Report Of Committee Research Articles

The Most Promising Alternative to Mercury-containing Dental Restorations

The European Union Environmental Commission report and the United Nation Minamata Convention have legislated for phasing-out of mercury-containing dental materials use (dental amalgams) by 2030.1, 2 Several Scandinavian countries have already banned the use of dental amalgams, and this ban is expected to grow to other countries worldwide.2, 3 This creates a market gap for materials which can be used as an alternative to dental amalgams.4 Varieties of mercury-free dental materials have been clinically approved as posterior restorations; such as (1) resin-based composite materials, and (2) glass-based materials, including glass ionomers and glass hybrids. Using these types of dental materials will decrease the mercury’s risks on human’s health and also contribute significantly in the reduction of the environmental mercury pollution.5, 6 Recently, several clinical approaches to treat dental caries lesions have shifted the focus to preserving tooth structure and use of adhesive materials. Considering this, Minimally Intervention Dentistry (MID) has become a crucial concept which includes three aspects to fulfil the requirement of preventive and restorative dentistry; these are early caries diagnosis, enhance remineralisation and minimal cutting of tooth surfaces.7, 8 This approach is identified as an Atraumatic Restorative Treatment (ART). The ART technique was adopted in 1994 by the World Health Organisation (WHO) as an alternative technique for dental caries management in the developed countries either for treating deciduous and/or permanent dentitions.9 The high viscous glass ionomer cement (GIC) is approved as an ideal candidate material to be used with ART technique; such as GC Fuji IX®, KetacTM Molar and Glass Carbomer®.10, 11 One of the main advances in dental materials field is based on the modifications of the GIC chemical compositions, by introducing a bioactive glass in different particle sizes (for promoting remineralising ability) and/or using a highly molecular weight of poly- acrylic acid (for enhancing matrix strength).12 When bioactive glass-containing dental materials come into contact with body fluid, will undergo to a sequence of bioactivity reactions; which is summarised into (1) ion exchange, (2) dissolution and (3) precipitation stages, leading to formation of apatite crystals in fractions identical to those of the natural bone and tooth components.13 Formation of apatite crystals [hydroxyapatite-Ca10(PO4)6OH2 or fluorapatite-Ca10(PO4)6F2] in the bioactive glass-containing GICs occurs via delivering of calcium (Ca2+), phosphate (PO43), hydroxyl (OH-) and/or fluoride (F-) species at the interfaces between the GIC/tooth surfaces and/or the GIC/oral environment.14 For this reason, the bioactive glass-containing GICs are considered as the most promising alternative restorative materials for posterior cavities.

Assessing the EU27 Potential to Meet the Nature Restoration Law Targets.

The Nature Restoration Law adopted by the European Union in 2024 aims to implement measures to restore at least 20% of its land and sea by 2030 and all ecosystems in need of restoration by 2050, focusing on among others agricultural land, forests, urban, marine, freshwater, and wetlands areas. The goal is to enhance the natural and semi-natural habitats' role in achieving climate targets and preserving biodiversity. Member States must submit detailed national restoration plans, outlining specific actions and mechanisms for monitoring progress. However, these plans should align with the ongoing Common Agricultural Policy and National Energy and Climate Plans objectives. Using data from European Commission reports and applying a semantic interval scale methodology, this study quantifies each Member State's ambitions and effectiveness under the National Energy Climate Plans and Common Agricultural Policy and establishes a benchmark for reporting under the Nature Restoration Law. The findings reveal the National Energy Climate Plans' wide disparities in implementing decarbonization measures, climate change adaptation and the implementation of nature-based solutions. The Common Agricultural Policy Plans exhibit only partial commitment to greening agriculture, yet their alignment with Nature Restoration Law objectives varies. Therefore, timely coordination between the three strategies is crucial to avoid conflicting goals, overlapping efforts, and wasting time and resources, ensuring the success of restoration actions.

Simplifying coronary artery disease risk stratification: development and validation of a questionnaire-based alternative comparable to clinical risk tools.

Coronary artery disease (CAD) comprises one of the leading causes of morbidity and mortality both in the European population and globally. All established clinical risk stratification scores and models require blood lipids and physical measurements. The latest reports of the European Commission suggest that attracting health professionals to collect these data can be challenging, both from a logistic and cost perspective, which limits the usefulness of established models and makes them unsuitable for population-wide screening in resource-limited settings, i.e., rural areas. Therefore, the aim of this study was to develop and externally validate a questionnaire-based risk stratification model on a population scale at minimal cost, i.e., the Questionnaire-Based Evaluation for Estimating Coronary Artery Disease (QUES-CAD) to stratify the 10-year incidence of coronary artery disease. Cox proportional hazards (CoxPH) and Cox gradient boosting (CoxGBT) models were trained with 10-fold cross-validation using combinations of ten questionnaire variables on the White population of the UK Biobank (n=448,818) and internally validated the models in all ethnic minorities (n=27,433). The Lifelines cohort was employed as an independent external validation population (n=97,770). Additionally, we compared QUES-CAD's performance, containing only questionnaire variables, to clinically established risk prediction tools, i.e., Framingham Coronary Heart Disease Risk Score, American College of Cardiology/American Heart Association pooled cohort equation, World Health Organization cardiovascular disease risk charts, and Systematic Coronary Risk Estimation 2 (SCORE2). We conducted partial log-likelihood ratio (PLR) tests and C-index comparisons between QUES-CAD and established clinical prediction models. In the external validation set, QUES-CAD exhibited C-index values of CoxPH: 0.692 (95% Confidence Interval [CI]: 0.673-0.71) and CoxGBT: 0.699 (95% CI: 0.681-0.717) for the male population and CoxPH: 0.771 (95% CI: 0.748-0.794) and CoxGBT: 0.759 (95% CI: 0.736-0.783) for the female population. The addition of measurement-based variables and variables that require a prior medical examination (i.e., insulin use, number of treatments/medications taken, prevalent cardiovascular disease [other than CAD, and stroke diagnosed by a doctor]) and the further addition of biomarkers/other measurements (i.e., high-density lipoprotein [HDL] cholesterol, total cholesterol, and glycated haemoglobin) did not significantly improve QUES-CAD's performance in most instances. C-index comparisons and PLR tests showed that QUES-CAD performs and fits the data at least as well as the clinical prediction models. QUES-CAD performs comparably to established clinical prediction models and enables a population-wide identification of high-risk individuals for CAD. The model developed and validated herein relies solely on ten questionnaire variables, overcoming the limitations of existing models that depend on physical measurements or biomarkers. University Medical Center Groningen.

La producción bibliográfica sobre educación para nunca más en Brasil

This article was presented as part of Axis II: Memory, Truth, Justice, and Reparation during the 10th Latin American and Caribbean Colloquium of Latin American and Caribbean Network of Human Rights Education and the Colombian Network of Human Rights Education (REDLACEDH), which took place at the National Pedagogical University of Bogotá, Colombia, from October 11 to 13, 2023. The event was organized by the REDLACEDH. These are the findings of a study on the production of literature regarding memory, truth, and justice; this production was born from experiences of education for “Never Again” in Brazil. The bibliographical research on social production related to the period 1964-1985 in Brazil originated from social organizations such as Movimiento de Mujeres por la Amnistía (Women’s Movement for Amnesty), Comités Brasileños de Amnistía (Brazilian Amnesty Committees), Comisión de Justicia y Paz (Justice and Peace Commission), Grupos Tortura Nunca Más (Torture Never Again Groups), Movimiento de Familiares de Muertos y Desaparecidos (Movement of Relatives of the Dead and Disappeared). The review encompasses political issues such as dossiers and reports on serious violations of human rights, the memory of hunger strikes inside political prisons, the historiography of resistance movements against the dictatorship, biographies, audiovisual productions, and educational practices of knowledge and memory originated from actions of resistance and defense. In this process, the significant roles played by former political prisoners, family members, lawyers, religious leaders, and human rights defenders are particularly noteworthy. The establishment of the Comisión Nacional de la Verdad (National Truth Commission) led to the emergence of productions stemming from human rights policy, including Truth Commission reports, academic studies, and research on transitional justice. At this stage, the centrality of political persecution by the authoritarian state returns, allowing space for silenced discourse.

Freedom of movement of workers in the European Union.Legal and economic aspects

Since Poland’s accession to the European Union, Polish citizens have been making significant use of the freedomof movement within the Community, a right to employment, and in particular to be posted to work in anotherMember States. The report of the European Commission on the application and implementation of the DirectiveNo. 2018/957 concerning the posting of workers in the framework of the provision of services shows areas where,despite the application of EU regulations, there are still many problems that need to be solved. The article addressesthe issue of Polish citizens exercising their freedom of movement within the EU and their consequences,taking into account legal and economic aspects.

Transition from environmental protection to environmental sustainability

The multiplication of sources of pollution, the increase and diversification of forms of environmental pollution have made environmental protection one of the most important and serious problems of humanity in recent decades, affecting human life and the economic development of countries and the whole world. Protection of the environment serves to maintain the quantity and quality of life on Earth, being assumed, through the Declaration of the United Nations Conference on the Human Environment in Stockholm in 1972, as the major desire and interest of the peoples of the whole world and, at the same time, becoming a duty of all governments. Alongside economic and social development, environmental protection is one of the three interdependent and complementary pillars of sustainable development, defined for the first time in the Brundtland Report of the World Commission on Environment and Development as development that meets the needs of the present generation without compromising the ability of future generations to meet their own needs. Clear and time-bound sustainable development goals have been set, global targets for a sustainable and prosperous future, but these are now proving elusive as the challenges are growing ever greater and more dangerous. The effects of global warming can be seen and felt everywhere, the climate crisis is increasingly being talked about, biodiversity and nature are in steadily increasing decline, a water crisis, a food crisis, and dangerous critical points are being predicted. In this context, the transition from environmental protection to environmental sustainability is essential to respond to contemporary global challenges, and requires a concerted effort from all of us - governments, institutions and companies, civil society and every individual. Sustainability is a proactive approach that is crucial for our survival and that of future generations and implies a responsible commitment to the planet, to conserve natural resources and ecosystems and to maintain ecological balance.

Navigating ‘deterioration in mental state’ – from recognition to response in general hospitals to satisfy ‘National Standards’: a discussion paper

Background The Australian Commission on Safety and Quality in Health Care ‘National Standards’ require general hospitals to have systems for clinicians to recognise and respond to patients’ deteriorating mental state. The lack of an evidence-based operational definition and clear guidance challenges this requirement. Objective To review governance mechanisms and assessment processes for deteriorating mental state in a metropolitan general hospital and propose an organisational framework. Methods A qualitative document analysis using the READ approach systematically reviewed hospital committee reports, health district policies, and training programs to identify and synthesise key assessment points and processes. Findings The study mapped assessment points for recognising and responding to deteriorating mental state across patient journey stages. An organisational systems infographic provides a blueprint for meeting National Standards accreditation criteria. Conclusions Hospitals should establish comprehensive systems to observe, monitor, assess, and refer individuals with deteriorating mental state, involving multiple governance processes and frameworks. Impact statement Our paper maps governance and assessment processes to enhance deteriorating mental state recognition in general hospitals, aligning with National Standards. Plain English Summary General Hospital staff often need to recognise and respond to patients whose mental health is getting worse. This problem is serious because a worsening mental state can lead to harmful behaviours, such as self-harm or violence, and can result in poor healthcare experiences for patients. Our paper aimed to find ways to help hospital staff better identify and manage these situations. We looked at the systems and processes currently in place in hospitals to see how they could be used to meet national healthcare standards for mental health care. We created a detailed plan that hospitals can follow to improve their mental health responses. This plan includes steps for governance, assessment, and clinical pathways, ensuring that all parts of the hospital system work together to support patients with deteriorating mental states. Our findings suggest that using existing hospital processes, rather than creating new tools, can help staff more effectively recognise and respond to mental health issues. This approach not only meets accreditation requirements but also enhances patient safety and care quality. This paper provides valuable insights for healthcare practitioners and policymakers, showing that with the right systems in place, general hospitals can better manage mental health care, ultimately leading to better outcomes for patients.

Data Monitoring Committee Reports: Telling the Data's Story.

A Data Monitoring Committee (DMC) plays a pivotal role in monitoring participant safety and efficacy and overseeing the integrity of clinical trials. DMCs accomplish this mission by periodically reviewing accumulating data to assess benefits and harms of interventions in ongoing studies and making subsequent recommendations regarding future clinical trial conduct to the trial sponsor. Reports summarizing data from the clinical trial are prepared for the DMC by statistical and data analysis centers to inform DMC decision-making. In practice however, these reports are often disorganized, complex, and provide overwhelming detail yet insufficient information, that hinders accurate and efficient interpretation of interim data. This review paper delves into the nuances of preparing effective DMC reports, highlighting the importance of simplicity, clarity, and thoughtful relevance in data presentation. We discuss structured approaches for preparing closed reports, which deal with sensitive and sometimes messy interim data, and underscore the use of visual summaries and narrative elements that enhance comprehension and facilitate efficient assessments of trial data. The paper outlines key principles for preparing DMC reports and provides practical guidance on their structure. Ultimately, this guidance seeks to ensure that the data's story is clearly and efficiently conveyed to facilitate the DMC decision-making process.

It hardly made a ripple: South Australia's Murray-Darling Basin Royal Commission Report in rural news discourse

In January 2019, the South Australian Government released the report of its Royal Commission into the Murray-Darling Basin, which investigated the implementation of the Basin Plan and allegations of water theft in upstream states. This study analyses the report and specialist rural media coverage of it. Previous research has found that rural media imaginaries of the rural space validate the ‘productive’ use of land and reinforce the discursive power of rural elites such as political actors, industry bodies and landholders, offering few opportunities for alternative voices. Drawing on the concepts of ‘agrarian imaginary’ and ‘settler common sense’ and adopting discourse analysis as a methodology, we found that while the report made a clear connection between settler activities and the ill health of the Basin, specialist rural media did not approach it as an opportunity to broaden the dominant rural imaginary but further cemented the productive use of land discourse.

The 1st SAU Annual Conference on Urological Research

In the fall of 2022, Dr. Benyi Li from the University of Kansas registered the scientific society with the title of Serican Academy of Urology (SAU), an international non-profit organization. The SAU is dedicated to uniting clinicians and basic scientists to tackle diseases related to the genitourinary tract. Prostate cancer, particularly castration-resistant prostate cancer and neuroendocrine prostate cancer, remains a significant public health issue. The academy held its first annual conference on December 26-29, 2023, in Cancun, Mexico. The conference was chaired by Dr. Xiaoqi Liu from the University of Kentucky, with generous sponsorship from SinoBiological, MedChemExpress, and Admera Health. Aiming to address the most urgent issues related to prostate cancer, the conference focused on topics such as epigenetics, lineage plasticity, therapy resistance, novel target identification, immunotherapy, and emerging technologies in the field. In honor of the late Dr. Changdeng Hu from Purdue University, one of the SAU founder members, Dr. Jiaoti Huang from Duke University presented a keynote address on developing grant applications through collaboration with pathologists. The Career Development Forum provided a platform for discussing career navigation and leadership development for the next generation of prostate cancer researchers. The conference concluded with a banquet, including an awards ceremony and committee reports.

Adaptation pathways and costing climate adaptation in Europe

Flexible adaptation pathways are vital for addressing intensifying climate hazards and their wide-ranging impacts across Europe. A 2024 World Bank and European Commission report provides insights how countries can identify the needs and costs of adaptation strategies.

Big data research is everyone's research-Making epilepsy data science accessible to the global community: Report of the ILAE big data commission.

Epilepsy care generates multiple sources of high-dimensional data, including clinical, imaging, electroencephalographic, genomic, and neuropsychological information, that are collected routinely to establish the diagnosis and guide management. Thanks to high-performance computing, sophisticated graphics processing units, and advanced analytics, we are now on the cusp of being able to use these data to significantly improve individualized care for people with epilepsy. Despite this, many clinicians, health care providers, and people with epilepsy are apprehensive about implementing Big Data and accompanying technologies such as artificial intelligence (AI). Practical, ethical, privacy, and climate issues represent real and enduring concerns that have yet to be completely resolved. Similarly, Big Data and AI-related biases have the potential to exacerbate local and global disparities. These are highly germane concerns to the field of epilepsy, given its high burden in developing nations and areas of socioeconomic deprivation. This educational paper from the International League Against Epilepsy's (ILAE) Big Data Commission aims to help clinicians caring for people with epilepsy become familiar with how Big Data is collected and processed, how they are applied to studies using AI, and outline the immense potential positive impact Big Data can have on diagnosis and management.

The Effect of Companies' Internal Control Structures on Their Financial Performance: An Application on BIST-30

Purpose: The aim of this study was to investigate the effect of internal control structures on the financial performance of firms included in the BIST-30 Index. Design/Methodology: The data of the firms for the period 2018-2022 were used annually. Return On Equity and Market value to book value were used in the study to represent profitability as dependent variables. The independent variables were the number of audit committee members, the number of internal control reports, the number of audit committee meetings, the number of audit committee reports, and the rate of graduates in the audit board. GMM which is a dynamic panel data analysis technique and Driscoll Kray Regression were used as the method. Findings: As a result of the findings, it is seen that the ratio of postgraduates on the audit committee, the number of audit committee members and the number of audit committee reports may have an effect on both ROA and PBRD, while the audit firm being a large firm may have an effect only on PBRD. Limitations: The reason is that the study was applied only to Türkiye and no country comparison was made. Originality/Value: There are a limited number of studies examining the impact of companies' internal control structures on their financial performance. This study is original in terms of both variables and method.

The impact of corporate governance on the cancer waiting time target of the English National Health Service hospitals

Purpose This paper aims to examine the impact of a board-level governance bundle (i.e. size, independence, expertise, meetings, gender diversity and multiple directorships) on the non-financial performance of National Health Service (NHS) hospitals – and, separately, by hospital type (i.e. trusts hospitals and foundation trusts hospitals). Design/methodology/approach A logit regression for panel data is used for a sample of 128 NHS trusts and foundation trusts across England from 2014 to 2018. The data was hand-collected from NHS hospitals’ annual reports and Care Quality Commission reports. The cancer waiting time target (i.e. 62-day cancer referral and treatment target) is used to measure non-financial performance. Findings The main findings for NHS hospitals indicate that multiple directorships positively and significantly affect non-financial performance. However, board expertise and gender diversity have a negative and significant influence. When the sample is partitioned, the results remain the same for the NHS foundation trusts hospitals. For NHS trust hospitals, except for multiple directorships having a positive and significant effect, all remaining governance attributes have an insignificant impact. Practical implications The findings have implications for policymakers and practitioners as they move to implement measures to improve hospital performance against the cancer waiting time targets in the English NHS. Originality/value To the best of the authors’ knowledge, this is the first study to examine the impact of corporate governance on cancer waiting time targets in public hospitals. Overall, this paper contributes to the corporate governance literature, especially in the context of public hospitals, and has significant practical and theoretical implications.

Investigation of the Effects of 12 Week Aerobic and Fitness Workouts on Individuals Diagnosed with Scoliosis: A Case Study

The study was conducted to examine the effects of aerobic and fitness exercises on scoliosis. A 19-year-old male patient, 1.65 cm tall and weighing 57 kg, with idiopathic S scoliosis was included in the study. The ethics committee report dated 01.07.2021-15974 was received from Muş Alparslan University Ethics Committee. Aerobic and fitness exercises were performed 4 days a week, one day apart, and warm-up exercises were applied before and after. Aerobic and fitness movements such as bench row, reverse butterfly, face pull and low row were included in the exercise program. The exercises were carried out by academics who are experts in their field, under the supervision of an orthopedic doctor. X-rays were used to evaluate the effect of the exercise program on scoliosis. X-rays were taken before and immediately after the exercise program. The orthopedic doctor reported that the scoliosis degree of the patient included in the study was 22.5 degrees before the exercise program, but after the 12-week exercise program, the degree decreased to 21.6 degrees and an improvement of 0.9 degrees was achieved. It was concluded that aerobic and fitness exercises applied specifically to the patient gave positive results in patients diagnosed with scoliosis.

Ruminant livestock and climate change: critical discourse moments in mainstream and farming sector news media

AbstractThere is ongoing contestation around greenhouse gas emissions from ruminant livestock and how society should respond. Media discourses play a key role in agenda setting for the general public and policymakers, and may contribute to polarisation. This paper examines how UK news media portrayed ruminant livestock’s impact on climate change between 2016 and 2021. The analysis addresses a gap in the literature by comparing discourses in national and farming sector newspapers using a qualitative approach. Four national and two farming sector news outlets were searched for articles published between 2016 and 2021. A corpus of 996 relevant articles was assembled, from which 154 were selected for in-depth examination using Critical Discourse Analysis. Four ‘Critical Discourse Moments’ (CDMs), each signifying a discursive shift in the debate, were identified over the 6-year studied period: 1) Low salience, diverging discourses, 2) We must eat far less meat, 3) Fighting the anti-meat agenda, and 4) Policy (in)action at COP26. There was a large increase in the number of published articles from January 2019 onward, partly associated with publication of the EAT/Lancet Commission report. CDM 2 (We must eat far less meat) occurred mainly in the national media, while CDM 3 (Fighting the anti-meat agenda) occurred mainly in the farming media. Our findings reveal both opinion polarisation and intergroup polarisation between national and farming sector media, and low engagement with food system power imbalances. Addressing polarisation will be important to enhance capacity for collective decision-making regarding methane emissions from ruminant livestock.

ЧЛЕНСТВОТО НА УКРАЙНА В ЕС – НАДЕЖДИ, ПРОТИВОРЕЧИЯ, ЗАПЛАХИ

This research paper examines the possible benefits and challenges of Ukraine's accession to the European Union. The text emphasizes the hopes and threats faced by Ukraine, the EU and other member states. By comparative analysis and analysis of data from European Commission reports and other organisations, the report examines the following aspects – military security and defence, foreign direct investment, energy, migration, internal and external security, corruption and agricultural policy. The results highlight the need for institutional changes, fighting corruption and supporting Ukraine's stability and development.

Legal regulation of biomedical research: key principles and their implementation.

Aim: To analyze the key principles underlying the legal regulation of biomedical research and evaluate their practical implementation in contemporary legal frameworks. Materials and Methods: This study employs a comprehensive literature review, including academic publications, legal documents, and international guidelines on biomedical research ethics. Qualitative analysis identified core principles of legal regulation. Comparative legal analysis assessed principle implementation across jurisdictions. Case studies of biomedical research projects provided practical insights. A systematic review of ethical committee reports and policy documents highlighted implementation challenges and best practices. Conclusions: Ethical principles in biomedical research form a complex framework essential for protecting participants' rights while advancing science. A shift from paternalistic models to patient autonomy is evident, yet implementation challenges remain, particularly in balancing information disclosure with potential negative impacts. Evolving biomedical technologies necessitate ongoing principle refinement. Future efforts should focus on improving complex medical information communication, ensuring informed decision-making, addressing vulnerable populations' needs, while maintaining balance between individual rights and societal benefits. Attention is paid to the principle of informed consent, which is fundamental to modern bioethics and medical practice, reflecting the transition from a paternalistic model to a model emphasizing patient autonomy.

Trend in the prevalence, awareness, treatment and control of hypertension among adult over in Nigeria over a 4-year period

Abstract Background Hypertension is the commonest risk factor for most cardiovascular and cerebrovascular diseases, also the commonest cause of sudden unexpected death in the country. Despite concerted efforts to reduce the burden of this condition through increasing awareness, treatment and control rate of hypertension among adults in Nigeria. The rates of hypertension awareness (60%), treatment (34%), and control (12%) have been reported recently These figures need to change for the improved health of the citizens. Objective The study assessed the trend in the prevalence, levels of awareness, treatment, and control of hypertension among adults in urban setting in Nigeria, Sub-Sahara Africa. Methods This was a retrospective study. Data collected from opportunistic screening of adults aged 15 years and above in 4 urban communities during May Measurement Month from 2020 to 2023 was analyzed. Standardized protocol was used to collected data on socio-demographics and anthropometric measurements, blood pressure and pulse rate were measured using digital blood pressure monitors after patient have rested for at least 15 minutes. Hypertension was defined based on the 7th Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of Hypertension. Data was analyzed using SPSS 22 and p-value <0.05 was statistically significant Results We analyzed data of 2676participants. The mean age was 40.4years (SD 15·04), 68·5% of whom were women, 2.8% had diabetes mellitus, and 50·9% were overweight/obese. A third of the participants (33·9%) had hypertension, more than half of whom (57·2%) were aware that they were diagnosed of hypertension. The prevalence reduced from 39.7% in 2020 to 26.8% in 2023. Among those diagnosed, 66.5% were taking medication, and among those taking medication 32.5% had controlled blood pressure. We noted an increasing improvement in the rate of awareness from 35.4% to 72.5%, treatment from 46.7% to 82.6% and control from 5.7% to 52.3% over the 4-year period, p-value 0.000 (figure 1). When comparing between the hypertensives and non-hypertensives; higher age group (55years and above), the presence of diabetic mellitus and overweight/obesity showed statistically significant association, all at p-value of 0.000 each (table 1). Conclusion Hypertension is still a major problem among urban dwellers in Akwa Ibom State, with almost every one out of three adults have the condition. Though there is a decreasing trend in the prevalence and increasing trend in the awareness, treatment and control of hypertension, these rates are still suboptimal. Urgent measures are needed to reduce the prevalence and improve hypertension control among this population.

Mixed-method study of women’s experiences of Respectful-Disrespectful Maternity Care in Cyprus

Abstract Background Since the WHO reports on Disrespect and Abuse (D&A) in childbirth, there was an increase in studies across Europe exploring women’s experiences. Even though contentious, a 2024 EU Committee report adopts the term obstetric violence. With the highest caesarean section (C/S) in the EU, the birth environment in Cyprus raises questions about informed choices. Methods The RESPECT mixed-method study gained insights into the experiences of women in Cyprus with focus groups (N = 6, 28 women) and survey (online and in-person) tapping on Rights for Respectful Maternity Care (RMC), as measured by Person-Centred Maternity Care scale (PCMC), autonomy in decision making (MADM), dignity and respect (MoRi) and mistreatment (MIST). Results Among 516 responses (61% first childbirth, 38.5% vaginal, 15% public sector, consistent with official statistics), the 35-item PCMC (range 0-100%) represents a continuum of quality standards deviations (Med=81, IQR=61-92). Lowest scores were recorded for “Communication & Autonomy”, with 28.5% reporting ‘feeling pushed into a decision’, with associations observed with younger age, first-time birth, mode and place of birth, highlighting social inequity. Based on MADM, 23.8%, 14.1% and 14.7% women were classified as having moderate, low or very low autonomy. For mistreatment, 32.0% reported at least one of 11 indicators, most commonly privacy violations and no freedom of movement. Formula feeding against wishes (13.6%), vaginal examinations (11.6%) and episiotomy (7.8%) where most common among 33.7% reporting procedures without consent. Deductive content analysis of narratives according to RMC triangulate findings of weak shared decision-making processes. Conclusions Given that C/S reduction was identified as a national priority in Cyprus, the RESPECT findings can widen the conversation about quality improvement and form the basis to engage with local stakeholders in an open-dialogue about RMC, guided by participatory action research principles. Key messages • In the medicalized birth environment of Cyprus, women report a range of sub-optimal practices, with ethical implications, primarily affecting the right to autonomy. • Adopting the Respectful Maternity Care framework, the findings can stimulate and shape quality improvement efforts in a participatory and inclusive process with local stakeholders.