Comprehensive Program Research Articles

Assessment of undergraduates nursing students’ knowledge toward MRI safety: Cross-sectional study

IntroductionMagnetic resonance imaging (MRI) has been traditionally regarded as a relatively safe imaging modality due to the absence of ionizing radiation. However, considerable immediate safety risks are intrinsic to the MRI environment, necessitating comprehensive awareness and training among healthcare professionals, particularly nurses, who accompany their patients to the MRI department in most cases. This study was carried out to evaluate the level of knowledge and awareness of MRI safety issues among nursing students within the nursing faculty at Jazan University (JU). Materials and methodsA descriptive, cross-sectional survey encompassing 128 undergraduate nursing students was conducted. A structured questionnaire comprising 25 questions was employed and classified into three sections, encompassing demographic data and MRI safety awareness. Data were analyzed using Microsoft Excel, and frequencies and percentages of responses were calculated and summarized. ResultsOf the 128 participants, 111 were females, and 17 were males, distributed across the 2nd (41%), 3rd (20%), and 4th (39%) academic years. Participants exhibited a commendable grasp of MRI contraindications related to ferromagnetic materials such as oxygen cylinders and metal needles. However, their knowledge concerning the operational aspects of MRI, such as examination duration, was found to be lacking, indicating a significant deficiency in comprehension regarding the operational aspects of MRI technology. ConclusionThis study highlights the relatively high level of awareness regarding MRI safety among nursing students at JU. However, the identified lack of knowledge pertaining to the operational aspects of MRI technology emphasizes the need for further education and training in this area. To address this gap, we recommend the establishment of comprehensive MRI safety courses and training programs customized for undergraduate nursing students.

Lesson Learned from Rehabilitation Medicine Point of View for A Male Patient After Total Right Scapulectomy

ABSTRACT
 Introduction: Chondrosarcoma is a rare cancer about 2 million inhabitants/year. Scapula is the most common location. Total scapulectomy can cause loss of many functions in shoulder movement that affects impaired upper extremity function.
 Case Report: A case presentation of 41 years old man, after total right scapulectomy caused by chondrosarcoma. The patient complained of difficulty raising right upper arm, he has limited range of motion in all right shoulder movement. Functional assessment showed disability in overhead activities and affected his vocational as an online driver. Comprehensive rehabilitation program was given. With the overall program in 2 months follow up patient can return to work and do overhead activities with modification.
 Conclusion: Rehabilitation can improve the function in patient after scapulectomy, rehabilitation program depends on the type of surgery and muscle remaining.
 Keywords: scapulectomy, chondrosarcoma, rehabilitation

Six Minutes Walking Test as Assessment in Determining Fitness to Work After Spinal Tuberculosis Post Stabilization and Comprehensive Rehabilitation: A Case Report

Introduction: Spinal tuberculosis is the most common extrapulmonary skeletal form of tuberculosis that can lead to neuromuscular deficit. Neuromuscular deficit may include paraplegia in both legs, inability to perform daily activities, and an increased risk of loss of occupation. Case Presentation: A 37-year-old male presented with a chief complaint of weakness in both legs and was unable to stand properly unassisted. This patient was diagnosed with spinal tuberculosis, confirmed by MRI. The rehabilitation program was designed for 6 months, focusing on the preservation of cardiorespiratory endurance and planning a return to work. Evaluation of physical fitness and working ability was carried out using the 6-Minute Walking Test (6MWT) and Work Ability Index (WAI) questionnaires to determine whether the patient was fit to work. Six months after the rehabilitation program, the patient showed moderate physical fitness and a WAI score of 37 indicating fitness to work. Conclusion: Complications of spinal tuberculosis can cause disability in daily activities and result in loss of occupation. In this case, after six months of a comprehensive rehabilitation program and evaluation of fitness capacity, the patient can return to work but still needs more support of his work ability than before the illness.

D Craft System

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Pathways towards carbon neutrality in low carbon cities: The role of green patents, R&D and energy use for carbon emissions

China is adopting innovative strategies to mitigate the carbon emissions and to enhance environmental sustainability. China's pilot low-carbon city program is a comprehensive program to attain carbon neutrality and green transformation. The current research is an attempt to explore the dynamic relationship between green patents, energy use, research and development (R&D) expenditure, and carbon dioxide emissions of Chinese cities considered for the China Pilot Low Carbon City Program (CPLCCP). The prime objective of current research is to examine the validity of the Environmental Kuznets Curve (EKC) theory in the context of energy use, R&D and green patents. This objective is realized by employing CS-ARDL, Q-ARDL, and Granger's non-causality approach on panel data of 118 Chinese cities for the period of 2003 to 2020. The estimated result reveals that allocating resources towards R&D and green technological innovation can substantially increase environmental sustainability across various quantiles. Furthermore, the empirical findings validate the existence of Environmental Kuznets Curve (EKC) theory. The study suggests fruitful insights for policymakers and stakeholders committed apropos sustainable development and carbon neutrality of China.

Effectiveness of adequate chicken egg white consumption on dyspnea degree and exacerbation incidence in stable COPD patients practicing strength and endurance exercises.

Lack of physical exercise and inadequate nutritional intake in chronic obstructive pulmonary disease (COPD) patients could lead to low muscle mass and function, which causes reduced respiratory function, increased incidence of exacerbations, exercise intolerance, increased visits to health facilities, and low health status. Therefore, physical exercise and good nutritional intake are the main foundations of a comprehensive pulmonary rehabilitation program for COPD patients. The aim of the study was to determine the effect of chicken egg white supplementation on dyspnea degree and the incidence of exacerbations in stable COPD patients who perform physical exercise independently at home. A quasi-experimental study was conducted in 38 stable COPD patients based on the Global Initiative for Chronic Lung Disease (GOLD) 2021 classification criteria. The patients were divided into two groups: the control group who did smartphone application-assisted physical exercises and the intervention group who did the same physical exercises plus chicken egg white supplementation for 12 weeks. Performed physical exercises included both strength and endurance training. The degree of dyspnea was assessed with modified Medical Research Council (mMRC) dyspnea scale and the incidence of exacerbations was assessed by direct interviews at the beginning and at the end of the intervention. A Fisher's exact test was used to assess the association between the intervention with dyspnea degree and exacerbation incidence. In the intervention group, chicken egg white supplementation for 12 weeks lowered the dyspnea degree by 3.16 times than the control (relative risk 3.16 with p=0.001). Furthermore, the incidence of exacerbations was also reduced by 1.8 times compared to the control group (relative risk 1.8, p=0.001). This study highlights a significant improvement in dyspnea degree and exacerbation incidence in COPD patients with the combination of protein supplementation and physical exercise. Therefore, adding chicken egg white intake could be beneficial for stable COPD patients practicing physical exercises.

Functional capacity and quality of life improvement in stable chronic obstructive pulmonary disease (COPD) patients following physical exercise and chicken egg white supplementation.

The pillars of comprehensive pulmonary rehabilitation program for chronic obstructive pulmonary disease (COPD) patients include physical exercise and good nutrition. The aim of this study was to evaluate the efficacy of pulmonary rehabilitation, which included physical exercise and chicken egg white supplementation, on the quality of life (QoL) and functional capacity among patients with stable COPD. The COPD patients were enrolled prospectively in this quasi-experimental study and completed a 12-week smartphone-guided home-based physical exercise program that comprised strength and resistance training three times per week for 30 minutes each session. Participants were divided into two groups: the control group who underwent physical exercise only, and the intervention group who had physical exercise and chicken egg white supplementation as a protein source. Patient characteristics including sex, age, nutritional status, comorbidities, smoking status, and obstruction severity, were evaluated. The COPD assessment test (CAT) score and six-minute walk test (6MWT) were used as the parameters to evaluate QoL and functional capacity, respectively. Of the total 50 patients included in the study, 12 were excluded due to follow-up and adherence problems. Our data indicated there were significant CAT score reduction and 6MWT improvement in both control and intervention groups after 12 weeks compared to baseline data. However, reduction of mean CAT score was higher in intervention compared to control group (-13.47±6.49 vs -5.42±5.07, p<0.001). In addition, the improvement of 6MWT was also higher in intervention group compared to control group (145.47±69.2 vs 32.42±17.3 meters, p<0.001). In conclusion, chicken egg white supplement to male patients with stable COPD who exercise with resistance and strength training could improve the QoL and functional capacity.

Analysis of a 5-year, evidenced-based, rational blood utilisation project in a South African regional hospital.

Blood products are a lifesaving but limited resource, particularly in resource-limited settings. Evidence-based transfusion criteria tailored to local hospitals have shown great promise in reducing costs, minimising shortages, and ameliorating the morbidity and mortality associated with liberal blood product usage. We implemented the "Saving Blood, Saving Lives" project to: promote responsible blood product use and reduce blood product ordering inefficiencies and expenditure. A comprehensive change management programme, preceded by 3 months of clinical department consultation and training, was implemented. A new evidence-based protocol for blood product utilisation was developed, together with an accountability form. This form was used in monthly audit meetings to refine policies, identify new problems, improve communication, and to drive hospital staff accountability and training. The primary measure of the programme's success was the change in the number of red cell concentrate units ordered. Project implementation required minimal time and no additional budget or staff. Annual red cell concentrate usage reduced from 7211 units in year one to 4077 units in year 5 (p < 0.001). Similar reductions were seen in freeze-dried plasma and platelet usage, as well as administrative costs. Total project saving, adjusted to baseline admission numbers, amounted to over R46 million ($2.5 million). As a change management programme centred the "Saving Blood, Saving Lives" project, was able to significantly reduce blood product-related administration and expenditure by implementing evidence-based transfusion criteria. The programme is simple, replicable and cost effective, making it ideally suited for use in resource-constrained environments.

Enhancing City Logistics for Sustainable Development in Jordan: A Survey-Based Study

Background: The global concern for the environment and sustainable development goals has led to a growing focus on the increasing activities of city logistics. This research study aims to evaluate the current state of city logistics within the framework of sustainable development and analyze the key factors that impact the efficient management of city logistics in Jordan. Methods: To achieve these research objectives, a quantitative approach utilizing a survey questionnaire was employed. The findings emphasize a significant disparity between current practices in city logistics and desired outcomes, indicating an urgent need for improvement in cost reduction, enhancement of quality of life, and promotion of sustainability. Results: The results reveal that the performance of urban authorities in managing city logistics is influenced by various factors, including regulatory inefficiencies, suboptimal human resource performance, deficiencies in information systems, and challenges related to coordination amongst stakeholders. Conclusions: Consequently, this paper puts forth actionable recommendations for improving city logistics management, which involve amending existing regulations, implementing comprehensive training programs for employees, strengthening infrastructure for information systems, and fostering robust communication channels between urban authorities and stakeholders.

An integrated, holistic, evidence-based, interdisciplinary approach to digital monitoring and remote care in patients with highly infectious diseases: TeleCovid.

During the first waves of the SARS-CoV-2 pandemic, hospitals were overrun with patients. To cope with this high influx of infectious patients, hospitals needed to postpone elective care. Additional ICU beds had to be opened, and the number of isolation units had to be increased. All of this placed considerable strain on the nursing and medical staff. At that time, the idea was launched to keep as many patients as possible at home and prevent their hospital admission through the use of a remote care program. Based on our previous experience with transmural care programs, we quickly developed a digital monitoring program to track the health status of Covid-19 infected patients at home.&#x0D; Patients could be registered for follow-up by their primary care physician or specialist. After registration, patients received access to a secured digital platform. They first had to complete an extensive survey in order to identify their medical and surgical history, as well as the symptoms present at that time. The severity of symptoms was also evaluated at the moment of the initiation of the digital monitoring. On the basis of the responses to the introductory questionnaire, a global personalized risk score was compiled. After this initial step was concluded, the patient was contacted by the medical monitoring team to arrange for the delivery of telemetric devices (such as peripheral oxygen saturation). Patients were monitored through a 4-layer system, consisting of diaries, validated surveys, telemonitoring of vital signs, and a digital communication system included in the digital platform. This resulted in close cooperation with GPs, home nurses, physiotherapists, and other caregivers. The remote care team monitored the condition of the patients on a 24/7 basis. If needed, they contacted the home caregivers with specific demands or instructions (e.g. administration of oxygen at home, blood sampling, administration of medication). &#x0D; In the spring of 2022, Paxlovid became available in Belgium for ambulatory treatment of Covid-19 symptoms in high-risk patients. It was quickly decided that we would also include the follow-up of Paxlovid treatment regimens within our care pathway. This created an entirely new approach to our remote monitoring since we had to tackle specific problems like drug-drug interactions but also therapeutic monitoring of certain specific drugs.&#x0D; &#x0D; TeleCovid was perceived as an integrated, comprehensive remote care program for Covid-19 patients. At first, this digital care program was perceived in such a way that we could prevent the hospitalization of Covid-19 patients. But very soon after its activation, GPs started to include patients so that they focus their attention and time on other patients. They could rely on the remote care program to be notified when the medical conditions of their patients deteriorated. The care program provided support and guidance to the patients AND their families so they felt safe while staying at home. We provided all possible care right at the home of the patients. This was only possible through intensive and continuing cooperation between many different healthcare providers, such as nurses, physiotherapists, social workers, GPs, and hospital specialists.

Improving foot ulcer risk assessment and identifying associated factors: Results of an initiative enhancing diabetes care in primary settings

BackgroundDiabetes-related lower extremity complications contribute significantly to the overall disability burden of type 2 diabetes (T2D). The screening of Diabetic Foot Ulcer (DFU) risk is essential for the early identification of its components, thereby preventing the progression to advanced complications. Unfortunately, identifying elements associated with foot ulcer development is often poorly executed, especially in primary care settings, particularly in low-middle-income countries. We assess the prevalence of DFU risk and its components while exploring sociodemographic, clinical, and behavioral characteristics linked to DFU risk in patients with T2D. MethodsThis cross-sectional study examined the characteristics of the feet of subjects involved in an initiative to enhance the quality of diabetes care in primary healthcare settings. The assessment included the presence of foot deformities, peripheral neuropathy through Loss of Protective Sensation (LOPS) evaluation, peripheral arterial disease (PAD), and a history of foot ulcer or lower extremity amputations. Participants were classified according to the IWGDF Risk Classification and subsequently divided into two groups for analysis: those at high risk for DFU (Groups 1, 2, or 3) and those at low risk for DFU (Group 0). Logistic regression was employed to identify the factors associated with DFU risk and its components. ResultsAmong the 1361 patients evaluated, 63.8 % were found to be at an increased risk for DFU. The reported prevalence of foot deformities, LOPS, PAD, and a history of foot ulcer was 91.9 %, 44.3 %, 36.5 %, and 4.5 %, respectively. In the adjusted analysis, factors significantly associated with DFU risk included male gender (OR =2.01; 95 % IC 1.54–2.61), secondary education or less (OR =1.65, 95 % IC 1.27–2.14), diabetes duration exceeding 10 years (OR = 1.75, 95 % IC 1.34–2.30), chronic kidney disease (OR =1.44, 95 % IC 1.11 – 1.88), diabetic retinopathy (OR =1.93, 95 % IC 1.42–2.62), onychomycosis (OR =1.46, 95 % IC 1.14–1.88) properly cut toenails (OR =0.60, 95 % IC 0.45–0.79), and sedentary behavior (OR =1.56, 95 % IC 1.14–2.14). ConclusionsRisk assessment of DFU within a comprehensive care program for adults with T2D receiving conventional primary care showed that a substantial proportion of these patients are at an increased risk and, thus, qualify as candidates for interventions aimed at mitigating foot-related risks. We recommend that diabetes healthcare schemes incorporate preventive organizational interventions to facilitate the timely identification of DFU risk, particularly in primary care scenarios, thereby alleviating the burden of diabetes-related lower limb complications.

Solvent Induced Cumulative Insult Irritant Contact Dermatitis through Glove Permeation: A Case-Report on the Chronic Occupational Skin Lesion

A young female laboratory worker presented with chronic cumulative skin lesion over hands. The occupational exposure history supported the prolonged and frequent exposure to multiple solvents which are recognised as work irritants, improper work practice and wrong use of protective glove. The diagnosis of Irritant Contact Dermatitis (ICD) was supported by workplace dermatology risk factors, clinical features, negative skin patch test to rule out hypersensitivity reaction and fulfilment of all seven Mathias Criteria. The effective management of occupational contact dermatitis requires practices change and exposure control. The comprehensive Hand Care Programs must be individualised and incorporate several important elements namely the skin care screening and surveillance, early referral for Occupational Health assessment, effective education and training programs and provision of hand moisturising products. The support of return to work (RTW) among the affected workers is of paramount important in order to minimise the negative impacts on their quality of work as well as home life.

Assessing the Impact of Multilevel Comprehensive Programming on SNAP-Ed Participant Behaviors.

To examine differences in dietary, physical activity, and food selection behaviors of Utah SNAP-Ed participants who had varied breadth of engagement with various components of multilevel programming. SNAP-Ed participants received a survey approximately 1 year after participating in nutrition classes. The survey measured diet, physical activity, and food selection behaviors and breadth of engagement with components of SNAP-Ed programming. Components of programming included nutrition education for adults and youth, nudge programs in food pantries and corner stores, farmers' market booths, social marketing campaign materials, and social media platforms. Kruskal-Wallis tests assessed differences in behaviors between varying breadths of program engagement. Among the 124 respondents, certain dietary behaviors improved with increased breadth of program engagement including intake of vegetables, low-fat dairy, and lean protein. Food selection behaviors including using MyPlate and preparing healthy foods on a budget, also improved with increased engagement. Physical activity was not impacted by additional breadth of exposure. Findings suggest that multilevel comprehensive programming may enhance the impact of SNAP-Ed education for certain behaviors. Additional research is warranted on the impact of SNAP-Ed multilevel programming on targeted behaviors and health outcomes.

Risk Factors and Prevention of Needlestick Instruments in the Medical Field: Systematic Review

Introduction: Needlestick and sharp object injuries represent a significant occupational hazard faced by healthcare workers worldwide. A systematic review focusing on needlestick and sharp object injuries among healthcare workers is essential due to the heterogeneous nature of existing research. The aim of this systematic review is to comprehensively synthesize existing literature to provide a comprehensive understanding of the prevalence, risk factors, and prevention strategies related to needlestick and sharp object injuries among healthcare workers. Methods: This thorough examination adheres to PRISMA principles and implements a pre-planned research plan to promote transparency and minimize partiality. It encompasses investigations involving medical personnel (such as nurses and physicians) centered on puncture wounds and sharp instrument mishaps, exploring contributing factors, occurrence rate, aftermaths, and preventative measures. A thorough exploration is conducted through various databases, with two separate evaluators examining and evaluating the studies. Suitable studies encompass both observational and intervention-based studies without constraints on publication dates. Information is extracted using a standardized format, and ethical clearance is not required as the review solely relies on already published data. Results: In our systematic review, we initially identified 1,523 articles through a database search, which underwent a stepwise screening process, resulting in 198 articles after assessing titles and abstracts. Subsequently, these 198 articles underwent a rigorous full-text evaluation. After this thorough assessment, 14 studies were included that met our predefined eligibility criteria. Our synthesis of the observational studies revealed recurring risk factors for needlestick and sharp object injuries among healthcare workers, including inadequate training, the impact of fatigue and extended working hours, and insufficient personal protective equipment (PPE). Additional factors like job category, experience level, and compliance with safety protocols were also highlighted in specific studies. Conclusions: This systematic review highlights the importance of standardized approaches to enhance healthcare worker safety, particularly in addressing risk factors like inadequate training, fatigue, and inadequate personal protective equipment (PPE). The effectiveness of prevention strategies, as demonstrated in our meta-analysis, underscores the value of comprehensive programs in reducing injury rates, emphasizing the need for more standardized and multifaceted safety measures across healthcare settings.

The Methodological Machinery of Wargaming: A Path toward Discovering Wargaming’s Epistemological Foundations

Abstract This paper proposes a comprehensive research program for determining the epistemological foundations of analytic wargaming. Wargaming has been used in military, government, and private sectors for decades, with tens of millions of dollars spent annually on it. In light of the changing strategic circumstances of the twenty-first century, it has only become more popular. However, the epistemological foundations of the method are poorly understood. Many professional wargamers contend that wargaming is an “art” and thus unable to be systemically evaluated. Recent work by a small coterie of international relations scholars has contended that wargaming can be reconciled with social science, typically by evaluating wargaming according to experimental standards. However, this solution strips wargames of most of their unique features and cannot explain why some of the most prominent wargames in history produced meaningful results. In this paper, I argue that in the attempt to better understand wargaming’s epistemology, scholars should begin by recognizing the prominent features of wargames and research each of these to determine if and how wargames produce rigorous knowledge. In making this argument, I identify five distinct “methodological machineries” of wargaming—the recurring processes through which wargames may produce knowledge—that distinguish wargaming from other social science methods: (i) they are representative, (ii) they feature consequential decisions made by human players, (iii) they are adjudicated, (iv) they are immersive, and (v) they are bespoke designs. I show how each of these machineries offers potential opportunities and dangers in the production of knowledge through the method of wargaming. In outlining these distinct features, I offer a clear and viable research program for epistemologists of wargaming.

The Effect of Teaching with Concept Maps on Academic Success in Biology Teaching: A Meta-Analysis Study

In this study, it was aimed to examine the effect of teaching using concept maps in biology teaching in the context of Turkey on academic achievement using the meta-analysis method that includes the synthesis of quantitative research. The problem of the research was determined as "What is the general effect of the use of concept maps and teaching method in biology teaching on academic achievement". Among the studies, some criteria were determined for the studies to be included in the meta-analysis, and a total of 24 studies that met these criteria formed the sample of the research. Hedges' g coefficient was used in the analysis of the data. In the current study, the Comprehensive Meta-Analysis program known as CMA was used to calculate the effect size and variances. Due to the heterogeneous nature of the research, the research was examined with the random effects model. When the findings are examined, it has been determined that the 1,598 effect sizes calculated for the random effects model have a large effect on the academic success of the teaching method with concept maps in biology teaching according to the classification made by Cohen (1988). According to this finding, the teaching method with concept maps in biology teaching, academic success; It was concluded that compared to the traditional method treated in the control group, it increased at a large level.

The Beginning of the Large-Scale Reconstruction of the Russian State Library: Architecture and Digitalization

The article reveals the foundations of design and research surveys, on the basis of which the Russian State Library (RSL) implemented the project of repair and restoration works for the central entrance of the library. The aim of the works was to adapt the cultural heritage object to modern use. The building complex, conceived in the mid — 1920s, was completed by 1940, but it was not fully commissioned until 1960. In the mid — 1970s, there was insufficient space to store the growing holdings. The front decoration of the central hall suffered enormous damage over the years. In 2019, a negative trend in the condition of the building was revealed. The main book depository was overloaded. The problems of the RSL are combined in a comprehensive investment programme for the reconstruction and restoration of infrastructure facilities. In 2019—2020, design solutions were developed for the repair and restoration of buildings and individual public spaces of the library. In 2021, the first stage of restoration of the entrance group began. The decision was made to carry out the work in a service-preserving environment and the challenge was to transform the very model of service to readers. The team working on the restoration made decisions reflecting the development of 21st century technologies and current standards for the automation of library processes. As a result of the works, new technological channels for the building operation and space for servicing readers were arranged, a climate control system was installed, the power supply and electric lighting system was replaced, historical interiors were restored, modern fire and engineering safety systems were created, a new centralized information and navigation complex for readers was deployed, etc. In 2023, a grandiose historical space was opened for the RSL readers.

Examining the Awareness Levels, Usage Trends, and Influencing Factors of Emergency Contraceptives Among Women in Ussa Local Government Area of Taraba State, Nigeria: A Cross-Sectional Research Inquiry

Unintended pregnancies and unsafe abortions remain significant global public health concerns, particularly in low-income countries. This research assessed the awareness, usage, and influencing factors of emergency contraceptives among women in the Ussa Local Government Area of Taraba State, Nigeria. The study employed a cross-sectional survey research design where 384 questionnaires were distributed among sampled women of the reproductive age group (15-49 Years) in the study area. The findings indicate that while roughly half of the respondents were aware of emergency contraceptives, there is room for improvement in terms of disseminating information about their availability and usage. Regarding the usage of emergency contraception, a sizable portion of respondents (34.3%) said they had used it, although the majority (65.7%) had not. Furthermore, formal sensitization on emergency contraceptives is lacking for a large part of the population, just as a significant proportion of respondents have yet to use them. The study also found that factors influencing women's attitudes toward emergency contraceptives in Ussa Local Government Area include economic constraints, knowledge gaps, moral beliefs, partner dynamics, social stigma, and the fear of negative health implications. Based on the findings of the study, the recommendations include enhancing health promotions by Health agencies in Ussa Local Government, encouraging parent-child discussions on reproductive health, engaging traditional and religious leaders in family planning promotions, establishing young girls-friendly centers, and implementing comprehensive reproductive health education programs to empower women and reduce unintended pregnancies.

Азербайджанский цифровой центр: стратегия в действии

The article explores the digital transformation landscape under pandemic and post-pandemic conditions. As global internet traffic continues to surge, nations worldwide are prioritizing digital strategies to keep pace with this rapid transformation. Azerbaijan, an oil-rich country seeking economic diversification, has taken a strategic approach to become a key player in the digital landscape. Neqsol Holding, utilizing its capital from the oil and gas industry, initiated the Azerbaijan Digital Hub, a comprehensive program comprising the Digital Silk Road, a Regional Data Center, an Internet Exchange Point, and the development of a digital ecosystem. The hub aims to reshape the internet map along the Silk Way and thrive amidst disruptive changes through three consecutive stages: ideation, incubation, and scaling. The article highlights the strategic choices made by Azerbaijan in establishing the Digital Hub and its potential impact on the nation's economy. It presents the shift from the «Castles» quadrant to the «Connectors» quadrant, adopting new power models and values for sustainable growth. The dynamic capabilities of the Digital Hub are explored, emphasizing its transformative nature and adaptability to rapid technological advancements. In conclusion, the article suggests that the success of the Azerbaijan Digital Hub depends on effective management of continuous change, fostering a culture of innovation, and leveraging strategic advantages through mergers, alliances, and investments. By navigating a complex and uncertain environment, the Digital Hub can solidify its position as a crucial player in the digital era.

Worldwide Child Routine Vaccination Hesitancy Rate among Parents of Children Aged 0-6 Years: A Systematic Review and Meta-Analysis of Cross-Sectional Studies.

Routine vaccine hesitancy is a major global health challenge observed in over 190 countries worldwide. This meta-analysis aims to determine the worldwide prevalence of routine vaccination hesitancy among parents of children aged 0-6. An extensive search was conducted in four scientific databases: PubMed, Scopus, Web of Science, and the Cochrane Library. Studies were included if they reported hesitancy related to WHO-recommended routine immunizations for children under 7 years of age. A single-arm meta-analysis was performed using the OpenMeta[Analyst] software. An initial search retrieved 5121 articles, of which only 23 publications, involving 29,131 parents, guardians, and caregivers from over 30 countries met the inclusion criteria and quality assessment. The cumulative prevalence of parental vaccine hesitancy was found to be 21.1% (95% CI = 17.5-24.7%, I2 = 98.86%, p < 0.001). When stratifying the prevalence of vaccine hesitancy per WHO region, significant variations were observed, ranging from 13.3% (95% CI = 6.7-19.9%, I2 = 97.72%, p < 0.001) in the Region of the Americas to 27.9% (95% CI = 24.3-31.4%) in the Eastern Mediterranean region. The study findings highlight the need for healthcare providers and governments to develop and improve comprehensive programs with communication strategies to reduce parental vaccine hesitancy.