Knowledge Deficits Research Articles

Exploring work readiness: A qualitative descriptive study of self-perceptions among new graduate nurses

BackgroundReduced work readiness is associated with elevated turnover rates, necessitating efforts to enhance the positive work readiness of newly graduated nurses to alleviate the shortage in the nursing workforce. Research into the work readiness of recent nursing graduates in China is still in its infancy. Most studies employ quantitative research methods, and further exploration of the self-perception of work readiness among new nurses in China is required. ObjectivesThis study aimed to investigate genuine experiences and self-perceptions of work readiness among new graduate nurses. DesignA qualitative descriptive study. MethodsSixteen new nurses from a provincial tertiary hospital in China were included in this study, which adhered to the consolidated criteria for reporting qualitative research (COREQ) checklist for reporting. The data collection process involved conducting semi-structured interviews from September to October 2021. Inductive content analysis was employed to analyze the interview data. ResultsThe study identified four themes encompassing new nurses' real-life experiences and self-perceptions of work readiness: psychological stress, emotional conflict, empathy fatigue, and ethical dilemmas. Psychological stress comprised three subthemes: knowledge and skill deficits, communication barriers, and fear. Empathy fatigue was primarily characterized by psychological and physical symptoms. Ethical dilemmas involved conflicts over differences in values and between clinical reality and standardized nursing practice. ConclusionDrawing from the self-perceptions of work readiness among new nurses found in this study, nursing administrators and educators must enhance the existing transition support program for new nurses. Additionally, the establishment of individualized training programs is recommended to further improve the work readiness of new nurses.

Exploring the Mechanisms of Traditional Chinese Herbal Therapy in Gastric Cancer: A Comprehensive Network Pharmacology Study of the Tiao-Yuan-Tong-Wei decoction.

The use of herbal medicine as an adjuvant therapy in the management of gastric cancer has yielded encouraging outcomes, notably in enhancing overall survival rates and extending periods of disease remission. Additionally, herbal medicines have demonstrated potential anti-metastatic effects in gastric cancer. Despite these promising findings, there remains a significant gap in our understanding regarding the precise pharmacological mechanisms, the identification of specific herbal compounds, and their safety and efficacy profiles in the context of gastric cancer therapy. In addressing this knowledge deficit, the present study proposes a comprehensive exploratory analysis of the Tiao-Yuan-Tong-Wei decoction (TYTW), utilizing an integrative approach combining system pharmacology and molecular docking techniques. This investigation aims to elucidate the pharmacological actions of TYTW in gastric pathologies. It is hypothesized that the therapeutic efficacy of TYTW in counteracting gastric diseases stems from its ability to modulate key signaling pathways, thereby influencing PIK3CA activity and exerting anti-inflammatory effects. This modulation is observed predominantly in pathways such as PI3K/AKT, MAPK, and those directly associated with gastric cancer. Furthermore, the study explores how TYTW's metabolites (agrimoniin, baicalin, corosolic acid, and luteolin) interact with molecular targets like AKT1, CASP3, ESR1, IL6, PIK3CA, and PTGS2, and their subsequent impact on these critical pathways and biological processes. Therefore, this study represents preliminary research on the anticancer molecular mechanism of TYTW by performing network pharmacology and providing theoretical evidence for further experimental investigations.

Abstract 496: Insights into correlation between nanomechanical properties and cytokines expression during gold nanoparticle endocytosis

Abstract Gold nanoparticles for therapeutic interventions have become a widely popular source due to the ease in surface chemistry available for modification. Several studies undertaken focusses on the size, shape of nanoparticles as well as the signaling mechanisms and yet, knowledge regarding the alteration in membrane dynamics such as nanomechanical properties and cytokines involved during their uptake has not been studies before. To overcome the knowledge deficit, we employed atomic force microscopy and qRT-PCR techniques to acquire nanomechanical attributes and cytokines expressions respectively, in Panc-1 and AsPC-1 cell lines treated with surface modified gold nanoparticles for 1- and 24-hours’ time point. In nanomechanics paradigm, impetus was given on both linear attributes such as membrane stiffness, deformation, and adhesion as well as non-linear attributes such as drained Poisson’s ratio, diffusion coefficient and pore size. On the other hand, qRT-PCR technique yielded alterations in relative mRNA expressions of pro-tumorigenic cytokines such as CCL2, CXCL1, CXCL2, CXCL3, IL8, IL11, IL18 and TGFβ-1. Further, using Pearson’s correlation, we deduced the dependency between nanomechanical properties and cytokines expressions. We evaluated several criteria such as receptor dependent vs independent, PEGylated vs non-PEGylated and 1 hr vs 24hrs, to deduce correlations between cytokines and nanomechanical attributes. In Panc-1 cell line, we observed that PEGylation vs non-PEGylation of gold nanoparticles demonstrated most significant correlations, whereas in AsPC-1 cell line, receptor independent mechanism played a pivotal role in establishing significant correlations. For instance, D_C and P_D were highly correlated with CXCL1, CXCL2 and TGFβ-1 when non-PEGylated gold nanoparticles were up taken by Panc-1 cells. Similarly, D_C and P_D were highly correlated consistently with our cytokine panel except for TGFβ-1. In AsPC-1 cell line, deformation was significantly correlated with CCL2, CXCL2, CXCL3 and IL-8 whereas, D_C and P_D were significantly correlated with CCL2, CXCL1, CXCL3, IL-18 and TGFβ-1 in receptor independent scenario. This study demonstrated that during the uptake of gold nanoparticles, non-linear nanomechanical attributes are detrimental over linear attributes. Moreover, Surface modified gold nanoparticles induce varying levels of alteration in pro-tumorigenic cytokines. Taken together, this study boosts our insights into correlations describing cytokines regulating nanomechanical attributes in endocytosis paradigm. Citation Format: Tanmay Kulkarni, Enfeng Wang, Ramcharan Singh Angom, Debabrata Mukhopadhyay, Santanu Bhattacharya. Insights into correlation between nanomechanical properties and cytokines expression during gold nanoparticle endocytosis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 496.

Study to Assess the Knowledge Level of Adolescent Girls Regarding Anaemia and Its Prevention in Selected Community Area of Mehrauli, Delhi

Anaemia is a global public health affecting human health as well as social and economic development. It is more prevalent in adolescent females. It is preventable and treatable. The most common cause recognized is iron deficiency. It is one of the major health concerns with prevalence of 59.1% (NFHS 2019-2021) among adolescent girls. The research was conducted in the year 2023, November on 50 adolescent girls were taken as sample using random sampling technique in selected community area Mehrauli, Delhi. Research design used in the study was descriptive research design & data was obtained through simple random sampling technique with the help of structured questionnaire for accessing the level of knowledge regarding anaemia and its prevention. The finding of the study indicates that 46.48% girls were having average knowledge score and subjects were deficit of knowledge regarding anaemia and its prevention. The calculated chi-square value between the level of knowledge and demographic variables was not statistically significant as evident from p < 0.05 value. Keywords: Knowledge, Anaemia and its prevention, Adolescent girls, Community Area.

An evaluation of knowledge and perception of pharmacology in undergraduate oral hygiene students and recent graduates at a single higher institution in Pretoria.

Pharmacology is an increasingly important area of study for oral hygienists,as it provides the scientific basis for safe and effective oral healthcare. However, a lack of fundamental understanding of the discipline among clinical graduates can present significant challenges. Oral hygienists require pharmacological training to meet the requirements of their scope of practice. Pharmacology knowledge assists with the diagnosis and treatment of oral conditionsand forms the foundation for further clinical competency development. The knowledge and perceptions of pharmacology for pharmacy, nursing and medical students have been well documented; however, little information is present for Bachelor of Oral Hygiene (BOH) students. This paper sets out to evaluate BOH students' and recent graduates' knowledge and perceptions of pharmacology at a single higher institution in Pretoria to identify possible gaps and weaknesses. A cross-sectional study design was used to collect data using an online questionnaire. The English-language questionnaire consisted of the self-reported perceptions and knowledge and actual knowledge of pharmacology of undergraduate BOH students and recent graduates. The questionnaire consisted of multiple choice questions, true or false questions and Likert scale questions. Ethics was obtained from the institution's Research Ethics Committee (REC 350/2021). Overall, the participants perceived the pharmacology module positively and understood its importance. Concerns were raised about insufficient time for studying and that assessments were more aligned to gaining factual knowledge than the development of problem-solving skills. Students rated their knowledge between 57.24% and 69.44%, with BOH III students and graduates having a statistically significant greater self-rated knowledge of antivirals, antifungals and common agents used to treat oral conditions in comparison with BOH I and BOH II students. Overall, BOH students and graduates' actual knowledge was between 45.24% and 66.84%. Although not statistically significant, the total self-rated knowledge of BOH III students and recent graduates tended to be higher than their actual knowledge. Knowledge deficits were evident with some pharmacological concepts across the various BOH groups, such as pharmacokinetics, pain, drugs altering dental treatment I: central nervous system drugs, drugs altering dental treatment II: respiratory and endocrine drugs, drugs altering dental treatment III: cardiovascular drugs, drug-drug interactions and common agents used to treat oral conditions. Self-rated knowledge deficiencies were noted by students and recent graduates for certain pharmacological concepts and were supported by the measurement of their actual knowledge. Further investigation into knowledge deficiencies is needed to guide curriculum review to further strengthen oral hygienists' pharmacological competencies and ensure alignment to their scope of practice.

Monetary Smurfing Analytics Model using ML

The act of taking money obtained from illegal operations, such as drug trafficking, and disguising it as profits from a legitimate business venture is known as money laundering. The money obtained through illegal action is regarded as dirty, and to make it appear clean, it is "laundered." Money laundering is a major concern to the country these days, as well as financial institutions. The sophistication of this illegal activity is growing; it appears to have beyond the tired old trope of drug trafficking to include financing terrorism and, of course, personal benefit. Research on anti-money laundering is crucial since money laundering is a global issue that seriously jeopardizes international security and financial stability. Furthermore, it's estimated that the banking system seizes only 0.2% of the money that has been laundered. The crime itself is growing more sophisticated and intricate, and banks are becoming more vulnerable as a result of its ongoing volume amplification. Considering the role that banking institutions play in the money-laundering industry, practitioners and researchers are becoming more interested in creative ways to solve problems and enhance anti-money-laundering efforts. Researchers are starting to look into the viability of artificial intelligence methods in this setting. A systematic knowledge deficit concerning a thorough study that meticulously examines and combines artificial intelligence methods for countering money laundering in the banking industry was discovered, though. To combat investment fraud, the majority of global financial institutions have been putting anti-money laundering measures into place. Data mining tools have emerged recently and are thought to be effective methods for identifying instances of money laundering.

Online Search Strategies and Results From a Crowdsourced Survey on Asymptomatic Bacteriuria.

Despite the prevalence of asymptomatic bacteriuria (ASB), what proportion of the population is aware of this condition and the quality of internet resources are currently unknown. This study aimed to use an online crowdsourcing platform to explore general knowledge and internet search strategies, along with the quality of information, on ASB. An online survey was administered through a crowdsourcing platform to women 50 years or older via Qualtrics, which is a sophisticated online survey tool. Participants completed a survey on ASB, and participants were asked how they would search the internet for information both on urinary test results and on ASB. Outcomes included survey responses, and qualitative data were coded and analyzed thematically. χ2 Testing and regression modeling were used to look for variables associated with concern for ASB. There were a total of 518 participants who passed attention check qualifications, and only 45 respondents (8.7%) had heard of ASB. Many were concerned about progress to a worsening infection (n = 387 [77.6%]). When controlling for confounders, education beyond a college degree was not associated with a lower concern for ASB when compared with those with a high school education or less (adjusted odds ratio, 0.63; 95% confidence interval, 0.25-1.55; P = 0.31). Medical providers were the target audience for a majority of the websites, and many of the patient-facing results were of poor quality. Our national survey of women demonstrated a prevalent knowledge deficit surrounding ASB. We must seek to create high-quality, readily available, patient-facing information to increase awareness of ASB, allay concerns, and increase antibiotic stewardship.

Application Of The Health Belief Model In Improving Healthy Behaviors Among Pregnant Women: A Literature Review

Introduction: Maternal mortality rates around the world are still high. The first place out of 25 countries in Asia Pacific is Salomon Island with 327 per 100,000 live births, while the sustainable development goal target in 2030 is 70 per 100,000 live births. Factors influencing the high maternal mortality rate are pregnancy complications, demographics, sanitation, maternal education, and husband's education. Knowledge deficits require intervention in order to change behavior with appropriate approaches, such as the HBM (Health Belief Model). Objective: to determine changes in health behavior with the application of the Health Belief Model among pregnant women. Methods: This study used a literature review design. The databases involved in the search are Scopus, PubMed, Web of Science, Embase, and Google Scholar. Inclusion criteria: research with the topic Health Belief Model in Pregnancy, publication 2018-2023, full text Mesh terms used: health belief model AND pregnant women OR pregnancy. Result: Database extraction results obtained (n = 8) articles from 235 articles. Educational or evaluation materials that use Health Belief Model were nutrition education, prevention of anemia, preeclampsia, gestational diabetes, influenza vaccination, prevention of urinary tract infections, and acceptance of the COVID-19 vaccination. Conclusions: This review demonstrates the lack of evidence-based research to apply Health Belief Model to pregnant women. Nurses need to apply the concept of health belief model to pregnant women in future research and education.

Extinction risk predictions for the world's flowering plants to support their conservation.

More than 70% of all vascular plants lack conservation status assessments. We aimed to address this shortfall in knowledge of species extinction risk by using the World Checklist of Vascular Plants to generate the first comprehensive set of predictions for a large clade: angiosperms (flowering plants, c. 330 000 species). We used Bayesian Additive Regression Trees (BART) to predict the extinction risk of all angiosperms using predictors relating to range size, human footprint, climate, and evolutionary history and applied a novel approach to estimate uncertainty of individual species-level predictions. From our model predictions, we estimate 45.1% of angiosperm species are potentially threatened with a lower bound of 44.5% and upper bound of 45.7%. Our species-level predictions, with associated uncertainty estimates, do not replace full global, or regional Red List assessments, but can be used to prioritise predicted threatened species for full Red List assessment and fast-track predicted non-threatened species for Least Concern assessments. Our predictions and uncertainty estimates can also guide fieldwork, inform systematic conservation planning and support global plant conservation efforts and targets.

Care Models and Barriers to Long-Term Follow-Up Care Among Childhood Cancer Survivors and Health Care Providers in Asia: A Literature Review.

Most available data evaluating childhood cancer survivorship care focus on the experiences of high-income Western countries, whereas data from Asian countries are limited. To address this knowledge deficit, we aimed to characterize survivorship care models and barriers to participation in long-term follow-up (LTFU) care among childhood cancer survivors (CCSs) and health care providers in Asian countries. Twenty-four studies were identified. Most institutions in China and Turkey adopt the oncology specialist care model, whereas in Japan, India, Singapore, and South Korea, after completion of therapy LTFU programs are available in some institutions. In terms of survivor barriers, findings highlight the need for comprehensive age-appropriate education and support and personalized approaches in addressing individual preferences and challenges during survivorship. Health care professionals need education about potential late effects of cancer treatment, recommended guidance for health surveillance and follow-up care, and their role in facilitating the transition from pediatric to adult-focused care. To optimize the delivery of cancer survivorship care, efforts are needed to increase patient and family awareness about the purpose and potential benefits of LTFU care, improve provider education and training, and promote policy change to ensure that CCSs have access to essential services and resources to optimize quality of survival.

Communicating About Water in the Floridan Aquifer Region: Part 1—What Do People Know About Water Science?

Meaningful engagement by the public in the water decisions that affect their lives requires basic scientific knowledge, such as where their water comes from, the factors that affect quality and availability, and the challenges that influence water supply. A 2020 study suggests that Florida and Georgia residents lack fundamental knowledge about their water resources, including regional water processes, including its challenges, and policies. This is the base information that would enable a person to competently participate in water discussions and make citizen-level voting decisions on topics related to the Floridan aquifer. The knowledge deficits identified in the study are areas on which water communicators can build the public’s water science comprehension and, thereby, support increased public engagement. The findings also suggest the level of water science complexity that the public is equipped to understand.

COVID-19 Impact on Family Medicine Residents Exam Performance.

The COVID-19 pandemic began interrupting family medicine residency training in spring 2020. While a decline in scores on the American Board of Family Medicine In-Training Examination (ITE) has been observed, whether this decline has translated into the high-stakes Family Medicine Certification Examination (FMCE) is unclear. The goal of this study was to systematically assess the magnitude of COVID-19 impact on medical knowledge acquisition during residency, as measured by the ITE and FMCE. A total of 19,101 initial certification candidates from 2017 to 2022 were included in this study. Annual ITE scores and FMCE scores were reported on the same scale (200-800) and served as the outcome measure. We conducted multilevel regression analysis to determine ITE score growth and FMCE scores compared to cohorts prior to COVID-19. During COVID-19, the increase in ITE scores from postgraduate year 2 (PGY-2) to PGY-3 was 25.5 points less, representing a 57.6% relative decrease; and from PGY-3 ITE to FMCE, it was 8.6 points less, a 12.7% relative decrease, compared with cohorts prior to COVID-19. FMCE scores were 6.6 points less during COVID-19, representing a 1.2% relative decline from the average FMCE score prior to COVID-19. This study found nonsubstantive COVID-19 impact on FMCE scores, but a considerable knowledge acquisition decline during residency, especially during the PGY-2 to PGY-3 period. While COVID-19 impacted learning, our findings indicated that residencies were largely able to remediate knowledge deficits before residents took the FMCE.

On the distribution and habitat use of the sub-Antarctic fly Hyadesimyia clausa Bigot (Diptera, Tachinidae) according to citizen science.

Hyadesimyia clausa Bigot is a morphologically striking tachinid that inhabits the Sub-Antarctic Ecoregion of the Magallanes Region in Chile and Tierra del Fuego province in Argentina. Much of the distributional information about this species is restricted to the Cape Horn islands, which have extreme environmental conditions, but the species' natural history, range limits, and habitat use have never been described or confirmed. Our goals were to describe the distributional limits of this sub-Antarctic fly with the help of citizen science and use this information type to describe this tachinid's habitat use and potential biological interactions with nonvascular and vascular flora. We found that citizen science significantly increased our understanding of the extent of occurrence, expanding the known distributional range by 195 km to the north and 153 km to the west. On the contrary, the values for the area of occupancy were not significant, but the occupancy overlap between different records was very low. We confirmed that H. clausa's habitat uses peatlands and although we have not provided evidence of pollination or movement of spores, we hypothesized, that the walking activity of H. clausa could help move sperm from mosses and pollen from the flowers of vascular plants, so they could act as potential pollinators. Citizen science can reduce and eliminate some scientific knowledge shortfalls and propose new ecological questions that could increase our knowledge of extreme ecosystems.

ASUHAN KEPERAWATAN IBU NIFAS PADA NY F POST SECTIO CAESAREA DI RUANG TERATAI RSUD BATARA SIANG PANGKEP

Sectio Caesarea is a medical action that is needed to help deliveries that cannot be carried out normally due to problems with the mother's health or the condition of the fetus, this problem can be overcome by the role of nurses in providing comprehensive nursing care. The purpose of this study is to be able to carry out nursing care for postpartum mothers with post-sectio caesarean section at Batara Siang Pangkep Hospital.The research method is a qualitative method with a case study approach.The results of the study were obtained in patients with post section caesarea pathological indications that need to be considered is the assessment on physical examination, namely breast enlargement, uterine contractions are good/hard, there is lochia rubra. some changes in physical, psychological and social problems. The nursing problems found in the case review were acute pain, knowledge deficit, risk of infection.the intervention still refers to the target, outcome criteria and time criteria. At the end of the evaluation all objectives can be achieved due to good cooperation between the patient, family and health team, suggestions the involvement of the patient, family and health team that is well established needs to be improved so that mutual trust arises

Healthcare professionals’ experiences and views of providing continence support and advice to people living at home with dementia: “That’s a carer’s job”

BackgroundPeople living with dementia at home and their family carers often feel unsupported by healthcare professionals in managing continence problems. In turn, primary and community-based healthcare professionals have reported lacking specific knowledge on dementia-continence. This study aimed to understand more about healthcare professionals’ experiences and views of supporting people living with dementia experiencing continence problems, as part of developing acceptable resources. Having a nuanced understanding of unmet need would facilitate the design of engaging resources that enable healthcare professionals to provide more effective continence support to people living with dementia at home.MethodsSemi-structured interviews were conducted with a range of healthcare professionals (n = 31) working in primary and community care in the South of England in 2023. Transcribed interviews were uploaded to NVivo 12, then analysed inductively and deductively using a thematic framework.ResultsContinence-related conversations were avoided by many healthcare professionals due to lack of dementia-continence specific knowledge. Many considered that continence problems of people living with dementia were largely outside their remit once a physical cause had been ruled out. This contributed to a lack of priority and proactivity in raising the subject of continence in their consultations. Challenges to providing support included limited consultation time and lack of access to specialist services with availability to support individuals.ConclusionThere is substantial scope to support primary and community-based healthcare professionals in their provision of continence-related support and advice to people living at home with dementia. This includes addressing knowledge deficits, enhancing confidence and instilling a sense of accomplishment.

Adolescent refractory anxiety disorders rising: Gut microbiota-associated metabolites to the rescue?

This review provides a comprehensive analysis of the gut microbiota and its associated metabolites in relation to stress and anxiety disorders, with a specific focus on adolescents. It addresses the dearth of information regarding the composition of microbiota-associated metabolites that have the potential to effectively alleviate anxiety and stress disorders in this age group. Adolescence is a vulnerable period characterized by hormonal, physiological, emotional, and environmental changes, making individuals more prone to psychiatric disorders that manifest as stress and anxiety. However, treatment is challenging due to patient non-compliance, particularly in refractory cases, necessitating tailored interventions. The gut microbiota, a vast community of microorganisms residing in the gastrointestinal system, plays a crucial role in influencing brain function through the microbiota-gut-brain axis (MGBA). Understanding the role of the gut microbiota in stress and anxiety disorders has opened avenues for potential targeted and innovative therapeutic approaches. This review consolidates the existing knowledge about gut microbiota and associated metabolites implicated in stress and anxiety disorders in adolescents. Through an extensive literature review, we compile a comprehensive list of microorganisms and metabolites known to alleviate symptoms of these disorders. The identification of microbiota-associated metabolites with the potential to ameliorate stress and anxiety disorders in adolescents can bridge the knowledge deficit and contribute to the development of novel treatment strategies and interventions, including unconventional approaches such as fecal microbiota transplantation (FMT).

Acquisition, status and transfer of knowledge in compression therapy : Cross-sectional study in healthcare professions using phlebological compression therapy

Due to scientific progress, healthcare professionals should regularly undergo appropriate continuing education. For this, knowledge transfer is essential. Therefore, the aim of this cross-sectional study was to investigate the acquisition, status and transfer of knowledge of professional groups applying phlebological compression therapy in Germany. Healthcare professionals (physicians, nurses and medical assistants) received aquestionnaire developed for this study, which queried different aspects of acquisition, status and transfer of knowledge. Responses from 522 participants were analysed. The topic of compression therapy was not taught in the nursing or medical education of 43.3%. Specialist journals that address compression therapy were read regularly (at least 6times/year) by 16.1% of the participants; 63.0% had no specialist books on this subject. Only 6.7% were aware of AWMF ("Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften") guidelines on the topic and 16.3% of the corresponding DNQP ("Deutsches Netzwerk für Qualitätsentwicklung in der Pflege") expert standard. In all, 41.2% participated in at least one internal training on compression therapy per year, 72.0% in external training and 19.2% in online training. Atotal of 30.7% stated that they did not use any information sources to acquire knowledge. Possible sources of knowledge about compression therapy in Germany are insufficiently known within the investigated healthcare professional groups studied or are not regularly used. The result is aconsiderable knowledge deficit with adiscrepancy between the current state of science and practice.

Towards Precision Ophthalmology: The Role of 3D Printing and Bioprinting in Oculoplastic Surgery, Retinal, Corneal, and Glaucoma Treatment.

In the forefront of ophthalmic innovation, biomimetic 3D printing and bioprinting technologies are redefining patient-specific therapeutic strategies. This critical review systematically evaluates their application spectrum, spanning oculoplastic reconstruction, retinal tissue engineering, corneal transplantation, and targeted glaucoma treatments. It highlights the intricacies of these technologies, including the fundamental principles, advanced materials, and bioinks that facilitate the replication of ocular tissue architecture. The synthesis of primary studies from 2014 to 2023 provides a rigorous analysis of their evolution and current clinical implications. This review is unique in its holistic approach, juxtaposing the scientific underpinnings with clinical realities, thereby delineating the advantages over conventional modalities, and identifying translational barriers. It elucidates persistent knowledge deficits and outlines future research directions. It ultimately accentuates the imperative for multidisciplinary collaboration to enhance the clinical integration of these biotechnologies, culminating in a paradigm shift towards individualized ophthalmic care.

Role of Governance in Implementing Climate Change Adaptation Strategies in the Congo Basin Case of Cameroon and the Democratic Republic of Congo

The low adaptability capacity of the Central African sub-region to climate change has made it one of Africans’ most vulnerable sub-regions in the continent as this sub-region depends heavily on resources sensitive to climate change. Cameroon and the Democratic Republic Congo are host to the world's second largest rainforest after the Amazon. This implies that climate change will undermine development in this sub-region and the rest of the continent as the effects of climate change are faced more by the most vulnerable. There is however rising interest in SSA to mitigate and adapt climate change solutions. While such efforts exist, knowledge on the governance arrangements exist in very fragmented forms. Specifically, knowledge on how global climate changes processes is reflected in national policies remain relatively less studied. So too are their limited evidence on how national policies play out at local level. Such knowledge deficits stall scientific evidence building and policy orientation to strengthen climate adaptation practices in countries of SSA, with Cameroon and DRC being classical examples. Yet theory building on climate change governance requires such context specific evidence. In addition, for a comprehensive policy to be adopted and made effective, climate change actions require such scientific evidence. This therefore validates the need to analyze how such global processes are framed into national policy and policy instruments for climate mitigation and adaptation, and to establish the connections and disconnections between what is framed at national level and what applies at local level in terms of climate change policy instrument and what explains such variations. Though effective climate action requires political commitment, well-aligned multi-level governance and institutional frameworks, laws, policies and strategies, as outlined by the Intergovernmental Panel on Climate Change (IPCC), there is still need for clear goals, adequate finance and financing tools, coordination across multiple policy domains, and inclusive governance processes in Cameroon and the Democratic Republic of Congo to harness these goals. This study investigated the role of governance in implementing climate change adaptation in Cameroon and the DRC. This research therefore aimed at examining the role of governance in implementing climate change adaptation strategies in Cameroon and the DRC. The study made use of primary and secondary data which was analyzed using content analysis to triangulate the relationship that exist between governance and the implementation of climate change adaptation strategies in Cameroon and the DRC. Results highlight the dominant role of governance in shaping adaptation efforts, challenges in implementation, spatial disparities, and the influence of national policies and stakeholder engagement. Policy recommendations emphasize the need for improving governance structures, enhancing stakeholder participation, mainstreaming gender considerations, and addressing financial constraints to build resilience and effectively respond to climate change impacts in both countries. The findings underscore the importance of context-specific strategies that prioritize inclusivity, transparency, and collaboration to address the complex challenges posed by climate change.

Disinfection of central venous access device needleless connectors: A human factors analysis.

Evidence-based central-line-associated bloodstream infection (CLABSI) prevention guidelines recommend the use of an antiseptic scrub to disinfect needleless connectors before device access. Guideline noncompliance may render disinfection ineffective. The goal of this study was to observe needleless-connector disinfection practices and to identify perceived facilitators and barriers to best practices of needleless-connector access. A human factors mixed-methods study involving nursing focus groups of perceived barriers and facilitators and clinical observations of compliance with instructions and protocols for use of 3.15% chlorhexidine gluconate/70% isopropyl alcohol (CHG/IPA) and 70% isopropyl alcohol (IPA) antisepsis products for central venous access device (CVAD) needleless-connector disinfection was conducted in intensive care units (ICUs) at 2 academic medical centers. Access to the antiseptic product and lesser workload were identified as best-practice facilitators. Barriers were the time required per needleless-connector access and knowledge deficits. Of the 48 observed access events, 77% resulted in needleless-connector disinfection. The observed mean needleless-connector scrubbing times when using IPA were substantially below the recommended time. Drying time after product use was negligible. Lack of access to the disinfection product, emergency situations, and high workload were barriers to needleless-connector disinfection. Observed scrubbing and drying times were shorter than recommended, especially for IPA wipes. These needleless-connector disinfection deficits may increase the risk of CLABSI. Ongoing education and periodic competency evaluation of needleless-connector disinfection, improvement of supply management, and staffing workload are required to imbed and sustain best practices. Further study involving a larger sample size in diverse patient populations is warranted.