Descriptive Research Articles

Geographical health inequalities in India: the impact of the COVID-19 pandemic on healthcare access and healthcare inequality.

With an emphasis on spatial health disparities, this study examines how COVID-19 has affected healthcare access and inequality in India. The study developed the Healthcare Access Index (HAI) and Healthcare Inequality Index (HII) to assess the pandemic's effects on healthcare. The study addresses spatial health disparities in healthcare access and inequality, filling gaps in the literature. The final aim of the study is to offer policy suggestions to lessen healthcare inequities in India, particularly in the context of COVID-19. The study incorporates secondary data from publicly accessible databases such as the National Family Health Survey, Niti-Ayog and Indian Census databases and employs a quantitative research design. The impact of the COVID-19 pandemic on healthcare access and healthcare inequality in India is examined using the HAI and the HII. The five dimensions of healthcare access - availability, accessibility, accommodation, cost and acceptability - were used in developing the HAI. The study uses a panel data analysis methodology to examine the HAI and HII scores for 19 states over the pre-COVID-19 (2015) and post-COVID-19 (2020) periods. In order to investigate the connection between healthcare access, healthcare inequality and the COVID-19 pandemic, the analysis employs statistical tests such as descriptive statistics, correlation analysis, factor analysis and visualization analysis. According to the study, COVID-19 impacted healthcare access and inequality in India, with notable regional inequalities between states. The pandemic has increased healthcare disparities by widening the gap between states with high and low HII ratings. Healthcare access is closely tied to healthcare inequality, with lower levels of access being associated with more significant levels of inequality. The report advises governmental initiatives to lessen healthcare disparities in India, such as raising healthcare spending, strengthening healthcare services in underperforming states and enhancing healthcare infrastructure. For Indian healthcare authorities and practitioners, the study has significant ramifications. In light of the COVID-19 pandemic, there has been a main focus on addressing geographic gaps in healthcare access and inequality. The report suggests upgrading transportation infrastructure, lowering out-of-pocket costs, increasing health insurance coverage and enhancing healthcare infrastructure and services in underperforming states. The HAI and the HII are tools that policymakers can use to identify states needing immediate attention and appropriately spend resources. These doable recommendations provide a framework for lowering healthcare disparities in India and enhancing healthcare outcomes for all communities. The study's originality resides in establishing the HAI and HII indices, using panel data analysis and assessing healthcare inequality regarding geographic disparities. Policy choices targeted at lowering healthcare disparities and enhancing healthcare outcomes for all people in India can be informed by the study's practical consequences.

Factors Influencing Outcome After Shoulder Arthroplasty (FINOSA Study): Protocol of a Prospective Longitudinal Study With Randomized Group Allocation

Background There is an increasing need for evidence-based postoperative rehabilitation strategies to optimize patient outcome. Knowledge of potential prognostic factors could steer the development of rehabilitation protocols and could result in better treatment outcomes and higher patient satisfaction. Objective This study aimed to investigate which potential prognostic factors predict baseline shoulder pain and function and its evolution in the first 2 years following surgery, in patients with total shoulder arthroplasty. The secondary objective is to investigate which potential prognostic factors predict baseline quality of life and its evolution in the first two years following surgery. Methods To reach the aims of this project, a prospective longitudinal study, running from January 2020 to March 2025, will be carried out with a follow-up of 48 months. Patients will be randomized based on sling wear. We will study factors such as shoulder function, patient expectations, psychosocial factors, lifestyle factors, sling wear, soft tissue integrity, and physiotherapy treatment. Test moments will take place preoperatively, at 6 weeks, 12 weeks, 6 months, 12 months, and 24 months. Descriptive statistics will be used to describe the patient population characteristics. Based on literature review, expert opinion, and univariate analyses, potential prognostic factors will be chosen as covariates. A mixed regression model for repeated measures will be used to assess both the evolution of the Shoulder Pain and Disability Index within persons from baseline over time and the differences in evolution between participants. Correlation analyses will be used to investigate associations between the other outcome measures such as the Constant and Murley Score, shoulder range of motion, shoulder muscle strength, and proprioception, and the primary outcome measure, the Shoulder Pain and Disability Index score. Potential prognostic factors not included in the model will be presented in a descriptive manner. Results Data collection started in January 2020. In April 2023 the sample size was reached. Data collection will end in April 2025. Analyses will follow when data collection is completed. Conclusions Knowledge of potential prognostic factors will have implications toward better rehabilitation strategies of patients after total shoulder arthroplasty. Trial Registration ClinicalTrials.gov NCT04258267; https://clinicaltrials.gov/study/NCT04258267 International Registered Report Identifier (IRRID) DERR1-10.2196/56522

Retrospective Analysis of the Impact of Screening for Psoriatic Arthritis (PsA) with the Psoriasis Epidemiology Screening Tool (PEST) in Clinical Dermatology Practice

Introduction: Patients with plaque psoriasis (PSO) have an increased risk of developing PsA as the disease severity progresses. While it is estimated that 30% of patients with PSO have PsA, nearly 16% of patients with PSO may have undiagnosed PsA.1,2 Implementing the PEST questionnaire for PsA screening in dermatologic practice may increase early intervention by improving rates of timely diagnosis.3 This observational study aimed to assess the proportion of patients with PSO and no previous PsA diagnosis who screened positive on the PEST and were then diagnosed with PsA by a healthcare provider in the PEST deployment period within the Advanced Dermatology and Cosmetic Surgery (ADCS) specialty dermatology network. Procedure/Study: De-identified, real-world patient data [2018–2019 and 2021–2022] were sourced from electronic health records within the ADCS network of outpatient facilities across 14 states in the United States. Patients were included in the analysis if they received care at an ADCS facility where the PEST was deployed, had ≥1 encounter with a diagnosis code for PSO, and never had a diagnosis code for PsA before their first diagnosis code for PSO. For outcomes directly related to PEST evaluations, data from 1/1/2021–12/31/2022 (PEST deployment period) were used. For outcomes not directly related to PEST results, data from 1/1/2018–12/31/2019 (period before PEST deployment) were evaluated. Descriptive statistics, including frequencies, percentages, and 95% confidence intervals (CIs) for categorical variables, were used to characterize the patient cohorts by study period. Results: Among ADCS facilities using the PEST during the deployment period (44% of practices in the network), the final study population included 14,308 and 21,142 patients with PSO in the period before PEST deployment and during the PEST deployment period, respectively. In the PEST deployment cohort, 1,100 (5.2%; 95% CI: 4.9–5.5) patients were screened using the PEST. In the period before PEST deployment, 327 (2.3%; 95% CI: 2.0–2.5) patients with PSO and no previous PsA diagnosis were subsequently diagnosed with PsA. During the PEST deployment period, 449 (2.1%; 95% CI: 1.9–2.3) patients with PSO and no previous PsA diagnosis received a subsequent PsA diagnosis without PEST screening. Of all patients with PSO who screened positive for PsA on the PEST (score ≥3; n=296), 10.8% (n=32; 95% CI: 7.6–15.1) subsequently received a formal PsA diagnosis during the PEST deployment period. Conclusion: These results suggest that a meaningful proportion of patients with PsA may be underdiagnosed in the dermatology setting. Deployment of the PEST in the clinical dermatologic workflow may provide an opportunity to diagnose PsA earlier and improve patient outcomes.

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.

Postinsertion Management of Cholecystostomy Tubes for Acute Cholecystitis: A Systematic Review

Background: Percutaneous gallbladder drainage (PGD) is indicated to treat high-risk patients with acute cholecystitis. Trends suggest increasing use of PGD over time as the population ages and lives longer with multiple comorbidities. There is no consensus on the management of cholecystostomies tube once inserted. This review aims to synthesize and describe the most common protocols in terms of the need and timing of follow-up imaging, management of a destination tube, timing of tube removal, and optimal interval time from tube positioning to delayed cholecystectomy. Methods: The study protocol has been registered on the International Prospective Register of Systematic Reviews–PROSPERO. Studies on adult patients diagnosed with acute cholecystitis who underwent a PGD from 2000 to November 2023 were included. The databases searched were MEDLINE, Embase, and Cochrane. The quality assessment tools provided by the NHLBI (National Heart, Lung, and Blood Institute) were applied and descriptive statistics were performed. Results: We included 22,349 patients from 94 studies with overall fair quality (6 prospective and 88 retrospective). In 92.7% of papers, the authors checked by imaging all patients with a PGD (41 studies included). Depending on protocol time, 30% of studies performed imaging within the first 2 weeks and 35% before tube removal (40 studies included). In the case of a destination tube, 56% of studies reported removing the tube (25 studies included). In the case of tube removal, the mean time after insertion was more than 4 weeks in 24 of the 33 included studies (73%). Interval cholecystectomies are more frequently performed after 5 weeks from PGD (32/38 included studies, 84%). Limitations included high clinical heterogeneity and prevalent retrospective studies. Conclusions: A standard management for percutaneous cholecystostomy after insertion is difficult to define based on existing evidence, and currently we can only rely on the most common existing protocols.

Exogenous Versus Endogenous Nandrolone in Doping Investigations: A Systematic Literature Review

Nandrolone, or 19-nortestosterone, is an anabolic steroid derived from testosterone, known for its androgenic and anabolic effects. Often used illicitly by athletes to boost performance, its use is banned by the World Anti-Doping Agency (WADA) in and out of competition. Nandrolone’s main metabolites, 19-norandrosterone (19-NA) and 19-noretiocholanolone (19-NE), are typically detected in urine. This systematic review, registered with PROSPERO and following PRISMA guidelines, examines nandrolone’s metabolism, factors affecting its natural production, and the analytical methods used in doping tests. Searches on PubMed, Scopus, and Web of Science yielded 517 studies, of which 57 were selected for analysis after excluding duplicates and unrelated articles. Descriptive statistics were applied to assess data on metabolic pathways, endogenous production influences, and detection techniques. Based on this review, it clearly emerges that the only technique that can distinguish endogenous production from an exogenous intake is gas chromatography/combustion/isotope ratio mass spectrometry (GC-C-IRMS). In addition, factors influencing endogenous production are considered and explored. Overall, this review provides useful information regarding nandrolone and its main metabolites.

Impact of Agroecological Practices on Crop Yield and Food Security in Southwestern Nigeria

This study examines the impact of agroecological practices on crop yield and food security in Southwestern Nigeria. Using data collected from a sample of smallholder farmers, descriptive statistics and regression analysis were employed to assess the relationship between agroecological techniques—such as organic farming, crop rotation, and integrated pest management (IPM)—and agricultural outcomes. The findings reveal that agroecological practices significantly improve crop yield, with organic farming having the strongest positive effect, followed by crop rotation and IPM. Additionally, these practices were associated with higher food security index (FSI) scores, indicating enhanced household food security compared to non-agroecological methods. While soil fertility management showed a positive relationship with yield, it was not statistically significant. The results underscore the potential of agroecological approaches to foster sustainable agricultural development, addressing the dual challenges of productivity and food insecurity in the region. The study recommends promoting these practices through policies and programs that support smallholder farmers, thereby enhancing agricultural resilience and economic well-being.

Provider Burden Associated With Apremilast Adverse Events

Introduction: In December 2021, the US Food and Drug Administration (FDA) expanded its initial approval for apremilast to include moderate and severe cases of psoriasis. However, real-world epidemiology data regarding the use of apremilast, the influence of adverse events (AEs), and the burden of AEs on managing physicians, has been lacking. This retrospective, observational, multisite study aimed to describe real-world patient characteristics, AEs (including diarrhea, nausea, and headache), and healthcare provider-level burden associated with the psoriasis treatment apremilast in the US. Methods: Dermatologists abstracted medical record data for adults treated with apremilast on or after January 1, 2018, who had ≥3 months of data available. Dermatologist and patient characteristics, including demographics and clinical characteristics, AEs, and provider burden in managing AEs were summarized using descriptive statistics. Results: Forty-seven dermatologists nationwide responded to a survey and conducted a chart review of 308 patients. Dermatologists practiced in various US geographic regions. The most common practice setting was in a private community with 2 to 5 physicians (34.0%). Most patients were White (74.4%), non-Hispanic (86.0%), and male (55.2%). The mean age at diagnosis was 43.6 years (SD, 16.8 years). AEs occurred in 29.2% of patients, with the most common being diarrhea (16.2%), followed by nausea (13.6%) and headache (4.9%). Diarrhea mostly occurred ≤30 days into treatment (87.2%) and resulted in 1 additional office visit (39.5%) and 3 phone calls per patient to their providers (34.9%). Nausea mostly occurred within 30 days (70.2%) and resulted in 1 additional visit (29.7%) and 1 phone call per patient (35.1%). The burdens of managing both diarrhea and nausea were similar, although diarrhea resulted in more phone calls to the healthcare provider. Conclusion: Diarrhea and nausea were common and resulted in an additional time and resource burden on dermatologists and their staff. Future research on the AE burden on providers and patients related to apremilast is needed.

AN ANALYSIS OF THE HEALTH LITERACY LEVELS OF STUDENTS IN A PUBLIC UNIVERSITY'S FACULTY OF HEALTH SCIENCES

Aim: This study aimed to assess the health literacy levels of students in the Faculty of Health Sciences at a public university and to investigate the relationships and differences between participants' sociodemographic characteristics and their health literacy levels. Methods: The study employed a quantitative, descriptive, cross-sectional, and correlational research design. Data were gathered through face-to-face surveys, utilizing a socio-demographic data form and the THLS-32 scale. Data analysis was conducted using IBM SPSS 22.00. Descriptive statistics, including frequency distributions, percentages, standard deviations, and arithmetic means, were calculated. The Kolmogorov-Smirnov test was used to evaluate the normality of data distribution, which revealed a non-normal distribution. As a result, non-parametric tests (Mann-Whitney U Test and Kruskal-Wallis H Test) were applied. Correlation analyses were performed using Spearman’s Rho coefficient, and statistical significance was evaluated at a 95% confidence interval with a 5% margin of error. Results: The findings indicated that 66.3% of participants exhibited sufficient or excellent health literacy levels. Female students had significantly higher TS-AI perceptions than male students. Health Management (HM) students demonstrated higher health literacy levels compared to Emergency Aid and Disaster Management (EADM) students. The highest literacy levels were observed among final-year students, and students with social security had higher TS perceptions than those without. Conclusion: The study concluded that the health literacy levels of students in the Faculty of Health Sciences were generally high, with significant differences based on gender, department, academic year, and social security status. These findings suggest a need for targeted strategies to improve health literacy, particularly among students in certain departments and those without social security

Exploring the impact of physical exercise on mental health among female college students: the chain mediating role of coping styles and psychological resilience

BackgroundFemale college students are a high-risk group for psychological conflicts, and they are more likely to adopt negative coping styles under stress, which can lead to anxiety, depression, and other psychological problems, as well as pose hidden threats to the healthy development of school education and social work. Although physical exercise is an important means of effectively alleviating the psychological health of female college students, and there may be a close relationship between coping styles and psychological resilience with physical exercise and psychological health, specific ways to promote the psychological health of female college students by influencing their coping styles and enhancing their psychological resilience have yet to be explored.MethodsThe present study employed a cross-sectional design to investigate a sample of Chinese undergraduate female college students. A total of 659 participants were recruited during the second half of the 2023–2024 academic year, and they all completed assessments including the Physical Activity Rating Scale, College Mental Health Scale, Brief Coping Styles Questionnaire, and Psychological Resilience Scale. Subsequently, descriptive statistics were utilized to analyze the obtained reliable data.Results and conclusionThe study revealed two significant correlations among female college students, namely the associations between physical exercise, coping styles, psychological flexibility, and mental health. Specifically, physical exercise exhibited a positive relationship with positive coping styles and psychological resilience while displaying a negative association with negative coping styles and mental health. Moreover, psychological resilience demonstrated a positive correlation with positive coping styles but displayed negative relationships with both negative coping styles and mental health. Additionally, there was a negative relationship observed between positive coping styles and mental health. Furthermore, it was found that physical exercise significantly impacted the mental health of female college students in a detrimental manner; meanwhile, coping styles and psychological resilience played crucial mediating roles in linking physical exercise to mental health outcomes. Ultimately, our mediation model sheds the underlying mechanisms through which physical exercise predicts mental health levels among female college students; these findings underscore the importance of promoting physical exercise as an effective means to enhance overall well-being.

Does targeted information impact consumers’ preferences for value-based health insurance? Evidence from a survey experiment

Abstract Objectives Value-based insurance design (VBID) aims to direct consumers’ preferences by incentivizing the use of high-value care and discouraging the use of low-value care. However, consumers often have limited knowledge of health insurance and the health insurance system, possibly distorting their preferences. In this study, we aim to investigate the impact of specific information treatments on consumers’ preferences for VBID. Methods We implemented an information experiment as part of a representative survey on health insurance literacy and preferences for VBID within Switzerland’s choice-based health insurance system. Preferences for VBID were measured through a discrete choice experiment. Cross-sectional data on 6,033 respondents aged 26–75 were analyzed using descriptive statistics and mixed logit regressions. Results Respondents showed strong preferences for their current health insurance instead of VBID alternatives. A general description of current regulations on cost-sharing, drug disbursement, and monthly premiums significantly increased preferences for VBID (p < 0.01). Pointing respondents specifically to VBID further reduced the opposition against VBID plans. At the same time, there is evidence for anchoring effects in copayments after receiving the information treatments, irrespective of the value of the care. Conclusions The results of this study highlight that individuals are susceptible to provided information about health insurance when building their preferences for VBID. One potential explanation is limited health insurance literacy, implying that tailored communication strategies may be needed to improve insurance decision-making. JEL Classification I11, I13.

An Efficient One-Dimensional Texture Representation Approach for Lung Disease Diagnosis

The remarkable increase in published medical imaging datasets for chest X-rays has significantly improved the performance of deep learning techniques to classify lung diseases efficiently. However, large datasets require special arrangements to make them suitable, accessible, and practically usable in remote clinics and emergency rooms. Additionally, it increases the computational time and image-processing complexity. This study investigates the efficiency of converting the 2D chest X-ray into one-dimensional texture representation data using descriptive statistics and local binary patterns, enabling the use of feed-forward neural networks to efficiently classify lung diseases within a short time and with cost effectiveness. This method bridges diagnostic gaps in healthcare services and improves patient outcomes in remote hospitals and emergency rooms. It also could reinforce the crucial role of technology in advancing healthcare. Utilizing the Guangzhou and PA datasets, our one-dimensional texture representation achieved 99% accuracy with a training time of 10.85 s and 0.19 s for testing. In the PA dataset, it achieved 96% accuracy with a training time of 38.14 s and a testing time of 0.17 s, outperforming EfficientNet, EfficientNet-V2-Small, and MobileNet-V3-Small. Therefore, this study suggests that the dimensional texture representation is fast and effective for lung disease classification.

Guardian Knowledge in Primary Congenital Glaucoma: A Cross-Sectional Study

Précis: Guardian education level and frequency of surgical interventions are key determinants of knowledge in primary congenital glaucoma, highlighting the need for targeted educational strategies. Background: Management of congenital glaucoma poses unique challenges, particularly concerning the patient guardians’ understanding of the condition, which is crucial for treatment adherence and follow-up compliance. This study aimed to assess guardians’ knowledge levels and identify the influencing factors. Methods: This cross-sectional study included 103 guardians of pediatric patients with PCG. Participants with missing data were excluded from the study. The participants were assessed using a 20-question survey covering various aspects of glaucoma. Descriptive and inferential statistics were used for analysis. Results: The sample included 96 guardians, primarily females (80.2%). The children’s ages varied significantly, averaging approximately 44 months (SD = 39.8). The guardians predominantly had secondary education (34.4%) and most were housewives (77.1%). There was a positive correlation between higher education levels and the overall knowledge score of guardians (P = 0.006). Similarly, the guardian’s locality showed a positive correlation with knowledge scores, with urban guardians having higher scores than rural guardians. Additionally, there was a positive correlation between the number of surgical operations performed on the child and the guardians’ knowledge. For the subtotals, variables such as the child order among siblings and age of the child showed significant positive correlations, emphasizing the multifaceted influences on guardians’ understanding. In the multivariate analysis, the guardian’s education level showed a significant positive correlation for the Overall Score, as did the number of operations performed on the patient. Conclusions: The study revealed gaps in guardian knowledge, irrespective of educational level or other demographic factors. Guardians’ education level and the number of operations performed on the child are critical determinants of guardians’ understanding of congenital glaucoma. Traditional approaches to educational interventions may require re-evaluation, and there is a pressing need for targeted educational interventions.

Smartphone use patterns and the impact on accommodation and convergence system of the eyes among Malaysian teenagers

AIM: To determine the smartphone use patterns and effects of smartphone use on accommodation and convergence system of the eyes among Malaysian teenagers. METHODS: A total of 62 participants aged between 13 and 17y were involved. A self-administered questionnaires containing 12 items was used to evaluate the smartphone usage patterns. This was followed by an eye examination, involving a battery of accommodation and convergence assessments before and after the smartphone use. The data analysis comprised descriptive statistics, paired t-test, and correlation coefficients. RESULTS: The use of smartphones is at a high level and at an optimal distance daily, with more than 6h a day watching video films, games, and completing school projects. Majority of the participants not reported eye strain factors and eye prescription changes with the use of digital devices. The use of a smartphone continuously for 30min was found to significantly decrease amplitude of accommodation, accommodative facility, and positive relative accommodation (P<0.001). Meanwhile, the lag of accommodation parameters and negative relative accommodation increased with the use of smartphones significantly (P<0.001). The near point of convergence (NPC) and distance and near negative fusional vergence decreased significantly (P<0.001). The NPC parameter was found to have a weak negative association with the frequency of smartphone use (R=-0.276, P<0.05). CONCLUSION: Frequent and continuous use of smartphones have increased visual stress and resulted in weakness of accommodation and vergence functions. Therefore, frequent break is mandatory when using a smartphone and appropriate visual hygiene, the 20-20-20 rule (every 20min, view something 20 feet away for 20s) are required during smartphone use to maintain visual function.

Physical Activities in Hong Kong Kindergartens: Grade-Level Differences and Venue Utilization

ABSTRACT This study aimed to (1) investigate the provision of physical activities in Hong Kong kindergartens across different grade levels and (2) examine the availability and utilization of venues in or near kindergartens for physical activities. We surveyed 526 hong Kong kindergarten teachers. Descriptive statistics and parametric statistical techniques (e.g. one-way ANOVA) were employed. Participants across all three grade levels reported implementing physical activities relatively infrequently (M = 2.47), with higher provision of unstructured physical activities involving low degrees of physical exertion and risk. However, K3 teachers (M = 2.55, SD = .45) were found to provide more physical activities than K1 teachers (M = 2.43, SD = .47, p = .033) and K2 teachers (M = 2.42, SD = .42, p = .030). Indoor venues were more commonly reported in or near kindergartens and were more frequently utilized for physical activities. In contrast, the availability and utilization of outdoor venues were limited. The results highlight the distance between internationally accepted physical activity guidelines and actual practices in Hong Kong kindergartens. We conclude that the limited opportunities for physical activities may not be enough for children to develop themselves optimally. Offering longer kindergarten programs and a wider range of easily accessible venues for physical activities would be vital to improving this situation.

Transitional implants in computer‐assisted implant surgery and fixed complete‐arch provisionalization: A retrospective case series

AbstractIntroductionUsing mini implants as transitional implants (TIs) for complete arch implant‐supported rehabilitations may overcome limitations associated with mucosa‐supported surgical guides and facilitate immediate fixed provisionalization. This study aimed to assess the success of TIs in supporting surgical guides for implant placement and fixed provisional prostheses.MethodsPatients who received TIs between 2012 and 2023 for a complete arch implant‐supported prosthesis were evaluated retrospectively. Patient demographic data, TI functionality in supporting a surgical guide and supporting a complete arch provisional prosthesis, and dates of TI placement and regular implant placement were collected. Descriptive statistics were used to determine the survival rate and success rate for TIs.ResultsTwenty‐six patients, 35 jaws, 136 TIs, and 216 regular implants were included. The survival rate of TIs was 74.26%; however, the use of TIs yielded success in 97% of jaws for supporting a surgical guide and a fixed complete‐arch provisional prosthesis throughout the complete provisional phase. An average of 4 TIs per maxilla and 3 TIs per mandible supported surgical guides. Thirty‐five provisional prostheses were placed on an average of 4 TIs in the maxilla and 3 TIs in the mandible. Thirty‐four provisional prostheses were successfully supported by TIs and regular implants until final restoration delivery. The survival of regular implants placed in conjunction with the use of TIs was 98%.ConclusionsUsing TIs to support a surgical guide and provisional prosthesis may be a predictable approach with a high success rate. All surgical guides planned to be supported on TIs were successful. Despite premature loss or replacement of TIs, this approach was able to support most provisional prostheses until the regular implants could be loaded.

Influence of Organisational Behaviour, Organisational Development, Organisational Culture and Leadership Style and Its Impact on Motivation in Public Organisation

One of the objectives of this research is to examine the relationship between organizational behavior and employee motivation, to highlight the relationship between organizational culture and employee motivation, to elaborate on the relationship between leadership style and employee’s motivation, and to investigate the relationship between organizational development and employee motivation. This research also works to investigate the role of leader in the organization. As we know, leaders are the people who are responsible for selecting a path for the whole organization. The researcher collect 113 samples from leaders in Public organization in India. The questionnaire was prepared by using Google Docs application. The survey questionnaires were distributed to more than 200 participants; 113 responses were received from participants. The researcher use descriptive statistics and Multiple regression analysis to test the hypothesis. This study is an attempt to explore the factors that affect and help motivate employees working in any organization, as it is necessary to strengthen these institutions by establishing the principles of Leadership Style, Organizational Culture and Work Environment, Organizational Behavior and Organizational Development.Leadership style

A Study on Impact of Work-Life Balance on Employee Retention in IT Companies

This study investigates the impact of work-life balance on employee retention in the IT sector, focusing on key demographic data, stress, and job satisfaction among employees. Data was collected from 100 employees through a structured survey. Descriptive statistics, correlation, and ANOVA were used to analyze the influence of worklife balance factors on retention rates. Results indicate a significant correlation between flexible work policies, organizational support, and employee retention. Key findings highlight that initiatives like childcare support, paid time off, and wellness programs play a crucial role in improving job satisfaction and reducing turnover

IMPACTO DA PNEUMONIA NA MORTALIDADE INFANTIL: ANÁLISE HOSPITALAR NO ESTADO DA BAHIA

Introduction: Pneumonia is a severe respiratory infection, often caused by bacteria, viruses, or fungi, that primarily affects the lungs and can impair gas exchange, leading to respiratory difficulties. In Brazil, pneumonia presents a significant public health challenge, with a particular impact on children under five years of age. This issue is especially evident in the state of Bahia, where the infant mortality rate due to pneumonia is one of the highest in the country. The causes of this high mortality are linked to a combination of factors such as lack of access to adequate medical care, low vaccination coverage, poor living conditions, overcrowded homes, and insufficient air quality. Objectives: The main objective of this study is to analyze the impact of pneumonia on infant mortality in the state of Bahia, focusing on hospital data analysis between 2020 and 2024. The research aims to identify the epidemiological trends of the disease, understand the associated risk factors, and encourage the implementation of public policies to reduce infant mortality caused by pneumonia. Justification: This research is relevant to public health because it highlights the persistent high rates of infant mortality due to pneumonia, a critical issue in socially vulnerable areas. The study contributes to understanding the social, economic, and healthcare access factors affecting the child population in Bahia, providing essential data for more effective public health policies. Methodology: The study is of an epidemiological nature, using a quantitative approach. Data were collected from records of pediatric pneumonia cases provided by the Health Department of the State of Bahia (SESAB) and DATASUS, covering the period from 2020 to 2024. Data on incidence, mortality, demographic characteristics (age, sex, race/ethnicity), and regional conditions were analyzed. The analysis was performed using descriptive statistics and techniques such as calculating mortality rates and identifying risk factors. Results and Discussion: The data revealed that between January 2020 and September 2024, there were 295 deaths due to pneumonia in children in Bahia. The highest mortality was observed in the age groups under 1 year (33.6%) and 1 to 4 years (37.3%), indicating extreme vulnerability of these age groups to the disease. Additionally, pneumonia mortality was higher among children of mixed-race (parda) background (76.3%), reflecting socioeconomic and healthcare access inequalities, particularly in peripheral and rural areas. A slight predominance of deaths among girls was also observed, though the gender difference was small (2.37%). Conclusion: This study highlights the social and regional inequalities contributing to high infant mortality from pneumonia in Bahia, emphasizing the difficulties in accessing healthcare services in more vulnerable areas. The analysis revealed that children under 5 years of age, especially those under 1 year old, are the most affected. To reduce these rates, it is urgent to implement public policies focused on improving healthcare access, expanding vaccination coverage, and strengthening living conditions in the most underserved areas of Bahia.

Investigating the role of the principal's individualized consideration and intellectual stimulation in shaping the academic performance of students in the secondary schools of Sidama Region, Ethiopia

The study sought to investigate the principal's perceptions and actions regarding individualized consideration and intellectual stimulation and their implications for students' academic progress. The study was guided by the following research question: How do school principals' transformational leadership strategies improve students' academic progress in Ethiopia's Sidama region? The study used a convergent parallel mixed research design. The data collection strategy was sound, with a modified questionnaire based on the MLQ used in the quantitative phase and an open-ended semi-structured interview in the qualitative phase. The study's dependent variable was student academic performance, while the independent variable was transformational leadership's individualized consideration (IC) and intellectual stimulation (IS) behaviors. The study's target participants were 95 principals and 5956 teachers. The survey used an appropriate sample approach, with 362 teachers and 91 principals from 24 public secondary schools. The qualitative phase involved ten principals and twenty teachers. The acquired data was analyzed using descriptive and inferential statistics. The study found that principals comprehend and practice transformational leadership behaviors. The study also revealed that the principal's individualized consideration and intellectual stimulation practices significantly impacted students' academic progress. The principal's self-assessment was r =.760 (p<.01), whereas the teachers' perception was r =.583 (p<.01).