half of the participants had poor knowledge, a negative attitude, and poor practices toward COVID-19. Additional health education programs by healthcare professionals and different media, coordinated and combined efforts of government and individuals' participation will be required to fight the spread of the infection.

Introduction: Blood transfusion involves the transfer of blood from donors to patients. A blood transfusion is carried out every 2 seconds in the US. It is made up of about 29000 units of red blood cells and is transfused every day in the US. When blood transfusion is done correctly, it can result in the saving of lives and the improvement of healthcare. However, it may also lead to immediate, late, delayed, and chronic complications. No previous studies have been conducted in Qatar to address this issue. Methods: This is a cross-sectional study intended to determine the knowledge, attitude, and practice toward blood transfusion among healthcare providers at Hamad Medical Corporation (HMC), which is the principal healthcare provider in Qatar. Participants between 18 and 25 years of age were selected for the research study. A 10-item online questionnaire that people can fill out on their own will be used to get the data needed for the analysis and meet the study's goals. Results: the analysis has indicated that facing negative reactions after blood transfusion and being worried about getting affected by any infection have a small positive association, with the specific values coming in at r = 0.317, p = 0.000. Fever after blood transfusion and feeling like refusing blood transfusion have a significant and moderate positive correlation, with the specific values coming in at r = 0.630 and p = 0.000. Conclusion: The findings of this study have helped us figure out how healthcare providers feel, what they know, and what they do during a blood transfusion.

Recent reports have it that over 85\% of data breaches are still caused by the human element, of which healthcare is one of the suitable organizations mostly targeted by cybercriminals. The work of healthcare staff is often associated with high workloads, high emergency cases, and a broad range of psychological, social, and cultural factors. The significance of these factors could undermine conscious care information security (IS) practice leading to serious violations. This study comprehensively examined the correlation between the psycho-social-cultural factors, work factors with IS and privacy behaviour in a hospital that has fully adopted electronic health records (EHR) management system. The findings are to facilitate the decision-making process towards improving the cyber-security practice in healthcare. A quantitative approach was adopted where we collected responses from 212 healthcare staff through an online questionnaire survey. A broad range of constructs was selected from psychological, social, cultural perception and work factors based on earlier review work. These were therefore related to some security practices, to assess the IS knowledge, attitude and behaviour gaps among healthcare staff in a comprehensive way. From the study, IS self-reported conscious care behaviour (ISCCB) risk was relatively higher as compared to information security knowledge (ISK) risks and information security attitude (ISA) risk. Furthermore, the study revealed that work emergency has a positive correlation with ISCCB (r=1.95, p-value =0.001) risk. Conscientiousness also had positive correlation with ISCCB risk (r=0.157, p-value=0.05) however agreeableness negatively correlated with ISK risk (r=-0.166, p-value =0.05), and ISA risk (r=-0.140, p-value =0.05). Based on these findings, intrinsic and extrinsic motivation methods combined with cutting-edge technologies can be explored to discourage IS risks behaviours while enhancing conscious care security practice.

Qualitative and quantitative values estimation is a crucial aspect of social data science and plays a vital role in social and psychological research. Numerous methods of personal values measurement such as Schwartz Value Survey (SVS) and its re-modified versions have been proposed and invented, but many are challenged with one or more limitations. In this article, an alternative approach in a new paradigm of values measurement called Kabiru’s Value Survey (KVS) was proposed to measure the relative degree of importance or significance attached to particular value-actions of an individual(s) in a given population over a period. The methodological innovations in KVS unlike other existing methods of human value measurement include the use of habitually reported practices associated with a particular value-action in place of judging the series of Schwartz hypothetical statements, the use of multiple dependent variables rather than a single coded hypothetical statement. In terms of data analysis, a new approach of multivariate compression is introduced which merges the chain of multiple dependent variables into one coded scale. Psychometric result interpretation is also another innovative aspect of KVS methodology. Finally, the proposed methodology however solved some of the criticized limitations of the other methods of human value measurement.

There are guidelines on lactation following maternal analgo-sedative exposure, but these do not consider the effect of maternal fasting, nor fluid abstention on human milk macronutrient composition. We therefore performed a structured search (PubMed) on ‘human milk composition’ and screened title, abstract and full paper on ‘fasting’ or ‘abstention’ and ‘macronutrient composition’ (lactose, protein, fat, solids, triglycerides, cholesterol). This resulted in 6 papers and one abstract related to religious fasting (n=129 women) and observational studies in lactating women (n=23, healthy volunteers, fasting). These data reflect two different ‘fasting’ patterns: an acute (18-25h) model in 71 (healthy volunteers, Yom Kippur/Ninth of Av) women and a chronic fasting (Ramadan) model in 81 women. Changes were most related to electrolytes and were moderate, with almost no changes in macronutrients during acute fasting. We therefor conclude that neither short term fasting nor fluid abstention (18-25h) affect human milk macronutrient composition, so that women can be reassured when this topic were raised during consulting. Besides the nutritional relevance, this also matters as clinical research samples – especially to estimate analgo-sedative exposure by lactation - are commonly collected after maternal procedural sedation, associated with maternal fasting and physiology-based pharmacokinetic (PBPK) models assume stable human milk composition.

The objective of the study was to investigate the gap between data and evidence-based decisions among healthcare professionals considering the enormous amount of individual and aggregate data collected. Our study assessed the capacity, skills, and knowledge of the Ministry of Health leadership staff to understand data management, analysis, utilization, and dissemination. Three key components were assessed: 1) Knowledge through true/false questions, 2) Level of Skill (and Competency) using a Likert scale, and 3) Understanding of Key Concepts and Tools based on a Likert scale. The 183 study respondents were diverse healthcare professionals from Kenya, Tanzania, and Rwanda. Majority of respondents had not received any training on data management, analysis, interpretation, and utilization techniques, further there was a significant difference between those who had received training versus those who had not(p=0.005). The respondents were competent in work-related experiences but lacked skills and knowledge on: data concepts and tools, study designs, and types of data analysis. These findings explain the gap between data management, analysis, utilization, and dissemination among health professional’s cadre. To enhance service delivery and optimal provision of health care, it is imperative to have all health care professionals receive a well-designed training on data management, analysis, interpretation, and utilization.

The artificial intelligence (AI) refers to the science and engineering of creating intelligent machines for imitating and expanding human intelligence. Given the ongoing evolution of the multidisciplinary integration trend in modern medicine, numerous studies have investigated the power of AI to address orthopaedic-specific problems. One particular area of investigation focuses on the shoulder pathology, which is a range of disorders or abnormalities of shoulder joint, causing pain, inflammation, stiffness, weakness, and reduced range of motion. There has not yet been a comprehensive review of the recent advancements in this field. Therefore, the purpose of this review is to evaluate the current AI applications in the shoulder pathology. This review mainly summarizes several crucial stages of the clinical practice, including predictive models and prognosis, diagnosis, treatment, and physical therapy. In addition, the challenges and future development of AI are also discussed.

Heat waves are a significant consequence of climate change threatening public health by increased morbidity and mortality. The aim of this study was to estimate individuals’ knowledge, attitudes and practice related to heat waves. We conducted an exploratory cross-sectional study in Greece during September 2023. We employed a convenience sample of 1055 participants. We used the heat wave knowledge, awareness, practice and behavior scale (HWKAPBS) to measure our outcome. We measured several socio-demographic variables, such as gender, age, educational level, etc. as potential determinants. Mean scores for the knowledge, awareness, practice and behavior factors were 12.5, 22.7, 22.2 and 12.1 respectively. Females had higher scores on the four factors compared with males. We found a positive relationship between self-perceived health status and awareness, practice and behavior about heat waves. Similarly, we identified a positive relationship between self-perceived financial status and awareness and behavior about heat waves. Increased age was associated with increased practice score, while increased educational level was associated with increased knowledge score. Additionally, behavior score was higher among participants in urban areas than those in rural areas. We found statistically significant positive correlations between the four factors. Levels of knowledge, awareness, practice and behavior about heat waves were high in our sample. Several socio-demographic variables affect participants’ knowledge, awareness, practice and behavior concerning heat waves.

The aim of this study was to explore the perceived impact of artificial intelligence (AI) on radiographers’ activities and profession in Switzerland. A survey conducted in the UK, translated into French and German, was disseminated through professional bodies and social media. The participants were Swiss radiographers (clinical/educators/ researchers/students) and physicians working within the medical imaging profession (radiology/nuclear medicine/radiation-oncology). The survey covered five sections: demographics, AI-knowledge, skills, confidence, perceptions about the AI impact. Descriptive, association statistics and qualitative thematic analysis were conducted. A total of 242 responses were collected (89% radiographers; 11% physicians). AI is being used by 43% of participants in clinical practice, but 63.8% of them did not feel confident with AI terminology. Participants viewed AI as an opportunity (57.2%), while 18.5% considered it as a threat. The opportunities were associated with streamlining repetitive tasks, minimizing errors, increasing time towards patient-centred care, research, and patient safety. The significant threats identified were reduction on work positions (22.6%), decrease of the radiographers’ expertise level due to automation bias (16.4%). Participants (68.3%) did not feel well trained/prepared to implement AI in their practice, highlighting the non-availability of specific training (87.6%). 93% of the participants mentioned that AI education should be included at undergraduate education program. Although most participants perceive AI as an opportunity, this study identified areas for improvement including lack of knowledge, educational supports/training, and confidence in radiographers. Customised training needs to be implemented to improve clinical practice and understanding of how AI can benefit radiographers.

This study was aimed to identify perception, knowledge, attitude and nursing practice toward use of physical restraints among clinical nurses, and further examined the factors associated with nursing practice toward use of physical restraints. The research participants were 180 nurses from a urban general hospital located in Korea. Data were collected using self-report questionnaires and analyzed using t-test, ANOVA, Pearson correlation coefficients, and multiple regression. There were significant negative relationships attitudes towards the use of physical restraints with knowledge (r = -.32, p &lt; .001) and nursing practice (r = -.12, p = .107). Knowledge showed a positive correlation with nursing practice (r = .28, p &lt; .001). Factors affecting nursing practice of clinical nurses were identified as knowledge (β= .23), education experiences (Yes) (β= .18), and work unit (ICU) (β= .43). The explanation power of this regression model was 22% and it was statistically significant (F=7.45, p&lt;.001). The findings from this study suggest that knowledge, education experiences and work unit were the strongest predictor on nursing practice toward use of physical restraints. Thus, we propose that developing and applying evidence-based educational intervention programs by work unit to reduce the inappropriate use of physical restraints in hospitals are required.

Background: The medical workforce plays a pivotal role in advancing human health, particularly within the healthcare system of Saudi Arabia. While the government-employed healthcare providers form the central structure of the system and offer free healthcare services, the private healthcare sector is also witnessing significant growth. In parallel, the field of child neurology has experienced notable transformations in recent years, with continued expansion. This expansion brings forth a range of challenges for both current and future pediatric neurologists, necessitating careful consideration and proactive measures to address them. Aim of the study: This study aims to analyze the current challenges faced by the pediatric neurology workforce. Methods: In May 2023, a community-based exploratory study was conducted involving 82 practicing pediatric neurologists as well as pediatric neurology trainees across the 13 regions of Saudi Arabia. A comprehensive 26-item questionnaire, divided into four sections, was utilized to assess the participants. Results: The survey received responses from a total of 82 pediatric neurologists in Saudi Arabia (response rate 55.03%), with 38 (46.34%) being male and 44 (53.66%) being female. The mean age was 33±1.225 years. The majority of participants practiced in major cities such as Riyadh and Jeddah. Around two-thirds had published three or fewer research articles. Approximately 30% were enrolled in a fellowship program. Nearly 50% of pediatric neurologists experienced some form of delay in obtaining their first job, ranging from 1 to 36 months. Conclusion: The landscape of the pediatric neurology workforce is currently witnessing noteworthy demographic shifts. With a majority of practitioners concentrated in major cities, there exists an ongoing demand for qualified professionals in peripheral areas. The study underscores the real-life challenges faced by pediatric neurologists, particularly the delay in securing employment after graduation, and underscores the critical importance of addressing these persistent issues along the journey of pediatric neurology.

Introduction Menstrual hygiene is a critical issue encountered by women and girls of the reproductive age, which negatively affects their health and empowerment. It is still deemed a taboo in several parts of the world and girls hesitate to discuss menstruation with their family members, friends, or schoolteachers, which creates hurdles when they attain their menarche. Girls residing in rural areas encounter more problems, since they lack proper resources, and knowledge to manage their menstruation in school as well as at home. Methods The descriptive cross-sectional design was used to assess the study questions. The consecutive sampling techniques was applied to recruit 300 female participants from remote area of Gilgit, Pakistan, who were 13- to 22-year-old. A pre-tested questionnaire was utilized to collect the data, and to analyze the data the SPSS version 21.0 was used. Results The study found that more than half of the participants had poor level of knowledge, practices, and negative attitude towards menstrual hygiene. This could be because of many cultural and social taboos attached to menstrual hygiene. Conclusions The study concluded that the study participants were not knowledgeable about menstrual hygiene. They had poor practices and attitude regarding menstrual hygiene. Hence, it is recommended that frequent sessions should be conducted by health care workers to enhance the knowledge of parents, teachers, and young girls, to increase the positive attitude and practices regarding menstrual hygiene. Keywords menstruation, knowledge, attitude, practices, Adolescents

The false codling moth (FCM), Thaumatotibia leucotreta (Meyrick), is believed to have originated from Ethiopia and sub-Saharan Africa. Currently, this pest has extensively spread and is found in most parts of Africa, with records in approximately 40 countries in over 100 host plant species. Despite Thaumatotibia leucotreta being the leading cause of interceptions of Capsicum and cut flowers exported by Kenya to the European Union, information on abundance and damage levels inflicted on capsicum is limited. The objective of the study was to assess the abundance and damage levels of T. leucotreta on capsicum in the selected counties in Lower Eastern Kenya (Kitui, Machakos, and Makueni counties). Higher T.leucotreta larval density per farm was recorded in Kitui County compared to other counties. In farms with capsicum only (not intercropped with other crops), the mean number of FCM larvae was relatively higher in Kitui. Farming practices such as the use of uncertified seeds and seedlings and the excessive use of pesticides may be the major contributors to high larval incidence in Kitui County.

Abstract Introduction There is a clear link between self-medication practice and ongoing pandemic diseases like COVID-19, According to studies conducted globally and the general Ethiopian population turned to self-medication and symptomatic treatment as a result of inadequate COVID-19 treatment and also about 80% of the population amassed drugs for pandemic use. Objective: The objective of this study was to assess self-medication practice for treatment of Covid-19 and reason to use self- medication among residents in Bedelle city and its surrounding, Southwest Oromia, Ethiopia. Methodology: A cross sectional study design was employed and the standardized questionnaire was developed by reviewing relevant literatures then the data was collected using face to face interview. Final data was analyzed by using SPSS version 23. Result: The final study contained 415 respondents in total, with a response rate of 98.5%. The majority of responses were females and between the ages of 18 - 25 Category. In this study population, the use of self-medication since the onset of the Covid-19 epidemic was reported by participants were around 50.6%. Analgesics (42.4%) and cold medicines (29.5%) were the most frequently used medications for treatment of COVID-19. Also the reported uses of these drugs included treatment of Covid-19 symptoms like the Headache (22.2%), Fever (13.2%), respiratory infective (14.3%), and cold (21.4%) were the most frequently reported symptoms for self-medication. Self-medication methods were used more frequently by women than Men. Conclusion: According to this study, analgesics and cold medications are commonly self- medicated drugs used for Covid-19 therapy. It is a serious health concern, particularly when COVID-19 symptoms are present, and high consumption of self-medication has been linked to COVID-19 prevention or treatment. Key words: Covid-19, Medicine, Practice, Bedelle city, Self-Medication

This review paper aimed at reviewing English language teaching articles on EFL teachers’ perceptions, practices and challenges towards communicative language teaching. In this review, two ELT articles, which have been conducted on teachers’ perceptions, practices and challenges towards communicative language teaching in EFL classes, were reviewed in detail. While reviewing the articles, the researcher adapted Rideley’s (2008) checklist to evaluate elements of article. Thus, articles were reviewed by focusing on the title, abstract, introduction, research questions, objectives, research design, participants, sample and sampling techniques, data collecting instruments, methods of data analyses, findings and references based on the checklist provided above. The review revealed that the articles had clear objectives, researchable questions, appropriate methods and inevitable conclusions. They tried to answer the questions which were raised in each article, and the objectives went along with the overall research findings. The review, on the other hand, revealed that the participants in the articles were not representative so as to conclude and generalize the overall population by taking only few participants which were selected even by using non probability sampling.

Rabies is endemic in southern Bhutan and children were reported to be the most frequent victims. We surveyed the knowledge, attitude, and practices on rabies among school children in three schools located in southern Bhutan. Descriptive statistics and logistic regression were performed to analyze the level of knowledge and variation of perception towards rabies among secondary school children. A total of 701 students (57.9% female, 42.1% male) had participated in the survey of which 98.2% heard about rabies. Most of the students demonstrated a good level of knowledge (59.7%) and a favorable perception towards rabies (57.7%). Multivariable logistic regression analysis revealed the importance of previous rabies awareness campaign increasing the likelihood of positive knowledge about rabies at the individual student and the school level. Similarly, higher grades of students’, employed mothers of the students, and students from villages were associated with more favorable perceptions. Overall, our study in rabies endemic areas of Southern Bhutan showed that most of the students have good knowledge and favorable perception towards rabies. However, we identified several knowledge gaps. Therefore, efforts should be made to address the knowledge gaps through regular awareness programs by actively engaging key stakeholders such as school-teachers and parents.

This study to assess the Physical Land Suitability Analysis for Cultivation of Selected Cool Weather Cereal Crops, Misha District, Hadiya Zone, South Central Ethiopia of major cereal crops of barley and teff in Misha district. Each of the criteria was separately reclassified and analyzed for their suitability for supporting barley and teff crops based on the FAO crop requirements specified for them. The major data sources were climatic data, soil, LGP and topographic data as well as key informant interview, questioner observation of crop requirements which have been considered to undertake suitability assessments of the study area. The factor maps like land use /land cover, temperature, rain fall, soil type and altitude were classified based on suitability evaluation methods of FAO and experts’ opinion. At final stage these were reclassified and standardized in GIS software extension tools, which led to the preparation of suitability analysis map of the major crops plant suitability classes. As part of spatial MCDM, AHP pair wise comparison module was used to derive internal and external weights for each individual factors and parameters respectively. Consequently, suitability analysis was done and weighted overlay suitability map was visualized with integration of GIS. The findings show that among total area of land suitability maps for both barley and teff cops were using weighted overlay techniques. The suitability map of teff crop shows that 12,038.22 hectare of the investigated area are highly suitable (S1), 19,646.07 hectare moderately suitable (S2) and 4,501.71 hectare marginally suitable (S3) and 112 hectare not suitable. On the other hand, the suitability map of barley crop shows that 7,898.52 hectare of the investigated area are highly suitable (S1), 22,830.08 hectare moderately suitable (S2), and 5,466.4 hectare marginally suitable (S3) and 103 hectare not suitable for economic reasons (N1). This was done for barley and Teff crops separately. Results of the study revealed that most of the lands in the study area are suitable for the cultivation of the selected crops and other crops. Based on finding, it could be recommended that this work would be used as policy guide for planners; investment could be successful in the District, further suitability research works should be carried out in order to optimize the major crop cultivation and production.

Bangladesh has adopted some special steps to control the quick spread of the COVID-19 pandemic situation. However, the local residents’ knowledge, attitudes, and practices towards the disease have a direct impact on the success of the controlling measures taken by the state. This article explores knowledge (K) about preventions, attitude (A) to the disease, and practices (P) of preventing COVID-19 situation of the young age groups residing in Bangladesh. Quantitative data were collected online using a KAP questionnaire from 932 participants. Results show the population is generally aware of the symptoms, keeping social distance by staying home and are concerned about re-spreading after the lock-down period. However, they are quite unsure about the possible medicines frequently talked about in the media and the necessity of avoiding animal protein. One of the major limitations is, these findings should not be generalized due to the low number of participants compared to the total population in Bangladesh.

Watching the international COVID-19 epidemics unfold during February and early March 2020, we began to highlight how outbreaks in care homes were inevitable, given the vulnerable patients in close proximity, and pressures on social care to help relieve pressure on the NHS. We suggested public health measures would significantly impact on care homes. Specifically we felt all homes would have multiple individuals isolated within days of introduction of guidance requiring isolation of new cough (or fever), and that a clear definition of an outbreak would be needed that differentiated COVID19 from influenza. We share the experiences of a GP practice looking after 900 nursing or dual registration care homes in the London Borough of Ealing in the early stages of the COVID19 Pandemic 2020. We believe that the altered presentation of cases of COVID19 in care homes contributed to the size of outbreaks, and that keeping COVID19 out of homes is the only way to manage this disease, with early isolation and complete segregation of positive and negative cases. We have seen over 300 suspected cases resulting in four fold (n=175) average monthly death rates, three fold usual issue of anticipatory medications, and approximately 32% mortality rate (up to 43% in over 90’s). Discharge pathways from hospital and admissions to care homes must be clear and robust. COVID19 naïve patients should not be admitted to units with outbreaks and COVID19 positive patients should not be admitted to anything other than a designated “hot” home until risk of contagion is passed. Some patients are testing positive at over 30 days since initial mild symptoms.

Through an investigation of recently discovered Incantation of Wish-Fulfillment amulets from the Silla kingdom, this paper reveals that early Korea had more diverse forms of dhāraṇī practices than previously assumed. This paper’s analysis of these amulets from Korea contributes toward filling the gap in our current understanding of the material practice pertaining to the Incantation of Wish-Fulfillment widely practiced in medieval East Asia. Based on an interdisciplinary analysis of the two amulet sheets of the Incantation of Wish-Fulfillment from Silla, this paper explored hitherto unknown aspects of early Korean dhāraṇī practice. Previously, the only material dhāraṇī practice in early Korea was thought to be the enshrinement of textual relics in pagodas based on the Pure Light Incantation, which has little connection to contemporaneous Chinese dhāraṇī practice. However, the newly discovered Incantation of Wish-Fulfillment amulets, whose date this paper inferred to be between the eighth and ninth century, show that the Unified Silla also had a dhāraṇī practice closely linked to the Chinese practice. However, unlike the Chinese Incantation of Wish-Fulfillment amulets that were buried in tombs, the Silla amulets were likely enshrined in one of the pagodas erected on Mount Nam, Gyeongju. At the same time, the Silla epigraph from Myogilsang Pagoda at Haeinsa shows that the Incantation of Wish-Fulfillment was placed in the pagoda so as to wish for good afterlives of the soldiers who died at the battle, suggesting that placing the Incantation of Wish-Fulfillment in a pagoda had a function similar to that of burying the Chinese amulet in the tomb.

This paper investigates the theoretical foundation for developing renewable geothermal resources locally. For this reason, we pay attention to the role of communities in geothermal development. This study presents arguments for a framework that approaches the geothermal resources as an endogenous factor of community development. To analyse it, we create a model that explains the local economic characters of the geothermal exploitation beyond its geological conditions. It aims to conceptualise a community based geothermal development standard referring to the endogeneity principle. Geothermal energy is given attention since the characteristics of this resource determine its use locally. We argue that the role of communities in geothermal exploitation is pivotal in the process of green growth for further expansion of geothermal energy use.

Because of hyper complexity, difficulty to define, multiple stakeholders with conflicting perspectives, and lack of clear-cut solutions, wicked problems necessitate innovative and adaptive strategies. Operations Research has been a valuable tool for managers to make informed decisions for years. However, as we face increasingly complex and messy problems, it has become apparent that relying solely on either hard or soft OR approaches is no longer sufficient. We need to explore more innovative methodologies to address these wicked problems effectively. This study has bridged the research gap by proposing a structured process encompassing a subdivision-based problem structuring method for defining the wicked problem, a multi-attribute decision-making (MADM) for prioritizing sub-problems, and a hard OR technique, data envelopment analysis (DEA) for tackling one of the most critical sub-divisions. The proposed methodology, implemented in a case study, focuses on a higher education institution experiencing a decline in student admissions and involves five steps. First, a diverse group of stakeholders is formed to ensure comprehensive consideration of perspectives. Second, the wicked problem is defined, considering long-term consequences, multiple stakeholders, and qualitative stakeholder opinions. Third, a hierarchical structure is created to break down the wicked problem into manageable sub-problems. Fourth, a multi-criteria decision-making (MCDM) method prioritizes sub-problems. Finally, the sub-problems are addressed one by one using a combination of soft and hard OR tools. The findings highlight the benefits of integrating hard and soft OR approaches. The article concludes with reflections on the implications of using a combined OR approach to tackle wicked problems in higher education and beyond.

The goal was to assess dental students' perception of digital technologies after participating in a CAD/CAM exercise for scanning, designing, and manufacturing computer-aided provisional fixed dental restorations. A survey was conducted among second-year dental students (pre-D2 and post-D2), first- (D1, negative control), third-, and fourth-year dental students (D3 and D4, positive controls). Only OSU College of Dentistry students who completed the activity and completed the surveys were included. Seven questions were rated, which evaluated changes in knowledge, skill, interest, the importance of technology availability in an office, patients' perception of technology, the importance of having the technology, and the expected frequency of clinics utilizing the technology. Statistical analysis was performed with a significance level of 0.05. A total of 74 pre-D2 and 77 post-D2 questionnaires were completed. Additionally, 63 D1, 43 D3, and 39 D4 responded to the survey. Significant differences were found for "knowledge" and "skill" between pre-D2 and post-D2, and pre-D2 and control groups (p<0.001). There was a significant difference between post-D2 and all controls for “interest” (p=0.0127) and on practice preference for technology availability (p<0.05). There were significant results between post-D2 and all controls regarding the importance of technology availability in an office (p<0.001) and the expected frequency of clinics utilizing the technology (p=0.01). No significance was found for "patient's value of technology" and "the importance of having the technology". The presence of technology in the practice and educational academic environments significantly improved students’ interest and perception of knowledge and skill.

This scholarly article provides an overview of the present and future issues and trends in social work on a global scale. Drawing upon recent bibliographic references and a review of the literature, this article explores the challenges faced by social workers in various regions and highlights emerging trends that are reshaping the field. The analysis incorporates insights from renowned authors and researchers to provide a comprehensive understanding of the current state and anticipated future of social work practice, education, and research worldwide.

This article aims to discuss the activities developed through the Pedagogical Residency Program for literacy of the Pedagogy course at UFF (Universidade Federal Fluminense) at INFES (Northwest Fluminense Institute of Higher Education) located in Santo Antônio de Pádua/Rio de Janeiro/Brazil, which due to the COVID-19 Pandemic, it started to be carried out remotely, in a virtual context, using digital technologies. We will describe the context and activities that were carried out within this new reality.

Choking and foreign body aspiration are significant causes of mortality and morbidity in young youngsters. This study aimed to investigate the effects of education programs on school students ' knowledge, attitude, and practice towards a choking person. This quasi-experimental study with a pretest-posttest control group design included a total of 282 school students. The students were divided into an intervention group (n = 141) and a control group (n = 141). After both groups completed the pretest, the intervention group received an education program on first aid for a choking person. Then, both groups were subjected to a posttest at the end of the program. The descriptive and inferential statistics analyzed the data. There were no significant differences between the two groups within the study parameters at the pretest (P = > 0.05). However, at posttest, a significant difference was observed in the knowledge (p = 0.001), attitude (p = 0.024), and practice (p = 0.001) of the intervention group compared to the control group. The intervention group showed significant improvement in the students’ knowledge, attitudes, and practices regarding first aid for a choking person. We suggest a continuous training program to improve the competency of first aid for a choking person.

SCARED-C instrument (the child version, 41 items) is used for screening anxiety in children between 8 to 18 years old and has been first introduced by Birmaher & collab. in 1995, with good psychometric data - internal consistency from α =.74 to .93 - and good discriminative validity indices in the original versions (1997, 1999). Since then, many countries have adopted the scale, for its utility in identifying five subsets of anxiety disorders (subscales): somatic/panic disorder, generalized anxiety, separation anxiety, social phobia, and school avoidance. The present study contains the first Romanian translated and adapted version of the SCARED-C instrument on a community sample of 477 children (8-18 years old) from Mureș county schools. The instrument showed moderate to good internal consistency (α Cronbach from to .63 to .91 for the total scale) and good test-retest reliability (.70) on a subset of 85 children sample. A confirmatory factorial analysis (CFA) was conducted to test the factor structure of the Romanian version of SCARED-C; results showed that SCARED-C has good psychometric properties to be used for screening anxiety in Romanian children and adolescents. The implications for using SCARED-C in dental practice are discussed. Future studies need to be conducted for exploring convergent and discriminative validity of the instrument and the sensitivity to current DSM-V criteria. Application on a dental pediatric sample is also required.

Purpose: To identify the impact of dealing with COVID-19 patients in clinical areas on nurses' professional self-concept and self-confidence. Background: Professional self-concept is considered a critical factor in the recruitment/retention process in nursing, nursing shortage, career satisfaction, and academic achievements. Professional self-confidence is also a crucial determinant in staff satisfaction, reducing turnover, and increasing work engagement. Design: Descriptive, comparative study. Methods: The study was conducted between February to May 2021 by utilizing a convenience sampling technique. A total of 170 nurses from two facilities were recruited from two COVID-19 and non-COVID-19 designated facilities. The level of professional self-concept and self-confidence was assessed by utilizing the Nurses' Self-Concept Instrument and Self-Confidence Scale. Results: The professional self-concept level among the exposed group to COVID-19 patients was lower than the comparison group, while the professional self-confidence level among the exposed group to COVID-19 patients was similar to the comparison group. On the other hand, the satisfied staff and those who received professional training in dealing with COVID-19 patients reported a higher level of professional self-concept. Conclusions: Dealing with COVID-19 patients has an impact on professional self-concept; the exposure group was lower than those who did not deal with COVID-19 patients, while the professional self-confidence level among the exposed group was similar to the comparison group. Getting professional training in dealing with COVID-19 patients and being satisfied at work were significant factors in improving the professional self-concept. Policymakers should create strategies that target the improvement of professional training in dealing with COVID-19 patients.

For their clinical use Mesenchymal Stromal Cells (MSCs), isolated from bone marrow (BM-MSCs) are considered Advanced Therapy Medicinal Products (ATMP) and need to be produced according to Good Manufacturing Practice (GMP). Human platelet lysate (HPL) represents a good GMP-compliant alternative to animal serum and after pathogen inactivation with Psoralen was more efficient and safer to produce MSCs in GMP. In this study MSCs cultivated in FBS (FBS-MSC) or inactivated HPL (iHPL-MSC), were compared for their immunomodulant properties. In particular, the effects of MSCs on: 1)proliferation of total Lymphocytes (Ly) and on naïve T Ly subsets induced to differentiate versus Th1 and Th2 Ly; 2) the immunophenotype of different T cell subsets; 3)the cytokine release to verify Th1, Th2 and Th17 polarization were analyzed by using in vitro co-culture system. We observed that iHPL-MSCs showed the same immunomodulant properties observed in the FBS-MSCs co-cultures. Although, a more efficient effect on the increase of naïve T cells and, in the Th1 cytokine release related to iHPL was observed. This study confirms that iHPL, used as medium supplement, may be considered a good alternative to FBS for a GMP-compliant MSC expansion to preserve their immunomodulant proprieties.

Aflatoxin contaminated maize is of public health concern in Kenya. Training farmers on good agricultural practice (GAP) has been touted as a mitigative measure. Little is known of the effect of such training on aflatoxin levels in maize grown in Kenya. This study evaluated what effect training farmers on GAP has on aflatoxin levels in maize grown in in maize grown in Kaptumo, Kilibwoni, and Kipkaren divisions in Nandi County. Ninety farmers were recruited for the study and interviewed on GAP. Maize samples were additionally collected from the participating farmers and analyzed for aflatoxins using competitive enzyme-linked immunosorbent assay (c-ELISA). All farmers prepared the land before planting, did correct spacing between the planted crops, carried out weeding, cleaned their stores before use, checked the condition of the maize after harvesting, sorted maize after shelling, and knew aflatoxins. A majority of the farmers (90%) used fertilizers, dried maize after harvesting, knew that aflatoxins were harmful to humans, and used clean transport in transporting the harvested maize. About 98% of farmers did stooking after harvesting and 97% used wooden pallets in the maize stores. The percentage of farmers who practiced early planting, top dressing, crop rotation, raising stores above the ground, applying insecticide after shelling and feeding damaged/rotten seeds to their animals was 84–96%, 62–80%, 67–85%, 86–98%, 63–81%, and 7–21% respectively. About 18/90 (20%) of all farmers reported that they had a relative who had died from liver cancer and the mean aflatoxin levels in season 1 were significantly different from season 2 (1.92 ± 1.07 ppb; 1.30 ± 1.50 ppb). Our findings suggest that although training farmers to adopt good agricultural practices was observed to be efficient in mitigating the problem of aflatoxins, the receptiveness of farmers to different aspects of the training may have differed. Therefore, in designing an optimized regional aflatoxin contamination strategy, local applicability should be considered.

A robust bank industry is a major player in the stability of an economy. The operational efficiency and stability of banks are therefore paramount. By way of financial ratios and Z-score, this study analysed UT Bank’s financial performance prior to the 2017 bank sector reforms in Ghana. Annual financials over a ten year period (2007-2016) were used. Debt management practices of UT Bank per the results obtained were quite on the hind side and unimpressive. This was reflected in the poor leverage and risk management variables. UT Bank would have been unable to meet creditors’ claims considering the mean average values of debt-to-assets and debt-to equity ratios of 0.76 and 0.90 respectively. The entire bank sector will benefit if credit management practices of individual banks are refreshed and worked on. The bank industry regulator should tighten its supervisory and monitoring role over banks to help detect early signs of non-performing banks. The study further recommends that statutory lending limits of banks be re-enforced to uphold the threshold of 10 percent for unsecured loans and 25 percentage for secured loans of net owned funds of the bank.

The Clinical Trials Transformation Initiative (CTTI) Investigator Qualification Project addresses the need for a more efficient and effective means of identifying qualified clinical investigators and delegates. Selection of investigators and delegates who are qualified by training and experience to conduct clinical trials is essential to safeguarding protections for study participants and ensuring data quality and integrity. Sponsors generally document investigator qualification through training on the principles of good clinical practice (GCP), as defined by the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH), adopted by regulatory authorities in the US, Japan and the European Union. Although these GCP principles provide an important foundation for promoting the conduct of quality clinical trials, the industry standard “one-size-fits-all” GCP training may not fully prepare investigators and delegates for conducting quality clinical trials. Routine GCP training alone may not be sufficient to prepare an inexperienced member of a site team, while repeating such training is unlikely to enhance the qualifications of an experienced researcher. The CTTI project team used findings from qualitative research activities, as well as input from an expert meeting with multiple stakeholders, to identify gaps and redundancies in the current training of investigators and their delegates and recommend practical, action-based solutions. CTTI provides recommendations on how to implement a more efficient and effective means of qualification for investigators and delegates, determine whether a site team is a good fit for a particular protocol, and improve the quality of clinical trial conduct.

Climate change is a buzzword in the world. Scientist has approved it as global warming with its projection of undesired and unpredicted frequent extreme events and their vulnerabilities not only at present but also at future. There is an assumption of occurrence of adaptive capacity and behavior of farmers in agriculture production activity at some extent to neutralize climate change vulnerabilities of flood and landslides on paddy production. This paper empirically examines the effects of climate change in paddy production and farmer’s adaptive behaviors to neutralize such climatic shocks and events in paddy production by employing CD production function based econometric model. The study employed primary data collected through 642 household surveys. The study finds that climatic shocks and events have huge loss (60%) in paddy production and revenue income in such plot where farmers have not indigenous knowledge and practices. But both small and larger farmers who have adaptive capacity and behavior with their indigenous knowledge have less loss in paddy production and revenue income, although they have heterogeneity in their socio-economic characteristics (income, asset holding, literacy, experience, land holding and age). The farmers who have used adaptive behavior have indigenous knowledge and experiences including bamboo wall construction to control flood and landslides and seed change to resist climatic shocks and events. In hilly region, the farmers have not sufficient alternative measures, except both adaptive measures because of their poverty, illiteracy and remote locations. The study finds their higher effective level to minimize vulnerabilities to paddy production and revenue per farm plot, although these adaptive behaviors are cost effective and local entity. Comparatively, bamboo wall construction is more effective measure in the paddy production than others are (seed switch) to minimize the flooding materials from the flood and the landslides. Thus, low cost indigenous adaption behavior of farmers is effective measure to climate change and climate change induced disasters and events vulnerability in paddy production.

The purpose of this study is to assess the solid waste management status and practice in Sendafa town, Oromia regional state residents. In order to achieve this goal, the researcher intends to employ both primary and secondary data from the Sendafa town municipality. With the aid of multi-cluster sampling and a purposive sampling method, the researchers chose a sample size of 398 people and 10 interview responders. To utilize a systematic sampling technique at intervals of residences, individual samples were chosen. Quantitative data was cleaned and analysed using STATA software. A multiple linear regression model and logistic regression other descriptive statistics methods were then used to change the results. The qualitative data were imported, coded, and thematised using ATLAS.ti.9 in order to prepare respondents' interviews for analysis. The findings indicate that residents' poor solid waste management practices are a result of a lack of awareness, low family income transportation issues, issues with waste collectors, a lack of a sense of responsibility and belonging, and a failure to enforce current solid waste management laws. Solid waste accumulates near roads, bridges, and residential areas that are close to landfills, contaminating the area and leading to diseases like TB and Asthma (and other related health issues in children and adults who live there). Thus, researcher recommends that to have sustainable solid waste management the town administrators should have plan to develop awareness creation symposium or panel of discussion, resolve transportation issues, monitor and guide the routine activities of waste collectors, develop sense of belongingness for themselves and for the community, develop integrated solid waste land fill projects and working with all stakeholders like NGO and health institution will minimize the adverse effect of improper solid waste management. Keywords: Solid Waste, Status of Solid Waste Management, Land fill site suitability

Zoonotic abortive diseases represent a significant health and economic risk for national public health. This cross-sectional survey was conducted from April to October 2021 among 200 selected small ruminant farmers in the three northern regions of Cameroon. Data collection was done through questionnaires administered by exchange with the herder and responses were coded and recorded on an Excel spreadsheet. The data were then analyzed with R software, version 2.13.0. An ANOVA test was used to assess significant differences in mean of Knowledge, Attitudes, Practices and Perception of zoonotic risks (KAPP) scores between regions. Pearson correlations were used to calculate the association between KAPP scores within regions. Small ruminant farmers surveyed had low mean scores for knowledge of abortive Toxoplasmosis and Chla-mydophilosis (0.1 ± 0.2), desirable attitude (0.32 ± 0.07), appropriate practice (0.36 ± 0.13) in managing abortion, and positive perception of zoonotic risks of Toxoplasmosis and Chlamydo-philosis in small ruminants (0.12 ± 0.33), respectively. KAPP was significantly (p<0.01) and posi-tively associated with knowledge (r=0.98) and risk perception (r=0.99). However, attitudes (r=0.06), practices (r=0.05) and risk perception of toxoplasmosis (r=0.07) and Chlamydophilosis (r=0.08) were not associated with farmers' knowledge. This study revealed significant knowledge gaps, low levels of desired attitudes, and high-risk behavioral practices. These results therefore call for capacity building of health professionals and farmers to better integrate the One Health concept in the management of neglected zoonotic diseases.

The digital era offers many opportunities to the wind energy industry and research community. Digitalisation is one of the key drivers for reducing costs and risks over the whole wind energy project life cycle. One of the largest challenges in successfully implementing digitalisation is the lack of data sharing and collaboration between organisations in the sector. In order to overcome this challenge, a new collaboration method called WeDoWind was developed in recent work. The main innovation of this method is the way it creates tangible incentives to motivate and empower different types of people from all over the world to actually share data and knowledge in practice. In this present paper, the challenges related to comparing and evaluating different SCADA data based wind turbine fault detection models are investigated by carrying out a new case study, the "WinJi Gearbox Fault Detection Challenge", based on the WeDoWind Method. Six new solutions were submitted to the challenge, and a comparison and evaluation of the results show that, in general, some of the approaches (Particle Swarm Optimisation algorithm for constructing health indicators, performance monitoring using Deep Neural Networks, Combined Ward Hierarchical Clustering and Novelty Detection with Local Outlier Factor and Time-to-failure prediction using Random Forest Regression) appear to have a high potential to reach the goals of the Challenge. However, there are a number of concrete things that would have to have been done by the Challenge providers and the Challenge moderators in order to ensure success. This includes enabling access to more details of the different failure types, access to multiple data sets from more wind turbines experiencing gearbox failure, provision of a model or rule relating fault detection times or a remaining useful lifetime to the estimated costs for repairs, replacements and inspections, provision of a clear strategy for training and test periods in advance, as well as provision of a pre-defined template or requirements for the results. These learning outcomes are used directly to define a set of best practice data sharing guidelines for wind turbine fault detection model evaluation. They can be used by the sector in order to improve model evaluation and data sharing in the future.