Descriptive Analysis Research Articles

Federally Qualified Health Centers and Performance of Medicare Accountable Care Organizations

ImportanceFederally qualified health centers (FQHCs) have increasingly participated in the Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs), one of the most widespread value-based programs. Although FQHCs may strengthen ACOs’ ability to provide affordable care to diverse Medicare beneficiaries, evidence on ACOs’ performance by FQHC participation is limited.ObjectivesTo compare beneficiary characteristics, utilization, expenditure, and quality between ACOs with and without FQHC participation and assess changes in ACO performance after including first FQHCs.Design, Setting, and ParticipantsUsing MSSP public use files, this cross-sectional study compared performance of ACOs that always had FQHC participation with ACOs that never had FQHC participation from January 1, 2016, to December 31, 2022, supplemented with staggered difference-in-differences analyses of ACOs’ first-time inclusion of FQHCs on performance measures. Data analysis was performed from December 1, 2023, to February 29, 2024.ExposureParticipation of FQHCs in the MSSP.Main Outcomes and MeasuresMeasures of ACO-assigned beneficiaries, utilization, expenditure, and quality per ACO-year.ResultsAmong 752 ACOs in the descriptive analysis, 140 ACOs always had at least 1 FQHC participant, whereas 612 ACOs never had FQHC participants. Compared with ACOs that never had FQHC participation, those that always had FQHC participation provided care to more socioeconomically disadvantaged beneficiaries (mean [SD] with dual eligibility, 2035.8 [2110.6] vs 1040.9 [1084.2] person-years; with disability, 3341.1 [3474.9] vs 1705.1 [1664.9] person-years; in racial and ethnic minoritized groups, 3690.6 [4118.4] vs 2515.1 [2762.9] person-years), with fewer primary care visits (mean [SD], 9956.6 [1926.3] vs 10 858.8 [2383.4] per 1000 person-years), more emergency department visits (mean [SD], 771.6 [190.9] vs 657.2 [160.0] per 1000 person-years), and lower levels of several quality measures. In the difference-in-differences analysis, 43 ACOs included FQHCs for the first time. Including first FQHCs was associated with increases of 872.9 dual-eligible (95% CI, 345.9-1399.8), 1137.6 disability (95% CI, 390.1-1885.1), and 1350.8 racial and ethnic minority (95% CI, 447.4-2254.1) person-years, with increases in rates of influenza immunization (5.9 percentage points [pp]; 95% CI, 1.4-10.4 pp), tobacco screening and cessation intervention (11.8 pp; 95% CI, 3.7-20.0 pp), and depression screening and follow-up (8.9 pp; 95% CI, 0.5-17.4 pp). No associations were observed between FQHC inclusion and utilization or expenditure.Conclusions and RelevanceIn this repeated cross-sectional study, MSSP ACOs with FQHC participation served more socioeconomically disadvantaged Medicare beneficiaries than those without FQHC participation. The inclusion of first FQHCs was associated with increased rates of several preventive services without increasing costs. Participation of safety net practices appeared to improve access to ACOs among beneficiaries from underserved communities.

Navigation Training for Persons With Visual Disability Through Multisensory Assistive Technology: Mixed Methods Experimental Study

Background Visual disability is a growing problem for many middle-aged and older adults. Conventional mobility aids, such as white canes and guide dogs, have notable limitations that have led to increasing interest in electronic travel aids (ETAs). Despite remarkable progress, current ETAs lack empirical evidence and realistic testing environments and often focus on the substitution or augmentation of a single sense. Objective This study aims to (1) establish a novel virtual reality (VR) environment to test the efficacy of ETAs in complex urban environments for a simulated visual impairment (VI) and (2) evaluate the impact of haptic and audio feedback, individually and combined, on navigation performance, movement behavior, and perception. Through this study, we aim to address gaps to advance the pragmatic development of assistive technologies (ATs) for persons with VI. Methods The VR platform was designed to resemble a subway station environment with the most common challenges faced by persons with VI during navigation. This environment was used to test our multisensory, AT-integrated VR platform among 72 healthy participants performing an obstacle avoidance task while experiencing symptoms of VI. Each participant performed the task 4 times: once with haptic feedback, once with audio feedback, once with both feedback types, and once without any feedback. Data analysis encompassed metrics such as completion time, head and body orientation, and trajectory length and smoothness. To evaluate the effectiveness and interaction of the 2 feedback modalities, we conducted a 2-way repeated measures ANOVA on continuous metrics and a Scheirer-Ray-Hare test on discrete ones. We also conducted a descriptive statistical analysis of participants’ answers to a questionnaire, assessing their experience and preference for feedback modalities. Results Results from our study showed that haptic feedback significantly reduced collisions (P=.05) and the variability of the pitch angle of the head (P=.02). Audio feedback improved trajectory smoothness (P=.006) and mitigated the increase in the trajectory length from haptic feedback alone (P=.04). Participants reported a high level of engagement during the experiment (52/72, 72%) and found it interesting (42/72, 58%). However, when it came to feedback preferences, less than half of the participants (29/72, 40%) favored combined feedback modalities. This indicates that a majority preferred dedicated single modalities over combined ones. Conclusions AT is crucial for individuals with VI; however, it often lacks user-centered design principles. Research should prioritize consumer-oriented methodologies, testing devices in a staged manner with progression toward more realistic, ecologically valid settings to ensure safety. Our multisensory, AT-integrated VR system takes a holistic approach, offering a first step toward enhancing users’ spatial awareness, promoting safer mobility, and holds potential for applications in medical treatment, training, and rehabilitation. Technological advancements can further refine such devices, significantly improving independence and quality of life for those with VI.

Development of video tutorials on building construction and utilities subjects assisted by Bandicam application for grade XI students at vocational high school

The implementation of Building Construction and Utilities learning for class XI in Vocational High School (VHS) has faced several challenges including student understanding, teachers’ competency, and learning media. This study aims to result in a product, including the feasibility test and effectiveness on the topic of door and window frame details drawing assisted by the Bandicam application. We employed the Research and Development (R&D) model of 4D Thiagarajan. The trial was conducted on 14 students of the Building Information and Modeling Design (DPIB) expertise program class XI with input from 2 experts and 1 teacher. The data was collected through interviews, observations, and questionnaires. The obtained data was analysed using quantitative and qualitative descriptive analysis and descriptive statistics. The results show that the 4 video products were feasible and effective as seen from the improvement of student learning outcomes in the subject of building construction and utilities.

COVID-19-related research data availability and quality according to the FAIR principles: A meta-research study

Background According to the FAIR principles (Findable, Accessible, Interoperable, and Reusable), scientific research data should be findable, accessible, interoperable, and reusable. The COVID-19 pandemic has led to massive research activities and an unprecedented number of topical publications in a short time. However, no evaluation has assessed whether this COVID-19-related research data has complied with FAIR principles (or FAIRness). Objective Our objective was to investigate the availability of open data in COVID-19-related research and to assess compliance with FAIRness. Methods We conducted a comprehensive search and retrieved all open-access articles related to COVID-19 from journals indexed in PubMed, available in the Europe PubMed Central database, published from January 2020 through June 2023, using the metareadr package. Using rtransparent, a validated automated tool, we identified articles with links to their raw data hosted in a public repository. We then screened the link and included those repositories that included data specifically for their pertaining paper. Subsequently, we automatically assessed the adherence of the repositories to the FAIR principles using FAIRsFAIR Research Data Object Assessment Service (F-UJI) and rfuji package. The FAIR scores ranged from 1–22 and had four components. We reported descriptive analysis for each article type, journal category, and repository. We used linear regression models to find the most influential factors on the FAIRness of data. Results 5,700 URLs were included in the final analysis, sharing their data in a general-purpose repository. The mean (standard deviation, SD) level of compliance with FAIR metrics was 9.4 (4.88). The percentages of moderate or advanced compliance were as follows: Findability: 100.0%, Accessibility: 21.5%, Interoperability: 46.7%, and Reusability: 61.3%. The overall and component-wise monthly trends were consistent over the follow-up. Reviews (9.80, SD = 5.06, n = 160), articles in dental journals (13.67, SD = 3.51, n = 3) and Harvard Dataverse (15.79, SD = 3.65, n = 244) had the highest mean FAIRness scores, whereas letters (7.83, SD = 4.30, n = 55), articles in neuroscience journals (8.16, SD = 3.73, n = 63), and those deposited in GitHub (4.50, SD = 0.13, n = 2,152) showed the lowest scores. Regression models showed that the repository was the most influential factor on FAIRness scores (R2 = 0.809). Conclusion This paper underscored the potential for improvement across all facets of FAIR principles, specifically emphasizing Interoperability and Reusability in the data shared within general repositories during the COVID-19 pandemic.

Developing Students’ Critical Thinking Skills Through Differentiated Problem-Based Learning

This study aims to analyse critical thinking skills through differentiated problem-based learning (PBL). The data analysis methods included descriptive analysis, normality tests, homogeneity tests, independent sample t-tests, N-Gain, and ANOVA. The results of the research explain that PBL with differentiated instruction effectively improves students critical thinking skills and a significant effect of learning models and learning styles on students critical thinking skills.

Integrating learner-centered design and user-centered design for meaningful instructor onboarding: Supporting large-scale curricular changes to general education

Supporting instructors through large-scale curricular changes to cross-disciplinary programs such as general education is a complex challenge. In this case-based narrative, we describe how one large R1 university in the Southwest United States developed and implemented an instructor support program during a large-scale general education program redesign for a program that had not been substantively revised since 1998. This program typically offers about 500 courses each semester and is taught by roughly 650 instructors. To support the phased rollout of the new program curriculum, we designed and implemented a Quick Start program to support instructors revising courses for the new program, serving over 400 instructors during its first year of implementation. We discuss our integration of learner-centered design principles (McCombs & Whisler, 1997; Weimer, 2013) to guide the development of the Quick Start program and user-centered design principles (Greer & Harris, 2018; Tham, 2022) to create accessible, useful, and context-driven learning content for the instructors. While these frameworks have been integrated in the past to develop learning materials for students (Jones, 2018; Shivers-McNair et al., 2018), our case-based descriptive analysis presents a novel application of this integration for faculty development. We describe how we integrated these principles to design, scale, iterate, and implement instructor onboarding to the new curriculum. Specifically, we offer four guiding pillars: (i) creating an aligned learning experience, (ii) building an instructional community, (iii) foregrounding an asset-based approach, and (iv) creating useful and usable materials to operationalize such an integration of learner-centered and user-centered design approaches for faculty development.

A VISÃO DOS ACADÊMICOS DE FISIOTERAPIA EM RELAÇÃO ÀS DISFUNÇÕES DO ASSOALHO PÉLVICO

INTRODUCTION: The undergraduate course in Physiotherapy aims to educate its students so that they become generalist Physiotherapists. It is part of their training to study human movement with the aim of preserving, developing and restoring the integrity of organs, systems and functions, in a global way. This study aimed to investigate the perception of physiotherapy students about pelvic floor dysfunctions, a topic of increasing relevance in physiotherapy practice, especially in the areas of women’s health and urogynecology. Considering the importance of the pelvic floor for essential functions, such as continence and support of pelvic organs. OBJECTIVE: To evaluate the level of knowledge of undergraduate students of the Physiotherapy course, from a private university in Teresina-PI, on the subject of the pelvic floor. METHODOLOGY: This is a cross-sectional exploratory study with a quantitative approach, of 180 students, and 91 volunteers who agreed to participate in the research. The descriptive statistical analysis was presented with their respective absolute, relative (mean and standard deviation) and percentage values. As a data collection instrument, a self-administered questionnaire was used, with open and closed questions related to the pelvic floor theme. Students enrolled in the Physiotherapy course at the Santo Agostinho University Center – UNIFSA, Teresina-PI, Brazil, of both sexes, and who were studying between the 1st and 9th period were interviewed. RESULTS: Regarding knowledge of the pelvic floor, 85.7% have knowledge about the pelvic floor, and 14.3% have no knowledge about the pelvic floor. When asked about knowledge about how to strengthen the pelvic floor, 20.9% have no knowledge about it, and 79.1% have knowledge about how to strengthen the pelvic floor. CONCLUSION: The results suggest that there is a discrepancy in the participants’ knowledge and that, although they claim to know about the pelvic floor, most also know how to strengthen the pelvic floor. However, it is necessary that the subject be addressed more in basic and pre-professional disciplines.

Impact of February 6, 2024 Earthquakes on Community Resilience

This study explores the interaction of people and place, the most important elements of geography, in the context of community resilience. Community resilience is the process of adaptation of a society to changing conditions by recovering from the effects of disasters as soon as possible. A resilient community is considered one of the most important components of disaster respons. In the context of increasing disaster risks, interest in increasing community resilience is growing in both academic and policy circles. This study seeks to understand how individuals affected by the February 6, 2023, earthquakes perceive resilience. These interviews were conducted as qualitative research. Typical case sampling was used in the study. Participants were selected from individuals who had experienced both earthquakes (January 24, Elazig and February 6, 2023, Kahramanmaraş) and equal gender distribution was sought. Interviews were conducted on July 15 and August 15, 2023, six months after the second earthquake. Interviews were conducted with 22 people, consisting of 11 female and 11 male earthquake survivors from Elazig, Kahramanmaraş, and Malatya, the three provinces affected by the earthquake. A descriptive analysis of the opinions obtained after the interviews was conducted. Similar answers were brought together, and conclusions on social resilience were evaluated in terms of social, environmental, economic, built, natura, and institutional environment dimensions.

Psychometric properties of the Maladjustment Inventory in a Spanish clinical and student sample.

The various systems of diagnosis and classification of mental disorders underline the need to evaluate the interference caused by the different disorders in a person's daily life. The Maladjustment Inventory (MI) evaluates the impairment in the individual's functioning in a brief and self-applied way, through six items. The objective of this research was to explore the psychometric properties of the MI scores through two studies, one with a Spanish clinical sample (Study 1) and another with a Spanish university students' sample (Study 2). The total sample was made up of 928 participants (81.1% women, n = 495 clinical sample). Descriptive analyses, exploration of internal structure and reliability, exploratory and confirmatory factor analyses, relationship with other variables (quality of life, anxiety, depression, neuroticism and extraversion), and percentiles and T-scores were performed. The results showed good psychometric properties of the MI, with a good fit model for one factor solution in both samples, Cronbach's alpha coefficient of 0.84-88, and evidence of validity based on the relationship with other variables. The good psychometric properties of the MI, together with its brevity, make it a recommended instrument for the evaluation of interference in both clinical and research contexts.

An Examination of Factors Influencing Physicians' Acceptance and Use of the e-Nabız System

Aim: This study aims to identify the factors influencing physicians' acceptance and use of the e-Nabız system by comparing two models. Methods: Conducted with 388 physicians from university hospitals across Turkey, the study utilized an online survey based on the Unified Theory of Acceptance and Use of Technology (UTAUT) scale. Descriptive analyses, frequency and percentage distributions, reliability analysis, confirmatory factor analysis, and structural equation modelling were applied to the collected data. Results: In Model 1, the behavioral intention was influenced by performance expectancy and social influence, while usage behavior was shaped by social influence, facilitating conditions, and behavioral intention. Model 1 accounted for 75% of the variance in behavioral intention and 69% in usage behavior. In contrast, Model 2 identified performance expectancy, anxiety, habit, personal technology innovativeness, and workflow as significant predictors of behavioral intention. Usage behavior in Model 2 was influenced by habit, facilitating conditions, anxiety, personal technology innovativeness, workflow, and behavioral intention, explaining 84% of the variance in behavioral intention and 85% in usage behavior. Conclusion: The findings indicate that Model 2 provides a more comprehensive explanation of the factors affecting the acceptance and use of the system. To enhance acceptance and usage, the study suggests focusing on anxiety management, emphasizing performance benefits, aligning the system with workflow, educating users about new technologies, and implementing incentives to foster habitual use. Future research should explore other technology acceptance models in various healthcare information systems to deepen understanding.

Characteristics of longitudinal maternal health studies in sub-Saharan Africa: A systematic mapping of literature between 2012 and 2022.

High maternal mortality rates in sub-Saharan Africa necessitate the need for aligned research focusing on prevalent causes and neglected conditions in the region. This mapping review aimed to describe the characteristics of longitudinal maternal health studies between 2012 and 2022 in sub-Saharan Africa and identify gaps in priority conditions or geographical locations. We identified references through a Medline (PubMed) search covering September 2012 to June 2022. We included prospective cohort or clinical trials that enrolled at least 1000 pregnant women, with a study site in sub-Saharan Africa, and published in English or French. Screening and data extraction were done in duplicate using EPPI-reviewer software. Descriptive analysis was used to summarize the results, identifying patterns in studies across time, country, study design, topics, and funders. We identified 213 eligible studies, which were covered in 534 publications. We identified studies in 33 of the 48 sub-Saharan African countries, with the majority in east and southern Africa. The predominant study topics were HIV (36.4%), nutrition (20%), and malaria (16.3%), with very few publications on hypertensive disorders of pregnancy (6.4%), ante/postpartum hemorrhage (3.7%), and sexually transmitted infections (3.2%). More studies were cohorts (115/213; 54%) than clinical trials. The National Institutes of Health (31.5%), Bill and Melinda Gates Foundation (22.1%), and USAID (10.8%) were the largest research funders. Identifying research trends and mismatches between research topics and disease burden provides useful information for guiding future research prioritization. In particular, gaps exist for studies on hypertensive disorders of pregnancy and ante/postpartum hemorrhage, among the top causes of maternal mortality in sub-Saharan Africa.

Effect of stress on study skills self-efficacy in Nursing students: the chain mediating role of general self-efficacy and self-directed learning.

The purpose of the study is to explore the current level of nursing students' study skills self-efficacy, and whether general self-efficacy and self-directed learning ability mediate the relationship between perceived stress (including positive stress and negative stress) and study skills self-efficacy. The survey was conducted among 1,289 nursing students including 795 students from Jinzhou Medical University and 494 students from Dalian University. Participants completed a self-designed questionnaire, which included the Study Skills Self-Efficacy Scale, Perceived Stress Scale, General Self-Efficacy Scale, Self-Directed Learning Instrument, gender, age, academic year, and other demographic characteristics. Descriptive analysis, independent-samples t-test, one-way analysis of variance, Pearson correlation analyses, and the bootstrap method were used for data analysis. Positive stress significantly positively predicted students' study skills self-efficacy, with an effect size of 0.686. Moreover, general self-efficacy and self-directed learning mediate the relationship between positive stress and study skills self-efficacy in nursing students, with effect sizes of 0.235 and 0.245, respectively. The direct effect of negative pressure on students' study skills self-efficacy is not statistically significant, but it has a significant negative predictive effect on study skills self-efficacy under the mediation of general self-efficacy and self-directed learning, with effect sizes of -0.337 and -0.238, respectively. This study explains how stress affects students' study skills self-efficacy, and the results have certain enlightenment significance for improving the stress management ability and study skills self-efficacy of college students in the future.

FACTORS INFLUENCING THE PURCHASE INTENTION OF MICRO TRANSACTIONS IN FREEMIUM MOBILE GAMES IN BANGKOK: A CASE OF HONKAI STAR RAIL

Purpose: The purpose of this research is to determine the significant influence of Performance Expectancy, Effort Expectancy, Social Influence, Hedonic Motivation, Price Value, and Game Satisfaction towards purchase intention of microtransactions in freemium mobile games in Bangkok in the case of Honkai: Star Rail. Understanding these influencing factors can help game developers and stakeholders gain valuable insights into player behavior and develop monetization strategies to maximize positive player experiences and revenue. Design/methodology/approach: This research uses primary and secondary data collection methods in addition to descriptive and inferential data analysis techniques to analyze the factors influencing the purchase intention of microtransactions in freemium mobile games. The data was collected from 396 respondents who live in Bangkok, have played Honkai: Star Rail on a smartphone, and have the intention to purchase microtransactions in Honkai: Star Rail. This research referenced twelve theoretical frameworks from previous studies to construct a conceptual framework. Findings: This research shows that Performance Expectancy, Hedonic Motivation, and Game Satisfaction have a significant influence on the purchase intention of microtransactions in freemium mobile games in Bangkok in the case of Honkai: Star Rail. Research limitations/implications: Because of the chosen research approach, the research results may lack generalizability. Therefore, researchers are encouraged to test the proposed propositions further. Practical implications: This research offers valuable insights for game developers and stakeholders to enhance monetization strategies for freemium games like Honkai: Star Rail. Social implications: This research highlights the growing influence of mobile gaming on consumer behavior. This has broader implications for discussions around digital consumption, addictive behaviors, and the ethics of in-game purchases, prompting stakeholders to consider responsible game design and marketing practices that prioritize player well-being while maximizing revenue. Originality/value: This paper fulfils an identified need to study the factors influencing microtransaction purchase intentions within the Bangkok market.

Complexity of the Therapeutic Regimen in Older Adults with Cancer: Associated Factors

Background/Objectives: Population aging is a worldwide phenomenon and is often associated with multimorbidity and polypharmacy. Complex medication regimens are common among older adults and contribute to the occurrence of harmful health outcomes. Age is one of the main risk factors for cancer. This study aimed to determine and characterize the therapeutic complexity in older patients with cancer, and analyze the factors associated with high complexity and the impact of the oncological context. Methods: A cross-sectional study with patients aged ≥65 years with cancer was conducted in three hospitals in northern Portugal. Data collection was obtained using self-reports. The medication regimen complexity was assessed using the Medication Regimen Complexity Index (MRCI). Descriptive and association statistical analysis were performed. Logistic, linear, simple and multiple regression analysis were conducted, with and without automatic variable selection. Results: A total of 552 patients were included (median age, 71; IQR, 68–76). The mean MRCI before the oncological context was 18.67 (SD 12.60) and 27.39 (SD 16.67) after the oncological context, presenting a statistically significant difference in the values obtained (p < 0.001). An elevated complexity was significantly associated with polypharmacy, chronic diseases and with the administration of high-risk medications (p < 0.05). High MRCI values showed a relationship with the occurrence of potential drug interactions (p < 0.001). There was no relationship with the existence of cardiac risk comorbidity. Conclusions: This study demonstrated the existence of high therapeutic complexity in older patients with cancer, suggesting the need for intervention to prevent medication-related problems in this vulnerable population.

Survey of Bariatric Surgeon Calibration Tube Use in Sleeve Gastrectomy.

The study objective was to identify variations in calibration tube use during sleeve gastrectomy and understand elements of ideal calibration tube performance. A survey was distributed via email and social media to bariatric surgeons, who were asked to rate the performance of their current calibration tube and an ideal calibration tube for five technical milestones involving visualization, positioning, suction capability, and sleeve sizing. Data was analyzed using descriptive and bivariate analyses including chi-square, Mann-Whitney, and Kruskal-Wallis tests. After eliminating incorrect screening question responses, 552 of 585 responses were analyzed. Demographics included 82% practicing in the USA, 64% in community practice, performing an average of 114 (SD = 94.5) sleeves annually. Calibration tubes used were most commonly reusable (54.2%) versus disposable (27.4%), endoscope (5.3%), or other (13.2%). Ninety-six percent of calibration tube sizes were 32 to 44 French. The reusable calibration tube had the lowest mean scores in all five technical areas, while the endoscope performed the best. When comparing surgeon current to ideal calibration tube performance, the endoscope performed closest to an ideal device, with significant p-values for technical milestones (i-iv). Despite the endoscope having the highest ratings for technical performance, surgeons rated higher satisfaction using disposable calibration tubes. Significant variation exists among the size and type of calibration tubes used for sleeve gastrectomy. Calibration tubes incorporating the visualization of an endoscope with the workflow of a disposable device could bridge technical performance and satisfaction goals for surgeons.

What do community paramedics in Germany do regarding the care of older people? A retrospective, descriptive analysis of low-acuity cases.

Non-life-threatening cases treated by emergency services have been increasing in recent years, especially in older people. In a region in Germany with approximately 600,000 inhabitants, the role of a specially trained community paramedic (Gemeindenotfallsanitäter, G-NFS) was introduced in 2019. The G-NFS is dispatched to low-acuity requests, attends the assignment alone and is allowed to treat patients at home. The aim of this study was to analyse the assignments attended by the G-NFS relating to the suspected diagnoses, with a focus on older people (≥ 65years) according to their care setting. In this descriptive, retrospective study, we analysed the anonymous assignment report forms 07/2023-12/2023 of cases where patients were aged ≥ 65years. The suspected diagnoses (free textfield) were categorised according to the International Classification of Primary Care 2nd Edition (ICPC-2) scheme. Furthermore, baseline characteristics, urgency of the assignment, provided measures, transport and further treatment were analysed, stratified by care setting. Of the 1,643 included anonymous assignment report forms, 52.9% (n = 869) related to patients aged ≥ 65years. In this population, the mean age was 80.7years (SD 8.2), 49.6% were female and most were in long-term care, whether as home care recipients (34.8%) or as nursing home residents (26.9%). The most frequent diagnoses were categorised as urological (24.9%), general and unspecified (13.7%), circulatory (13.6%), digestive (12.8%), musculoskeletal (11.5%) and respiratory (10.3%). In 52.7% of the cases no transport was necessary, while 73.7% of urological cases did not need to be transported. The G-NFS was dispatched mainly to older people. Most of them were in long-term care and were not transported. The most common suspected diagnoses were categorised as urological, followed by general and unspecified, and circulatory, and differed by care setting. There is a strong need to strengthen outpatient healthcare structures for low-acuity health issues in older and immobile patients.

The experience with Hugo™ robot-assisted surgery on complex gynecological patients in Panama.

The Hugo™ robotic assisted surgery system is a relatively new robotic platform developed by Medtronic. The study objective was to describe the experience of using Hugo™ robotic assisted surgery in gynecological surgeries and compare robotic assisted surgery-related outcomes between complex and non-complex gynecological patients at the Pacifica Salud Hospital. We performed secondary data retrospective analysis of 144 consecutive patients who underwent gynecological surgery with Hugo™ robotic assisted surgery system (Medtronic) at the Pacifica Salud hospital in Panama City from July 19, 2021, to August 3, 2023. Complex patients were defined as those with one or more risk factors for surgery complications. Descriptive analysis of participants' sociodemographic and robotic assisted surgery-related characteristics. Due to the non-normal distribution of the RAS-related numeric variables, we compared these variables between complex and non-complex cases of gynecological patients using Kruskal-Wallis's test. The study found that Hugo™ robotic assisted surgery system was safe for gynecological surgery in patients with and without risk factors for developing major surgery complications. None of the patients experienced any complications, and they had short hospital stays with low blood loss without requiring a blood transfusion. The Hugo™ robotic assisted surgery system was technically sound and did not present technical failures. The results could be a reference for adopting this technology and developing best practices in the Latin American region.

Attitudes toward Sexting, Peer Pressure and Sexting among Adolescents

Objective – This study examines the correlation between demographic characteristics (age and gender), attitudes toward sexting, and peer pressure and sexting behavior among adolescents.Materials and Methods – The current study was conducted among 359 adolescents ages 15-17 in Bosnia and Herzegovina, with data collected again one year after baseline. Participants completed questionnaires on demographic data, sexting behavior, attitudes toward sexting, and peer pressure.Results – Descriptive analyses showed that although adolescents have negative attitudes toward sexting, they do participate in sexting, reporting more receiving (62.95 % –64.06 %) than sending (30.91 % – 32.31 %) and posting (8.91 % – 8.63 %) sexts. Regression analysis revealed that age, gender, attitudes toward sexting and the influence of peer pressure in the fields of risky behavior and parental relationships are significant predictors of various types of sexting. Attitudes toward sexting and peer pressure to engage in risky behavior were also a predictor of sexting behavior one year later. Conclusion – The findings highlight the importance of addressing attitudes toward sexting and peer pressure in future preventive interventions related to sexting.

The Role of the School’s Committee in Implementing P5 in the Era of Independent Learning

The purpose of this study was to determine the role of the school committee and its contribution in improving the quality of education in the era of independent learning. This study was conducted at SMP Negeri West Jakarta Region 1. Interviews, observations, documentation, and literature reviews were the data collection tools used. This study is qualitative research with a descriptive analysis method. The data collection process was carried out through in-depth interviews and questioner. The technique of data analysis was classifying data based on the category, counting the frequency and percentage. This study found that the school committee, as part of the school element, is responsible for the smooth implementation of school programs in the current era of independent learning, the implementation of the Pancasila Student Profile Strengthening Project (P5), building relationships with the school community, improving facilities and infrastructure, and encouraging improvements in the quality of school resources. Here, the result of the percentage of each the categories they are: an advisory agency (consideration) as much as 25%, a support agency (supporter) as much as 25%. a controlling agency (controller) as much as 23% and a mediator as much as 27%.

Analysis of cutaneous leishmaniasis among military personnel in the Islamic Republic of Iran: a spatiotemporal study between 2018 and 2022, trend forecasting based on ARIMA model.

Cutaneous leishmaniasis is one of the few infectious diseases whose global prevalence is on the rise. Iran ranks among the eight most affected countries in the world. Iranian military personnel are often sent to endemic areas for cutaneous leishmaniasis without prior immunity, and they have fewer health facilities in military centers than the general population. This study aims to comprehensively investigate the situation of cutaneous leishmaniasis in Iranian military personnel across all units from 2018 to 2022 and predict the disease trend using time series analysis up to the end of 2025. We analyzed data from the Iranian Ministry of Health to perform spatiotemporal and descriptive analyses based on patient frequency. Variables examined included age distribution, cutaneous leishmaniasis types (zoonotic or anthroponotic), month of healthcare facility visits, and lesion locations. This study employed the ARIMA model (p = 2, d = 0, q = 1)(P = 3, D = 0, Q = 0), for time series analysis and forecasting the disease trend up to 36 months after 2022. Over five years, 2,894 patients were reported. The Esfahan, Khuzestan, and Ilam provinces had the highest average patient counts, with hot spots primarily found in central, south, southwestern, and western Iran. Although the total number of patients with zoonotic cutaneous leishmaniasis was almost equal to anthroponotic cutaneous leishmaniasis, in high-risk provinces such as Esfahan, Khuzestan, and Ilam, the confirmed cases of zoonotic cutaneous leishmaniasis were much more than anthroponotic cutaneous leishmaniasis. patient numbers peak in October and November. Demographic analysis revealed that younger patients outnumbered older patients. Lesion locations were frequent on the forelimbs and lower limbs. The time series analysis for 36 months after 2022 indicated the seasonal pattern of the disease and predicted an upward trend after 2022. While overall cases have declined, provinces such as Esfahan exhibit an upward trend. The expansion of hotspots from the west and southwestern to the center and south of Iran, coupled with an increasing trend in time series analysis, suggests the potential emergence of new foci and a rise in patient numbers in the future. In provinces with high disease prevalence, preventive measures should be prioritized, particularly in Ilam, Khuzestan, and Esfahan.