Adequate Practices Research Articles

Gestational Diabetes Mellitus, Breastfeeding, and Progression to Type 2 Diabetes: Why Is It So Hard to Achieve the Protective Benefits of Breastfeeding? A Narrative Review

Women diagnosed with gestational diabetes mellitus (GDM) face a significantly heightened risk of developing type 2 diabetes mellitus (T2DM) later in life. Breastfeeding (BF) has been identified as a potential strategy to delay or prevent T2DM; however, women with GDM often encounter barriers in initiating and maintaining adequate BF practices compared to those with uncomplicated pregnancies. This paradox prompts an exploration into the causes of these BF challenges and considers the possibility of reverse causation: Does prolonged and intensive BF mitigate the risk of subsequent glucose dysregulation and T2DM? Alternatively, do women with compromised insulin secretion and sensitivity, who are predisposed to T2DM, struggle to sustain intensive BF practices? This narrative review aims to explore the interplay between GDM, BF, and T2DM development by examining the different factors that present BF challenges among women with GDM. Understanding these dynamics is crucial for establishing realistic BF expectations and developing effective clinical and public health strategies to support BF in this high-risk population.

Gerenciando riscos em salas de vacina: um estudo de segurança em Unidades Básicas de Saúde de Salvador, BA

Introduction: The risks in vaccination rooms imply not only damage to users, but also to vaccination coverage. Objective: to analyze structural conditions and factors that facilitate and hinder risk management in vaccine rooms. Methods: This cross-sectional study was conducted in the vaccination rooms of the Basic Health Units (UBS) of a health district in Salvador, BA. Data collection: form for interview with the responsible professional and on-site observation of these services. The following were analyzed: physical-structural conditions; care for the refrigeration chamber and thermal boxes; Nursing conduct; and training of professionals. Results: 91.3% vaccination rooms were studied. These services operate in exclusive spaces; immunobiologicals stored in refrigerated chambers. Vaccines are packaged and used according to the expiration date. Professional team: one nurse and two nursing technicians were present in 66.6% of the rooms; the hand hygiene practice of the professionals was 76.1%. Nursing team training was observed in 19%, annual training in 14.2%, and participation in scientific events in 19%. Of the 21 vaccine rooms, 5 (23.8%) had adequate risk management practices, 14 (66.6%) had risk management practices requiring adjustment, and 2 (9.6%) had inadequate risk management. Statistical correlation was identified between risk management practices and individual items from the categories analyzed to ratify the good practices in the vaccination room presented here. Conclusion: This study highlights inadequacies in vaccination rooms and the need to review work processes, as well as to incorporate systematic strategies for managing the numerous risks related to these services, to guarantee user safety.

Knowledge and practices of parents of school age children towards Helminthiasis and malaria in northwestern Ethiopia

BackgroundHelminthiasis and malaria prevail in developing countries including Ethiopia, where they claim lives, retard physical and mental growth, reduce productivity and contain economic growth. Implementing helminthiasis and malaria control strategies require adequate knowledge and practices of the affected communities. Knowledge and practices of parents of school age children was assessed in relation to risk of child infection with Helminthiasis and malaria.MethodsA total of 398 parents of school age children attending Maksegnit Number Two Elementary School from September 2020 to June 2021 were interviewed regarding their sociodemography, knowledge and practice towards Helminthiasis and malaria. The risk of child infection with Helminthiasis and malaria in relation to sociodemography and household practices was tested using multivariable logistic regression model.ResultsRisk of child infection with Helminthiasis was lower when the responding parent was female (OR = 0.54; CI = 0.32–0.92) and monthly household income was ≥ 2001 birr (OR = 0.39; CI = 0.22–0.70). A monthly income of ≥ 2001 birr was associated with a low risk of child infection with malaria (OR = 0.37; CI = 0.21–0.65). Children living with married parents were at higher risk of Helminthiasis (OR = 2.25, CI = 1.33–3.81) and malaria (OR = 2.71, CI = 1.60–4.58) infection. Latrine with wooden floor was correlated with a high risk of child infection with Helminthiasis (OR = 7.2; CI = 2.16–23.95). While washing with soap after toilet (OR = 0.09; CI = 0.03–0.34) and eating washed cabbage/fruit (OR = 0.26; 0.15–0.44) were associated with a lower risk of infection. Parents who participated in environmental management based vector control were less likely to report child infection with malaria (OR = 0.44; 0.20–0.97). A child living in residual insecticide sprayed house was at risk of malaria infection (OR = 3.16; CI = 1.45–6.92).ConclusionsIn general female responding parent, higher household income, and washing with soap after toilet or eating washed cabbage/fruit were associated with decreased risk of intestinal helminthiasis infection in children. In addition, higher income and participation in enviroinmental management based vector contol were associated with decreased malaria infection risk in children.

Food safety knowledge, attitudes, and practices among food handlers in collective catering in central Morocco

Food safety is a significant challenge for countries worldwide due to the growing number of food poisoning outbreaks, particularly in the catering sector, which impacts consumer health and imposes additional economic costs on countries. The role of food handlers in restaurants is crucial for guaranteeing this safety and protecting the health of citizens. This pioneering study in central Morocco aimed to assess food safety knowledge, attitudes, and practices (KAPs) among food handlers and to identify key factors influencing adequate knowledge, positive attitudes, and effective practices. A cross-sectional study was conducted among food handlers in restaurants in Fez prefecture in central Morocco between July 2021 and January 2022 using a questionnaire survey. The results revealed that the 282 food handlers included in this study exhibited moderate levels of knowledge (65.31 %) and practices (62.91 %), and a high level of attitudes (75.61 %) towards food safety. A moderate positive correlation was observed between knowledge and practices (r = 0.291, p < 0.05), as well as between attitudes and practices (r = 0.327, p < 0.05). The most significant positive correlation was between knowledge and attitudes (r = 0.907, p < 0.05). Moreover, professional experience and age significantly influenced the level of knowledge; the nature of job and work experience influenced attitudes; gender, education level, nature of work, and marital status influenced the level of practices; and training impacted them all. Nevertheless, those surveyed have knowledge gaps, particularly about cross-contamination, personal hygiene, time and temperature control, especially the temperature danger zone (between 40 °F and 140 °F), and thawing. Training programmes that emphasize these dimensions of food safety need to be implemented. The findings of this study, carried out for the first time in Fez, will provide a solid basis for further research. They will also assist responsible authorities in better understanding food safety in Morocco by selectively planning food safety training based on KAPs to prevent food poisoning and protect consumer health.

Assessing Community Pharmacists' Management of Acute Diarrhea in Saudi Arabia: A Simulated Patient Study.

Antimicrobial resistance poses a significant threat to global health, and community pharmacists are positioned to play a crucial role in mitigating this issue. The present study aimed to evaluate the extent of compliance among community pharmacists in Saudi Arabia with relevant regulations and clinical guidelines in the management of suspected infectious diarrhea. This cross-sectional study employed simulated patients presenting with diarrhea to assess the management practices within 200 community pharmacies in two major cities across Saudi Arabia. Trained pharmacy students presented pharmacists with three case scenarios involving adult patients with diarrhea. Statistical analysis included descriptive statistics and chi-square tests to examine the relationships between pharmacist characteristics and practice categories. The findings of this study indicate that the performance of community pharmacists in managing diarrhea is suboptimal. Notably, less adequate practice emerged as the predominant outcome at 63% (n = 126). Only 14% (n = 28) of pharmacists demonstrated adequate practice, while 23% (n = 46) exhibited poor investigative practice. Metronidazole dispensing increased across scenarios, from 16.92% (n = 11) in Scenario 1 to 30.3% (n = 20) in Scenario 3. Most pharmacists inquired about the patient's age (72%; n = 144); however, only a limited number probed for symptoms of dehydration (5.5%, n = 11) and medication history (3%, n = 6). A significant association was found between geographical location and practice performance (p = 0.015). This study reveals significant deficiencies in the management of infection-related diarrhea, underscoring the urgent need for enhanced training and regulatory measures within community pharmacy settings in Saudi Arabia to improve patient care and effectively address antimicrobial resistance (AMR).

Knowledge, Attitude, and Practice of the General Population toward Pediatric Obstructive Sleep Apnea in Al-Baha Region, Saudi Arabia: A Cross-sectional Study

Abstract Context: Obstructive sleep apnea syndrome in children is characterized by partial or complete upper airway obstruction during sleep, leading to disrupted breathing and altered sleep patterns. Prompt diagnosis and intervention are crucial for preventing severe health complications. Aim: The aim of the study was to evaluate the knowledge, attitudes, and practices related to pediatric OSA among residents of the Al-Baha region, Saudi Arabia, and explore associations with sociodemographic factors to improve the health outcomes and quality of life of the affected children. Settings and Design: The study design was an observational cross-sectional study. Subjects and Methods: From the general public in the Al-Baha region, 413 participants were recruited through an online self-administered questionnaire. Data were collected between May 4 and June 5, 2024. Statistical Analysis Used: Descriptive statistics, frequency distributions, and Chi-square test. Results: The majority of participants were predominantly female (66.3%) and aged 18–30 years (61%). Most participants were single and held a bachelor’s degree. An adequate level of knowledge about OSA was demonstrated by 64% of the participants, 78% exhibited a positive attitude, and 62% showed an adequate practice level. Young adults and females had the highest levels of knowledge and positive attitudes, with females also displaying better practice habits than males. Participants with 1–3 children demonstrated better practice levels than those with more children. Conclusion: Adequate awareness of pediatric OSA was demonstrated in the Al-Baha region, particularly among young adults and females. Positive attitudes and effective practices are influenced by education and profession. While current awareness efforts are effective, targeted interventions can further improve knowledge and practice.

An Analysis of Common Errors Made by Grade 7 Students in Writing English Paragraphs at a Secondary School in Hanoi, Vietnam

Error analysis is a technique that identifies and classifies the inappropriate forms that foreign language learners produce (Crystal, 1987), and it is considered a useful tool for helping them improve their writing skills. The study investigated the secondary students' common errors in writing English paragraphs. During the first term of the school year 2023-2024, 43 grade 7 students from a secondary school in Hanoi participated in a descriptive quantitative research project. The participants were asked to complete three writing tests at three different times to generate their written errors based on Ferris’ (2014) model of error analysis. The findings indicate that the types of errors that grade 7 students made are lexical errors, syntactic errors, morphological errors, orthographical errors, and paragraph errors. Lexical, syntactic, and orthographical errors are greatly committed by the students. Accordingly, it comes to the conclusion that secondary students in general and 7th graders in particular struggle with writing English paragraphs. The results of the research would also give the secondary teachers of English some implications, such as focusing on grammatical patterns, emphasizing irregular instances, offering adequate practice opportunities, implementing explicit instructions, and engaging students in interactive exercises, visual aids, collaborative activities, authentic materials, etc. to mitigate the students' written errors.

A qualitative exploration of mothers' perspectives on infant formula use in Uruguay

The transformation of the first-food systems and the widespread availability and marketing of breastmilk substitutes undermine efforts to promote adequate breastfeeding practices. The objective of the present research was to explore mothers' perspectives on infant formula use in Montevideo, the capital of Uruguay. A generic qualitative design was used to explore mothers' perspectives on the factors that act as enablers or barriers for infant formula use. Semi-structured interviews with thirty-four mothers of 0–23 months old children, aged between 25- and 40-years old, were conducted. The interview transcripts were analyzed using content analysis based on inductive-deductive coding considering the framework of the Capability, Opportunity, Motivation, and Behavior (COM-B) model. The discourse of the interviewees enabled the identification of a wide range of barriers and enablers for the use of infant formula, which were related to the three components of the model: capabilities, opportunity, and motivation. The health system emerged as the key determinant of infant formula use. Most of the participants who used infant formula referred to medical indication when explaining the reasons underlying their infant feeding decisions. The working status of the mother and emotional aspects of the child feeding experience were also identified as key enablers of infant formula use, whereas knowledge about health benefits and breastfeeding techniques, support from families and health-professionals, and motivation to breastfeed were key barriers. Taken together, these results suggest that strategies to reduce the use of infant formula in Uruguay should mainly focus on providing opportunities to breastfeed by improving the quality of the support and guidance provided to families in the health system and facilitating greater balance between breastfeeding and work.

Outcome expectations, self-efficacy, eating environment, and eating behaviors by the stages of change in adequate sodium intake among university students: a cross-sectional study

Objectives: This study investigated whether outcome expectations, self-efficacy, eating environment, and eating behaviors differed according to the stages of change in adequate sodium intake among university students. Methods: The participants were students recruited from nine universities in Seoul, Korea. An online survey was conducted, and data from 351 participants were analyzed. Participants were classified into pre-action and action stages based on adequate sodium intake. Data were analyzed using t-test, χ2-test, analysis of covariance, and correlation analysis. Results: Participants in the action stage (22.8%) felt fewer disadvantages of eating sodium adequately compared to those in the pre-action stage (77.2%, P &lt; 0.001) and perceived more self-efficacy for healthy eating behaviors (P &lt; 0.001) and controlling sodium intake (P &lt; 0.01). The participants in the action stage also showed more desirable eating behaviors than those in the pre-action stage, including general eating behaviors, behaviors related to sodium intake, and sodium checks (P &lt; 0.001). The physical environment in the action stage was more supportive of adequate sodium intake (P &lt; 0.05). Eating behaviors, self-efficacy, and outcome expectations were significantly correlated with the stages of change; however, some differences were noticed in the correlation of the subscales of variables with the stages of change when examined by sex. Conclusion: We observed differences in factors according to the stages of change in adequate sodium intake. For the pre-action stage, nutrition education can be planned to modify negative expectations of eating adequate sodium, foster self-efficacy, and practice general eating behaviors and behaviors to gradually reduce sodium intake. It is also necessary to alter the physical environment to reduce sodium intake. In the action stage, support and reinforcement are needed to continually practice and maintain desirable eating behaviors. Nutrition education for women may be planned using multiple paths, whereas a simple strategy may be useful for men.

Impact of rubrics on students’ self-assessment and overall performance in an EAP writing course

This study investigates the impact of rubric use on students’ self-assessment and overall performance in an English for Academic Purposes (EAP) writing course. Recognizing the complexity of academic writing, which requires substantial guidance and effort, the research examines how rubrics can help align students’ self-assessments with instructor’s and / or program expectations. The study involved six students from diverse cultural and academic backgrounds who participated in multiple rounds of rubric-related assessments and following reflective activities. The findings suggest that consistent use of rubrics can significantly enhance students’ understanding of writing criteria, improve the correlation between student and instructor evaluations, and consequently lead to better writing outcomes. However, certain challenges such as lower proficiency levels, time constraints, or lack of interest / motivation may limit students’ ability to fully comprehend and utilize rubrics effectively while performing a writing task. The research highlights the need for clear and measurable rubric descriptors to support students’ comprehension, additionally to providing multiple writing samples for reference and allowing adequate practice time. These insights contribute to the ongoing discussion on rubric effectiveness in General English Language Teaching (General ELT) and EAP settings, offering practical suggestions how to improve academic writing instruction and bridge the gap between students’ performance and instructor’s and/ or program expectations.

Effect of Corporate Governance on Increasing Foreign Direct Investment in Saudi Arabia

This research paper aimed to investigate the relationship between corporate governance and foreign direct investment (FDI) in the Kingdom of Saudi Arabia. It examined various aspects of corporate governance such as executive compensation, financial reporting, board composition and the shareholder rights. It analyzed the trends, patterns and factors that may affect the decisions of foreign direct investors. The findings revealed that the Kingdom of Saudi Arabia has conducted a great progress in the field of utilizing corporate governance on increasing the foreign direct investments; however, there is a need for improving the quality. The study also provided some recommendations to create more stable environment to support FDI adequately as well as utilizing adequate corporate governance practices such as strengthening the independent board oversight and enhancing the rights of shareholders are among these factors. Improving the executive compensation practices and adopting international financial reporting can increase the number of investments as well as there will be coherence between the economic regulations in the Kingdom and those of other countries. Increasing the corporate social responsibility as well as strengthening the regulatory framework to facilitate applying corporate governance measures as well as enhancing foreign direct investments are recommended as well. Fostering the culture of good governance and providing facilities to attract foreign investments are suggested along with asserting the importance of enhancing the international cooperations.

A mouse model of volumetric muscle loss and therapeutic scaffold implantation.

Skeletal myofibers naturally regenerate after damage; however, impaired muscle function can result in cases when a prominent portion of skeletal muscle mass is lost, for example, following traumatic muscle injury. Volumetric muscle loss can be modeled in mice using a surgical model of muscle ablation to study the pathology of volumetric muscle loss and to test experimental treatments, such as the implantation of acellular scaffolds, which promote de novo myogenesis and angiogenesis. Here we provide step-by-step instructions to perform full-thickness surgical ablation, using biopsy punches, and to remove a large volume of the tibialis anterior muscle of the lower limb in mice. This procedure results in a reduction in muscle mass and limited regeneration capacity; the approach is easy to reproduce and can also be applied to larger animal models. For therapeutic applications, we further explain how to implant bioscaffolds into the ablated muscle site. With adequate training and practice, the surgical procedure can be performed within 30 min.

Evaluating robotic assistance on the learning curve and efficiency of mandibular angle ostectomy: an animal model study.

This study evaluated the efficacy and learning curve of a maxillofacial surgical robotic system (MSRS) guided by electromagnetic navigation for mandibular angle ostectomy (MAO), compared to traditional surgical methods. The study utilized a controlled experiment involving thirty rabbits, paired divided into experimental and control groups. The experimental group underwent MAO using the MSRS, while the control group was treated with conventional surgical techniques. The surgeons performing the procedures were inexperienced in robotic surgery and MAO to assess the learning curve and the impact of robotic assistance. Key parameters measured included the accuracy of ostectomy, setup time, and ostectomy efficiency, with data analyzed through a paired-t test to compare the performance between the two groups. The study indicated a significant reduction in ostectomy time for the experimental group, with improved accuracy and efficiency in ostectomy. The study found that robotic assistance could decrease the risk of complications and enhance surgical outcomes. It also highlighted the presence of an initial learning curve when adopting new robotic technologies, which could be mitigated through adequate training and simulation practices. Using MSRS for MAO could lead to faster early learning curves and increased ostectomy efficiency compared to traditional surgical methods. It demonstrated the potential benefits of integrating robotic systems into craniofacial surgery, suggesting a promising direction for future surgical practices.

Investigation of Shiga toxin-producing Escherichia coli and evaluation of the microbiological quality of raw vegetable sal-ads

Foodborne diseases (FBD) are a significant public health concern worldwide, affecting millions of people annually. Symptoms of FBD range from mild gastrointestinal discomfort to more severe conditions, which in some cases can lead to death. Raw vegetables, especially those consumed in ready-to-eat (RTE) salads, are particularly susceptible to microbial contamination. This study aimed to investigate the presence of Shiga toxin-producing Escherichia coli (STEC) and to evaluate the microbiological quality of 77 RTE raw vegetable salads from 20 restaurants in Niterói, RJ, Brazil. None samples presented STEC, nor the safety indicators (SI) Salmonella spp. and Listeria monocytogenes. However, 89.6% of the samples were considered unfit for human consumption, since they presented at least one hygiene indicator (HI) outside the established standards. The majority of samples (95.5%) were unsatisfactory for Enterobacteriaceae (EB), followed by total aerobic bacteria (TAB) (76.6%), thermotolerant coliforms (C45) (32.5%) and Escherichia coli (EC) (1.3%). The difference between the occurrences of hygiene indicators was not significant. Given the high percentage of inadequate samples found in the study, it is clear that there is a need for stricter surveillance and adequate hygiene practices in restaurants. To reduce the risks of microbial contamination in RTE raw vegetable salads, several approaches can be implemented. These include continuous training of food handlers, implementation of food safety management systems such as Hazard Analysis and Critical Control Points (HACCP), and regular inspections. In addition, consumers also play an important role by demanding safe food and following safe food handling and consumption practices at home.

Students and Veterinarians Views About Clinical Anatomy and Topographic Anatomy Courses in Veterinary Education

In this study, it was aimed to evaluate the views of veterinarians and students about the topographic anatomy course and clinical anatomy course with the help of a survey. For this purpose, a total of 4 separate surveys were created, 2 for topographic anatomy course and 2 for clinical anatomy course. For each course, one of these forms was applied to the 3rd, 4th and 5th grade students in Veterinary Medicine. Other survey forms were applied to veterinarians who working in different regions in Turkey. As a result, 98% of the participants emphasized that anatomy knowledge was important for safe and adequate clinical practice. 59% of the students stated that the contents of the topographic anatomy course were not sufficient in this form, 92.3% stated that it should be explained with radiological images and 96.2% explained with clinical sciences. Only 35.5% of veterinarians stated that the information they learned in the systematic anatomy course was sufficient for clinical practices. 92.1% of veterinarians stated that clinical anatomy course should be present in the curriculum in recent years. According to the results, after taking systematic anatomy course, it was observed that it was a necessity to give the anatomy course associated with clinical sciences during the later periods.

The epidemiology and microbiology of central venous catheter related bloodstream infections among hemodialysis patients in the Philippines: a retrospective cohort study

BackgroundDespite efforts to improve the management of catheter-related bloodstream infections (CRBSI) in literature, temporary CVCs continue to be used for maintenance hemodialysis outside of acute care settings, particularly in the Philippines.MethodsWe conducted a retrospective cohort study to investigate the incidence, outcomes, risk factors, and microbiological patterns of CRBSI among adult kidney disease patients undergoing hemodialysis at the Philippine General Hospital, the country's largest tertiary referral center. We included all adult patients who received a CVC for hemodialysis from January 1, 2018, to August 31, 2019, and followed them for six months to observe the occurrence of CRBSI and its outcomes.ResultsOur study documented a CRBSI incidence rate of 6.72 episodes per 1000 catheter days, with a relapse rate of 5.08%, a reinfection rate of 15.74%, and a mortality rate of 6.09%. On multivariable regression analysis, we identified autoimmune disease, dialysis frequency of > 3 × per week, use of CVC for either blood transfusion or IV medications, renal hypoperfusion, drug-induced nephropathy, and hypertensive kidney disease as significant risk factors for CRBSI. Gram-negative bacteria, including B. cepacia complex, Enterobacter, and Acinetobacter spp, were the most common organisms causing CRBSI. Multidrug-resistant organisms (MDROs) comprised almost half of the isolates (n = 89, 44.5%), with Coagulase-negative Staphylococcus species having the highest proportion among gram-positive organisms and Acinetobacter spp. among gram-negative isolates.ConclusionOur findings emphasize the need for more stringent measures and interventions to prevent the propagation of identified pathogens, such as a review of sterile technique and adequate hygiene practices, continued surveillance, and expedited placement and utilization of long-term access for patients on maintenance hemodialysis. Furthermore, CVC use outside of hemodialysis should be discouraged, and common antibiotic regimens such as piperacillin-tazobactam and fluoroquinolones should be reviewed for their low sensitivity patterns among gram-negative isolates. Addressing these issues can improve hemodialysis patients' outcomes and reduce the CRBSI burden in our institution.

Improving the Accuracy of Patient Self-Care After Joint Replacement Surgery

Joint replacement wound stitches are typically not removed until two weeks after the operation. Therefore, patients with joint replacement must be able to execute proper wound care after discharge from the hospital to reduce the risk of wound infection. Prior data from Chang Gung Memorial Hospital's orthopedics ward indicate only 69% of joint-replacement patients are able to perform wound care properly at home. Potential causes for this noted by patients include age-related forgetfulness, being unable to discern redness or swelling in the wound, and language comprehension difficulties (i.e., Taiwanese vs. Mandarin). Poor rates of wound care may also be attributable to incomplete wound care education by nursing staff and wound care education being provided without adequate practice on the day of patient discharge. This project was implemented to improve the accuracy of wound self-care performed by patients after joint replacement surgery and to enhance their related knowledge and wound-care technical correctness. A wound care education checklist, wound care cue cards, wound care video clips, wound condition red flag cue cards, and customized wound care pack were proposed and implemented. The rate of accuracy of wound self-care performance increased from 69% pretest to 98% posttest, showing the intervention to have effectively improved post-discharge wound care quality. To effectively improve the post-discharge accuracy of wound self-care in patients with joint replacement, the consistency of post-surgery wound care education given by nursing staff to patients should be improved, patients should be reminded of wound assessment and care steps, and patients should be aware that wound abnormalities require an immediate return to the hospital for follow-up treatment.

A Global Review of Advanced Practice Nursing in the Emergency Department.

As demands in the way of healthcare delivery increase, nurse practitioners have become essential components in optimizing access to healthcare and improving outcomes around the globe. The authors recognize the vital role nurse practitioners play globally and that education, practice, and credentialing differ significantly across countries. Many countries have a wide variation in educational requirements, resulting in a lack of adequate advanced practice nursing training and regulation of practice. Additionally, many countries are experiencing increased demands in the form of emergency services, with long waiting times and severe crowding in emergency departments. Worldwide, many programs are being developed to educate advanced practice nurses on improving emergency medical care, but developing such programs is a complex process This article aims to discuss the scope of practice and roles of advanced practice nurses globally. We will also attempt to clarify and improve these global standards and discuss competencies in this role.

Global primary predictors of extinction risk in primates.

Identifying the main predictors of species' extinction risk while accounting for the effects of spatial and phylogenetic structures in the data is key to preventing species loss in tropical forests through adequate conservation practices. We recorded 22 705 precise geographical locations of primate occurrence across four major geographic realms (Neotropics, mainland Africa, Madagascar and Asia) to assess predictors of threat status using a novel Bayesian spatio-phylogenetic approach. We estimated the relative contributions of fixed factors (forest amount, body mass, home range, diel activity, locomotion, evolutionary distinctiveness and climatic instability) and random factors (space and phylogeny) to primate extinction risk. Precipitation instability increased the extinction risk in the Neotropics but decreased it in mainland Africa and Madagascar. Forest amount was negatively associated with extinction risk in all realms except Madagascar. Body mass increased the extinction risk in the Neotropics and Madagascar, whereas home range increased the extinction risk in mainland Africa and decreased it in Asia. Evolutionary distinctiveness negatively influenced extinction risk only in mainland Africa. Our findings highlight the importance of climate change mitigation and forest protection strategies. Increasing the protection of large primates and reducing hunting are also essential.

Knowledge And Attitude Of Nurses About Radiation Safety And Radiation Protection: A Scoping Review

Background: Radiation is an electromagnetic wave which is coming across the daily activity of humans. There are naturally occurring and man-made radiations. X-rays, being the commonest radiation mostly known to the people are used in the medica field for diagnostic and therapeutic aspects. Despite of being at good in the preliminary evaluation of pathologies, it also possess a risk of biological effects of radiation on living tissues. This is crucial for the people who are associated with radiation as part of their occupation. The occupational staff must be well aware of the biological effects of radiation and the different means of radiation protection and safety. Nurses, being the largest community in the healthcare, and associated with most of the procedures carried out in a hospital, are expected to have a good knowledge and understanding about the radiation and radiation safety. The aim of this review was to assess the nurses’ awareness and knowledge of radiation safety and protection, which is essential for their health and performance as a healthcare team. Materials and Methods: A systematic search was conducted using PubMed and ProQuest databases with relevant keywords from 2013 to 2023. A total of 104 articles were found based on the search techniques, were screened for eligibility based on predefined criteria and only 7 articles were included in the final analysis. Results: The review found that nurses’ knowledge and attitudes towards radiation safety and protection were insufficient and varied across different settings and specialties. The main barriers to adequate knowledge and practice were lack of education, training, and resources. Conclusion: The review highlighted the need for improving nurses’ knowledge and competence in radiation safety and protection through regular and comprehensive training programs, guidelines, and policies. This would enhance the quality and safety of the services provided by the nurses and protect them from the harmful effects of radiation exposure.