Studies comparing provider and patient views and experiences of self-management within primary healthcare are particularly scarce in disadvantaged settings. In this qualitative study, patient and provider perceptions of self-management were investigated in five socio-economically disadvantaged communities in Stockholm. Twelve individual interviews and three group interviews were conducted. Semi-structured interview guides included questions on perceptions of diabetes diagnosis, diabetes care services available at primary health care centers, patient and provider interactions, and self-management support. Data was analysed using thematic analysis. Two overarching themes were identified. These were characterized by inherent dilemmas representing confusions and conflicts that patients and providers experienced in their daily life or practice respectively: adopting and maintaining new routines through practical and appropriate lifestyle choices (patients); and balancing expectations and pre-conceptions of self-management (providers). Patients found it difficult to tailor information and lifestyle advice to fit their daily life. Healthcare providers recognized that patients were in need of support to change behavior, but saw themselves as inadequately equipped to deal with the different cultural and social aspects of self-management. This study highlights patient and provider dilemmas that influence the interaction and collaboration between patients and providers with respect to communication and uptake of self-management advice.

Objective: Diabetes disproportionately affects African Americans leading to higher morbidity and mortality. This study explores the experiences of African Americans adults who successfully self-manage their type 2 diabetes (called Peer Ambassadors) and provided phone-based peer support in a 6-month culturally tailored diabetes self-management program for African Americans guided by the Information-Motivation-Behavioral skills model. Design: A group discussion using a semi-structured discussion guide was conducted. Qualitative content analysis was used to identify the facilitators and barriers to completing the role of a Peer Ambassador, and to develop strategies for overcoming possible challenges in the future. Setting: Key informant discussions were conducted in a community location to gain insights into Ambassadors’ motivations and challenges in delivering peer support. Participants: Three Peer Ambassadors completed ethics training, peer mentor training and received a phone call guide before providing support to their peers. Results: There were four core themes related to Peer Ambassador experiences: (1) Motivation to be a Peer Ambassador, (2) Program elements that supported Peer Ambassador role, (3) Key elements of achieving engagement, and (4) Challenges related to being a Peer Ambassador. Conclusions: This study showed Peer Ambassadors in a culturally tailored peer-supported self-management program found fulfillment in sharing experiences and supporting peers. They highly valued educational group sessions for knowledge updates and sustaining their health-related goals, suggesting the potential benefits of recognizing milestones or providing advanced training for future program sustainability. Findings suggest the importance of recruiting motivated patients and providing effective facilitation for peer support roles, including addressing barriers such as time commitment and lack of socialization opportunities.

Living with a chronic disease involves a variety of daily life limitations that severely affect people in their daily life. Identifying and promoting self-management strategies may improve health outcomes and increase patients’ autonomy. The purpose of the present study was to explore the perceived limitations and self-management strategies of elder patients suffering from chronic diseases. An inductive content analysis was applied, with a purposive sampling of 21 patients living with chronic conditions. Data was collected through semi-structured interviews. Two main-categories were emerged from content analysis, namely “Limitations of daily life” and “Disease Management”. Physical restrictions and negative feelings were referred to as daily burdens, while scheduling and self-care, supporting environment and technology were related to disease management. Information, training and provision of digital literacy may increase patients' self-efficacy in managing their chronic condition.

(1) Background: Prevention of acute cardiovascular events in patients with cardiovascular diseases (CVDs) requires promoting health-protective behaviors (e.g., physical activity) and preventing health-compromising behaviors (sitting). Digital health interventions provide much potential. Based on multiple behavioral change theory, an intervention (reCardial app) was evaluated, and the following hypotheses were tested: H1: Health behaviors (physical activity, sitting) and disease self-management (self-care maintenance, self-care confidence) are closely interrelated. H2: Change in health behaviors and disease self-management indicators over time is more pronounced in reCardial app-users. H3: In the intervention group, changes in systolic and diastolic blood pressure indicate a positive trajectory. (2) Methods: A study with the design of a randomized controlled trial over 12 weeks was conducted. 40 CVD-patients were randomized equally to the Intervention Group (35% women; Mage=60.6years) and Control Group (45% women; Mage=61.5years). (3) Results: Findings support H1 with significant correlations between health behaviors (r=0.45-0.63**), and disease self-management (r=-0.32-0.54**), H2 with Eta²=0.21 (not statistically significant) and H3 partially with d=0.101 for systolic blood pressure but not regarding diastolic blood pressure. (4) Conclusions: Replications are needed with larger samples and more objective measures. The app can help prevent and manage CVD by means of promoting health-protective behaviors and preventing health-compromising behaviors. Taking different behaviors into account can increase intervention effects and with that support of users.

Type 1 diabetes imposes a complex and challenging routine on patients and caregivers. Therefore, considering individual experiences and personal facilitators to promote assertive interventions is crucial. However, no studies have addressed these perspectives in the Brazilian adult population. We aimed to identify psycho-behavioral characteristics perceived as facilitators for coping with the condition. We used a biographical method to conduct semi-structured, face-to-face, in-depth interviews for each participant. Transcripts were analyzed using inductive thematic analysis. Participants (n = 22) were aged 18–57 years (mean: 30.2, standard deviation (SD): 8.7), and the duration since diagnosis was approximately 20.6 years (SD: 4.6). Twelve (54.4%) were women, 13 (59.1%) used insulin pumps, 14 (63.6%) had at least a college degree, and 13 (59.1%) had HbA1C (glycated hemoglobin) levels above 58 mmol/mol (7.5%). Five major themes emerged: 1) peer learning, 2) ownership, 3) welcoming experiences, 4) equity, and 5) reframe the path (P.O.W.E.R.). All themes appeared in the lived experiences shared by participants with HbA1C levels below 58 mmol/mol (7.5%). Improved glycemic control can be achieved, and the challenges encountered in diabetes care within similar socioeconomic contexts can be addressed, by an interdisciplinary care team that takes P.O.W.E.R into consideration when providing person-centered care strategies.

Background: Even though a number of studies have verified the positive effect of physical activity (PA) on self-related health (SRH) no previous research has examined this association among pediatric patients with Type 1 diabetes mellitus (T1DM). Objective: The purpose of this study was to investigate the association between regular physical activity (PA) and self-rated health (SRH) in pediatric patients with Type 1 diabetes mellitus (T1DM) who lacked diabetes care. Methods: We conducted a retrospective study among pediatric patients with T1DM who lacked diabetes care and were enrolled in a diabetes education program between January 2011 to January 2015 at the endocrinology clinic of Seoul National University Children’s Hospital in South Korea. The eligible participants for this study were 37 pediatric patients with T1DM aged 9 to 17 years. PA was divided into regular PA and muscle strength exercise to analyze the relationship with SRH using binomial logistic regression analysis. Results: The results showed SRH of pediatric patients with T1DM who did not engage in regular PA was significantly lower than those who did (OR in regular PA = .199 [95% CI: .040, .995]; OR in regular muscle strength exercise = .097 [95% CI: .023, .825]). Conclusions: In conclusion, regular PA and muscle strength exercise in pediatric patients with T1DM who lacked diabetes care were effective in improving their SRH. A systematic plan is required to enhance regular PA for pediatric patients with T1DM.

Medically underserved communities have limited access to effective disease management resources in the U.S. Mobile health applications (mHealth apps) offer patients a cost-effective way to monitor and self-manage their condition and to communicate with providers; however, current diabetes self-management apps have rarely included end-users from underserved communities in the design process. This research documents key stakeholder-driven design requirements for a diabetes self-management app for medically underserved patients. Semi-structured survey-interviews were carried out with 97 patients with diabetes and 11 healthcare providers from medically underserved counties in South Texas to elicit perspectives and preferences regarding a diabetes self-management app, and their beliefs regarding such an app’s usage and utility. Patients emphasized the need for accessible educational content and for quick access to guidance on regulating blood sugar, diet, and exercise and physical activity using multimedia rather than textual form. Healthcare providers indicated that glucose monitoring, educational content, and graphical visualization of diabetes data were among the top-rated app features. These findings suggest that specific design requirements for the underserved may improve the adoption, usability, and sustainability of such interventions. Designers should consider health literacy and numeracy, linguistic barriers, data visualization, data entry complexity, and information exchange capabilities.

Abstract Background: Diabetes mellitus is dramatically increasing in the wide world. The managing of diabetes care emphasized the self-management education and support into patients’ care and family care. Objective: to review and synthesizes the effectiveness of DSME strategies involving family as a key person to provide social support for diabetes mellitus self-management of glycemic uncontrolled patients Method: Three databases through PubMed, CINAHL, and Scopus were reviewed to assess the relevant articles. The following search terms: “type 2 diabetes,” “self-management,” “family support,” and “glycemic uncontrolled.” We summarized details of family support on self-management among glycemic uncontrolled patients for 14 existing studies. Results: A total of 22 intervention studies were identified. Those studies have a heterogeneous of the education strategies, support perceived, follow-ups strategies and outcomes among type 2 DM. Family integration on diabetes self-management education (DSME) has a positive impact on several outcomes including, self-care behaviors, psychological outcomes, self-efficacy and clinical outcomes Conclusions: This systematic review found robust data related to the integration of family support on diabetes self-management among glycemic uncontrolled patients. Consequently, the improvement in outcomes was identified. Implications: The findings suggest model of family engagement is better and needed for sustaining the diabetes care in the long-term care

Background: The adoption of self-care behaviors among patients with congestive heart failure (CHF) is essential for the management of their health condition. However, there is a lack of tools for estimating self-care in CHF patients. We aim to develop and validate the Hippocratic heart failure self-care scale (HHFSCS). Methods: the scale includes 22 items which are reviewed by a committee of experts. Individuals indicate the frequency at which they follow each self-behavior on a five-point Likert scale. Adult patients with CHF (n=250) from a General Hospital, in Athens, were participated in the study from June 2020 to March 2021. Reliability coefficients and Explanatory Factor Analysis (EFA), using a Varimax rotation and the Principal Components Method were used to assess the psychometric measurements. Results: The Cronbach’s alpha coefficient of the HHFSCS was 0.807. The exploratory factor analysis identified two domains that accounted for 88.44% of the variance of the scale items; however, each sub-scale could not be used as an independent scale. Finally, the test-retest showed a significant strong correlation (r=0.973, p<0.001). Conclusions: The HHFSCS is a reliable and valid tool for assessing self-behaviors in CHF patients. Health professionals can use it in their clinical practice to improve the management of patient’s health conditions.

During software development requirement gathering is an important phase. Requirements are the basis of software development. The success or failure of any software depends upon level of understanding developed in requirements. During software development requirements keeps on changing due to different reasons. Hence requirements are such a critical phase that leads to the total project failure. So, to understand the impacts and to identify the conflicts with existing requirements, it is important to manage and analyze the requirements well. Requirement change management is the interest of this paper. Different requirement change management techniques has been discussed in this paper and analyzed them well and finally conclude the results accordingly.

Diabetes mellitus (DM) and obesity account for the highest burden of non-communicable diseases. There is increasing evidence showing therapeutic patient education (TPE) as a clinically and cost-effective solution to improve biomedical and psychosocial outcomes among people with DM and obesity. The present systematic review and meta-analysis presents a critical synthesis of development of TPE interventions for DM and obesity and the efficacy of these interventions across a range of biomedical, psychosocial and psychological outcomes. A total of 54 of these RCTs were identified among patients with obesity and diabetes and were thus, qualitatively synthesized. Out of these, 47 were included into quantitative synthesis. There was substantial heterogeneity in reporting of these outcomes (I²= 88.35%, Q= 317.64), with significant improvement (SMD=0.36, 95% CI: 0.23 to 0.49) noted in biomedical outcomes in the intervention group. The effect sizes were comparable across interventions delivered by different modes and delivery agents. These interventions can be delivered by allied health staff, doctors or electronically as self-help programs, with similar effectiveness (P < 0.001). These interventions should be implemented in healthcare and community settings to improve health of patients suffering from DM and obesity.

Diabetes self-management education helps to improve health outcomes, quality of life and to reduce expenses for diabetic patients. This systematic review aimed to examine the effectiveness of diabetes self-management education used for newly diagnosed patients with type 2 diabetes (T2DM). A review of studies that have researched the use and the impact of health education in newly diabetic patients with T2DM was implemented. A literature search was conducted using the electronic database of Pub MED, Walters Kluwer, Cochrane Library, Elsevier, JSTORE between January 2017 – November 2022. The data on participants and intervention characteristics were extracted by two reviewers independently. We found 789 studies and after selection of PRISMA flow chart we selected 19 studies, including 2512 newly diagnosed adult T2DM. Biomedical results presented the pooled effect of HbA1c -0.64%, FBG -0.32. The evaluation of emotional and social results and behavioral effects has been evaluated respectively in 10 and 9 studies. The education and support of recently diabetic patients help to improve biomedical, psychosocial, and behavioral results. This intervention must be ongoing to maintain healthy behaviors

The Upper Hunter Valley is a major coal mining area in New South Wales (NSW), Australia. Due to the ongoing increase of mining activities, PM10 (air-borne particle with an aerodynamic diameter less than 10 micrometres) pollution has become a major air quality concern in local communities. The early part of this study identified two air quality subregions in the valley. This paper aims to provide a holistic summarisation of the relationships between elevated PM10 pollution in two subregions and the local- and synoptic-scale meteorological conditions for spring and summer, when PM10 pollution is relatively high. A catalogue of twelve synoptic types and a set of six local meteorological patterns have been quantitatively derived and linked to each other using the self-organising map (SOM) technique. The complex meteorology-air pollution relationships have been visualised/interpretated on the SOM planes for two representative locations. It was found that the influence of local meteorological patterns differed significantly for mean PM10 levels vs the occurrence of elevated pollution events and between air quality subregions. In contrast, synoptic types showed generally similar relationships with mean vs elevated PM10 pollution in the valley. Two local meteorological patterns, the hot-dry-northwesterly wind conditions and the hot-dry-calm conditions, were found most PM10 pollution conducive in the valley when combined with a set of synoptic counterparts. These synoptic types are featured with the influence of eastward migrating continental high pressure system and westerly troughs, or a ridge extending northwest towards coastal northern NSW or southern Queensland from the Tasman Sea. The method and results can be used in air quality research for other locations of NSW, or similar regions elsewhere.

To mitigate the adverse impacts of urban stormwater on streams, watershed managers are increasingly using low impact development and green infrastructure (LID-GI) stormwater control measures such as rain gardens—vegetated depressional areas that collect and infiltrate runoff from rooftops and driveways. Their catchment-scale performance, however, can vary widely, and few studies have investigated the cumulative performance of residential rain gardens for event runoff control in intermediate-sized (i.e., 1-10 km2) suburban catchments. We modeled three years of continuous rainfall-runoff from a 3.1 km2 catchment in Columbia, MD, USA, using the Storm Water Management Model (SWMM). Various extents of rain garden implementation at residential houses were simulated (i.e., 25%, 50%, 75%, and 100% coverage) to determine the effects on peak flow, runoff volume, and lag time. On average, treating 100% of residential rooftops in the catchment reduced peak flows by 14.3%, reduced runoff volumes by 11.4%, and increased lag times by 3.2% for the 223 rainfall events during the simulation period. Peak flow reductions were greater for smaller storm events (p&lt;0.01). Our results show that residential rain gardens can significantly improve the runoff response of suburban catchments, and that they represent an effective and relatively low-cost option for urban watershed management and restoration.

Diagnosis and treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in women remain insufficient. Fluctuations of reproductive hormones during the premenstrual period, postpartum period and (peri)menopause are neglected, even though they impact ADHD symptoms and as-sociated mood disorders [1]. Therefore, we created a female-specific treatment group for women with ADHD and premenstrual worsening of ADHD and/or mood symptoms. We describe the group programme and underlying rationale, offering a qualitative analysis of the participants’ evaluation. The 7 two-weekly sessions foreground the menstrual cycle and address several ADHD-specific topics in relation to this cyclical pattern: emotional regulation; impulsivity; setting boundaries, and triggers. Concurrently, women track their menstrual cycle and (fluctuating) ADHD and mood symptoms with an adjusted premenstrual calendar. In total, 18 women (25-47yrs) participated in three consecutive groups. We analysed the evaluation of the last group. Participants experienced the group as a safe and welcoming space. Recognition was valued by all. The topics discussed were deemed valuable and the structure suited them well. Completing the premenstrual calendar augmented awareness and recognition of individual cyclical symptoms. Discussing ADHD throughout the lifespan increased self-understanding. Participants took their menstrual cycle more seriously, prioritising self-acceptance and self-care in the luteal phase of the cycle. Exploring a cyclical approach in a group setting seems to be a positive addition to treatment for female ADHD.

The organic fraction of municipal solid waste (OFMSW) is a significant environmental threat, and an economic and social challenge to manage. As such, the efficient treatment of OFMSW is a significant key factor in achieving sustainable waste management. Decentralized Composting (DC) develops a new framework of waste management. The DC Analysis Model (DCAM), proposed in our previous study, provides a powerful tool for decision makers, based on the quantification of the DC project characteristics. In this paper, we focus on the qualitative analysis as a complementary tool to support decision making, in cases where quantitative analysis is unequivocal. The qualitative analysis identifies the main players in the field, the critical stakeholders and the potential conflicts between them. It also reveals the root problems and the core competencies for the project's implementation. DCAM qualitative analysis in Shefa-Amr (case study) indicates that unresolved root problems, such as the “lack of national regulation”, “clear ownership of the project” and “lack of ongoing budget” can result in an unsustainable composting system. Countering that, “the commitment of the municipality”, together with “economic viability” and securing “suitable areas for placing composters” are among the most important core competencies for the effective implementation of DC projects.

Not only does this paper present a novel type-2 fuzzy system for identification and behavior prognostication of an experimental solar cell set and a wind turbine, but also it brings forward an exquisite technique to acquire an optimal number of membership functions and the corresponding rules. It proposes a seven-layered NCPRT2FS. For fuzzification in the first two layers, Gaussian type-2 fuzzy membership functions with uncertainty in the mean, are exploited. The third layer comprises rule definition and the forth one embeds fulfillment of type reduction. The three last remained layers are the ones in which resultant left–right firing points, two end-points and output all get assessed correspondingly. It should not be neglected off the nutshell that recurrent feedback at the fifth layer exerts delayed outputs ameliorating efficiency of the suggested NCPRT2FS. Later in the paper, a modern structural learning, established on type-2 fuzzy clustering, is held forth. An adaptively rated learning back-propagation algorithm is extended to adjust the parameters ensuring the convergence as well. Eventually, solar cell photo-voltaic and wind turbine are deemed as case studies. The experimental data are exploited and the consequent yields emerge so persuasive.

Today, issues related to people’s mental health and well-being have been described as a challenge for society, globally as well as in Sweden. This calls for new approaches to mental health promotion. The aim was to evaluate the adequacy of the content and structure, describing experiences of study circles as a means of supporting participants' self-care and self-compassion. The overall design is a descriptive, QUAL+quan design, where quantitative and qualitative results are integrated. Five participants participated in a focus group interview, of whom four completed questionnaires. One individual interview was conducted with the study circle leader. Study circles can be an arena for mental health promotion as learning and sharing of experience contributes to a sense of coherence, as well as self-compassion and a genuine concern for one’s own and others' wellbeing, but not considered an alternative to psychiatric care, for those in need of professional services. Study circles can be a possible means to support self-care and thereby promote mental health in the general population, and a valuable contribution to public health. However, in addition to modifications of the content, further research is needed on the qualifications for study circle leaders as well as the dissemination of study circles.

Self-employed individuals comprise around 15% of Canada’s workforce. For those with cancer, frequent functional loss and diminished work ability due to side effects of the disease and its treatment significantly impact their well-being and business vitality. Compared to salaried can-cer survivors, the self-employed experience greater reductions in work hours and up to 48% greater income loss, yet most research addresses the former population. To describe self-employed Canadian cancer survivors’ experiences continuing and returning to work, our quali-tative study examines their strategic efforts to continue working throughout the disease trajecto-ry or return to work post-recovery. Employing an interpretive description approach and an in-terview guide based on a vocational rehabilitation model for cancer survivors, we analyze data from 23 participants—both French- and English-speaking—from six Canadian provinces, with eight different job types and nine different cancer diagnoses. Our constant comparative analysis of the transcribed interviews reveals four major themes and twelve sub-themes: Impact of can-cer on the self-employed function (physical, cognitive, and psychological), on their ability to maintain their business, and financial well-being, and facilitating factors for working with can-cer. Cancer disclosure and non-disclosure were both deemed viable strategies, but ceasing work was not. We thus recommend professional support for self-employed cancer survivors in plan-ning any necessary business modifications to accommodate their condition and cancer treatment to lessen the negative impact of cancer on self and on their business well-being.

Background: This study aimed to develop and evaluate a dietary self-care promotion program for hemodialysis patients based on Hurley's self-efficacy model. Methods: The needs of hemodialysis patients were identified, and an online community-based dietary self-care promotion program was developed with expert evaluations. 44 hemodialysis patients were randomly assigned to an experimental group (n=22) and a control group (n=22). The program was applied to the experimental group for four weeks. Before and after the intervention, as well as four weeks after the intervention, dietary self-efficacy, dietary self-care behavior, interdialytic weight gain, serum phosphorus, and serum potassium were assessed in both groups. Results: Significant differences over time and between groups were observed in dietary self-efficacy, interdialytic weight gain, serum phosphorus, and serum potassium. The interaction between time and group was also significant. While no significant differences were found over time in dietary self-care behavior, significant group differences and interaction effects between time and group were identified. Conclusions: The results indicate that the dietary self-care promotion program using an online community for hemodialysis patients is more effective in enhancing dietary self-efficacy and dietary self-care behavior compared to conventional treatment. This suggests the clinical applicability of the proposed dietary self-care promotion program.

Rapid SARS-CoV-2 self-tests have the potential to expand access to COVID-19 testing and improve community-level case detection, particularly in resource-constrained countries such as Kenya. However, prior to their introduction, their acceptability must be assessed. This qualitative study explored key decision-takers’ values towards SARS-CoV-2 self-testing in Kenya. Healthcare workers, representatives of civil society, and potential implementors from Mombasa and Taita-Taveta were selected as decision-takers. Semi-structured interviews and focus group discussions were used to collect data on their values towards self-testing. A thematic analysis approach was applied. Most informants considered that the Kenyan public is equipped to accept and use self-testing safely as an approach to help to reduce workload at public healthcare facilities, and know one’s COVID-19 status in a private manner. The informants emphasized the need to provide counselling to end-users, to support those needing to self-isolate, and to engage different civil society stakeholders in information provision on self-testing. Fear of stigma and of forced isolation were noted as potential deterrents to self-testing uptake for some individuals. In conclusion, there is high acceptability of self-testing in Kenya among decision-takers. However, enhanced education, counselling, and addressing deterrents to testing would be helpful to ensure effective use of SARS-CoV-2 self-testing in Kenya.

Growing evidence suggests that healthcare provider advice may increase tobacco cessation, reduce alcohol use, and improve the adoption of desirable lifestyle behaviors among patients. However, how brief interventions and other provider-patient interactions can shape cumulative adoption of multiple modifiable behaviors is less well studied for diabetes prevention and control. Using weighted internet panel survey data from a large socio-demographically diverse urban population in the United States (n=1,003), the present study describes differences in group characteristics among those who had been “ever diagnosed” with prediabetes/diabetes versus those who had not. It also examines the associations between the cumulative adoption of lifestyle behaviors and each of the following: a) lifetime prediabetes/diabetes diagnosis; b) brief lifestyle intervention exposure (i.e., received provider advice/encouragement); and c) recent provider-patient communication about diabetes. There were several group differences in “ever diagnosed” prediabetes/diabetes status by age, employment status, health status, nutrition knowledge, blood pressure/hypertension diagnosis, and diabetes-related health behaviors (p<0.05). Each of the three provider-patient interactions of interest were positively associated with a higher cumulative sum of adopted modifiable lifestyle behaviors for diabetes prevention and management. Results suggest that provider advice/provider-patient interactions of any type can have a salutary impact on whether individuals with prediabetes or type 2 diabetes will engage in recommended lifestyle behavior modifications.

Overcrowding in the emergency department is a problem that generates several implications for bed management, which is deemed one of a hospital's most critical processes. Effective management of hospital production capacity includes bed management processes, which can be improved in order to leverage hospital performance. Thus, this study sought to understand how bed management works and identify the main factors that influence its management. The study was performed through a case study, with data collected from semi-structured interviews and bibliographic research, which were triangulated. Thematic content analysis of the interviews and cross-analysis were performed. As a result, the main factors that influence hospital Bed management were identified: communication between teams and units; definition of performance goals; decisions shared between units; occupation and discharge planning by the teams; length of stay; the role of the nurses; and COVID-19. The greatest difficulties in the management process are related to these factors. Additionally, suggestions are provided to mitigate such reported difficulties.

The objectives of this study are threefold. First, we evaluate the applicability of the information–motivation–behavioral skills (IMB) model for predicting organic food purchase intention (OFPI) in adults with chronic conditions. Second, we examine the indirect effects of organic food knowledge, attitudes toward organic food purchase, and subjective norms on OFPI through self-efficacy. Third, we examine whether these indirect effects are moderated by gender and educational attainment. Data were collected from Indian adults with chronic conditions using a self-administered questionnaire. The results show significant indirect effects of organic food knowledge, attitude toward organic food purchase, and subjective norm on OFPI through self-efficacy. Moreover, the mediating effect of knowledge was moderated by gender and education attainment, with the effect being stronger for females and among individuals with a lower level of education. Organic food marketers, social marketers, and public health agencies promoting organic food consumption to people with chronic conditions should aim to increase their confidence in comprehending organic food. This study contributes to the literature by assessing the applicability of Fisher and Fisher’s (1992) IMB model in understanding behavioral intention toward organic food.

Background Coronavirus disease 2019 (COVID-19) almost ceased to spread across the globe, but post Covid psychological experiences are rarely documented. It is essential to understand the individual psychological needs and challenges regarding working during the covid-19 pandemic and resilience and psychological health to continuing work in the aftermath of this crisis. Objective To explore the psychological transformation of staff nurses after COVID-19 Methods A phenomenological and purposive sampling approach was employed. Registered nurses working at the largest health organization in Qatar includes 14 health facilities were invited to participate in this study. 17 nurses who were working in the facilities and were deployed during the first, second and third wave of Covid 19 participated in the interview. Data were collected through semi-structured face-to-face interviews using quarantine measures. The interview data were analyzed using inductive thematic analysis. Results The psychological transformation of participants was summarized into three themes fear zone, Learning zone and growth zone. These themes were classified into 10 sub-themes Fear and anxiety, Influence of media and news, Frequent change in policies and guidelines were the fear zone factors .Secondly Coping mechanism, teamwork, establishing compassionate care, social acceptance, personal and professional benefits helps them learn psychologically. Thirdly growth factors such as confident & resilient, Sense of purpose and Change life perception and meaning Conclusion Working during COVID-19 imposed many challenges on nurses such as workload and stress. However, the different waves of the pandemic may increase the resilience, confidence and life meaning in nurses. Their previous experiences in handling difficult situations during the pandemic may make the nurses become more confident in dealing with stressful situations and working under pressure.

Background: Level of perceived competence as a basic psychological need could trigger achievement of diabetes self-management goals. Due to lack of a specific data collection tool to measure level of self-competence among Persian speaking patients with diabetes this study was conducted for cross-cultural adaptation and psychometric assessment of the Persian version of Perceived Competence Scale for Diabetes (PCSD-P). Methods: Standard translation/back-translation procedure was carried out to prepare a preliminary draft of the PCSD-P. Content and face validity of the early draft were checked by an expert panel including 15 scholars in the field of health education and promotion as well as nursing education with experience of working and research on diabetes. The final drafted questionnaire was completed by 177 randomly selected patients with type 2 diabetes. Based on the collected data structural validity of the contrived version was appraised using exploratory and confirmatory factor analysis (EFA, CFA). Cronbach's alpha and Intraclass Correlation coefficients (ICC) were used to check the scale’s reliability and internal consistency. ; (3) Results: The estimated measures of Content Validity Index (CVI= 0.95) and Content Validity Ratio (CVR= 0.8) were in the range of acceptable recommended limits. The EFA analysis results demonstrated a single factor solution according to the items’ loadings for the component. The model fit indices i.e. RMSEA= 0.000, CFI=1, TLI=1, GFI= 0.998, NFI= 0.999 RFI= 0.995 confirmed consistency of the hypothesized one-factor solution. Values of the internal consistency and reliability coefficients were also in the vicinity of acceptable range (α= 0.892, ICC=0. 886, P= 0.001). Conclusions: The study findings revealed good internal validity and applicability of the PCSD-P to measure degree of self-competence among Persian speaking type 2 diabetes patients to manage the chronic disease. Due to unrepresentativeness of the study sample future cross-cultural test of PCSD-P on diverse and broader Persian speaking populations is recommended.

Background and Objectives: Elders’ needs are rarely examined beforehand, and thus, although technology-based tools can enhance self-management, acceptability rates are still low. This study aimed to examine and compare self-reported needs, priorities, and preferences of elders with heart failure (HF), diabetes mellitus (DM), and chronic obstructive pulmonary disease (COPD) toward technology use to enhance self-management. Materials and Methods: A convenience sample of 473 participants over 60s (60.5% females), diagnosed with HF (N=156), DM (N=164), or COPD (N=153) was recruited. They were administered a questionnaire about the usefulness of technology in general and in specific areas of disease management. Results: Most participants (84.7%) admitted that technology is needed for better disease management. This was equally recognized across the three groups both for the overall and specific areas of disease management (in order of priority: ‘Information’, ‘Communication with Physicians &amp; Caregivers’, and ‘Quality of Life &amp; Wellbeing’). Sociodemographic differences were found. Cell phones and PCs were the devices of preference. The four common features prioritized by all three groups were related to ‘information about disease management’ (i.e., monitoring symptoms, reminders for medication intake, management and prevention of complications), whereas the fifth one was related to ‘communication with physicians and caregivers (i.e., in case of abnormal or critical signs). The top disease-specific feature was also monitoring systems (of respiratory rate or blood sugar or blood pressure, oxygen), whereas other disease-specific features followed (i.e., maintaining normal weight for HF patients, adjusting insulin dose for DM patients, and training on breathing exercises for COPD patients). Conclusions: Elders in these three samples seem receptive to technology in disease management. mHealth tools, incorporating both common and disease-specific features and addressing different chronic patients, and being personalized at the same time, could be cost-saving and useful adjuncts in routine clinical care to improve self-management.

The COVID-19 pandemic has disrupted healthcare worldwide, potentially impacting disease management. This cross-sectional study assessed the influence of COVID-19 on diabetes self-management in 341 Saudis with type 2 diabetes using the Diabetes Self-Management Questionnaire (DSMQ). The DSMQ contains 16 items across 4 domains assessing glucose management, dietary control, physical activity, and healthcare use. Three additional items measured the perceived overall impact of COVID-19. Total DSMQ scores were significantly higher in patients aged &gt;60 years versus younger groups. Scores were significantly lower in patients diagnosed for 1-5 years versus longer durations. Patients on insulin had higher glucose management subscores than oral medication users. Overall, DSMQ scores were higher than the pre-pandemic Saudi population and Turkish post-pandemic findings. DSMQ results suggest that while COVID-19 negatively impacted some self-management domains, Saudi patients upheld relatively good diabetes control during the pandemic. Further research is warranted on specific barriers to optimize diabetes care during public health crises.

Weight loss solutions are on the rise, and there is growing interest in natural alternatives to the pharmaceuticals in the market, which are not devoid of relevant side effects. To this end, the objective of the current study is to assess the effects of a botanical-based blend comprised of lemon verbena and hibiscus extracts in weight management, body fat, appetite, lipid, and glucose profiles, in an overweight population, for 90 days. As a result, the volunteers presented significant weight loss in absence of diet, which coincided with decreased body fat. Body fat was assessed by anthropometry, electrical bioimpedance and DEXA scan. Cholesterol levels were also significantly decreased. Satiety assessment revealed that the product contributed to increased feeling of fullness and satisfaction after a meal, compared to the placebo group, which could contribute to the weight loss observed. Blood glucose and blood pressure levels remained unchanged, which was expected as the volunteers were normoglycemic and their blood pressure was in the healthy range. In conclusion, daily supplementation of a botanical-based blend contributes to weight loss in overweight individuals, in absence of diet, while not affecting other parameters that are in the healthy range. This product could be a candidate alternative or add-on to other weight loss products, as part of a healthy lifestyle.

Sources are classified into two depending upon the factor of reviving. These sources, which cannot be revived into their original shape once they are consumed, are considered as nonrenewable energy resources, i.e., (coal, fuel) Moreover, those energy resources which are revivable to the original condition even after being consumed are known as renewable energy resources, i.e., (wind, solar, hydel) Renewable energy is a cost-effective way to generate clean and green electrical energy Now a day’s majority of the countries are paying heed to energy generation from RES Pakistan is mostly relying on conventional energy resources which are mostly nonrenewable in nature coal, fuel is one of the major resources, and with the advent of time their prices are increasing on the other hand RES have great potential in the country with the deployment of RES greater reliability and an effective power system can be obtained In this thesis, a similar concept is being used and a hybrid power system is proposed which is composed of intermixing of renewable and nonrenewable sources The Source side is composed of solar, wind, fuel cells which will be used in an optimal manner to serve load The goal is to provide an economical, reliable, uninterruptable power supply. This is achieved by optimal controller (PI, PD, PID, FOPID) Optimization techniques are applied to the controllers to achieve the desired results. Advanced algorithms (Particle swarm optimization, Flower Pollination Algorithm) will be used to extract the desired output from the controller Detailed comparison in the form of tables and results will be provided, which will highlight the efficiency of the proposed system.

The aim of this paper is to study the main areas in which Artificial Intelligence (AI) will impact the field of project management that relates to cost, risk and scheduling. The research model was based on a previous study of the ten project management knowledge areas presented in the PMI’s PMBOK 6th edition where project schedule-, cost- and risk management knowledge areas were identified as being the ones most likely to be affected by the development of AI. A group of experts that participated in the study agreed that AI will affect the project management profession in the future. Different elements of the three knowledge areas were considered to be affected more by AI than others. The schedule baseline is the element believed to be affected the most out of the project schedule management elements. For project cost management, the estimation of resource cost is believed to be affected the most. In the case of project risk management, the application of AI will have the strongest impact on the probability and impact format.

Background: Health management is gaining importance as a business resource to enhance employee well-being. The rise of remote work during COVID-19 impacted lifestyle habits. This study explores the impact of tele-exercise intervention on remote workers' lifestyle habits, aiming to improve health and productivity. Methods: This study divided into remote (G1) and face-to-face (G2) groups. Over three months, G1 followed a 30-minute weekly exercise program. Measurements and questionnaires were collected at three time points covering areas like presenteeism, weight, sleep, stress, job satisfaction, and happiness. Data underwent Two-way repeated measures ANOVA, Autocorrelation, Correlation Analysis, and Correspondence Analysis to assess differences and relationships between G1 and G2. Results: ANOVA showed that a significant difference was observed in Daily Stress (DS) between G1 and G2, with G1 exhibiting higher DS. Autocorrelation Analyses showed for G1 that strong relationships each of BMI, Presenteeism (PST), Daily Stress (DS), Stress Relief (SR), Sleep Quality (SQ), Purpose of Work (PW), and Satisfaction of Life (SL) in the time frame. Correlation Analysis showed for G1 that the pairs of PRS and SQ, and DS and SL had strong positive relationships, and the pairs of BMI and PRS, and BMI and SQ had strong negative relationships. Autocorrelation Analyses showed for G2 that strong relationships each of SR, Stress due to Remote Work (SRW), ST, SQ, and PW in the time frame. Correspondence Analysis showed that that G1 was encompassed in a job and life satisfaction area, and G2 was encompassed in a sleep and stress for weight control area.

Tinnitus is a phantom sound perception in the ears or head and can arise from many different medical disorders. Currently, there is no standard treatment for tinnitus that reliably reduces tinnitus. Individual patients reported that acupressure at various points around the ear can help to reduce tinnitus, which was investigated here. With this longitudinal observational study, we report a systematic evaluation of auricular acupressure on 39 tinnitus sufferers, combined with a self-help smartphone app. The participants were asked to report about tinnitus, stress, mood, neck and jaw muscle tensions twice a day using an ecological momentary assessment study design for six weeks. On average, 123.6 questionnaires per person were provided and used for statistical analysis. The treatment responses of the participants were heterogeneous. On average, we ob-served significant negative trends for tinnitus loudness (Cohen’s d effect size: -.861), tinnitus dis-tress (d = -.478), stress (d = -.675), and tensions in the neck muscles (d = -.356). Comparison with a matched control group revealed significant improvements for tinnitus loudness (p = .027) and self-reported stress level (p = .003). The positive results of the observational study motivate fur-ther research including a randomized clinical trial and long-term assessment of the clinical im-provement.

The practice of quantified-self sleep tracking is increasingly common nowadays among healthy individuals as well as patients with sleep problems. However, existing sleep-tracking technologies only support simple data collection and visualization, and are incapable of providing actionable recommendations that are tailored to users' physical, behavioral and environmental context. Here we coined the term context-aware sleep health recommender system (CASHRS) as an emerging multidisciplinary research field that bridges ubiquitous sleep computing and context-aware recommender systems. In this paper, we presented a narrative review to analyze the type of contextual information, the recommendation algorithms, the context filtering techniques, the behavior change techniques, the system evaluation, and the challenges in peer-reviewed publications that meet the characteristics of CASHRS. Analysis results identified current research trends, the knowledge gap, and future research opportunities in CASHRS.

Considering the increasing rate of energy consumption and its environmental detrimental effects, as well as considering the use of non-renewable energy sources such as fossil fuels, energy management issues have become more important. Given the 40% share of the building industry's total energy consumption, as well as the 80% share of energy consumed during the operation period, attention to the areas of energy management and optimization during the operation period of the buildings can have a major impact on buildings’ energy performance. In this research, through identifying building energy management tools and studying previous studies and assessing the effects of building energy management systems, the economic and environmental impacts of using building energy management systems on the annual energy consumption in an office building in Tehran as a case study has been investigated. The results indicate a 32 percent reduction in energy consumption and a significant reduction in the release of the environmental pollutants in smart mode compared to the base mode. Moreover, considering the social costs associated with the emitted pollutants as well as the return period, it has been attempted to identify the factors contributing to the economic justification of using smart heating and cooling systems. According to the results, the use of smart energy management systems can be considered as an effective step in optimizing and managing energy consumption in the construction sector.

The focus of our study was the changes in the composition of semi-natural dry grasslands in Hungary. Since these valuable habitats were created with the help of humans, their preservation also requires regular treatment. Our mowing experiment aimed to investigate the suppression of the native Calamagrostis epigejos L. Roth. In Hungary, in the Cserhát Mountains, eight permanent plots were mowed twice a year. The vegetation was sampled annually between 2001 and 2011. The effects of mowing were investigated with repeated measures analysis of variance (ANOVA). After 10 years, the C. epigejos cover of the mowed plots decreased significantly, from the initial average of 62.38 to 7.50%. Surprisingly, we also experienced a similar decrease in the control plots. Regular treatment also had a positive effect on the number of species and diversity. Species richness increased continuously in both treatment types, which indicates the combined effect of vegetation succession and treatment. The biomass growth of other Poaceae and Fabaceae species, which are important from a grassland management perspective, was also facilitated by mowing. Our results suggest that long-term in situ experiments and continuous botanical studies are needed to establish a reliable utilization of grasslands.

Distribution System Operators (DSOs) are adapting to changing energy demands and the shift toward renewable and decentralized energy. Circularity is increasingly relevant for DSOs as their distribution systems age and need replacing. Taking circular action, however, is generally regarded as challenging as the current circular economy (CE) landscape is highly fragmented and rarely touches the implementation level. A longitudinal case study at Dutch DSO Liander on the circu-larity of distribution transformers was used to understand empirical success factors for taking circular action and to generate prescriptive knowledge on the operationalization of circularity. Six design propositions for circular action were formulated that suggest to 1) initiate small-scale cir-cularity experiments, 2) involve technical and strategic experts, 3) synergize circularity with more urgent, primary goals 4) translate circular initiatives bottom-up and top-down, 5) collaborate with other DSOs, and 6) create multidisciplinary teams. At DSO Liander, selecting the right interventions depending on the changing context contributed to operationalizing circularity for distribution transformers and achieving circularity targets. The generalizable design propositions could assist other DSOs in optimizing their strategy toward circular action.

Design changes seem inevitable in engineering, procurement and construction EPC projects. Such changes create a need for a proactive approach to adjusting project scope, cost and time (the triple constraints) for efficiency and effectiveness in overall delivery. This study investigates the causes and implications of design changes in order to improve design change management practices. Data for the study was obtained through online interviews with New Zealand industry practitioners. Thematic analysis was used to collate the results into meaningful data. The study found that design changes were predominantly caused by clients' inadequate strategic planning, insufficient attention to design, EPC contractors' inadequate design ability, and on-site variations. There were three categories of such design changes: direct impact on the project, the reciprocal and complementary effect on stakeholders, and the far-reaching impact on the community. The study concludes by suggesting improvements, such as strengthening the integration of project teams to enhance design quality, strategic alignment of stakeholders at the planning stage, early contractor involvement (ECI) between the planning and design phases, and improving collaboration between design and construction teams. Further, a combination of high technical skills (e.g. design ability) and soft skills (can-do attitude, interpersonal skills, problem-solving skills, documentation skills, etc.) are needed to effect the desired improvement in design change management.

This study is a two-phase hybrid study on the behavioral activities of undergraduate students during the COVID-19 pandemic lockdown. A questionnaire survey of students during the whole school period and a semistructured interviews with 13 undergraduates of different majors were conducted. First, we found that compared with primary and secondary school students, undergraduates showed many problems with self-time management. Second, the behavior of undergraduates at home may result from multiple factors, such as past experience, professional identity and behavioral habits. When secondary school provided a relatively relaxed learning environment or secondary school teachers placed more emphasis on continuous effort, and when students had a strong sense of the social value of their undergraduate major, students worked harder and achieved more during the pandemic. Otherwise, it was easier for students to slack off and be passive during the pandemic. Altogether, this study deepens our understanding of undergraduates' self-management of free time, and the differences in the values underlying different behaviors and the formation process of various behaviors.

Big data analytics tools are the use of advanced analytic techniques targeting large and diverse volumes of data that include structured, semi-structured, and unstructured data from different sources and in different sizes from terabytes to zetabytes. The health sector is faced with the need to generate and manage large data sets from various health systems, such as electronic health records and clinical decision support systems. This data can be used by providers, clinicians, and policymakers to plan and implement interventions, detect disease more quickly, predict outcomes, and personalize care delivery. However, little attention is paid to the connection between big data analytics tools and the health sector. Thus, a systematic review of the bibliometric literature (LRSB) was developed to study how the adoption of big data analytics tools and infrastructures will revolutionize the healthcare industry. The review integrated 77 scientific and/or academic documents indexed in SCOPUS presenting up‐to‐date knowledge on current insights on how big data analytics technologies influence the healthcare sector and the different big data analytical tools used. The LRSB provides findings related to the impact of Big Data analytics on the health sector by introducing opportunities and technologies that provide practical solutions to various challenges.

Business-to-business (B2B) manufacturing companies are increasingly confronted with transformative trends such as sustainability, digitalization, and servitization. These trends are changing how product portfolios are developed, and value contributions are assessed, and therefore have disruptive potential. Dealing with these disruptive factors in Product Portfolio Management (PPM) is a largely unexplored topic. This study presents an empirical-qualitative exploration that contributes significantly to the field. The aim is to clarify the extent to which disruptive factors influence the evaluation and shaping of the product portfolio in B2B manufacturing companies. The Gioia method was used to evaluate 21 semi-structured interviews with experts from leading B2B manufacturing companies. Eight overarching challenges in PPM resulting from the disruptive factors were identified. Based on the eight overarching challenges and their associated causal relationships, two aggregated dimensions of action were derived: (1) increasing speed and flexibility by using generative artificial intelligence (AI) in a defined PPM process and (2) adjusting the product portfolio evaluation to consider various strategic drivers. These two dimensions of action call for future research to overcome the disruptive factors in PPM.

Background: Covid-19 patients with any pre-existing cardio-vascular disease (CVD) are at highest risk for viral infection and for developing of severe disease. Pathophysiological mechanism is characterized by the viral link to Angioten-sin-Converting Enzyme 2 (ACE2) and the involvement of the endothelial system with the release of cytokines and direct damage on myocardium, micro throm-bosis, and alterations of oxygen diffusion. Aim of the study is to analyze clinical course, treatment and outcome in patients (gender stratified) with pre-existing CVD. Methods: Out of the 1299 (700 M/599 F) patients admitted to Internal Medicine COVID Unit of “Castelli Hospital”, Lazio, Italy, from 01/01/2021 to 31/12/2021, 278 patients (167 M/111 F), mean age 76 (76 M/ 75 F) had previous CVD. Demographic characteristics, length of the stay (LOS) and oxygen therapy were evaluated. Results: Most common CVD pathologies were Hearth Failure (HF): 131 (72 M/59 F), Atrial Fibrillation (AF): 45 (25 M/20 F), Myocardial Infarction (MI): 26 (19 M/7 F) and associations among them. 100% of CVD COVID patients under-went Non-Invasive Ventilation (NIV) and were treated with more than 5 drugs. HF was linked with increased LOS (23 days) compared to AF (21 days), MI (18 days) and no CVD (16 days). Overall mean LOS was 16,5 days. 21,4% of total pa-tients had CVD. Conclusions: Timely identification and evaluation of patients with pre-existing CVD are fundamental for adequate treatment based on gender, severity and state of illness and for risk reduction. Keywords: polypharmacy, gender medicine; COVID 19; Sars CoV 2; cardiovas-cular disease.

Type 1 Diabetes mellitus (T1DM) occurs when insulin is not produced in the Pancreas due to the autoimmune destruction of the beta cells. The patients may be diagnosed after 80-90% of the beta cells are destroyed. Insulin remains the essential medicine in T1DM management, under continuous monitoring of glucose levels. T1DM management consists of a complex and precise set of self-care measures for the entire life; during this continuous process, the patients could become overwhelmed, angry, anxious, frustrated, and/or discouraged. Therefore, to be widely used and provide general benefits, new technologies for DM management must provide clinical advantages without compromising safety. The compliance of T1DM patients is also essential, thus improving their quality of life (QoL). Moreover, the accessibility of the new system for patients through healthcare coverage is critical; they must be able to buy the new devices and accessories and pay for their maintenance. In this context, our work aims to describe the most recent technologies regarding continuous glucose monitors (CGMs) and continuous subcutaneous insulin infusion (CSII) systems, correlated with psychosocial impact and capacity to improve T1DM patients' life quality.

The 2030 global agenda of the United Nations emphasizes peace, human rights, gender equality, partnership, and women's empowerment. It balances the social, economic, and environmental dimensions of sustainable development. The SDG framework was designed to be integrated and indivisible, making the interconnections of 17 Goals and 169 Sustainable Development Goals Targets (SDTs) more complex that need extensive and intensive investigative research. Recent studies have increased on the interrelationships of SDGs, but none of these have focused on integrating Climate Change (CC), Sustainable Forest Management (SFM), and Information and Communication Technology (ICT), also known as CSI Nexus. This study aims to investigate and identify the 169 SDTs linked to CC, SFM, and ICT and assesses the significance of the relationships between these variables. The alignment of SDTs to CSI Nexus was identified through clustering and mapping techniques. The result argued that 56 SDTs are directly connected within CC+SFM+ICT, 16 within CC+SFM, one within SFM+ICT, and 51 within ICT+CC. Our result suggests that CC is significantly associated with SFM; however, ICT has no significant association with CC and SFM. It further asserts that the ICT and SFM have minimal influence on the SDG 2030 framework. The proposed CSI Nexus and SDTs Integration Framework was a science-informed guide for priority-setting, policy coherence, and decision-making supporting the 2030 Sustainable Development Goals. This study does not include interactions, network analysis and visualization, simulations, and modeling between SDG targets.

Risk assessment management have been a hot topic for the researchers since a very long time. Software risk management is an important part of project management as it contains the identification, analysis, estimation and monitoring of different risks present in the system. This helps developers in decision making while assessing the problems that could arise in the software systems. Risk management is very complex in large scale system as these systems have very complex development. The paper describes risk management techniques for large scale system. Furthermore we have provided a detailed comparative analysis of these techniques with commonly identified risks in software systems and have provided a systematic order for risk management process to ensure risk mitigation.

Purpose: This study's objective was to examine international research trends in behavior management that had been written about in journals that were indexed by Scopus and authored by scientists from all around the world.Patients and methods: We examined publications in the Scopus database using bibliometric and content analysis. We only retrieved English-language articles. The VOSviewer program was used for content analysisResults: We found 808 papers on behavior management during the previous 50 years by following the study strategy. The study concentrated more on authors, nations, institutions, journals, documents, and keywords, as well as the annual scientific production (classification by subject area and document type)Conclusion: The finding prompts a discussion regarding behavior management for next research.

The current article examined stoma self-care and health-related quality of life in patients with drainage enterostomy, describe clinical and sociodemographic variables and analyze the relations between all of them. Trained interviewers collected data using a standardized form that queried sociodemographic and clinical variables, collected from the electronic medical record, in addition to the Specific Self-Care for Ostomized Patients Questionnaire (CAESPO) and Stoma Quality of life (S-QoL) from January 2016 to January 2017. This was a multicenter, cross sectional study conducted in four hospitals of the province of Castellon (Spain) where 120 participants were studied. Significant differences were found in Self Care according to sex (p = .043); married participants show higher score (p < .01); also, significant differences according to work activity were observed (p < .01). Regarding the clinical variables, differences were observed according to the autonomy of care, the presence of complications in the stoma, the use of irrigation and the type of effluent (p < .01). We can highlight the importance of the skills related to self-care by ostomized patients has for a good level of quality of life related to health. In this learning process, the figure of the stoma therapist plays a very important role.

Background: This study consists of a brief psychological intervention, which uses the Self-Regulation Therapy (SRT, procedure based on suggestion and classical conditioning), to improve coping with stress and emotionality by reproducing the positive effects of illegal drugs: cannabis, cocaine, ecstasy. Method: 15 volunteers (8 males, 7 females), with a mean age of 24.67 (SD = 4.43), underwent intervention to improve their coping with stress and emotionality using SRT. They carried out pre- and post-intervention scores for 10 days and during a 4-week fol-low-up. The employed instruments were: COPE (Coping Skills Inventory) and PNAS (Positive and Negative Affect Schedule). Results: SRT was superior to non-intervention for the 4 coping strategies (2= .829, .453, .411 and .606) and for positive (2= .371) and negative emotionality (2= .419). An improvement in scores was evidenced in the follow-up scores compared to the pre-intervention measures. Conclusions: This study shows for the first time that it is possible to use illegal drugs, considered harmful to public health, to improve young people’s coping capacity and emotionality by reproducing their positive effects with SRT.

In the face of escalating climate concerns and the push for sustainable development, the global shift towards renewable and decentralized energy systems presents new challenges and opportunities. This study investigates integrating decentralized energy production, particularly photovoltaic (PV) systems, into national energy planning, aiming to optimize energy strategies that balance local production and consumption with national objectives. By analyzing the Swiss energy model, the research employs the EnergyScope and REHO models to assess the strategic implications of decentralized versus centralized energy systems. Results show that a decentralized approach can significantly reduce PV installation needs to 35 GW, about 23% of potential capacity, and decrease annual system costs by 10% to CHF 1230 per capita. This strategy emphasizes local consumption, minimizes grid reinforcement demands, and leverages economic advantages while addressing overproduction challenges through effective energy storage and grid management. Conclusions underline the strategic value of combining centralized and decentralized methods for resilient and sustainable energy planning. The study contributes to the discourse on energy policy and infrastructure planning, advocating for a hybrid model that accommodates both local conditions and broader energy objectives, urging further research into climate impacts and technology integration for a comprehensive energy future.

The COVID-19 pandemic has put a lot of pressure on health systems worldwide. Mass vaccination against SARS-CoV-2 has reduced morbidity and mortality worldwide. Despite their safety profiles, vaccines like any other medical product can cause adverse events. Yet, in countries with poor epidemiological surveillance and monitoring systems, reporting vaccine-related adverse events is scarce. The objective of this study was to describe self-reported vaccine adverse events after receiving one of the available COVID-19 vaccine schemes in Ecuador. A cross-sectional analysis based on an online self-reporting 32-questionnaire was conducted in Ecuador from April 1st to July 15th, 2021. Participants were invited by social media, radio, and TV to voluntarily participate in our study. A total of 6,654 participants were included in this study. A 38.2% of the participants reported having at least one comorbidity. Patients received AstraZeneca, Pfizer, and Sinovac vaccines, and these were distributed 38.4%, 31.1%, and 30.5%, respectively. Pain, inflammation at the injection site (20,01%), and headache (16,91%) were the most reported adverse events. Women addressed ESAVIs (64%), more often than men (36%). After receiving the first dose of any available COVID-19 vaccine, a total of 19,481 self-reported ESAVIs were informed (86.9% were mild, 11.6% moderate and 1.5% severe). In terms of vaccine type and brand, the most reactogenic vaccine was AstraZeneca with 57.8%, followed by Pfizer (24.9%) and Sinovac (17, 3 %). After the second dose, 6,757 self-reported ESAVIs were reported (87.0% mild, 10.9% moderate, and 2.1% severe). AstraZeneca vaccine users reported a higher proportion of ESAVIs (72.2%) in comparison to Pfizer/BioNTech (15.9%) and Sinovac Vaccine (11.9%). Swelling at the injection site, headache, muscle pain, and fatigue were the most common ESAVIs for the first as well as second dose. In conclusion, most ESAVIs were mild. AstraZeneca users were more likely to report adverse events. Participants without a history of COVID-19 infection, as well as those who receive the first dose, were more prone to report ESAVIs.

Peru has one of the highest informal employment rates in Latin America (73%). Previous studies have shown higher prevalence of poor self-perceived health (P-SPH) in informal workers compared to formal. The study’s aim is to analyse the role of working conditions in the association between informality and SPH in urban working population in Peru. We conducted a cross-sectional study based on 3098 workers from the working conditions survey of Peru 2017. Prevalence of P-SPH and exposure to poor working conditions were calculated separated by formal and informal employment and stratified by sex. Poisson regression models were used to assess the association between P-SPH and informal employment, with its prevalence ratios (PR) crude and adjusted for working conditions. Informal employment was 76% in women and 66% in men. Informal workers were more exposed to poor working conditions than formals and reported worse SPH. Workers in informal employment showed higher risk of P-SPH than formals: PR 1.38 [95% CI: 1.16 – 1.64] in women and PR 1.27 [95% CI: 1.08 – 1.49] in men. Adjustment by working conditions weakened the association in both sexes. In women, this association was only partially explained by worse working conditions 1.23 [95% CI: 1.04 – 1.46]. The negative effect on informal workers’ health is partially explained by poor working conditions. However, there is a part of the effect explained by informality per se.

Livestock management is challenging for resource-poor (R-P) farmers due to unavailability of quality feed, limited professional advice and rumor-spreading about animal health condition in a herd. This research seeks to improve animal health in southern Africa by promoting sericea lespedeza (Lespedeza cuneata), a nutraceutical fodder legume. An automated geospatial model for precision agriculture (PA) can identify suitable locations for its cultivation. Additionally, a novel approach of radio frequency identifier (RFID) supported telemetry technology can track animal movement, and the analyses of data using artificial intelligence can determine sickness of small ruminants. This RFID-based system is being connected to a smartphone app (under construction) to alert farmers of potential livestock health issues in real-time so they can take immediate corrective measures. An accompanying Decision Support System (DSS) site is being developed for R-P farmers to obtain all possible support on livestock production, including the designed PA and RFID-based DSS.

Many relevant health social actors have voiced concerns about the danger of self-medication in times of growing use of over-the-counter medicines and, in some contexts, unregulated selling of them. Previous research has examined the incidence of parental self-medication as well as the use and abuse of antibiotics without professional advice. However, these studies have limited evidence on the role of family doctors and the perceived severity of self-medication in the case of parents. Based on Health Belief Model, our research tested the effects of exposure to medical information on the perceived level of self-treating the children without medical advice. Specifically, we aimed to assess whether exposure to information warning about the risks of treating children without a medical prescription influences parents' attitudes toward administering medicines to their children without medical advice. The results showed that our respondents evaluated the practices of self-medication negatively, especially when it came to treating their children without medical advice. However, their attitudes towards self-medication varied depending on their beliefs about administering certain medications. Additionally, the results showed that the perceived level of satisfaction with the family physician could be a significant factor in controlling and avoiding the treatment of children without professional advice.

The Ministry of Health evaluates hospital management in accordance with the standard of quality of service. The concept of Shariah hospitals offers management services that exceed the standard of quality of hospital care. The study aims to illustrate the concept of Shariah hospitals in Indonesia. We collect related literature from various media via online search with the keywords “Shariah hospitals,” “implementation of Shariah hospitals,” and “application of Shariah hospitals.” Main findings: The study finds that the Shariah hospitals built by the philosophy of Islam are willing to provide the best health-care services to patients. A code of conduct must be fulfilled by the hospital management in Shariah hospitals: (1) general liability, (2) obligations to society and the environment, (3) obligations to patients, (4) obligations to the leaders, staff, and employees, and (4) relationships with related institutions. The foremost challenges include the improvement of health personnel performance and the quality of services in addition to perceptions that are not inclusive of the system of Shariah hospitals. This implementation should run consistently and with the commitment of all parties. Such insight, in turn, can be counted as an input to an approach to health services, particularly in increasing the performance rates, such as hospital. This study is the first to provide new insight into discussion about shariah hospital by presenting its focuses on Islamic approaches in meeting the quality standards of health services in hospitals so as to obtain more value. However, exclusive principles—Islamization, heterogeneity, and the performance of health workers—challenge the implementation of this hospital system.

The aim of the present cross-sectional study was to analyze the differential impact of the first COVID-19 lockdown (3rd April 2020) on stress, health practices, and self-care activities across different Hispanic countries, age range and gender groups. 1082 participants from Spain, Chile, Colombia, and Ecuador took part in this study. Irrespective of the country, and controlling for income level, young people, especially females, suffered a greater level of stress, perceived the situation as more severe, showed less adherence to health guidelines and reported lower levels of health consciousness, in comparison to their male peers and older groups. However, in the case of self-care, it seems that older and female groups are generally more involved in self-care activities and adopt more healthy daily routines. These results are mostly similar between Colombia, Ecuador, and Spain. However, Chile showed some different tendencies, as males reported higher levels of healthy daily routines and better adherence to health guidelines compared to females and people over the age of 60. Differences between countries, genders and age ranges should be considered in order to improve health recommendations and adherence to guidelines. It would also be crucial to identify vulnerable groups to promote the adoption of health behaviors that may help in the development of effective public health strategies. Future studies should be addressed to explore the possible causations of such differences in more cultural-distant samples and at later stages of the current outbreak.

Introduction: The academic landscape is increasingly recognizing the complex interplay of personal and professional responsibilities on scholarly productivity. For women scholars, particularly those with significant parenting duties, this balance is even more precarious. This study aims to explore how family responsibilities, personal vulnerabilities, and motivational theories such as Imposter Syndrome and Self-Determination Theory (SDT) influence the motivation to publish scholarly work. Understanding these dynamics is crucial for developing supportive mechanisms that can enhance academic productivity and personal fulfilment. Methods: Utilizing a Qualitative Evidence Synthesis (QES) framework, this study will systematically review and synthesize qualitative research on women scholars' experiences in academia, focusing on the challenges and motivators related to publishing. Data sources will include academic databases, grey literature, and first-hand narratives. Thematic analysis will be employed to identify key themes and patterns across the collected data. Results/Findings: Preliminary findings suggest that the dual demands of parenting—especially in extreme cases such as assuming responsibility for seven children—and academic work significantly impact women scholars' publishing activities. Personal vulnerabilities, including imposter syndrome and low self-efficacy, further exacerbate these challenges. However, the data also highlight resilience strategies and the potential for intrinsic and extrinsic motivational factors to mitigate these effects. Discussion: The study underscores the nuanced impact of familial and personal factors on academic motivation. The preliminary findings suggest that addressing imposter syndrome and enhancing self-determination could be pivotal in supporting women scholars. The role of institutional policies and academic culture in either exacerbating or alleviating these challenges is also discussed. Significance: By elucidating the specific challenges and motivators for women scholars in publishing, this study will contribute to the development of targeted interventions and policies that support work-life integration and promote academic productivity. The insights that will be gained could inform mentorship programs, institutional support systems, and policy reforms aimed at fostering a more inclusive and supportive academic environment.

Background: The adoption of self-care behaviors among patients with arterial hypertension (AH) plays an important role in the management of their health condition. However, a lack of scales assessing self-care is observed. We aimed to develop and validate the Hippocratic hypertension self-care scale. Methods: From a pool of questions derived from a literature review, 18 items were included in the scale and reviewed by a committee of experts. Participants indicate the frequency at which they follow the self-behavior prescribed in each statement on a five-point Likert scale. Data were collected between April 2019 and December 2019. Re-sults: 202 consecutive adult patients with AH were enrolled in the study. The internal consistency of the scale was found to be 0.807, using Cronbach’s alpha coefficient. An exploratory factor analysis identified two do-mains that accounted for 92.94% of the variance of the scale items; however, each sub-scale could not be used as an independent scale. Finally, the test- retest of the scale showed a significant strong correlation (r=0.0095, p<0.001). Conclusion: Our data indicate that the scale is a reliable and valid tool for assessing self-behaviors in patients with AH. Health professionals can use it in their clinical practice to improve the management of patients’ health condition.

The uniqueness of each system stems from the fact that the risks of disasters are specific and that their presence and manifestation are not universal and the same for every country. Just as no country is the same in all other segments, their disaster risk management systems are unequal. The paper describes the systems in four different countries, through observation and comparison of four areas of activity that are implemented in dealing with disasters. First of all, in the paper, the legal basis and institutional frameworks on which these systems rest in each of the countries were considered – starting from the international level and guidelines given at international conferences, to all by-laws and local disaster activity plans. It was considered how each of the states implements risk mitigation activities and how it increases preparedness for them. When the system recognizes risks, their probability and the frequency of their occurrence, activities are planned to prepare the country and every individual in it for a potentially unwanted event. Differences in the ways of mitigating risks and preparing all elements of the system and protected values for disasters are presented. The third element of action in the event of disasters concerns the response. In this segment, questions are raised regarding institutional solutions in the system, division of responsibilities, the priority of response and mobilization of resources at all levels. The last phase, the one that occurs after the disaster, and that is the recovery from it, depends on the reaction. In the paper, it was discussed how in the end, when a disaster occurs and when damage to the population, environment, material and other goods occurred, how each of the states implements reconstruction, i.e. how it recovers - whether that recovery was previously well planned or whether ad hoc solutions are applied.

It is known that breastfeeding difficulties are often seen in the first weeks of the postpartum period and that various factors are effective in the mother's early cessation of breastfeeding. Mothers' self-efficacy and perception of insufficient milk are among these factors. This study aimed to examine the effect of hot application applied to the breast with the help of Thera Pearl in the postpartum period on milk perception and postpartum breastfeeding self-efficacy. This is a randomized controlled study. The study was completed with a total of 64 puerperal mothers, 31 of whom were control and 33 were experimental. Personal Information Form, Breastfeeding Observation Form, Breastfeeding Self-Efficacy Scale and Insufficient Milk Perception Scale were used to collect data. As a result, self-efficacy and milk perception are important factors affecting breastfeeding. In this study, we found that Thera pearl application increased breastfeeding self-efficacy, but did not affect milk perception.

The enterprise software sector is experiencing a significant transformation driven by rapid technological progress and evolving business needs. An effective release management process is crucial for the solution providers and customers, as they incorporate the principles of Industry 4.0 and 5.0. With the growing dependence on software solutions and services, ensuring their quality, reliability, and security is highly necessary. The release management process incorporates strategic planning, regression testing, accurate deployment, and continuous monitoring of software updates. However, the rapid advancements in artificial intelligence (AI) and machine learning (ML) create a unique challenge to the release management process. The existing research needs to address the necessary adaptations for Industry 5.0, mainly in product-based software organizations, to the release management process without a change management system. After working with several software solution stakeholders, based on the responses from SaaS project stakeholders, we have presented a revised software release readiness workflow by incorporating a change management module. The preliminary result based on data over a limited period of time indicates that the revised workflow has the potential to improve the management of slippage, particularly by more effectively addressing NFR-related issues, thereby resulting in more predictable and reliable release cycles.

This study empirically analyzes the effectiveness of resource optimization utilizing artificial intelligence (AI) within cloud computing environments. It compares systems that have been transitioned from a Monolithic structure to Microservices Architecture (MSA) with those adopting a simple Rehost strategy, to validate the operational efficiency of two systems whose resource efficiency has been enhanced compared to traditional legacy systems. The research is based on systems that determined resource efficiency post-cloud migration using APM tools. It points out the limitations of traditional heuristic operation methods in resource optimization, which lead to issues such as application performance degradation, resource over-allocation, and increased operational costs. This study aims to overcome the conventional resource optimization standards that depended on the average peak usage of CPU and memory infrastructure, by introducing AI-based optimization tools, and applying on-premise standards to cloud and container environments to achieve resource optimization. The paper emphasizes the importance of resource optimization through AI-based automation tools, exploring the possibilities of resolving real-world application performance issues in cloud environments, reducing unnecessary resource usage costs, and cutting down on labor risks and operational expenses. Through this, it presents strategic directions on how AI technology can offer financial and operational advantages in managing cloud resources.

In 2015, the Self-Action Leadership Theory—a qualitative, nomological expansion of self-leadership theory rooted in atmospheric and astronomical metaphor aimed at expanding the personal freedom of individuals, organizations, and nations by bolstering the existential growth of individuals through a series of Maslow-esque stages of holistic, personal development. This article introduces an accompanying, practitioner-based Model of Self-Action Leadership (SAL) aimed at the implicit enhancement of a holistic range of administrative processes through explicit training, mentoring, and coaching in the model’s general and universally-applicable principles and practices. The SAL model produces an original construct of personal leadership practice that builds upon the extant self-leadership academic canon, which dates back to 1983 (Manz, 1983). It also provides an analogue to four of the five core processes of Project Management by positioning a self-action leader (an individual) as the ongoing “project” at hand. The SAL Model is rooted in action research and was developed through a variety of self-oriented, action research projects in conjunction with a comprehensive, qualitative, analytical autoethnographic study of a scholar’s life experiences.

Climate change affects water resources through the decrease of rainfall and the increase in temperatures and evapotranspiration. An indirect impact of climate change is also the increase of water uses by human activities. In this review, 320 papers were retrieved, of which 134 spanning five continents impacts and solutions to be used to better understand the effects of climate change on water resources, ecosystems, human health, security and socio-economic aspects were selected. Here, suggestions and proposals by scientists from around the world towards solutions, tips and ideas to deal with climate change and the best solutions for future water management were presented. The main solutions highlighted concern integrated water resources management, political direction, policies, increase in knowledge and new technologies. Furthermore, most of the papers analyzed underline that water resources management needs to incorporate protection and restoration of ecosystems and their services. Nature-based solutions need to be the starting point of new scientific and innovative ways to deal with climate change and towards future climate adaptation. In this complex evolution of the water resource, where is the management of the water resource in Italy going?

During the last 20 years, with the development of Information and Communication Technologies (ICTs), an emerging interest has appeared in Digital Community Engagement (DCE) in the process of cultural heritage management. Due to a growing need to involve a broader community in the Historic Urban Landscape approach, social media are considered one of the most important platforms to promote the public participation process of urban heritage conservation in the context of rapid urbanization. Despite the growing literature on DCE, which has delivered a general overview of different digital technologies and platforms to enhance heritage conservation, little research has been done on taking stock of the utilization of social media in this process. This study aims to fill the research gap by providing a more comprehensive picture of the functionalities of social media platforms and impacts on sustainable urban development through a systematic literature review. As a result, 19 out of 248 DCE relevant articles are selected as objects to illustrate the contribution of social media. The study identified the characteristics of these applied social media tools, explores their roles and influences in cases. The article concludes with directions for further research.

Background: Indonesia is an archipelago with various cultured, will bee affects all aspects of people's lives, including beliefs related to health behavior and health care. One problem that needs serious attention is the elderly group because the elderly are a vulnerable group who have a high risk of experiencing health problems, such as anemia with hypertension, so they need good care management. The research objective was to determine self-management intervention for hypertensive elderly. Methods: This research is a literature review with five databases (Scopus, CINAHL, ScienceDirect, PubMed, Proquest), the study design used is an experimental, descriptive, cross-sectional, and review systematic, in March 2021. Guidelines for using JBI to measure quality and listing check out Prisma in this review guide. A feasibility study based on title, abstract, full text, and research methodology. The data analysis used narrative analysis based on the research findings. Results: Twelve articles met the predefined review inclusion criteria. The study found eight interventions for self-management in elderly hypertension, namely: 1) Knowledge of hypertension, 2) Regulation of physical activity, 3) Limitation of alcohol and cigarette consumption, 4) Sleep rest and stress management, 5) Diet and body weight management, 6) Blood pressure control, 7) Family and social support, 8) Adherence to therapy regimens. Conclusion: The conclusion of the study results obtained eight elderly self-management interventions, this done properly will affect compliance in optimizing the health of the elderly.

Background: A growing number of clinical practice guidelines (CPGs) with regards to non-pharmacological interventions for breast cancer survivors are available. However, given the limitations in guideline development methodologies and inconsistency of recommendations, it remains uncertain how best to design and implement such non-pharmacological strategies to tailor interventions for breast cancer survivors with varied health conditions, healthcare needs, and preferences. Aim: To critically appraise and summarise available non-pharmacological interventions for symptom management and health promotion that can be self-managed by breast cancer survivors based on the recommendations of the CPGs. Methods: Clinical practice guidelines which were published between January 2016 and September 2021 and described non-pharmacological interventions for breast cancer survivors were systematically searched in six electronic databases, nine relevant guideline databases, and five cancer care society websites. The quality of the included CPGs was assessed by four evaluators using the Appraisal of Guidelines for REsearch and Evaluation, second edition tool. Content analysis was conducted to synthesise the characteristics of the non-pharmacological interventions that were recommended by the included CPGs, such as the intervention’s form, duration and frequency, level of evidence, grade of recommendation, and source of evidence. Results: Fourteen CPGs were identified and analysed. Of the 14 CPGs appraised, only five were rated as high quality. The domain with the highest standardised percentage was “scope and purpose” (84.61%), while the “applicability” domain had the lowest standardised percentage (51.04%). Five guidelines were assessed as “recommended”, seven were rated as “recommended with modifications”, and the remaining two were considered “not recommended”. Regarding the content analysis, physical activity/exercise, meditation, hypnosis, yoga, music therapy, stress management, relaxation, massage, and acupressure were the common self-managed non-pharmacological interventions recommended by the 14 CPGs. Physical activity/exercise was the only self-managed non-pharmacological intervention that was mostly recommended for psychological and physical symptom management by the included CPGs. However, there were significant disparities in terms of level of evidence and grade of recommendation in the included CPGs. Conclusion: The recommendations for the self-managed non-pharmacological interventions were varied and limited among the 14 CPGs, and some were based on medium- and low-quality evidence. More rigorous methods are required to develop high-quality CPGs in order to guide clinicians in offering high-quality and tailored breast cancer survivorship care.

BackgroundGood management behavior in patients with diabetes mellitus can reduce disease complications and improve quality of life. This philosophical problem is very important for nurses who are able to provide management care for diabetic patients. The purpose of this literature review is to describe the concept, model or theory that can be used in improving the management of diabetes mellitus patients.MethodsThe method used is by searching several studies published through the Scopus database, PubMed, CINAHL, SpingerLink, and web of science (WOS). The search strategy uses a combination of the terms MeSH Terms. The research questions were designed using the principles of the PICOS framework. Selected studies were published from 2017-2022.ResultsA total of 15 studies were included, with 12 using quantitative methodology and 3 were qualitative. The studies were conducted across various countries. The majority of articles used the concept of self-management intervention based on digital-based development and e-health (n=6), Dorothea Orem's self-care deficit nursing theory n=2) and the transtheoretical model (n=2). These concepts, models and theories are able to improve good self-management through lifestyle changes, psychosocial, cultural acculturation and increase in spiritual values (n=6).ConclusionTransitional change focuses on changing the modifiable factors found in the concepts, models and theories of the articles obtained. Future research can be developed to assess the existence of elaborations and modifications based on the philosophy that people with diabetes are responsible for their own health.

Health self-tracking is an ongoing trend as software and hardware evolve, making the collection of personal data not only fun for users but also increasingly interesting for public health research. In a quantitative approach we studied German health self-trackers (N=919) for differences in their data disclosure behavior by comparing data showing and sharing behavior among peers and their willingness to donate data to research. In addition, we examined user characteristics that may positively influence willingness to make the self-tracked data available to research and propose a framework for structuring research related to self-measurement. Results show that users' willingness to disclose data as a "donation" more than doubled compared to their "sharing" behavior (willingness to donate= 4.5/10; sharing frequency= 2.09/10). Younger men (up to 34 years), who record their vital signs daily, are less concerned about privacy, regularly donate money, and share their data with third parties because they want to receive feedback, are most likely to donate data to research and are thus a promising target audience for health data donation appeals. The paper adds to qualitative accounts of self-tracking but also engages with discussions around data sharing and privacy.

The compelling effects of climate change on forests may have been underestimated in the past few decades in practical forestry. Although the first attempts to draw attention to this complex problem appeared almost half a century ago, the debate has been conceptual rather than experimental and applicative. At first glance, the con-cerns were mainly related to sustainable forest management (SFM) issues, which obviously needed attention. Over time, the effects of climate change have been mainly considered in the context of the SFM; they started from various and somewhat different scales and goals. Over time, more research and awareness of the im-portance of SFM under the pressure of climate change have led to the development of a clearer field that can be defined as ‘adaptive forest management’ - to climate change. One of the characteristics of this discipline is to be featured by the absence of univocal methods and / or objectives to be pursued but to identify, verify, and adapt methods to the various climatic and forest types and conditions found in the field. Therefore, this work shows some phases of forest planning and management concepts and criteria over time and recalls some innovative and / or adaptive methods related to the approach to forest planning and management under climate change

Tinnitus is an auditory phantom perception in the ears or head in the absence of a corresponding external stimulus. There is currently no effective treatment available that reliably reduces tinnitus. Educative counseling is a treatment approach that aims to educate patients and inform them about possible coping strategies. For this feasability study, we implemented educational material and self-help advice in a smartphone app. Participants used the educational smartphone unsupervised during their daily routine over a period of 4 months. Comparing the tinnitus outcome measures before and after smartphone-guided treatment, we measured changes in the tinnitus-related distress, but not in tinnitus loudness. Improvements on the Tinnitus Severity numeric rating scale reached an effect size of .408, while the improvements on the THI were much smaller with an effect size of .168. Analysis on the user behavior showed that frequent and intensive use of the app is a crucial factor for treatment success: participants that used the app more often and interacted with the app intensively, reported a stronger improvement of the tinnitus. Between study allocation and final assessment, 26 of 52 participants dropped out of the study. Reasons for the dropouts and lessons for future studies are discussed in this paper.

In August 4 2011, United Nations Environmental Program (UNEP) submitted an unprecedented, scientific, groundbreaking Environmental Assessment Report (EAR) of Ogoniland, to the Nigerian government. This was the outcome of a 14–month intensive evaluation of the extent of pollution. It was intended that UNEP’s recommendations would be implemented to restore the devastated environment, on the one hand, and on the other, counteract the numerous environmental health issues that have for decades, plagued Ogoniland. However, five years post EAR, and, despite the seriousness of the situation, no significant resolution has occurred, both on the part of the government, and on the part of Shell Petroleum Development Company (SPDC) or Shell. To date, millions of Niger Delta residents, particularly those living in the oil-bearing communities, continue to suffer severe consequences. Although, the assessment was conducted in Ogoniland, other communities in the Niger Delta are also affected. This article explores prevailing issues, using Ogoniland (a microcosm of the Niger Delta) as an example. A multidisciplinary approach for sustainable mitigation of environmental health risks in the Niger Delta is paramount, and Environmental Management tools offer valuable strategies. Adopting UNEP’s recommendations for addressing environmental health problems requires implementing the Environmental Management/Environmental Management System (EM/EMS) model.

The restrictions imposed by the Covid-19 pandemic left many older adults isolated and confined. Under active aging theory, self-management is crucial for well-being among older adults coping with aging. The current study examines how (a) initial self-management, and (b) changes in self-management due to independent physical training, affect psychological outcomes in a sample of care home residents following outbreak of the pandemic. 64 older adults (53 females, 11 males), mean age is 82.23, reported on their self-management abilities, then embarked on six months of training in chair exercises (one session per week). The training exercises were halted after 22 sessions due to the pandemic, but some residents continued to practice independently. Eight weeks after the outbreak of the pandemic, residents who had continued to practice at least once per week (n = 35) and those who had not continued to practice (n = 29) were questioned again about their self-management, and about five psychological outcomes: anxiety, traumatic stress, satis-faction, general mood, and post-traumatic growth (PTG). Self-management improved among older adults who independently practiced the exercises, and declined among those who did not. Pre-pandemic self-management significantly predicted post-outbreak traumatic stress symptoms, anxiety, general mood, and satisfaction with life, but not PTG. However, the difference in self-management between the pre-pandemic and post-outbreak measures was associated with PTG, and made a unique contribution to prediction of the other effects. Self-management abilities among older adults can be seen as a protective factor against adverse psychological outcomes at times of trauma. Further, the improvement in self-management among older adults who independently practiced physical excises made a unique contribution beyond initial self-management abilities.

Effective solid waste management is crucial for protecting public health and the environment. Global concentration on finding sustainable methods of handling waste continue to top the list of most governmental-related project checklists. This paper provides a case study on the management of municipal solid waste in the cities of Karlsruhe, Germany and Navrongo, Ghana as developed and developing countries respectively. This study aimed at comparing and drawing lessons from how these two different cities manage their solid waste. The waste management system in Karlsruhe prioritizes waste separation, recycling, and a pay-as-you-throw system has led to an efficient and sustainable waste management system that minimizes waste and protects the environment. Karlshrue's adoption of a continual developmental plan structure focused on integrated WM concepts is credited with safeguarding the long-term viability of waste management in the city. In contrast, Navrongo's waste management system faces several challenges, including inadequate resources and infrastructure, traditional waste disposal practices, and the lack of well-planned waste management strategies. To improve effective solid waste management systems in Ghana, a collaborative approach involving the government, local organizations, and the community is necessary. This can include investing in infrastructure, implementing waste separation and recycling programs, and educating the public on the benefits of sustainable waste management practices. Learning from successful models like Karlsruhe can help accelerate the development of sustainable waste management practices in Ghana, and ultimately protect public health and the environment.

A disaster wrecks those affected. It spares many in the affected areas, yet those spared may be indirectly impacted. Specific risks are often inherent within a social system or physical location, but they can also be created due to unavoidable natural or technological hazards. The consequences, however, can be similar in that they wreak havoc in communities and destroy economic systems. The analytical framework of deterrence and coping has ascertained beneficial in many circumstances, but a cost benefit calculation is a must to infer the feasibility of planning strategy and resource allocation. This study points to the Cost-Benefit Analysis (CBA) of flood management by District Disaster Management Kulgam. The assessment is established on secondary pooled data collected from administration offices, NGOs, published Journals, and local and national newspapers. It also characterised the strategy, the technique adopted, and the sources of flood damage cost information. The totalled benefits report for 78686.18 lakh of rupees, and that of total costs account for 2218.75lakh of rupees. The Benefit-Cost ratio greater than one (>1) indicates that Flood Management in District Kulgam was economically feasible and successfully governed. The State of Jammu and Kashmir put up with necessary prevention and administration measures to break the spell of devastation due to floods to significant status.

Chronic conditions like type 2 diabetes mellitus (T2DM), arterial hypertension (HTN), and obesity are major global health issues, causing significant morbidity and mortality. In Latin America, these conditions contribute to millions of premature deaths annually, posing challenges exacerbated by limited healthcare access and poor primary care quality, particularly in Mexico. Complementary medicine presents a potential solution, offering minimally invasive techniques to improve physical, mental, and spiritual well-being. Effective treatment adherence, crucial for positive outcomes, is influenced by self-efficacy, the ability to manage one's behavior in response to medical conditions. However, treatment adherence rates remain low, indicating a pressing public health concern. This study aimed to explore how perception of complementary medicine and treatment adherence predict self-efficacy among individuals with chronic conditions in Mexico. Analyzing data from 113 participants revealed significant correlations between variables, with treatment adherence positively associated with self-efficacy and perception of holistic medicine negatively correlated with self-efficacy. Regression analysis showed that incorporating perception of complementary medicine and treatment adherence significantly explained self-efficacy levels, suggesting the potential of complementary therapies in holistic healthcare approaches. However, collinearity between variables highlights the need for further research to better understand these relationships and their implications for improving healthcare outcomes in Mexico. Integrating complementary therapies with conventional treatments could enhance overall well-being and treatment adherence, offering promising avenues for addressing chronic conditions in the region. These findings underscore the importance of comprehensive healthcare approaches that integrate both conventional and complementary modalities to optimize health outcomes and quality of life for individuals with chronic conditions in Mexico and beyond.

Many clinical research datasets have a large percentage of missing values that directly impacts their usefulness in yielding high accuracy classifiers when used for training in supervised machine learning. While missing value imputation methods have been shown to work well with smaller percentages of missing values, their ability to impute sparse clinical research data can be problem specific. We previously attempted to learn quantitative guidelines for ordering cardiac magnetic resonance imaging during the evaluation for pediatric cardiomyopathy, but missing data significantly reduced our usable sample size. In this work, we sought to determine if increasing the usable sample size through imputation would allow us to learn better guidelines. We first review several machine learning methods for estimating missing data. Then, we apply four popular methods (mean imputation, decision tree, k-nearest neighbors, and self-organizing maps) to a clinical research dataset of pediatric patients undergoing evaluation for cardiomyopathy. Using Bayesian Rule Learning (BRL) to learn ruleset models, we compared the performance of imputation-augmented models versus unaugmented models. We found that all four imputation-augmented models performed similarly to unaugmented models. While imputation did not improve performance, it did provide evidence for the robustness of our learned models.

This article explores the relationship between metabolic syndrome and cardiovascular disease, providing a comprehensive overview of its risk factors and prevalence. Metabolic syndrome, characterized by a cluster of interconnected risk factors, significantly increases the likelihood of developing cardiovascular disease and type II diabetes. The study, conducted over a one-year period, involved 117 patients with ages between 30 to 79 years old. Various elements such as gender, age, education level, background, smoking, alcohol consumption, dietary aspects, physical activity, and their contribution in developing the metabolic syndrome, were analysed.Central adiposity and high blood pressure emerged as prominent elements of the condition. The findings underscore the importance of a healthy lifestyle in the prevention and management of metabolic syndrome. Encouraging regular physical activity, maintaining a balanced diet, rich in fresh vegetables and fruits, and avoiding harmful behaviours, such as smoking or alcohol consumption, are essential in reducing the risk of metabolic syndrome and its associated cardiovascular complications. The study highlights the need for public health initiatives, as well as individualized preventive strategies to combat the rising prevalence of metabolic syndrome. Through promoting awareness of its risk factors and implementing effective interventions, healthcare professionals can contribute to better cardiovascular health worldwide. Further research in this area will continue to enhance our understanding of the metabolic syndrome and refine preventive and therapeutic approaches for its management.

Aquaculture assumes a pivotal role in meeting the escalating global food demand, and shrimp farming, in particular, holds indispensable significance for the global economy and food security, providing a rich source of nutrients for human consumption. Nonetheless, the industry faces formidable challenges, primarily attributed to disease outbreaks, and the diminishing efficacy of conventional disease management approaches, such as antibiotic usage. Consequently, there is an urgent imperative to explore alternative strategies to ensure the sustainability of the industry. In this context, the burgeoning field of epigenetics emerges as a promising avenue for combating infectious diseases in shrimp aquaculture. Epigenetic modulations entail chemical alterations in DNA and proteins, orchestrating gene expression patterns without modifying the underlying DNA sequence by utilizing DNA methylation, histone modifications, and non-coding RNA molecules. Exploiting epigenetic mechanisms presents an opportunity to enhance immune gene expression and bolster disease resistance in shrimp, thus revolutionizing disease management strategies and optimizing shrimp health and productivity. Additionally, the concept of epigenetic inheritability in marine animals holds immense potential for the future of the shrimp farming industry. To this end, this comprehensive review thoroughly explores the dynamics of epigenetic modulations in shrimp aquaculture, with a particular emphasis on its pivotal role in disease management. It accentuates the significance of harnessing advantageous epigenetic changes to ensure the long-term viability of shrimp farming while deliberating on the potential consequences of these interventions. Overall, this appraisal highlights the promising trajectory of epigenetic applications, propelling the field toward strengthening sustainability in shrimp aquaculture.

The functioning of the parents’ emotional sphere is very important to a child’s mental and physical health. This study focused on investigating the association between mothers’ emotional intelligence (EI) and paediatric type I diabetes (T1DM) disease management in their children. We hypothesized that mothers’ EI is associated with T1DM outcomes. Mothers of children with T1DM aged 6-12 years were surveyed. One hundred and thirty-four mothers, the main caregivers of their diabetic children, provided measures of EI and completed a demographic questionnaire. The primary indicator of diabetes management was haemoglobin A1c (HbA1c; the main form of glycosylated haemoglobin). EI scales and subscales were associated with glycaemic management indices. Logistic regression analysis was applied for the assessment of the association between parents’ EI and their paediatric with T1DM disease management. The analysis demonstrated a statistically significant correlation between T1DM management and mothers’ ability to understand and control own emotions, to transform their own negative emotions into positive and to control own negative emotions. Mothers’ EI scales and subscales of understanding and regulating their own emotions, subscales of transforming their own negative emotions into positive ones and controlling their own negative emotions were statistically reliable predictors of glycaemic control in children with T1DM.

Self-healing is the capability of materials to repair themselves after damage has occurred, usually by interaction between molecules or chains. Physical and chemical processes are applied for the preparation of self-healing systems. There are different approaches for these systems such as heterogeneous systems, shape memory effects, hydrogen bonding or covalent-bond interaction, diffusion and flow dynamics. Self-healing mechanisms can occur in particular by heat and light exposure or by reconnection without direct effect. The applications of these systems display an increasing trend in both R&D and industry sectors. Moreover, self-healing systems and their energy storage applications are currently getting great importance. This review aims to provide general information on recent developments in self-healing materials and their energy applications in view of the critical importance of self-healing systems for lithium-ion batteries (LIBs). In the first part of the review, an introduction about self-healing mechanisms and design strategies of self-healing materials is given. Then, selected important healing materials in the literature for the anodes of LIBs are mentioned in the second part. The results and future perspectives are stated in the conclusion section.

Diabetes is one of the fastest spreading diseases of civilisation in the 21st century. The aim of the study was twofold: 1) to find differences in personality traits, self-esteem, body- esteem, and imagery between healthy women and women with diabetes 2) to check whether there are differences in analyzed factors in women with diabetes who participate in sports compared to women who do not. We used 3 questionnaires: Imagination: in sport - short form, Self-Esteem Scale (SES), and BFIS Personality, which were tested online. We found that women with diabetes were characterised by significantly higher neuroticism and lower extraversion and higher conscientiousness (marginally significant). We also found that women with diabetes who practice sport rated their bodies more highly in terms of sexual attractiveness and made better use of imagined affirmations than healthy women who were not active. Our study provides new insights into diabetics in terms of coping with the disease.

Systems biology has been established for more than a decade in the post-genomic era. With the help of the computational and mathematical tools, systems biology reconstitutes the entire scenario of the cell, tissue and even organism from the pieces data generated in the past decades. However, the modern biology is mainly focusing on the structure and function of the biomolecule, cell, tissue or organ, which are far from the essence of the life because of missing thermodynamic information. It is doubtable that the current systems biology-based omics is no-how to fully understand the dynamic courses of the structure, function and information in life. For this reason, we promote a novel concept of aquamoleculomics, in which the biological structure and function as well as thermodynamic characteristics and bioinformation of the aquamolecule complexes are included in this theoretical model of systems biology. Water is mother of life, matter and matrix of organism. Indeed, the fundamental roles of H₂O molecules in biological processes might be dramatically underestimated. Extremely speaking, H₂O networks in the living system might be engaged in all the biological processes including building all the biological structures, the residential places of the motherhood molecules as the honeycombs of honeybees.

A global approach towards quality management highlights the need for constructing a new body of knowledge that views the field of global quality from a systems perspective. Based on the results of field experiments, and in light of the need to develop new global quality management terminology, the current article presents several key concepts in this field, with emphasis on a systems-oriented rationale and perspective. As such, the article is an important stage in building this body of knowledge, and towards the conceptualization of key variables used in global quality management, from a systems approach that interacts with the fields of international management and strategic management.

Chronic liver diseases stimulate a degree of hepatocyte injury. This previously mentioned modifications, alters the known liver architecture and finally ends in cirrhosis. Liver pathology as cirrhosis develops after a long period of pathological alterations. The management of this liver pathology, is centred on the treatment of the causes and complications. Liver transplantation can be required in some cases. The aim of this article is to identify the best available evidences analyzing liver samples, normall and pathological. Normal liver with hepatocytes, Kiernann space, connective septa, observations using lens x10 and samples colored with Goldner Szekely trichrome stains. Beside, for comparisions, ill liver images, classic stain H&E. Inflammation is a great point that results in replacement of the healthy liver parenchyma with fibrotic tissue and regenerative nodules. In addition, progressive portal hypertension, systemic inflammation, and liver failure drive cirrhosis outcomes. All this previously mentioned factors, area great impact on the health-related quality of life of adult patients with liver cirrhosis. The management of this liver pathology, is centred on the treatment of the causes and complications. Liver transplantation can be required in some cases.

The global transport sector of the world economy contributes about 15% of the Greenhouse Gas (GHGs) emissions in the world today. The University of Saskatchewan has pursued the green energy transition over the years. They have spearheaded diverse sustainability projects and agendas, due to the importance of curbing climate change and advancing sustainability. The transport system in the university campus is one area of focus where the Sustainability Office plans to introduce some innovations, as a way of curbing GHG emissions while also advancing sustainability practice in the university campus. The study carried out an economic benefit analysis on the campus fleet (consisting of 91 ICE vehicles) to determine if it is economically or financially feasible to transition from Internal Combustion Engine (ICE) or PVs (Petrol Vehicles) to Electric Vehicles (EVs). The analysis used RETScreen Expert software for analyzing renewable energy technology projects. The variables of Payback Period (PBP), cash flow projections, savings made from transitioning (fuel cost savings and energy cost savings), Benefit-Cost-ratio, GHG emission reduction potential, etc. were analyzed. The findings revealed that the GHG emission from the campus fleet will be reduced by 100% (this will result in the removal of about 298.1 tCO₂ from the environment). Also, the fleet manager will save approximately $129,049 (88.9%) in fuel costs. Apart from these, the return on investment will be achieved in year 5 (all things being equal), but can be reduced to year 2 if the vehicles are put into constant and active use (eliminating most idle times. Also, the Sustainability Office will be making a GHG reduction revenue of $14,906.

The paper deals with the design of a systematic procedure for implementing strategy changes into internal business processes for a project-oriented production type of organization. In the first part of the contribution, a summary of the theoretical starting points for the field of strategic management and change management is presented. In the second part, the contribution deals with the analysis of the current situation in the area of the impact of the change of strategy on the management of business processes. In the last part, the proposal of the procedure for implementing strategy changes into internal business processes and the verification results are presented. The proposed procedure includes steps where the selection and verification of key performance indicators at individual levels of management plus the quantification of the impact of the change in strategy on the processes takes place. The management can thus monitor and evaluate the chosen processes in accordance with the fulfilment of the chosen strategy of the company. The last chapter presents the verification of the proposal for the systematic introduction of changes into the processes.

Chronic non-communicable diseases (NCDs) are major public health problems and a significant financial burden on public health systems. By 2030, mortality due to NCDs, such as cardiovascular diseases, cancer, respiratory diseases, and diabetes, is predicted to increase in Brazil. A peculiar aspect of NCDs involves their long-term and integrated care management. This paper proposes a chronic disease management platform based on artificial intelligence to deliver digital health services everywhere. The proposed platform is anchored and built with healthcare 4.0 technologies, such as wearable devices, the internet of medical things, and artificial intelligence cloud-based solutions that allow the deployment of a smart healthcare system. In addition, the paper presents the feasibility of the platform in a diabetes prediction study case. For the study case, an initial dataset was established with bio-impedance, oxygen concentration, pulse rate, skin impedance, and skin temperature attributes. A baseline was implemented with ten regression models to assess the prediction performance of the mean squared error, root mean squared error, and r-squared score to compare predictive findings with capillary blood glucose measurements. Results evidence that the decision tree regressor and three ensemble methods (bagging decision tree regressor, random forest regressor, and AdaBoost regressor) yielded improvement over the other models. Moreover, a comparison among those models revealed that the decision tree regressor outperforms them and presents promissory outcomes.

Background: Assessing the impact of bone health clinical management in breast cancer (BC) patients receiving adjuvant endocrine therapy and designing a personalized clinical pathway to reduce bone loss, in an Italian research hospital. Methods: The primary endpoint was to assess (through the process improvement organizational method) the clinical pathway that post-surgical BC patients prescribed with endocrine therapy undergo to prevent bone loss. The secondary endpoint was to design a personalized clinical pathway for a prompt implementation of guidelines, to assess and possibly prescribe antiresorptive therapy. Results: During the first year of the new diagnostic therapeutic assistance pathway execution, an 60% increase in Dual-Energy X-ray Absorptiometry evaluations within 30 days and a 39.5% increase in antiresorptive therapy prescription within 90 days (since prescription of endocrine therapy) were shown, thus increasing patients’ compliance. Conclusion: Case managers and bone health specialists in this context can improve patients’ adherence to therapies and bone health, helping physicians to expand their collaboration.

Effective management of water distribution systems requires an integrated approach, but none of the available frameworks for one are in broad use in the water supply industry. Frameworks developed include a management standard of the American Water Works Association and Distribution System Optimization, a methodology for physical, hydraulic, and water quality performance assessment. The intelligent systems framework also offers a pathway to integration, but it lacks a definite structure. The voluntary aspect of adopting innovations within the fragmented and unregulated nature of the water utility industry poses a barrier to adoption of such innovations. Another barrier is the uncoordinated arrangements of water research stakeholders with different incentive structures. Intelligent water systems offer a way to incentive utilities to encourage implementation. They can provide a bottom-up approach where utilities see advantages, as opposed to a top-down approach where they are expected to adopt a method without seeing clear benefits. Research to develop new and improved tools is needed, but the research roadmap should prioritize implementation.

The number of people with gluten-related illnesses has been increasing and the available treatments include the introduction of a gluten-free diet. In the bakery industry, there are problems with gluten-free products, namely the important characteristics that this component gives to doughs and the low nutritional value they present. A disease that has also increased in recent years is diabetes mellitus, which is characterized by a lack of insulin and the effectiveness of its action (type 1 diabetes) or tissue insensitivity to the hormone (type 2 diabetes). In terms of treatments, there are several approaches: inhibition of digestive enzymes (α-amylase and α-glucosidase) or techniques based on mechanisms of action (stimulation of insulin production and release, insulin transport and decreased glucose absorption). Hyperglycemia is also associated with the production of reactive oxygen species, which leads to cell apoptosis. On the other hand, there was also an association with high levels of cholesterol in the body, which contributed to the development of other types of diseases. In this sense, macroalgae have been studied as a source of natural compounds and used as food supplements, due to their protein, amino acid and mineral content, and the anti-diabetic effect in controlling the glycemic index, oxidative stress and cholesterol have already been demonstrated. Seaweed emerges as a promising source of bioactive nutraceuticals for individuals with coeliac disease, diabetes, and hyperglycemia. The rising prevalence of gluten-related illnesses calls for effective treatments, and seaweed's potential in enhancing the nutritional value of gluten-free products is noteworthy. Additionally, its demonstrated anti-diabetic effects, including glycemic index control, oxidative stress reduction, and cholesterol management, make it a valuable dietary supplement. Further research is needed to explore the specific bioactivities of seaweed compounds and their mechanisms of action. Integrating seaweed-based nutraceuticals into diets could complement traditional treatments, offering potential health benefits to those with coeliac disease and diabetes.

Nowadays Air-Source Heat Pumps (ASHP) in combination with a Photovoltaic (PV) installation are a very promising option for a necessary and urgent energy transformation in European Union (EU). It is extremely important to develop solutions that will help maximize the use of energy generated from renewable energy sources (RES). Such issues include the problem of insufficient use of generated electricity in PV on-grid microinstallations in residential buildings. This paper's aim is to analyze the results of one-year-round operation of a PV array grid-connected hybrid installation with ASHP for domestic hot water (DHW) preparation in a residential building in Cracow, Poland in the context of increasing self-consumption (SC) of PV energy. Models of systems are built and simulated in Transient System Simulation Tool 18 (TRNSYS) software. Simulations were carried out for different scenarios involving different building electricity consumption profiles, PV system capacity and specified runtime management of ASHP. The novelty of this study lies in the evaluation of the impact of a certain range of conditions on the energy performance of the system, in particular on SC. The results showed that the use of ASHP, with specified runtime management, results in an increase in monthly SC values from 7 to 18%, and annual SC values up to 13%. Also determining the appropriate size of the used PV system depending on whether it is present ASHP in the installation is crucial to increase the value of the SC parameter. Overall, this study provides valuable insights into the potential benefits of PV panels and ASHP operating together, in particular on SC values.

Each sport has its specific rules, which determine what is allowed (or not) impacting directly on the sport demands. Studies involving physiological and time-motion measurements have shown that soccer is a highly demanding sport. The new coronavirus disease 2019 (COVID-19) has been a world health crisis. Soccer seasons were interrupted worldwide to avoid spreading the virus. Leagues resumed the season (no fans at the arenas) after several weeks of interruption, causing overlay of schedule. This overlay (e.g., games every Sunday and Wednesday) will cause accumulated fatigue on players, raising the risk of injuries. Considering this condensed calendar, the Fédération Internationale de Football Association (FIFA) has changed (temporarily) up to five substitutions during elite games (instead of three as the regular rule allows). Considering the already published scientific evidence, clearly, the change in the soccer substitution rule due to COVID-19 is insufficient. Implementing unlimited substitutions may benefit soccer players' health, coaches’ jobs, more entertainment for fans and sponsors (e.g., keeping intensity during all game, including on the second half) and eventually prolonging the useful life of the players. A real game-changer!

To better understand the shape memory materials and self-healing materials, a new series of liquid-crystalline shape memory polyurethane (LC-SMPU) composites, named SMPU-OOBAm, were successfully prepared by incorporating 4-octyldecyloxybenzoic acid (OOBA) into the PEG-based SMPU. The effect of OOBA on the structure, morphology and properties has been carefully investigated. The results demonstrate that SMPU-OOBAm have liquid crystalline properties, triple-shape memory properties and self-healing properties. The incorporated OOBA promotes the crystallizability of both soft and hard segments of SMPU, and the crystallization rate of the hard segment of SMPU decreases when the OOBA-content increases. Additionally, the SMPU-OOBAm forms a two-phase separated structure (SMPU phase and OOBA phase), and it shows two-step modulus changes upon heating. Therefore, the SMPU-OOBAm shows triple-shape memory behavior, and the shape recovery ratio decreases with an increase in the OOBA content. Finally, SMPU-OOBAm shows self-healing properties. The new mechanism can be ascribed to the heating-induced “bleeding” of OOBA in the liquid crystalline state and the subsequent re-crystallization upon cooling. This successful combination of liquid crystalline properties, triple-shape memory properties and self-healing properties make the SMPU-OOBAm composites with many promise applications in smart optical devices, smart electronic devices and smart sensors.

Directive 2018/844/EU on energy efficiency claims almost 80% of final energy consumption in EU is used within the buildings. Subsequent Directive (EU) 2023/1791 introduced in 2023 expected 68% of the World population living in urban areas. Both Directives enhanced the role of energy management (EM) applied on the city buildings. The study introduces the development of energy management in Czech municipalities between the years 2009 and 2023. The main goal of this article is to present selected results of the unique national survey focused on the energy management in Czech municipalities conducted in 2023 and compare it with results of national surveys implemented in 2009 and 2018. The main method is the evaluation of deep survey conducted among the municipal representatives or energy managers in the past with the new survey conducted in 2023. The results show that EM became notably more important issue for the most Czech municipalities. The number of cities implementing EM significantly grew and the number of city energy managers increased too. On the other hand, the used potential of energy savings triggered by establishing EM is insufficient. This article should be applied to stress power of municipal EM in performing energy efficiency and RES projects and encouraging government to support municipal energy managers in their complex role.

The construction of molecular robotic-like objects that imitate living things is an important challenge for current chemists. Such molecular devices are expected to perform their duties robustly to carry out mechanical motion, process information, and make independent decisions. Dissipative self-organization plays an essential role in meeting these purposes. To produce a micro-robot that can perform the above tasks autonomously as a single entity, a function generator is required. Although many elegant review articles featuring chemical devices that mimic biological mechanical functions have been published recently, the dissipative structure, which is the minimum requirement, has not been sufficiently discussed. This article aims to show clearly that dissipative self-organization is a phenomenon involving autonomy, robustness, mechanical functions, and energy transformation. Moreover, the author details the recent experimental results of an autonomous light-driven molecular device that achieves all of these features. In addition, a chemical model of cell-amplification is also discussed to focus on the generation of hierarchical movement by dissipative self-organization. By reviewing this research, it may be perceived that mainstream approaches to synthetic chemistry have not always been appropriate. In summary, the author proposes that the integration of catalytic functions is a key issue for the creation of autonomous microarchitecture.

: BACKGROUND: The prevalence of smoking among students is a growing concern, particular-ly among medical students. Being associated with stress, competitiveness, and various social in-fluences, smoking can have detrimental effects on self-esteem and self-efficacy and may create a vicious cycle that may contribute to students’ well-being and academic performance out-comes.METHODS: A cross-sectional study on 456 medical students was conducted via an online survey using structured questionnaires on socio-demographic characteristics, smoking habits, nicotine dependence, self-esteem, and self-efficacy. RESULTS: The prevalence of smoking was 31.1% The scores of self-esteem and self-efficacy were positively correlated with smoking habits (W1=0.957, W2=0.975, P<0.05). Students presented rather low smoking addiction with male stu-dents having slightly higher scores than female students on self-esteem and self-efficacy, mili-tary students had higher self-esteem scores than civilians with physical activity having a posi-tive correlation with non-smoking behavior. CONCLUSION: According to our results, self-esteem and self-efficacy were slightly positively correlated with smoking habits. Furthermore, there was no statistically significant association between other social factors and smoking. Our results may develop a theoretical basis for medical students’ psychological variables studying for further implementation of university educational programs and preventive interventions em-powering students towards an overall better quality of life, addressing, among others, smoking behaviors.

Alphaviruses, flaviviruses, measles viruses and rhabdoviruses are enveloped single-stranded RNA viruses, which have been engineered as expression vector systems for recombinant protein expression and vaccine development. Due to the presence of non-structural genes encoding the replicase complex, a 200,000-fold amplification of viral RNA occurs in the cytoplasm of infected cells providing extreme transgene expression levels, which is why they are named self-replicating RNA viruses. Expression of surface proteins of pathogens causing infectious disease and tumor antigens provide the basis for vaccine development against infectious diseases and cancer. The self-replicating RNA viral vectors can be administered as replicon RNA, recombinant viral particles, or layered DNA/RNA replicons. Self-replicating RNA viral vectors have been applied for vaccine development against influenza virus, HIV, hepatitis B virus, human papilloma virus, Ebola virus and recently coronaviruses, especially SARS-CoV-2 the causative agent of the COVID-19 pandemic. Measles virus and rhabdovirus vector-based SARS-CoV-2 vaccine candidates have been subjected to clinical trials. Moreover, RNA vaccine candidates based on self-amplifying alphaviruses have also been evaluated in clinical settings. Various cancers such as brain, breast, lung, ovarian, prostate cancer and melanoma have also been targeted for vaccine development. Robust immune responses and protection have been demonstrated in animal models. Clinical trials have shown good safety and target-specific immune responses. Ervebo, the VSV-based vaccine against Ebola virus disease has been approved for human use.

The system identification problem with multiple nonlinearities is relevant. Its decision depends on many factors. These include: feedbacks, the method of connecting nonlinear links, signal properties. They affect the identifiability of the system parameters. We introduced a condition for the excitation constancy for state variables, which considers the S-identifiability of the system. We propose system decomposition by measuring input to identify parameters. Each subsystem has an implicit identification representation. It guarantees obtaining estimates of subsystem parameters based on experimental data. The trajectories boundedness of adaptive system proved in parametric and coordinate spaces. Conditions guaranteeing exponential stability of the system obtained. Systems of self-oscillation generation and nonlinear correction of a nonlinear system consider. Conditions for the trajectories boundedness of the adaptive system obtained for these cases. The influence of nonlinearity and feedback on the system performance estimated.

Converting chemical energy from green hydrogen to electricity using Membrane Exchange Protons Fuel cell (PEMFC) is a promising solution in various applications such e-mobility and building facilities. The electrical efficiency of PEMFCs can reach 60%. However, they are immensely sensitive to the working temperature, requiring good thermal management. Active thermal management systems are expensive and energy-consuming. Passive thermal management systems enable PEMFC thermal management without additional energy consumption. Here various passive thermal management technologies are reviewed. Different techniques are thorougly described and critically compared in terms of complexity, efficiency, cooling rate, scope of applicability, and the sizes of PEMFCs to which they apply. The conclusions provide a solid background for further investigations, and recommendations for future work are suggested.

The complex systems that require safety are the Safety Critical Systems. Maintaining these systems is a big challenge. Now a days, safety is a very critical requirement for the latest systems. Safety critical systems must be safe. Different approaches to ensure quality and safety in safety critical systems has been discussed in this paper. A comparison is also conducted between these various approaches. Safety critical systems must remain more influential in future.