Achievement Of Goals Research Articles

Reframing Education: Evaluating the Transformative Effects of the 2013 Curriculum

This research aims to analyze the impact of implementing the 2013 Curriculum, focusing on consistent implementation, evaluation of learning outcomes, acceptance by students and parents, and adaptation of teaching methods and continuous feedback. The research method involves direct observation and interviews with educators, students, parents, and school administrators to understand curriculum implementation and its impact comprehensively. The findings show that consistent curriculum implementation produces a structured learning experience while evaluating learning outcomes. Increases student academic performance. The positive reception from students and parents and adapting innovative teaching methods enrich the learning process. A system of feedback and continuous improvement ensures the relevance and effectiveness of the curriculum. The conclusion of this research confirms that implementing the 2013 Curriculum effectively supports the achievement of educational goals by improving the quality of learning and stakeholder involvement.

Interconnected factors in EFL engagement: classroom climate, growth mindset, and achievement goals.

This study explores the relationships among classroom climate, growth mindset, achievement goal orientation, and student engagement in the context of English as a foreign language (EFL) education in China. The study aims to understand how these factors interact to influence student engagement and motivation in EFL learning. Data were collected through a questionnaire administered to 587 Chinese undergraduate EFL students. The questionnaire assessed students' perceptions of classroom climate, growth mindset, achievement goal orientation, and engagement. Structural equation modeling (SEM) was utilized to examine the relationships among these variables. The SEM analysis revealed significant positive correlations among classroom climate, growth mindset, achievement goal orientation, and student engagement. Both classroom climate and growth mindset were found to directly and positively predict student engagement. Additionally, achievement goal orientation mediated the relationships between both classroom climate and student engagement, and between growth mindset and student engagement. The findings underscore the interconnectedness of classroom climate, growth mindset, and achievement goal orientation in shaping student engagement in EFL education. These results suggest that fostering a positive classroom climate and promoting mastery-oriented goals can enhance student motivation and contribute to more effective language acquisition. Practical implications for EFL educators are also discussed.

Social Infrastructure and Organizational Resilience - A Theoretical Model

Abstract Background Considering resilience as a necessity for health care organisations (HCOs), many researchers argue that fluidity is a must and that organisational structures (formal and informal) hinder the adaptability and resilience of health care organisations. Contrary to this statement, my thesis posits that fundamental adaptive processes leading to new equilibria depend on a stable core that persists amidst change, enabling and catalysing these transformations. Methods The phenomenon of resilience within healthcare organisations is examined through the lens of sociological systems theory. Rooted in Talcott Parsons’ assertion that social systems, including healthcare organisations, must perform four basic functions (Adaptation, Goal Achievement, Integration, Latency: AGIL) to survive and function, our research uses the deductive method to derive the necessary structural social components required to cope with external demands. Results The application of the methods yields four complex basic structures rooted in the social structure of healthcare organisations: adaptive structures (flexible structures & resource generating structures), goal achievement structures (governance enabling collective goal setting, decision making and persistence), integrative structures (social capital and social networks) and sustainability structures (socialisation structure, knowledge base, organisational culture). Conclusions As the core of stability, this ‘four-component social infrastructure’ is essential for facilitating higher-order forms of resilience, such as new equilibria. In its absence, healthcare organisations would flounder during change, posing risks to the resilience of these HCOs. Thus, structure is indeed inherent in the chaos of resilience activities. In other words, there is order in the chaos of resilience, and it is essential. Key messages • Fundamental adaptive processes leading to new equilibria depend on a stable core that persists amidst change, enabling and catalysing these transformations. • There is order and structure in the chaos of resilience.

Low-density lipoprotein cholesterol goal attainment with "inclisiran first" versus usual care in patients with atherosclerotic cardiovascular disease

Abstract Background Rapid and sustained attainment of guideline-recommended low-density lipoprotein cholesterol (LDL-C) goals is critical for patients with atherosclerotic cardiovascular disease (ASCVD). In VICTORION-INITIATE, inclisiran administered twice-yearly by a healthcare professional earlier in the treatment pathway allowed more patients with ASCVD to achieve and sustain LDL-C goals vs current usual care (UC). Purpose To evaluate cumulative LDL-C exposure in the overall population and LDL-C goal attainment and safety in subgroups of participants (type of ASCVD, timing of ASCVD event, and history of statin intolerance) who received an "inclisiran first" implementation strategy (IF; adding inclisiran immediately on failure to achieve LDL-C <70 mg/dL [1.8 mmol/L] with maximally tolerated statins) compared with UC. Methods VICTORION-INITIATE was a 330-day, prospective, pragmatically designed trial that randomised participants 1:1 (stratified by insurance status) to IF (open-label inclisiran 284 mg at Days 0, 90 and 270 plus UC) or UC alone (lipid management directed by treating physician’s discretion). The study took place at 45 sites across 20 states in the USA. Treating physicians had access to LDL-C measurements and were encouraged to intensify treatment per clinical practice guidelines. This prespecified subgroup analysis evaluated LDL-C goal attainment by timing of the most recent ASCVD event (<1 year/≥1 year prior to consent), ASCVD subtype (coronary heart disease [CHD], peripheral arterial disease [PAD], and cerebrovascular disease [CVD]) and statin intolerance status. Cumulative LDL-C exposure over time in the overall population and safety by subgroup were also evaluated. Results Of 450 patients randomised to IF or UC, 11.1% and 84.2% had an ASCVD event <1 year or ≥1 year prior to consent, respectively; 91.8%, 18.2% and 14.7% had a history of CHD, CVD or PAD, and 25.8% were statin intolerant. Cumulative exposure to LDL-C to Day 330 was lower in patients treated with IF vs UC (mean time-adjusted LDL-C: 42.4 mg/dL vs 90.7 mg/dL, Figure). Significantly more patients who received IF achieved LDL-C goals of <70 mg/dL and <55 mg/dL at Day 330 vs UC, irrespective of subgroup (Table). Across subgroups, the incidence of treatment-emergent adverse events (TEAEs) and serious TEAEs were similar between IF and UC (IF: 52.6−71.2%, UC: 46.2−66.0% and IF: 10.7−28.3%, UC: 11.4−22.2%, respectively). Conclusions Participants with ASCVD and LDL-C >70 mg/dL who received IF had lower cumulative LDL-C exposure over the study period than those treated with UC. IF resulted in rapid and sustained achievement of LDL-C goals regardless of ASCVD subtype, event timing and statin intolerance. The safety profile of IF was consistent across the subgroups analysed.

Analysis of Apron Movement Control (AMC) Personnel Availability Towards Airside Supervision Operational Activities of PT Angkasa Pura I Pattimura Ambon International Airport

Apron Movement Control (AMC) is a unit that is responsible for flight operations, aircraft movement supervision, vehicle traffic, passengers and cleanliness supervision in the airside area and recording flight data on the apron. AMC officers are one of the factors that also determine the achievement of organizational goals in the airport sector, because the human resources of AMC officers are the subject of every activity in the organization, the assessment for subjects is carried out through their performance assessment. Through a combination of human resources, facilities/equipment and procedures in a series of elements that work together in carrying out the functions and tasks of supervision and service on the airside so that the goals are achieved. This study aims to determine the supervision of the AMC unit at Pattimura Ambon International Airport in terms of human resources and supporting facilities as well as obstacles in carrying out supervision in the airside area and efforts to overcome obstacles. This study uses a descriptive qualitative approach. The data used are primary and secondary data. Primary data is obtained from observation and interviews, while secondary data comes from literature studies and photographs related to the problems studied. The data analysis techniques used are data reduction, data presentation and drawing conclusions. To test the validity of the data, the triangulation technique is used. The research time was in March 2024. The results of the study showed that the supervision of the AMC unit at Pattimura Ambon International Airport was carried out in accordance with PM-IK (Quality Procedures and Work Instructions), starting from supervision of FOD (foreign object debris), fuel spills, vehicle speed according to SKEP/140/VI/1999, supervision of aircraft movements, supervision of the use of PPE according to procedures and supervision of wind running up / idle. The number of AMC unit human resources currently has 7 personnel consisting of 6 implementing personnel and 1 leader. The AMC unit has equipment that is suitable for use including Handy Talky (HT), Telescope (Binoculars), Computer, Ear Muff, Bad Marshaller, Sunglasses, Light Stick, Raincoat, Follow Me Car, Speed Trap and CCTV. The obstacle in AMC supervision is the lack of personnel so that the workload increases and there are still service users / workers who violate the rules on the airside. The AMC unit has attempted to submit additional personnel and the AMC unit strictly enforces service user discipline according to procedure.

Management of children with heterozygous familial hypercholesterolemia worldwide: a meta-analysis

Abstract Background HeFH is one of the most frequent monogenic disorders in the world, leading to premature ASCVD. Purpose The aim of this meta-analysis was to evaluate the efficacy and safety of lipid lowering therapy (LLT) and achievement of LDL-C goal in heFH children. Methods The main endpoint was efficacy of goal achievement for LDL-C and other lipid parameters: total cholesterol [TC], triglycerides [TG], high density lipoprotein cholesterol [HDL-C], apolipoprotein B [apo B] and lipoprotein(a) [Lp(a)]), and the LLT safety (adverse events [AEs], including endocrine function, and growth indices). The secondary endpoint was an effect of LLT on attainment of LDL-C goal treatment (<3.5 mmol/L/130 mg/dL). Results A total of 41 studies with 4667 pediatric patients at mean age 12.08±2.4 years were included. At median follow-up of 18.8 months, the group on LLT had significantly higher mean reductions of TC, LDL-C, TG, and increased HDL-C compared to control (-1.75 [-67,7 mg/dl], -1.84 [-71.2 mg/dl], -0.11 [-9.74 mg/dl], 0.08 mmol/L [3.1 mg/dl], respectively, p<0.001 for all). In the subgroup analysis according to different types of LLT we observed a significantly higher mean reduction of LDL-C by statin combined with ezetimibe treatment, followed by PCSK9 inhibitors, statins in monotherapy, and monotherapy with ezetimibe (-2.48 [-95.9 mg/dl], -2.16 [-83.5 mg/dl], -2.03 [-78.5 mg/dl], and -1.50 mmol/L [-58 mg/dl], respectively, test for overall effect: p<0.001). The pooled LDL-C was reduced by 33.44% (-2.14 mmol/L [-82.8 mg/dl], p<0.001) and failed to reach the goal treatment (<3.5 mmol/L) by 12.6% (95%CI, 12.4 – 12.9%). 38.7% of children achieved the LDL-C goal, 23.9% fell short by up to 10%, 10.7% experienced moderate failure (were over the LDL-C target between >10-20%), and 26.7% failed by more than 20% to reach the LDL-C target. When comparing different regions, only Sweden and Greece achieved the LDL-C goal <3.5 mmol/L in the follow-up, followed by the Netherlands, Norway, Poland, USA, UK, France, Spain, Belgium, and Austria (with the following additional required LDL-C reduction to be on the goal: 2.2%, 3.4%, 3.5%, 8.9%, 10.2%, 11.2%, 11.2%, 15%, 19.4%, respectively). For other investigated countries over 20% mean LDL-C reduction was required. All parameters related to endocrine function and demographic indices were unaffected by LLT therapy (p>0.05). The adverse events were not reported significantly higher when compared to the control and the prevalence of therapy discontinuation was only 0.8%. Conclusions Despite the efficacy of LLT in children with HeFH and the low occurrence of discontinuation-related adverse events, achieving LDL-C treatment goals was relatively rare, with large differences between the investigated countries. These results underscore the importance of considering early combination therapy of statins and ezetimibe, and PCSK9 inhibitors (if available) to attain LDL-C goals effectively.Lipoproteins reduction with LLT.Goal achievement and therapy safety.

Lipid lowering therapy and the unmet targets in Indian patients with angiographically proven coronary artery disease: results from the OLS registry

Abstract Introduction The Lipid Association of India (LAI) 2020 guidelines classify patients with established atherosclerotic cardiovascular disease in either very high-risk or extreme-risk groups and recommend that intensive lipid-lowering therapy (LLT) should be administered to such patients to achieve a target low-density lipoprotein cholesterol (LDL-C) level below 50 mg/dl at least (preferably < 30 mg/dl in extreme risk groups). Purpose This study aimed to assess the achievement of the LAI-recommended LDL-C goals in patients with angiographically proven coronary artery disease (CAD). Methods The Optimization of LDL-C in the Stable CAD (OLS) registry started in August 2023 in 10 interventional cardiology centers across Northern India. Interventional cardiologists (ICs) were treating all enrolled patients with angiographically proven stable CAD, and data were collected at a single visit, including the most recent LDL-C and the LLT in the preceding three months of that LDL-C reading. The primary outcome was achieving the LAI-recommended LDL-C goal of <50 mg/dl. The achievement of the American College of Cardiology (ACC) recommended goal of <70 mg/dl was also assessed. Results A total of 1860 patients with angiographically proven CAD were enrolled in this ongoing registry over four months (August 2023- November 2023). The mean age of the study population was 60.2 + 9.2 years, and 79% were males. 30.3% of patients had Diabetes mellitus (DM), 36.1% had hypertension (HTN), 42.3% were obese (body mass index > 25kg/m2), and 17.8% of patients were current smokers. 74.2% of patients had a history of myocardial infarction, while 76.7% had undergone prior percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Rosuvastatin was the statin prescribed in 59.4% of patients, while atorvastatin was prescribed in 37.2%. 1270 (68.3%) of patients were taking high-intensity statin (HIS) therapy (either 20-40 mg rosuvastatin or 40-80 mg atorvastatin). Only 22 (1.2%) patients took other lipid-lowering agents, including ezetimibe, bempedoic acid, and fibrates. None of the patients were using PCSK9 Inhibitors. Only 482(25.9%) patients achieved their LAI recommended goal of LDL-C <50 mg/dl, 113(6.1%) achieved LDL-C < 30 mg/dl, while 863(46.4%) achieved ACC goal of <70 mg/dl. Notably, only 62(3.3%) patients were not taking any lipid-lowering treatment. Conclusion Results of the OLS study demonstrate the high-risk status of CAD in Indian patients with a high prevalence of DM, HTN, and obesity. Most patients were post-PCI/CABG, mainly because ICs did enrolments. More than two-thirds of patients were taking HIS and very few were not taking any treatment. Despite this, only one-fourth of patients achieved the target LDL-C goals. Greater and early utilization of combination LLT, including HIS and non-statin LLT, is likely needed to reduce these gaps for patients at the highest risk.

PROGRESSO DO BRASIL NA IMPLEMENTAÇÃO DE ÁREAS COSTEIRAS E MARINHAS PROTEGIDAS COM FOCO NA META 11 DE AICHI

he rapid global loss of biodiversity has promoted initiatives to develop a global network of Protected Areas (PAs), with the Aichi targets suggesting that countries protect at least 17% of continental areas and 10% of marine and coastal areas. For Brazil, there is a knowledge gap regarding the evaluation of qualitative and quantitative objectives through practical indicators of goal achievement and effective management. This study holistically addresses the conservation status of Brazil concerning Aichi Target 11 for marine and coastal ecosystems, using systematic literature review and marine spatial coverage analysis. The results show an increase to 26% of marine spatial coverage, with greater coverage by Environmental Protection Areas. There is a predominance of studies on "Management Effectiveness," with less focus on equitable management and integration between terrestrial and marine landscapes. Indicators primarily focus on "Ecological" and "Governance" dimensions, neglecting "Social" and "Economic" dimensions. Key challenges include the need for increased financial investment, connectivity between protected areas with different social and ecological contexts, and local community involvement in equitable management. Additionally, there is a need for increased coverage of integral protection areas and standardization of qualitative assessments. Keywords: Protected areas; Management effectiveness; Aichi Target 11; Conservation policy; Coastal and marine systems.

Assessing progress towards viral hepatitis B and C elimination in prisons in the European region

Abstract Background In 2016 the WHO launched the global health sector strategy for the elimination of viral hepatitis, alongside a dedicated monitoring&evaluation (M&E) framework to assess progress at national, regional and global levels. Despite being a priority setting for viral hepatitis elimination in Europe, prisons are rarely integrated into national monitoring efforts. Besides, prisons are particular contexts with a high viral hepatitis prevalence, where it is possible to utilize adequate micro-elimination strategies. Objectives We aimed to assess available metrics of viral hepatitis burden and coverage of prevention and control interventions in prison settings in Europe using routine sources of data. Methods We adapted the WHO M&E framework for viral hepatitis elimination to the prison context. The resulting M&E framework has 49 indicators of which 10 are defined as core. Data were sourced from available European prison surveillance systems at European level, namely: European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and WHO Health in Prisons European Database (HIPED). Results In total 38 countries in the European region provided data to either data sources for 2020. For WHO-HIPED, among core indicators, 3 out of 10 could be calculated for HCV, and covered prevalence, HCV treatment availability and treatment outcome. Concerning HBV, 3 core indicators out of 10 could be calculated and covered prevalence, screening availability and treatment coverage in prison. With EMCDDA surveillance system we could calculate 4 HCV core indicators and 6 HBV core indicators. Lessons Availability of health data from prison settings is scarce, hampering the current capacity to monitor the progress in the viral hepatitis elimination within prisons contexts strategies and its relative contribution to global health goals achievement. A coordinated and standardised M&E framework tailored to this specific setting is needed to foster data collection and systematic monitoring. Key messages • Micro-elimination strategies in prison context contribute to the global health goals achievement. • A coordinated and standardized M&V framework, adapted to the prison context, is needed to foster data collection and monitoring of the viral hepatitis elimination strategy.

Unveiling homozygous familial hypercholesterolemia in Greece: a comprehensive analysis of baseline traits and LDL goal achievement in adults from the HELLAS-FH Registry

Abstract Background Homozygous familial hypercholesterolemia (HoFH) is a severe genetic disorder characterized by markedly elevated low-density lipoprotein cholesterol (LDL-C) levels. This study aimed to analyze demographic characteristics, lipid profile, and rate in achieving LDL-C targets in adult HoFH patients in Greece. Methods This is a cross-sectional analysis of the Hellenic Familial Hypercholesterolemia Registry (HELLAS-FH). Adults with genetically or clinically diagnosed HoFH were included. Median LDL-C levels were assessed during HoFH diagnosis and enrollment. Results Seventeen HoFH adults (mean age 41 years and mean age at diagnosis 31 years, men 58.8%). Genetic confirmation of HoFH was available in 10 patients, while the remaining were diagnosed based on clinical criteria. Family history of atherosclerotic cardiovascular disease was documented in 70.5% of patients. Clinical presentations varied, with 47.0% exhibiting tendon xanthomas, 17.6% xanthelasmas, 23.5% corneal arcus, and 52.9% premature coronary artery disease (CAD). Predominant treatment involved statins (88.2%), ezetimibe (58.8%),PCSK9i (23.5%), lomitapide (29.4%), while LDL apheresis was utilized in 23.5%. Median LDL-C levels were 407 mg/dL (10.53 mmol/L) at diagnosis and 226 mg/dL (5.84 mmol/L) at enrollment. None of the patients achieved the LDL-C target set by the 2019 EAS/ESC Guidelines. Conclusion The challenges of delayed diagnosis, undertreatment, and unattained LDL-C targets persist in HoFH management in Greece, emphasizing the critical need for effective lipid-lowering interventions to mitigate cardiovascular risk.

Leadership Empathy and Employee Retention in Health Sector NGOs in Kenya

Aim: Employee turnover undermines the achievement of organizational goals. Retaining talented employees is a significant challenge for many health sector non-governmental organizations (NGOs), and it threatens their sustainability. Previous studies have been conducted to determine the causes of employee turnover in Kenya; however, there is inadequate empirical evidence regarding the correlation between emotional intelligence competencies and employee retention. This study aimed to determine the impact of leadership empathy on employee retention in health sector NGOs in Kenya. Methods: The study was conducted based on Bar-On’s Emotional Intelligence Competencies Model. Positivism was the philosophical foundation of this descriptive design study. The analysis unit included 30 health sector NGOs in Kenya, while the observation unit included 1,500 management-level employees. The Yamane formula was used to determine the study sample size, which consisted of 316 respondents. A stratified random sampling technique was implemented to determine the sample. A semi-structured questionnaire was used to collect the study data. Statistical Package for the Social Sciences software (version 26) was used for data analysis, where descriptive and inferential statistics were computed. The findings are presented in tables and figures and prose form. Results: The study found a positive influence, indicating that increased empathy enhanced employee retention. Therefore, we concluded that leadership empathy is positively and significantly correlated with employee retention in health sector NGOs in Kenya. Recommendations: Managers and supervisors in health sector NGOs should receive training and development programs to enhance their empathy skills. Additionally, health sector NGOs should provide workshops, seminars, and coaching sessions that emphasize developing leadership empathy skills through active listening, perspective-taking, and genuine concern for others.

Performance trends and goal achievement of health indicators in Gyeongsangbuk-do and Daegu Metropolitan City.

The core goal of South Korea's health policy is equity. To this end, regional disparities in health indicators must be identified. However, as an in-depth analysis of health disparities and health indicators in Gyeongsangbuk-do and Daegu Metropolitan City is lacking, this study examined the trends in performance and goal achievement in health indicators. Data collected from 2011 to 2022 for 31 cities and counties in the Gyeongbuk region (23 regions in Gyeongsangbuk-do and eight regions in Daegu Metropolitan City) were analyzed to examine 28 health indicators across three categories: health behavior, health outcomes, and healthcare utilization. The data were analyzed using SPSS/WIN 23.0. The findings for health indicators showed significant and persistent gaps in health levels in Gyeongsangbuk-do, particularly in health behavior (31.3% and 68.7%), health outcomes (33.3% and 55.6%), and healthcare utilization (33.3% and 100%), in Gyeongsangbuk-do and Daegu Metropolitan City, respectively. Central government is vital for infrastructure development and financial assistance to effectively enhance health services in the local communities of Gyeongsangbuk-do.

Predictors of Happiness and Life Satisfaction among University Teacher-Trainees on Internship

The study investigated the factors that drive happiness and life satisfaction among university teacher trainees on school practice internship. It was a purely qualitative study that employed explorative methods and a phenomenological design because it dealt with the subjective experiences about happiness and life satisfaction during internship as a phenomenon. It was conducted on a population of 25 participants drawn from a total population of about 700 teacher trainees on internship placement. The respondents were selected using both purposive and convenient sampling technique. These methods were preferred because purposively, the respondents were teacher trainees on internship and conveniently, they were under the supervision of the corresponding author. Data was collected using in depth interviews and analysed using themes and narratives drawn from the transcribed data. Results’ presentation, analysis and discussions was done concurrently. The findings revealed that happiness and life satisfaction among teacher trainees on internship school practice placement is determined by economic and financial drivers, supervision processes, collegial social support and connections, student or learner attributes, logistical provisions and follow up factors. As a result of the findings, universities invested in teacher training and schools hosting internship teacher trainees are required to boost the university-based and school-based factors in order to promote happiness and life satisfaction among the trainees respectively through provision of teaching practice logistics, supervisor support and evaluation, student/learner discipline, as conditions aimed at enhancing happiness, for the end goals of academic achievement

Protecting Water Resources in North African Countries as an Entry Point to Achieve the Sixth Sustainable Development Goal

This article examines the legal framework on water in the Maghreb countries and analyzes if the existing legal framework guarantees the achievement of the sixth Sustainable Development Goal by 2030. One of the most important challenges faced by North African countries is the scarcity of water resources. Water scarcity and difficulty of providing the population with potable water, causes a thirst crisis and disruption of biodiversity, and thus preventing the achievement of sustainable economic and social growth, especially since the communities of this region are known for their intensive agricultural activity. The MENA region is among the most exposed to the negative effects of climate change, as the decrease in rainfall and its temporal and spatial variation leads to frequent floods and multiple droughts. All these pose the problem of dealing with the legal system considering the weak official cooperation between these countries to deal with this reality and find the necessary mechanisms to protect water resources from depletion, face climate change and reduce its effects. This article focuses on the Maghreb countries: Morocco, Algeria, Tunisia and Mauritania. The choice of these countries is motivated by the fact that they share the same climatic characteristics and above all they suffer in the same way from the repercussions of global warming. Water resources in these countries are under increasing pressure amid population and industrial growth, irrigated agriculture, urbanization, tourism, climate change, overexploitation of aquifers and deteriorating water quality. In terms of methodology, the article employs a literature review of studies in this field as well as an analysis of legal texts related to water and the environment in the countries surveyed. This study shows that the Maghreb countries have made considerable efforts at the legal level to guarantee access to water for their citizens, however there are many peculiarities and insufficiencies for which the study presents some recommendations susceptible to help with the attainment of the 6 SDG objective within 2030.

The carbon emission reduction benefits of the transformation of the intensive use of cultivated land in China

The transformation of the intensive use of cultivated land has an important impact on agricultural carbon emissions (ACE). However, the existing research on the impact mechanisms of the transformation of intensive use of cultivated land on carbon emissions is not clear. In view of this, this study constructs the impact mechanism of the transformation of intensive use of cultivated land on carbon emissions from the perspective of production factors substitution based on the theory of induced technological change and the theory of marginal returns. Using the Cobb-Douglas production function, this study identifies the transformation patterns of intensive use of cultivated land in China from 1980 to 2021. Furthermore, this study simulates the carbon emission reduction benefits brought about by the transformation of the intensive use of cultivated land by considering the cost of agricultural production. The results show that, first, from 1980 to 2021, the price of agricultural labor increased by 224.10%, while the price of other agricultural production factors significantly decreased. China’s intensive use of cultivated land methods has undergone four stages: agricultural labor–intensive (ALI), yield–enhancing factor–intensive (YEFI), labor–saving factor–intensive (LSFI), and innovation factor–intensive (IFI). In 2021, most of China’s provinces were in the YEFI or ALI stages. Second, between 1993 and 2021, the transformation of China’s intensive use of cultivated land brought about an 87.48% increase in carbon emissions, while the spatial clustering effect of carbon emissions weakened. Furthermore, the results show that, the transition of the use of cultivated land from ALI to YEFI and YEFI to LSFI will reduce carbon emissions by 7.89%, and input factors costs will increase by 23.85%. If all regions, except for those in the IFI stage, transition to the LSFI model, it will result in a 17.56% reduction in carbon emissions, with a corresponding increase of 33.40% of the input factors input costs. This research enriches the theoretical foundation of literature about the transformation of the intensive use of cultivated land. It also expands the research perspective on agricultural carbon emissions. This research also helps provide references for the direction of the transformation of the intensive use of cultivated land in China and the achievement of the dual carbon goals.

Fostering Multicultural Community Harmony to Enhance Peace and Sustainable Development Goals (SDG’s)

Purpose: This service aims to foster harmony in a multicultural community in the city of Solo as a concrete step to increase peace and support the achievement of the Sustainable Development Goals (SDGs). Theoretical Framework: This study uses a cultural integration thinking framework and a participatory approach to building social harmony. The focus is on developing an understanding and appreciation of cultural diversity, as well as increasing positive interactions between ethnicities and religions to create an inclusive environment. Methods: This service uses a participatory approach involving a variety of local stakeholders, including ethnic and religious communities, local governments, and community institutions. Activities include organizing intercultural dialogue workshops, cultural diversity training, and public campaigns to promote tolerance and peace. Results and Conclusion: The results of this service show an increased awareness of cultural diversity and appreciation for differences among the people of Solo. Inter-ethnic and religious interactions are increasing, creating a stronger foundation for social harmony. In conclusion, participatory and integrative approaches are effective in building harmony in multicultural societies to support peace and sustainable development. Implications: This service has a positive impact by increasing tolerance, reducing social conflicts, and strengthening social cohesion in the city of Solo. The impact is also seen in increasing community participation in local development activities and achieving related SDGs targets. Originality/value: Its uniqueness lies in its participatory approach that actively involves all relevant parties, as well as focusing on cultural integration as the main foundation for the development of sustainable social harmony in a multicultural environment such as the city of Solo.

Asia-Pacific Real-World Evolocumab Use, LDL-C Reduction, Physician Goals, and Patient Perceptions: HALES Observational Study.

Real-world data are needed to understand the effectiveness of new therapeutic options for low-density lipoprotein cholesterol (LDL-C) reduction in Asia-Pacific clinical practice. Description of evolocumab use among adults with establisHed Atherosclerotic cardiovascuLar diseasE or hypercholesterolemia in ASia-Pacific region (HALES) was performed to better understand characteristics of and clinical decision-making for adults with established atherosclerotic cardiovascular disease/hypercholesterolemia after local evolocumab approval. The HALES observational study, conducted at 33 sites (Hong Kong, Thailand, South Korea, Singapore, Taiwan, and Australia) comprised (1) chart review of patients who received evolocumab, a proprotein convertase subtilisin/kexin type9 inhibitor (PCSK9i), and (2) physician/patient survey and one-time data collection of patients with high cardiovascular risk initiating evolocumab or initiating/continuing non-PCSK9i lipid-lowering therapy. Patients could only enroll in (1) or (2). Chart review included 724 very high-risk patients initiating evolocumab from regulatory approval to 2021. From median baseline LDL-C of 3.2mmol/L (123.7mg/dL), patients had a median percent change in LDL-C of - 60.8% at 1-6months. Goal achievement increased from 7.9% to 69.8% for < 1.8mmol/L (< 70mg/dL) and 4.4% to 57.8% for < 1.4mmol/L (< 55mg/dL) from baseline to 12months. In the one-time data collection, more patients had ≥ 1.8mmol/L (≥ 70mg/dL) baseline LDL-C in the evolocumab vs non-PCSK9i group (95.2% and 48.5%, respectively). Surveys found that physicians applied guideline-recommended treatment targets, and patients demonstrated gaps in understanding cardiovascular risk. Real-world, Asia-Pacific data showed that LDL-C reduction after initiating evolocumab was consistent with that observed in other clinical trials and patient populations. Graphical abstract available for this article.·.

Advances in the Neuro-Rehabilitation of Parkinson’s Disease: Insights from a Personalized Multidisciplinary Innovative Pathway

Background/Objectives: Parkinson’s disease (PD) is a progressive neurodegenerative disorder that requires comprehensive and personalized rehabilitation. This retrospective study focused primarily on the usability and patient acceptability of the innovative pathway. In addition, the secondary objective was to evaluate the effectiveness of a personalized and multidisciplinary rehabilitation pathway on cognitive function, especially executive functions. Methods: We conducted a retrospective study on 80 patients with PD (Hoehn and Yahr scores 1–3). Patients were divided into an experimental group (EG), which received the innovative pathway, and a control group (CG), which received traditional therapy. The rehabilitation program included three phases: initial outpatient assessment, a two-month inpatient program, and a telerehabilitation phase in a day hospital (DH) or home environment. Interventions combined traditional therapies with treatments based on robotic and virtual reality. Cognitive assessments (Mini Mental State Examination—MMSE—and frontal assessment battery—FAB), mood (Hamilton Rating Scale—Depression—HRS-D), anxiety (HRS-Anxiety—HRS-A), and goals achievement (GAS) were the primary outcome measures. Results: At baseline, there were no significant differences between the groups in terms of age, gender, education, or test scores. After rehabilitation, EG showed significant improvements in all measures (p &lt; 0.001), particularly in cognitive tests and goal achievement. CG improved in GAS (p &lt; 0.001) and mood (HRS-D, p = 0.0012), but less than EG. No significant changes were observed in the MMSE of CG (p = 0.23) or FAB (p = 0.003). Conclusions: This study highlights the high usability and acceptability of VR and robotics in PD rehabilitation, contributing to improved adherence and patient engagement. The experimental group showed greater cognitive benefits, particularly in executive functions. These results are in line with the existing literature on personalized technology-based rehabilitation strategies for PD.

Achievement motivation and mental health among medical postgraduates: the chain mediating effect of self-esteem and perceived stress.

Medical postgraduates generally experience high levels of depression and anxiety. Previous studies have investigated the impact of various achievement motivations on depression/anxiety among medical students. This study focused on self-esteem and perceived stress, examining the internal mechanisms through which achievement motivation affects depression/anxiety. 530 medical postgraduate students (66.04% female and 33.96% male) were administered the Achievement Goal Orientation Scale, Self-Esteem Scale, Perceived Stress Scale, and Depression-Anxiety-Stress Scale. Results indicated that: (1) mastery-approach goals were negatively correlated with depression/anxiety; mastery-avoidance goals were positively correlated with depression/anxiety; performance-avoidance goals positively predicted depression/anxiety; (2) self-esteem mediated the relationship between achievement motivation and depression/anxiety; (3) perceived stress played a mediating role in the relationship between achievement motivation and depression/anxiety; (4) self-esteem and perceived stress played a chain mediating role in the relationship between achievement motivation and depression/anxiety; (5) there was no significant linear correlation between mastery-approach goals and depression/anxiety. Although this study employed a cross-sectional design and self-report scales, both of which have certain limitations, the findings still hold significant theoretical and practical implications. The research reveals a mediating pathway between achievement goals and mental health, offering new insights into mental health education for medical graduate students.

E-learning Supporting Infrastructure Investment in South Africa: Perspective of a Developing Economy

South Africa is one of the developing economies. Most of its provinces are in rural areas and have poor or lack of reliable critical infrastructure to enable development as in the case of urban areas. Infrastructure refers to physical structures that serve as the underlying foundation for the functioning of an economy. It includes physical facilities such as communication systems (telephone lines, broadband), and power supply systems (electrical grids, dams, etc.). The focus of the study is on information communication technological infrastructure (ICT) such as telephone and broadband networks and electricity infrastructure that support the adoption of e-learning. Many schools in South Africa are in rural areas and are attended by the majority of learners. These learners should perform the same way as learners in urban schools. Urban schools have better access to ICT infrastructure. Due to a lack of equitable ICT infrastructure, many education institutions back-tracked from the hybrid teaching mode implemented during the coronavirus (COVID-19) lockdown to the traditional class/lecture-room mode of teaching. It is revealed in the study that South Africa struggles in the area of infrastructure development. These affect the achievement of sustainable development goals (SDGs) which are heavily dependent on infrastructure, including education. E-learning offers a better advantage compared to traditional class/lecture-room-based education. ICT infrastructure that supports the provision of e-learning is not equitably distributed, and those that are available are not enough and reliable. South Africa is reported to need R4.8 trillion to achieve its critical infrastructure goals, indicating a dire need for infrastructure investment. Under-investment in infrastructure affects all sectors of the economy, including the education sector.