Continuous Assessment Research Articles

Development of Teaching Elements Based on Total Physical Response Activities for Improving Quranic Recitation Proficiency among Converts: Application of The Fuzzy Delphi Method

The Quran is a vital guide for Muslims, requiring proper recitation with tajwid. However, many converts struggle with accurate Quranic recitation even after years of embracing Islam. This study aims to develop Total Physical Response (TPR)-based teaching activities to enhance Quranic recitation proficiency among converts by integrating physical movements with learning, aiding in recognizing Hijaiyah letters and tajwid rules. Utilizing the Fuzzy Delphi Method (FDM), this study achieved expert consensus on proposed TPR-based activities. Ten experts in technical and vocational education, educational technology, and curriculum development participated, selected through purposive sampling. Data collection involved a two-stage process: a workshop where experts rated each activity on a 5-point Likert scale, followed by FDM analysis, transforming responses into triangular fuzzy numbers. This rigorous evaluation required at least 75% consensus and a threshold value (d) not exceeding 0.2. Findings validated all 25 TPR-based activity elements, demonstrating their suitability for teaching Quranic recitation to converts. TPR’s integration of physical activities significantly enhances memory retention and understanding, making it effective for converts with diverse backgrounds and minimal prior Quranic knowledge. The study recommends developing structured modules, providing expert training, creating interactive learning environments, and implementing continuous assessments. Incorporating Higher Order Thinking Skills (HOTS) and varied teaching methods aims to improve engagement and motivation, ultimately making Quranic learning more effective and enjoyable for converts.

Post-seismic topographic shifts and delayed vegetation recovery in the epicentral area of the 2018 Mw 6.6 Hokkaido Eastern Iburi earthquake

The 2018, Mw 6.6 Hokkaido Eastern Iburi earthquake in Japan triggered over 10,000 landsliding in an area spanning about 500 km2, altering the local topography and leading to the accumulation of loose deposits on hillslopes and in valleys. However, a comprehensive post-seismic landslide inventory and an assessment of topographic changes are lacking, hindering a quantitative hazard assessment. Additionally, the extent of vegetation recovery in areas affected by coseismic landslides, a key indicator of post-seismic debris flow hazard, has not been evaluated. Here, we utilize high-resolution digital elevation models and multi-temporal satellite imagery to analyze topographic changes and vegetation dynamics in the earthquake’s epicentral area (seismic intensity >5.5). We observe that the event roughened the overall gentle topography of the region and made the slopes steeper. Owing to the absence of significant rainstorms and snowmelt post 2018, only a few debris remobilizations (60) and new landslides (80) have occurred in the affected region. Moreover, we noticed a slow vegetation recovery in the post-seismic phase, suggesting that the likelihood of debris flows and gully erosion remains elevated, highlighting the need for continued monitoring and assessment.

Understanding water dynamics in Dal Lake: a comprehensive analysis of physiological parameters and seasonal variations.

Maintaining the standard of water quality in an aquatic habitat necessitates continual assessment of its physicochemical properties. The purpose of this study was to evaluate physicochemical properties and to discuss the causes of spatiotemporal variability in key physicochemical parameters at five different locations of Dal Lake. Water samples were collected in four seasons for 3 years (i.e., January 2019-December 2021) to evaluate various physicochemical properties using standard methods. The analysis shows that the macrophytic development has increased due to organic and inorganic load, leading to the Lake's deterioration. The analysis indicates positive and negative correlations among various parameters across five sampling sites. Principal component analysis shows that two components (PC1 and PC2) explain 47.35, 47.54, and 48.11% of the variability in the years 2019, 2020, and 2021, respectively. From 2019 to 2021, the continuous decrease in dissolved oxygen and increased levels of magnesium, conductivity, alkalinity, total hardness, calcium hardness, total phosphorus, and nitrate-nitrogen suggest a trend toward eutrophication in the lake.

Systematic literature review: implementation of inclusive education policies in Indonesia: a state administration perspective

This study thoroughly investigated the implementation of inclusive education policies in Indonesia, focusing specifically on the state administration perspective. Using a systematic literature review (SLR) approach, the research meticulously identifies meticulously identified the main challenges encountered and proposes proposed effective solutions for policy implementation. The key themes highlighted in this study include the urgent need for improved educational facilities, comprehensive teacher training programs, and the development of flexible teaching methods tailored to the individual needs of each student. Additionally, the findings underscore underscored the critical importance of stakeholder collaboration and the continuous assessment of policies to adequately meet the diverse needs of all students. This comprehensive and in-depth analysis not only contributed to a more inclusive and equitable education system in Indonesia but also provided valuable insights that are essential for future policy enhancements. By addressing these issues in detail, the study aimed to pave the way for more effective and inclusive educational practices across the nation.

Predicting the severity of mood and neuropsychiatric symptoms from digital biomarkers using wearable physiological data and deep learning

Neuropsychiatric symptoms (NPS) and mood disorders are common in individuals with mild cognitive impairment (MCI) and increase the risk of progression to dementia. Wearable devices collecting physiological and behavioral data can help in remote, passive, and continuous monitoring of moods and NPS, overcoming limitations and inconveniences of current assessment methods. In this longitudinal study, we examined the predictive ability of digital biomarkers based on sensor data from a wrist-worn wearable to determine the severity of NPS and mood disorders on a daily basis in older adults with predominant MCI. In addition to conventional physiological biomarkers, such as heart rate variability and skin conductance levels, we leveraged deep-learning features derived from physiological data using a self-supervised convolutional autoencoder. Models combining common digital biomarkers and deep features predicted depression severity scores with a correlation of r = 0.73 on average, total severity of mood disorder symptoms with r = 0.67, and mild behavioral impairment scores with r = 0.69 in the study population. Our findings demonstrated the potential of physiological biomarkers collected from wearables and deep learning methods to be used for the continuous and unobtrusive assessments of mental health symptoms in older adults, including those with MCI. Trial registrationThis trial was registered with ClinicalTrials.gov (NCT05059353) on September 28, 2021, titled “Effectiveness and Safety of a Digitally Based Multidomain Intervention for Mild Cognitive Impairment”.

Preliminary Observations of the Loke Microdialysis in an Experimental Pig Model: Are We Ready for Continuous Monitoring of Brain Energy Metabolism?

Brain energy metabolism is often disturbed after acute brain injuries. Current neuromonitoring methods with cerebral microdialysis (CMD) are based on intermittent measurements (1-4 times/h), but such a low frequency could miss transient but important events. The solution may be the recently developed Loke microdialysis (MD), which provides high-frequency data of glucose and lactate. Before clinical implementation, the reliability and stability of Loke remain to be determined in vivo. The purpose of this study was to validate Loke MD in relation to the standard intermittent CMD method. Four pigs aged 2-3 months were included. They received two adjacent CMD catheters, one for standard intermittent assessments and one for continuous (Loke MD) assessments of glucose and lactate. The standard CMD was measured every 15 min. Continuous Loke MD was sampled every 2-3 s and was averaged over corresponding 15-min intervals for the statistical comparisons with standard CMD. Intravenous glucose injections and intracranial hypertension by inflation of an intracranial epidural balloon were performed to induce variations in intracranial pressure, cerebral perfusion pressure, and systemic and cerebral glucose and lactate levels. In a linear mixed-effect model of standard CMD glucose(mM), there was a fixed effect value (± standard error [SE]) at 0.94 ± 0.07 (p < 0.001) for Loke MD glucose(mM), with an intercept at - 0.19 ± 0.15 (p = 0.20). The model showed a conditional R2 at 0.81 and a marginal R2 at 0.72. In a linear mixed-effect model of standard CMD lactate(mM), there was a fixed effect value (± SE) at 0.41 ± 0.16 (p = 0.01) for Loke MD lactate(mM), with an intercept at 0.33 ± 0.21 (p = 0.25). The model showed a conditional R2 at 0.47 and marginal R2 at 0.17. The established standard CMD glucose thresholds may be used as for Loke MD with some caution, but this should be avoided for lactate.

Lifting COVID-19-associated non-pharmaceutical interventions: potential impact on notifications of infectious diseases transmitted from person to person in 2022 in Bavaria, Germany.

The COVID-19 pandemic and associated non-pharmaceutical interventions (NPIs) have led to substantial decreases in case numbers of infectious diseases in several countries worldwide. As NPIs were gradually lifted, intense or out-of-season outbreaks of respiratory and gastrointestinal diseases were reported, raising the hypothesis of a potential catch-up effect of infections. By analysing surveillance data from the federal reporting system for notifiable infectious diseases, we aimed to assess the potential impact of lifting COVID-19 associated NPIs on notifications of selected infectious diseases in Bavaria, 2022. We compared influenza, chickenpox, norovirus gastroenteritis, rotavirus gastroenteritis weekly case numbers in a pre-pandemic period (2016-2019) and 2022 using two time series analyses approaches: (i) a predictive model forecasting weekly case numbers for the pandemic years 2020-2022, based on 2016-2019 data, (ii) interrupted time series model, based on 2016-2022 data, including a term per pandemic period. In 2022, incidence rates were higher compared to pre-pandemic period for influenza (IRR = 3.47, 95%CI: 1.49-7.94) and rotavirus gastroenteritis (IRR = 1.36, 95%CI: 0.95-1.93), though not significant for rotavirus gastroenteritis. Conversely, case numbers remained significantly below pre-pandemic levels for chickenpox (IRR = 0.52, 95%CI: 0.41-0.65) and norovirus gastroenteritis (IRR = 0.59, 95%CI: 0.42-0.82). Seasonality changed notably for influenza, showing an earlier influenza wave compared to pre-pandemic periods. The lifting of NPIs was associated with heterogenic epidemiological patterns depending on the selected disease. The full impact of NPIs and their discontinuation may only become clear with continued monitoring and assessment of potential additional contributing factors.

Performance Status and End-of-Life Outcomes in Patients With Metastatic Castration-resistant Prostate Cancer Treated With Androgen Receptor Targeted Therapy.

Androgen receptor targeted therapies (ARTs) are widely preferred over taxane chemotherapy due to their good tolerability and similar efficacy. However, there is a paucity of data that support the use of ART therapy or describe end-of-life (EOL) outcomes in patients with metastatic castration-resistant prostate cancer (mCRPC) with reduced performance status (PS) (European Cooperative Oncology Group [ECOG] ≥2). We performed a retrospective, single-institution study of 142 patients with mCRPC who received ART therapy between 2010 and 2021. We assessed each record for baseline demographic and clinical information, ART treatment course, and survival and EOL outcomes. Our primary aim was to compare overall survival (OS) between the two groups (ECOG ≥2 vs 0 to 1), and our secondary aim was to describe EOL outcomes. Fisher exact tests and Wilcoxon signed-rank tests were used to compare baseline characteristics. Cox regression was used to compare OS for patients with ECOG ≥2 at the start of treatment with those who had an ECOG of 0 or 1. Descriptive analyses were performed to assess EOL outcomes between the groups. Patients with mCRPC and decreased PS experienced shorter OS on ART compared with those with higher PS. Moreover, when examining EOL outcomes, a near majority of these patients died in the hospital, with a greater percentage among those with an ECOG ≥2. These findings highlight the need for continual assessment of PS, improved shared decision-making in ART treatment, and additional research exploring the association between PS and EOL outcomes.

The Impact of Classroom-Based Assessment (CBA) Implementation on the Performance of B40 Pre-School and Primary School Students

Classroom-Based Assessment (PBD) is applied in the education system in Malaysia. It substitutes the public examination system at the primary school level and gives prominence to summative and formative assessment holistically. This case study was conducted to identify the effectiveness and challenges of PBD implementation on the development of students, specifically the B40 group of pre-school and primary school students. To obtain research data, an in-depth interview instrument was conducted on 13 study participants from a quota sample. Interview findings were analyzed to form themes and were confirmed by experts through the Cohen Kappa index of 0.803. Findings regarding the effectiveness of PBD showed that PBD is a holistic assessment for B40 students, especially students who are weak in learning, as it encompasses a comprehensive learning and continuous assessment. PBD is also beneficial for B40 students as they are given the opportunity to achieve the desired mastery level; thus, the gap between B40 students and non-B40 students can be minimized. In addition, this study also highlighted the achievement of B40 students through their mastery of subjects at school. Challenges in the implementation of PBD for B40 preschool and primary school students encompass three aspects, namely challenges in knowledge, achievement and implementation. In terms challenges in knowledge, parents are seen to be oblivious regarding PBD. Challenges in achievement exist when students do not sufficiently master the subjects and unmindful of PBD implementation of. Finally, challenges in implementation, which refers to strenuous individual assessment due to the large number of students. Furthermore, attendance of B40 students is a major challenge in the implementation of PBD. In addition, another challenge in implementation is the need and financial, and parental support. This study explores towards critical discussion and understanding to improve the learning system and further realize the benefits in the implementation of PBD, especially for B40 preschool and primary school students.

Extending a MAPE-K loop-based framework for Dynamic Difficulty Adjustment in single-player games

Dynamic Difficulty Adjustment (DDA) has emerged as a notable solution to address the demand for adaptive gameplay in digital games. However, the DDA domain presents various research challenges that require careful consideration. In response, this study introduces an approach that merges insights from self-adaptive systems with the specific requirements of adaptive gameplay. Our contribution involves extending the DDA-MAPEKit framework, which was previously presented. Constructed on the modular MAPE-K loop foundation, this solution facilitates the assimilation of multiple DDA strategies. The primary objective is to provide tailored treatment for distinct game mechanics (or groups of mechanics) by constructing individual MAPE-K loops for each of them. Notable enhancements include the development of a descriptive player model involving continuous player profile assessment, performance calculation, and modifications to the rules’ system to better align with the player’s conditions. A proof of concept is executed by applying DDA-MAPEKit in a Space Shooter game to assess the viability of the proposed model. Simulations are conducted both with and without the DDA mechanisms. Encouraging results are obtained through a comparative analysis of the gathered data. Evidence points out that incorporating the DDA mechanism, implemented with DDA-MAPEKit, may effectively lead to adapting variables depicting the complexity of game mechanics following the player’s performance. This fact underscores the potential effectiveness of our approach in addressing the challenges within the realm of DDA.

A novel model for real-time risk evaluation of vehicle–pedestrian interactions at intersections

Safety decisions for vehicles at an intersection rely on real-time, objective and continuous assessment of risks in vehicle–pedestrian interactions. Existing surrogate safety models, constrained by ideal assumptions of constant current speed and reliant on interaction points, often misjudge risks, and show inefficiency, inaccuracy and discontinuity. This work proposes a novel model for evaluation of those risks in vehicle–pedestrian interactions at intersections, which abstracts the pedestrian distribution density around a vehicle into a generalized model of driver-pedestrian interaction preferences. The introduction of two conceptions: ’driving risk index’ and ’driving risk gradient,’ facilitates the delineation of driving spaces for identifying safety–critical events. By means of the trajectory data from three intersections, model parameters are calibrated and a multidimensional vehicle–pedestrian interaction risk (VPIR) model is proposed to adapt the complex and dynamic characteristics of vehicle–pedestrian interactions at intersections. Commonly used surrogate safety models, such as Time to Collision (TTC), are selected as benchmark models. Results show that the proposed model overcomes the limitations of the existing interaction-point-based models, and offers a ideal assessment of driving risks at intersections. Finally, the model is illustrated with a case study that assesses the risks in vehicle–pedestrian interactions in varied scenarios and the case study indicates that the VPIR model works well in evaluating vehicle–pedestrian interaction risks. This work can facilitate humanoid learning in the autonomous driving domain, and achieve an ideal evaluation of vehicle–pedestrian interaction risks for safe and efficient vehicle navigation through an intersection.

Exploring Perceived Usefulness and Ease of Use of Facebook as a Tool for Continuous Assessment in a Sri Lankan State University

This study aimed to explore how a group of English as a second language students (ESL) of a Management Faculty at a state university in Sri Lanka perceived the usefulness and ease of use of Facebook (FB) as a tool for Continuous Assessment (CA). It was imperative to assess students' perceptions regarding the implementation of FB for CA, as it represents a novel concept within the institute where this study took place. The study involved 257 participants, 191 females and 66 males. Data were collected through two open-ended questions, and the measurement scales developed and validated by Davis (1989) were used to analyze the usefulness and ease of use of FB. Findings indicate that most of the participants perceive FB as a useful tool for CA. As for its ease of use, only a few participants commented. The study's conclusion suggests that while FB has potential as a tool for CA, improvements are necessary regarding its ease of use. This study contributes to the current debate on the use of social media platforms as tools for CA, in higher educational contexts.

Flexible adaptive sensing tonometry for medical-grade multi-parametric hemodynamic monitoring

Continuous hemodynamic monitoring in a wearable means can play a crucial role in managing hypertension and preventing catastrophic cardiovascular events. In this study, we have described the fully wearable tonometric device, referred to as flexible adaptive sensing tonometry (FAST), which is capable of continuous and accurate monitoring of hemodynamic parameters within the medical-grade precision. In particular, the FAST system integrates a 1 × 8 unit array of highly sensitive and highly flexible iontronic sensing (FITS) with 1 mm spatial resolution and a closed-loop motion system. The flexible tonometric architecture has been used to determine the radial arterial position with high sensitivity and high conformability, which simplifies the biaxial searching process of the traditional applanation tonometry into a highly efficient uniaxial applanation while keeping the medical-precision assessments. Importantly, a self-calibration algorithm can be automatically implemented during the applanation process, from which the intra-arterial blood pressure wave can be continuously predicted within the medical-grade precision, and subsequently, multi-parametric hemodynamic analysis can be performed in real-time. Experimental validations on health volunteers have demonstrated that the FAST measurements are all within the required accuracy of the clinical standards for continuous pulse wave assessments, blood pressure monitoring as well as other key hemodynamic parameter evaluations. Therefore, the FAST system, by integrating the flexible iontronic sensing array, provides a real-time, medical-grade hemodynamic monitoring solution in a continuously wearable manner, from which remote patient-centered monitoring can be delivered with both medical precision and convenience.

Diurnal sex differences in morphine withdrawal revealed by continuous assessment of voluntary home cage wheel running in the rat

Animal studies modeling recreational opioid use show more severe withdrawal symptoms in male compared to female rats, whereas our study modeling opioid use for pain showed a greater withdrawal-induced decrease in wheel running in female rats. The objective of this experiment was to determine whether sex differences in spontaneous morphine withdrawal are caused by differences in assessment method (i.e., wheel running vs. somatic symptoms). Twice daily injections of morphine (5 – 20 mg/kg, s.c.) for 5 days produced a dose and time dependent decrease in wheel running that was greater in male compared to female rats. Termination of morphine administration resulted in an overall decrease in running and a decrease in the amount of running during the dark phase of the light cycle from 95 % to approximately 75 %. In male rats, this decrease in the percent of dark running was caused by a large decrease in dark phase running, whereas female rats had a slightly higher increase in light phase running. Withdrawal also reduced maximal running speed and caused a decrease in body weight that was larger in male than female rats. Withdrawal symptoms were greatest on the day following the last morphine injection, but persisted for all 3 days of assessment. Morphine withdrawal produced a greater decrease in dark phase wheel running and body weight in male rats and a greater increase in light phase running in female rats. Voluntary home cage wheel running provides a continuous measure of opioid withdrawal that is consistent with other measures of opioid withdrawal.

Raman spectroscopy as an alternative rapid microbial bioburden test method for continuous, automated detection of contamination in biopharmaceutical drug substance manufacturing.

To investigate an in-line Raman method capable of detecting accidental microbial contamination in pharmaceutical vessels, such as bioreactors producing monoclonal antibodies via cell culture. The Raman method consists of a multivariate model built from Raman spectra collected in-line during reduced-scale bioreactor batches producing a monoclonal antibody, as well as a reduced-scale process with intentional spiking of representative compendial method microorganisms (n=4). The orthogonal partial least squares regression discriminant analysis model (OPLS-DA) area under the curve (AUC), specificity and sensitivity were 0.96, 0.99, and 0.95, respectively. Furthermore, the model successfully detected contamination in an accidentally contaminated manufacturing-scale batch. In all cases, the time to detection (TTD) for Raman was superior compared to offline, traditional microbiological culturing. The Raman OPLS-DA method met acceptance criteria for equivalent decision making to be considered a viable alternative to the compendial method for in-process bioburden testing. The in-line method is automated, non-destructive, and provides a continuous assessment of bioburden compared to an offline compendial method, which is manual, results in loss of product, and in practice is only collected once daily and requires 3-5 days for enumeration.

Investigating the Impact of Senna alata Extract on Hematology and Histopathology of Juvenile of Clarias gariepinus

This paper sheds light on the mechanism of action, potential effects and implication of Senna alata on fish health and ecosystem. Senna alata is renowned for its medicinal properties and ornamental value but is also recognized for its potential toxicity, particularly to aquatic organisms Understanding the toxicity of Senna alata to Clarias gariepinus fingerlings is essential for sustainable aquaculture practices and environmental conservation efforts. 250 juveniles of C. gariepinus were procured from E. I farm Limited in Ikot Ekpene, Akwa Ibom State. Water quality tests were carried out to ensure that optimum water conditions were maintained and that the results obtained were solely due to the effects of the treatments (toxicants) on the fish samples. Chronic toxicity bioassay was done to determine the toxicity of the extract on the blood parameters and tissues of sensitive organs of the exposed fish. The bioassay was designed to be intermediate termed chronic test with 14 days exposure using sub-lethal concentrations of the treatment (0.0gm/, 0.18mg/L, 0.27mg/L. 0.4mg/L, 0.60mg/L, 0.90mg/L). Toxicology dose response (fish mortality) was subjected to detailed analysis using Statistical Package for Social Sciences (SPSS) 22.0. Data were analyzed using descriptive statistics. Senna alata exerted a toxic effect on the fish in the present study and toxicity increased with increased concentration. These findings underscore the potential adverse effects of prolonged exposure to Senna alata on the physiological and cellular integrity of the fish. Intriguingly, the absence of pathological changes in the control groups suggests a distinct response attributable to the treatment. This highlights the importance of continued monitoring and assessment of the impacts of Senna alata on aquatic organisms and ecosystem, emphasizing the need for further research to elucidate the underlying mechanisms and potential long-term consequences.

Advancing Glucose Monitoring: A Near-Infrared Device for Continuous Invasive Assessment

Diabetes is a chronic disease that affects millions of people worldwide, with the number of newly diagnosed cases continuing to rise at an alarming rate. Patients diagnosed with diabetes require routine monitoring of their blood glucose levels, which is commonly done through invasive and minimally invasive techniques. However, these methods are often painful, prone to infection, and costly in the long run. Therefore, it is necessary to develop non-invasive, pain-free, affordable glucose monitoring techniques. Near-infrared spectroscopy has emerged as a promising technique among the non-invasive techniques for glucose monitoring, with several studies reporting its efficacy in detecting glucose concentration. This study designed and developed a near-infrared system based on an 1150nm wavelength for continuous non-invasive glucose monitoring. The system gave the output voltages that vary with increased glucose concentrations. It was ascertained from the Clark error grid analysis that the glucose concentration falls within region A and region B. This implies that the device is suitable for measuring glucose concentration non-invasively. As per Bland Altman's analysis, the majority of the data points were within both limits of agreement except one data point that was outside the upper limit of agreement, indicating 93% degree of accuracy, and the residual plot indicates that the regression model for the system is appropriate for predicting non-invasive glucose measurements.

Implementation of Competency-Based Curriculum in Improving the Quality of Education in Schools

The aim of this research is to evaluate Curriculum Effectiveness: Understanding the extent to which a competency-based curriculum can improve the quality of education by measuring student learning outcomes, level of mastery of material, and students' ability to apply the knowledge and skills they learn. This research uses qualitative/quantitative methods with a descriptive approach. Some of the instruments used in this research are student portfolios, practical exams, formative assessments. The researcher's data collection techniques used interviews, questionnaires, classroom observations, classroom observations, document analysis, exams and assessments, focus group discussions, and reflective notes. This research shows that the implementation of Competency-Based Curriculum (KBK) in the context of school education requires the active involvement of teachers in preparing more contextual learning that is oriented towards skills development. Students are expected to become successful, honest, disciplined, and responsible individuals. However, the quality of education in Indonesia still requires many improvements, including the implementation of appropriate policies as an alternative solution to educational problems. Relevant KBK programs with initiatives for training education personnel include participation in various places, development of family planning organizations, and utilizing the education process to address educational gaps. The importance of administrative support, resource availability, and continuous evaluation and assessment are key to the successful implementation of KBK. Parental and community involvement are also crucial in supporting the implementation of KBK, which ultimately positively impacts the quality of education, student motivation, and alignment with local needs.

Spirituality, Self-Efficacy, and Medication Use in African American Women with Hypertension: Beyond the Prescriptions.

Objective: This study aimed to determine the relationship between spiritual, religious, and existential well-being and self-efficacy for appropriate medication use in African American women with hypertension. Methods: In this study, we conducted cross-sectional correlations using linear regression analysis. An African American sample of women from across the United States with hypertension was chosen through a purposive sampling technique. An online survey was used. Results: There were 186 African American women with hypertension who took part in the study, with an average age of 57.15 (SD = 12.79) years. The study found significant correlations between spiritual (p = .022), religious (p = .033), and existential (p = .021) well-being and self-efficacy for appropriate medication use in African American women with hypertension. The study concluded that no women reported high spiritual, religious, or existential well-being, only moderate. Nor were they very confident that they would take their medications under changing or challenging circumstances. Conclusion: African American women are the most religious aggregate in the United States, and there is evidence that spiritual, religious, and existential well-being affects their self-efficacy for appropriate medication use. Clinicians and researchers must collaborate to enhance medication adherence through continuous education, assessment, and reinforcement while also attuning their practice to spiritual, religious, and existential well-being effects on self-efficacy for appropriate medication use in African American women.

Unmet care needs in psychiatric healthcare context: A systematized literature review.

Missed, rationed or unfinished nursing care represents a global problem that jeopardizes the provision of quality and safe care. This phenomenon is frequently observed in adult, paediatric and child healthcare facilities and various care units. The findings of this review contribute valuable information to inform evidence-based practices, foster organizational improvements and ultimately optimize the overall quality of care in psychiatric healthcare settings. In addition, the review illuminates the far-reaching consequences of care on both patient and nurse outcomes, emphasizing the urgent need for tailored strategies to mitigate these effects. Based on the synthesis of the literature, a thorough and continuous assessment of patient care needs in the physical, psychological and social domains is needed, primarily utilizing standardized instruments designed for psychiatric settings to ensure a comprehensive understanding of unmet needs. Based on identified unmet needs, nurses should develop individualized care plans and tailor interventions to address them. In addition, nurse managers must adopt and implement regular monitoring mechanisms to track the prevalence of unmet care needs and at the same time establish reporting systems that capture the proportion of unmet needs, allowing timely interventions and adjustments to care delivery. Lastly, nurse managers must not only emphasize the importance of ethical care practices and dignity-focused interventions but also educate healthcare providers, especially nurses, on the potential threats to patient dignity arising from unmet care needs. INTRODUCTION: Despite frequent observations of unmet care needs in acute care adult settings, there are a limited number of studies that focus on investigating this phenomenon in the psychiatric setting. To synthesize the existing empirical research on unmet care needs in psychiatric healthcare settings. The search was carried out in August 2023 in four scientific databases, PubMed, ProQuest, Web of Science and OVID Nursing, based on their institutional availability. The search produced 1129 studies. The search and retrieval process reflected the recommendations of the Preferred Reporting Items for systematic reviews and meta-analyses. This review included 14 studies investigating unmet care needs in the psychiatric healthcare setting. Unmet care needs included three domains: physical, psychological and social. The analysis of the factors revealed factors related to the characteristics of the organization, nurse and patient. The classification of unmet needs provides a comprehensive understanding of the various challenges facing people in psychiatric healthcare settings. Identified factors that influence the occurrence of unmet care needs will help prevent the occurrence of unmet care needs and timely assessment. The resolution of needs helps to achieve patient and nurse outcomes, increase the quality of care provided and patient satisfaction in a psychiatric healthcare setting.