Management Research Articles

Exploring the Impact of Instrument-Assisted Soft Tissue Mobilization on Functional Measures and Quality of Life in Knee Osteoarthritis Patients: A Randomized Controlled Trial

Background: Knee osteoarthritis (KOA) is a prevalent disabling condition characterized by pain, stiffness, and functional limitations, significantly impacting quality of life, particularly among older adults. Instrument-assisted soft tissue mobilization (IASTM) is a technique that has shown promise in reducing pain and increasing the range of motion. Objectives: This study aimed to investigate the effects of IASTM on functional measures and quality of life in KOA patients. Methods: Thirty participants with unilateral KOA were randomized into IASTM and sham groups. The intervention consisted of four sessions over two weeks, combining IASTM with exercise therapy. Functional performance was assessed using the 6-minute walking test (6MWT) and the timed up and go test (TUG). Quality of life was evaluated using the 36-item short-form health survey (SF-36) and the Lequesne Algofunctional Index (LAI) Questionnaires. Results: A mixed ANOVA revealed significant improvements in functional performance in both groups after treatment in the 6MWT (P < 0.001) and TUG (P = 0.003) tests. Significant improvements were observed in the SF-36 subgroups for physical functioning (P = 0.002), role limitations due to physical problems (P < 0.001), energy/vitality (P < 0.001), pain (P < 0.001), and total score (P < 0.001). There was also a significant time*group interaction effect for role limitations due to emotional problems (P = 0.005), with the IASTM group showing improvement after treatment while the sham group experienced a decline. The LAI questionnaire also indicated significant improvements in both groups (P < 0.001) after treatment. Conclusions: Both IASTM and sham interventions, combined with exercise therapy, led to improvements in functional measures and quality of life. However, the IASTM group exhibited a more pronounced positive trend in the 6MWT and TUG tests, as well as a significant interaction effect for emotional role limitations. These findings suggest that while exercise alone can improve function and quality of life, the addition of IASTM may further enhance these outcomes, supporting its integration into KOA management strategies to improve activities of daily living and overall quality of life.

Endometrial Atypical Hyperplasia and Risk of Endometrial Cancer

Endometrial atypical hyperplasia (EAH) is a premalignant condition with a substantial risk of progression to endometrial cancer (EC), with the endometrioid subtype being the most common. EAH is characterized by abnormal endometrial gland proliferation and cellular atypia, often resulting from prolonged unopposed estrogen exposure. This review aims to explore the clinical significance of EAH, its risk of progression to EC, and the current approaches to management. The risk of EAH progressing to EC ranges from 20 to 50%, influenced by factors such as histopathology and genetic mutations including PTEN and KRAS. Key risk factors include obesity, polycystic ovary syndrome, and postmenopausal status. Abnormal uterine bleeding is a hallmark symptom of EAH and early-stage EC, necessitating diagnostic evaluation through endometrial biopsy and transvaginal ultrasonography. Therapeutic management strategies depend on patient risk and fertility considerations. Hormonal therapy, particularly progestins, is the mainstay for fertility preservation, while hysterectomy is preferred for higher-risk patients. Regular monitoring with biopsies is essential for those undergoing conservative treatment. Recent advancements in the management of EAH and EC have shifted towards incorporation of molecular diagnostics and targeted therapies, enabling better risk stratification and individualized care. Biomarkers and minimally invasive surgical techniques are emerging as promising approaches in improving outcomes for women with EAH. This review underscores the importance of early diagnosis and personalized management in preventing the progression of EAH to EC, highlighting current clinical practices and potential future developments in this field.

Strategi Pengelolaan Instagram @indonesiabaik.id Sebagai Media Informasi Publik oleh Kominfo

Instagram @indonesiabaik.id is a social media managed by the Ministry of Communication and Information, a social media management strategy is needed as a public information medium. This study aims to find out how to implement the strategy used by the Ministry of Communication and Informatics in managing social media Instagram @indonesiabaik.id, this is examined through the theory of four steps of public relations in processing the data obtained to achieve the expected research objectives. The research method used is a qualitative approach and descriptive analysis techniques, data obtained came from in-depth interviews with informants. The results obtained from the data processed in this study show that the Instagram social media management strategy used by @indonesiabaik.id is in accordance with what is contained in the four steps of public relations theory, this can be seen from the processes and activities carried out in managing Instagram @indonesiabaik.id when defining problems, planning and compiling programs, taking action and communicating, and in carrying out program evaluations that are in accordance with the theory used in this study as a reference. Keywords: communication strategy, social media, Instagram, information media, qualitative

The outcome of haematopoietic stem cell transplantation in a patient with STAT1 gain-of-function: a case report

Background: The human signal transducer and activator of transcription 1 (STAT1) is a latent cytoplasmic transcription factor and one of seven members of the STAT family. Autosomal dominant (AD) STAT1 gain-of-function (GOF), characterized by enhanced phosphorylation of the tyrosine-701 residue and STAT1 activation, is commonly associated with chronic mucocutaneous candidiasis (CMCC), immunodeficiency, aneurysms, malignancies, and autoimmune phenomena. The best management strategies for patients with STAT1 GOF remain unclear. Typically, the standard care includes supportive treatments such as antimicrobial prophylaxis, either alone or combined with immunoglobulin replacement therapy. Biological therapies such as JAK inhibitors have been shown to alleviate symptoms of infection and autoimmune disorders in patients with STAT1 GOF mutations. However, there is a lack of long-term outcome data for JAK inhibition. Hematopoietic stem cell transplantation (HSCT) is an alternative treatment option for a subset who experience a persistent disease course despite conventional therapy. However, the effectiveness of HSCT for this condition is not yet well established. Methods: Our patient’s medical records were analyzed retrospectively, including her medical history. Results: We present the outcome of HSCT performed on a 27-year-old female with STAT1 GOF, conducted as a treatment for acute myeloid leukemia (AML). Conclusion: HSCT may serve as an alternative and potentially curative treatment for certain STAT1 GOF patients with progressive, life-threatening conditions that do not respond to conventional therapies. Additional research is needed to improve the management of these patients. Statement of Novelty: We present a novel case study of HSCT as a treatment for AML in a 27-year-old patient with STAT1 GOF, highlighting the potential for curative outcomes in progressive, life-threatening conditions unresponsive to conventional therapies. This case contributes to the limited body of evidence supporting the efficacy and challenges of HSCT in STAT1 GOF patients.

Over-the-Wire Retrieval of Infectious Hemodialysis Catheter-Related Right Atrial Thrombus Causing Recurrent Pleural Empyema and Sepsis: A Case-Based Review

Introduction: Infectious catheter-related right atrial thrombus (CRAT) is a potentially fatal but often underestimated contingency associated with central venous catheter (CVC) in patients on hemodialysis. Management guidelines for CRAT are lacking, and its occurrence poses clinical challenges. Here, we describe the case of an infectious CRAT in a young patient on hemodialysis with peculiar clinical complications and perform a literature review. Case presentation and literature review: A 30-year-old man on hemodialysis after bilateral nephrectomy due to polycystic disease presented with hyperpyrexia resistant to broad-spectrum antibiotics. A pleural empyema caused by methicillin-resistant Staphylococcus aureus (MRSA) was diagnosed. Since fever persisted despite targeted antibiotic therapy, a transthoracic echocardiogram to exclude infective endocarditis was performed, showing a right atrial thrombus. CVC was promptly removed and the thrombus was aspirated through a percutaneous retrieval system. The thrombus cultural exam resulted positive for MRSA. After performing an extensive literature review, we could not find another case reporting the concomitance of these two rare complications. Conclusions: CRAT is a life-threatening complication in hemodialysis patients. While various treatment options exist, evidence-based guidelines are lacking, leading to individualized management strategies. Minimizing CVC use remains the best option for preventing such a complication.

The efficacy of nano‐cellulose‐based composites in heavy metal removal from wastewater: a comprehensive review

AbstractThis comprehensive study delves into the innovative application of nano‐cellulose‐based composites for addressing the multifaceted challenges of wastewater treatment. This review introduces the innovative use of nano‐cellulose composites, particularly highlighting the novel synthesis routes that enhance their pollutant adsorption capabilities beyond conventional materials. These materials stand out for their regenerative properties and integration with functionalized matrix materials, marking significant advancements in sustainable wastewater treatment technologies. As the environmental and public health risks associated with untreated wastewater escalate, the development of efficient and sustainable treatment technologies has become crucial. Nano‐cellulose composites, derived from natural and renewable sources, offer significant advantages, including high surface area, superior mechanical strength, and notable biodegradability. This review explores various synthesis methods—mechanical, chemical, and enzymatic—that enhance the adaptability of nano‐cellulose composites to meet specific treatment needs. Main findings demonstrate these composites' effectiveness in removing a wide array of pollutants, including heavy metals, organic compounds, dyes, and microbial contaminants, with detailed removal capacities provided for each pollutant category in comparative tables. The potential for regeneration and reuse highlights their practical sustainability and economic viability. Future research should focus on improving production scalability and cost‐effectiveness, assessing environmental impacts and ensuring regulatory compliance to advance the application of nano‐cellulose composites in wastewater treatment. This study paves the way for these materials to become central to innovative, efficient, and eco‐friendly wastewater management strategies. © 2024 Society of Chemical Industry (SCI).

Types of refractive errors in a sample of Iraqi children with Intermittent exotropia

Background One of the most common strabismus types in children is intermittent exotropia, which masks the deviation of one eye outward, mostly in children aged 2-4 years. It may affect visual development and often coexists with refractive mistakes. Unlike esotropia, which usually links to hyperopia, intermittent exotropia might have a different relationship with refractive errors and thus lead to myopia. Methods In this cross-sectional study from August 2021 to December 2023, 179 patients diagnosed with intermittent exotropia were recruited via an outpatient clinic of Najah Al-Quraishi, Baghdad, Iraq. The refractive errors were compared by autorefractometry and retinoscopy after cycloplegic dilation. Data analysis was constructed under the use of IBM SPSS V.26 for the determination of emmetropia, myopia, and hyperopia prevalence. Results The most expected refractive error among the 179 patients was emmetropia, which occurred in 68 patients (38%). Low hyperopia and low myopia were also common, with 64 and 40, respectively. A limited number of patients had moderate/high myopia and moderate/high hyperopia; in detail, the prevalence was following: 5% of patients had moderate myopia, while 0.5% of patients suffered from high myopia; symmetrically, 5% were moderate to high hyperopia. From the data collected, a trend emerged for a low refractive error and symmetric refractive error in both eyes. Conclusion Contrasted to prior conventional wisdom about refractive error in strabismus, it established the greater incidence of emmetropia in patients with intermittent exotropia. The findings call for specific management strategies to be applied in this population.

Biological control of locusts and grasshoppers: A review

Locusts and grasshoppers (Orthoptera: Acrididae) are pests of agricultural importance, devastating crops and pastures. This group includes hundreds of pest species and affects the livelihoods of one in every ten people worldwide. Their outbreaks can be chronic or episodic, with alternating periods of invasion and recession. Here, we review the natural enemies of locusts and grasshoppers in both their native and invaded ranges across the globe to assess the need for their conservation and maintenance as part of the natural suppression of outbreaks and to augment outbreak suppression as potential biological control agents. More than 70 natural enemies have been reported to attack locusts and grasshoppers, including entomopathogenic fungi, bacteria, nematodes, predatory insects, birds, reptiles, and mammals. Particular attention is given to the well-studied species of locusts and grasshoppers for which more information is available and to natural enemies in the locust-affected countries as part of the recent trend of looking for indigenous natural enemies. Such organisms can play a vital role in integrated pest management strategies for locusts and grasshoppers, particularly entomopathogens that can be incorporated with chemical pesticides into the management system. Among the organisms considered, Metarhizium acridum is noteworthy for inclusion in integrated pest management programs.

Factors influencing carbon and water use efficiency in changing environments

IntroductionVegetation plays a crucial role in terrestrial ecosystems, acting as a vital link connecting the lithosphere, hydrosphere, and atmosphere in terms of energy flow and material cycling. Changes in surface vegetation significantly regulate the water cycle, energy flow within terrestrial surfaces, and global carbon balance.MethodsThis study focuses on nine major river basins in China to quantitatively investigate the impacts of climate factors, vegetation dynamics, and land use changes on carbon use efficiency (CUE) and water use efficiency (WUE).ResultsThe primary controlling factors of WUE trends are NDVI (average contribution: 33.75% ± 6.90%) and VPD (average contribution: 28.04% ± 3.98%). NDVI predominates in the Haihe, Yellow River, Yangtze River, Pearl River, and Songliao River basins, while shortwave radiation (Srad) dominates in the southeastern rivers and inland river areas, and humidity (Shum) in the southwestern river basins. For CUE trends, the main controlling factors are Srad (average contribution: 36.46% ± 3.40%) and precipitation (Pre) (average contribution: 26.72% ± 5.20%). NDVI negatively influences the Huaihe River and southeastern river basins, while Pre negatively influences the Songliao River and Yellow River basins, and Srad negatively influences the Huaihe and southwestern river basins. Pre predominates in the Huaihe, Songliao, Haihe, southwestern river basins, and inland river areas, while Srad predominates in the Pearl River, Yangtze River, and Yellow River basins.DiscussionClimate factors and vegetation dynamics have significant regional impacts on WUE and CUE across different river basins, especially the roles of NDVI and VPD on WUE, and Srad and precipitation on CUE. These differences underscore the importance of developing region-specific management strategies to optimize ecosystem services in each basin.

Professional values, ethical climate and job satisfaction of nurses and their selected sociodemographic and occupational characteristics

AimTo explore the relationship of selected socio-demographic and occupational characteristics of nurses and their level of professional values, hospital ethical climate and job satisfaction.MethodsCross-sectional study was conducted among 388 Polish nurses from the spring of 2021 to winter of 2023, in the eastern part of Poland; and followed by Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Four research tools were used to collect data together with questionnaire for socio-demographic and occupational characteristics.ResultsProfessional values such as activism correlate negatively with religious beliefs (Z = −1.789; p = 0.044), this means that nurses who are more involved in professional change activities are likely to be less associated with religious beliefs. A positive correlation was observed between the Ethical Hospital Climate Survey subscale—peer relations and nurses’ education level (H = 5.638; p = 0.048), indicating that a higher education level was associated with better relationships with colleagues at work. A negative relationship was identified between nurses’ external job satisfaction and their marital status (Z = −1.958; p = 0.040), that is, married nurses feel less satisfaction with the external aspects of their jobs than their single colleagues.DiscussionThese findings underscore that medical staff management should take into account both sociodemographic factors [e.g., age, education, place of residence, marital status, religious beliefs, as well as professional factors (working hours, qualification course, etc.)] that affect nurses’ professional values, job satisfaction and the ethical climate of the hospital. These underscore the need to adapt management strategies to the individual needs of employees, which can contribute to improving working conditions in healthcare facilities.Data collection toolThe data collection tool consists of four sections.DemographicsCollected background and demographic information.Nurses’ professional values scale (NPVS-3)Assessed professional values among nurses.Hospital ethical climate survey (HECS)Assessed hospital ethical climate among nurses.Minnesota satisfaction questionnaire-short form (MSQ-SF)Assessed job satisfaction levels among nurses.

Scratching the surface: Unveiling the complex interplay of itch and psoriasis through contemporary research

The long-lasting presence of itch is an unbearable symptom for people with psoriatic disease, having a profound effect on their quality of life. The itch experience in psoriasis is complex and multifaceted. It is underpinned by neuroimmune interactions, skin barrier dysfunction, and central sensitization pathways. While it has recently been realized that there are neuroimmune interactions in the pathophysiology of itch, tackling chronic itch still proves to be a challenge. The aim of this Perspective Article is two-fold: to assess the novel optimal management strategies for psoriasis-associated itch, while considering the mechanisms of itch in psoriasis and future directions for research.

Biological Control of Aphids in China: Successes and Prospects.

Aphids are small, soft-bodied insects, and many are notorious pests of field crops, vegetables, fruit trees, ornamental plants, and trees. In China, there is an increasing emphasis on utilizing biological control agents, including aphidopathogenics, and selective pesticides for the management of aphids. In particular, preventive integrated pest management strategies with early interventions reduce the financial and environmental costs associated with treatments of outbreaks. Decades of progress have proved that biological control is a cost-effective and environmentally safe control option. Here, we review the history and progress of aphid control, with an emphasis on major natural enemies, mass-rearing, and conservation, and provide two successful cases, constraints, and future perspectives on aphid biological control in China.

Raw Material Management Strategy in The Production Process of Tos-Tos Tortilla Chips (Case Study at PT Dua Kelinci)

PT Dua Kelinci is a company based in Pati that operates in the food industry. The purpose of this study is to analyze the raw material management strategy in the production process within PT Dua Kelinci’s Tos-tos Tortilla Chips division. The focus of this study is the role of the production supervisor in managing raw materials and ensuring efficient processes. This study employed a qualitative descriptive method, utilizing primary data collected through interviews. The data was then analyzed through data reduction, data presentation, and conclusion drawing. The findings of the study indicate that PT Dua Kelinci implements its raw material management strategy by (1) following a production process in accordance with work guidelines that outline monthly food orders, (2) recording input and output materials for accurate tracking, and (3) sourcing materials based on the quantity and variety of food orders, ensuring timely procurement of required flavors. This approach ensures a smooth production process, helps maintain product quality, and fulfills customer demands. Efficient management of raw materials not only reduces the likelihood of production delays but also ensures operational stability and cost control. The study concludes that strategic raw material management is essential for sustaining production efficiency and product quality at PT Dua Kelinci.

The Effect of Border Crops and Physical Barriers on Incidence of Chilli Leaf Curl Complex and Associated Insect Populations

Chilli Leaf Curl (CLC) possesses a significant biotic threat leading to substantial yield losses in chilli cultivation. Various agents such as thrips, aphids, mites and the viruses transmitted by whiteflies have been identified as contributors to CLC. In order to mitigate this issue, three types of physical barriers were used: an insect-proof net (1 m high) surrounded by three rows of maize crops, an insect-proof net (1 m high) alone, and three rows of maize crops. A control was maintained without a physical barrier. The experiment was laid out as randomized complete block design with three replicates. Identification of pests and diseases, CLC disease incidence and yield attributes were assessed. Results revealed that the treatment with an insect-proof net combined with a maize border exhibited the lowest disease incidence (2±0.45, p=0.01) compared to chilli plants with a maize border only. The whitefly population varied across the treatments (p=0.03) and with the age of the crop (p<0.0001). Among the treatments, the control and insect-proof net exhibited a significantly lower population of whiteflies. Thrips did not show a significant response to the treatments (p=0.54) indicating that the presence of physical barriers had no notable effect on thrips counts. Additionally, there was no significant difference in the number of pods per plant (p=0.74) and yield per plant across the treatments (p=0.54). In conclusion, the use of insect-proof net with a maize border surrounding the chilli cultivation would help to develop integrated pest management strategies to reduce chilli leaf curl incidence as well as whitefly population.

Perinatal outcomes in pregnancies achieved after fertility treatments with and without diet-controlled GDM.

To evaluate the rates of adverse perinatal outcomes among women who conceived after fertility treatments with and without diet-controlled GDM. In this retrospective population-based cohort study, all pregnancies of non-diabetic and diet-controlled GDM women who conceived after fertility treatments (in-vitro fertilization - IVF and ovulation induction - OI) and delivered between the years 1996-2016 in a tertiary medical center, were included. Pregnancies of women with pre-gestational diabetes mellitus, and those complicated with gestational diabetes mellitus A2, multiple pregnancies, congenital malformations and those lacking prenatal care, were excluded. Demographical, clinical, and obstetrical characteristics were recorded, and pregnancy complications and adverse perinatal outcomes were compared between the groups. Multivariate logistic regression models were used to control for confounders. Statistical analyses were performed using logistic regression to control for potential confounders. A p-value of < 0.05 was considered statistically significant. During the study period, 6254 deliveries met the inclusion criteria, 10.23% of them (n = 640) had diet-controlled GDM. Pregnancies with diet-controlled GDM were found to be associated with significantly higher rates of hypertensive disorders of pregnancy (15.6% vs. 9.8%, p < 0.001), polyhydramnios (5.9% vs. 2.7%, p < 0.001), and cesarean deliveries (40.8% vs. 31.9%, p < 0.001). Diet-controlled GDM was also found to be an independent protective factor against perinatal mortality (aOR = 0.22, 95% Cl 0.05-0.92, P = 0.04) possibly due to the more intensive monitoring and management typically provided to women undergoing fertility treatments. This close care may mitigate some of the risks associated with ART, leading to improved perinatal outcomes. Among pregnancies achieved after fertility treatments, diet-controlled GDM was associated with reduced perinatal mortality and higher rates of certain pregnancy complications. These findings highlight the importance of close monitoring and careful management of women with diet-controlled GDM, as it may help mitigate risks associated with ART pregnancies. Further research is needed to understand the mechanisms behind these outcomes and to optimize management strategies for this specific population.

Energy Management System for Polygeneration Microgrids, Including Battery Degradation and Curtailment Costs

Recent advancements in sensor technologies have significantly improved the monitoring and control of various energy parameters, enabling more precise and adaptive management strategies for smart microgrids. This work presents a novel model of an energy management system (EMS) for grid-connected polygeneration microgrids that allows optimizing the management of electrical storage systems, electric vehicles, and other deferrable loads such as heat pumps. The main novelty of this model is that it incorporates both climate comfort variables and the consideration of the degradation of the energy storage capacity in the control strategy, as well as a penalty for the dumping of surpluses. The model has been applied to a smart, sustainable building as a case study. The results show that the proposed model is highly adaptable to diverse weather conditions, minimizing renewable energy losses while satisfying the energy demand and providing comfort to the building’s users. The study shows (i) that EVs’ dynamic charging schedules play a crucial role, (ii) that it is possible to minimize a battery’s degradation by optimizing its cycling, averaging one cycle per day, and (iii) the critical impact of seasonal weather patterns on microgrid energy management and the strategic role of EVs and storage systems in maintaining energy balance and efficiency.

Trait responses, nonconsumptive effects, and the physiological basis of Helicoverpa armigera to bat predation risk.

Predation reduces the population density of prey, affecting its fitness and population dynamics. Few studies have connected trait changes with fitness consequences in prey and the molecular basis and metabolic mechanisms of such changes in bat-insect systems. This study focuses on the responses of Helicoverpa armigera to different predation risks, focusing on echolocating bats and their calls. Substantial modifications were observed in the nocturnal and diurnal activities of H. armigera under predation risk, with enhanced evasion behaviors. Accelerated development and decreased fitness were observed under predation risks. Transcriptomic and metabolomic analyses indicated that exposure to bats induced the upregulation of amino acid metabolism- and antioxidant pathway-related genes, reflecting shifts in resource utilization in response to oxidative stress. Exposure to bat predation risks enhanced the activity of DNA damage repair pathways and suppressed energy metabolism, contributing to the observed trait changes and fitness decreases. The current results underscore the complex adaptive strategies that prey species evolve in response to predation risk, enhancing our understanding of the predator-prey dynamic and offering valuable insights for innovative and ecologically informed pest management strategies.

The Synergistic Effect of Biomechanics and Psychological Feedback in Physical Education Teaching: Enhancing Motor Skills and Psychological Resilience

The combination of biomechanics and psychological feedback presents a unique approach to improving physical education outcomes. Biomechanics offers a detailed understanding of movement, allowing for the optimization of motor skills based on scientific principles. Meanwhile, psychological feedback helps students adapt mentally, fostering resilience and improving performance under pressure. This research explores how the dual application of biomechanical analysis and psychological feedback can enhance both physical and mental capacities in students during physical education. Through motion capture technology and real-time data analysis, motor skill performance is broken down into key components such as force, speed, and coordination. Students receive targeted feedback, allowing them to refine their techniques efficiently. Concurrently, psychological feedback mechanisms, such as self-reflection and stress management strategies, are introduced to help students build mental resilience and maintain focus. Results are a significant improvement in both motor skills and psychological well-being. Students displayed greater accuracy and efficiency in performing complex physical tasks and reported reduced anxiety and stress during physical education activities. The synergy between biomechanics and psychological feedback not only improved motor performance but also enhanced students' overall experience, making physical education more engaging and effective.

Management strategies and corticophobia among healthcare professionals involved in the care for atopic dermatitis: a Dutch survey.

Many healthcare professionals (HCPs) deliver care for patients with atopic dermatitis (AD). Although pivotal, management strategies and the relation with corticophobia among HCPs have not been investigated. This study aimed to investigate management strategies for AD and its relation with corticophobia among HCPs. Dutch general practitioners (GPs), youth healthcare physicians (YHPs), pediatricians, dermatologists, pharmacists, and pharmacy assistants participated in a survey on management strategies and corticophobia. The Topical Corticosteroid Phobia questionnaire for professionals (TOPICOP-P) was used to measure attitudes toward topical corticosteroids (TCS). Higher scores reflect a more negative attitude. A total of 407 HCPs (124 GPs, 33 YHPs, 51 pediatricians, 56 dermatologists, 58 pharmacists, and 85 pharmacy assistants) participated. Compared to dermatologists other HCPs were more reluctant with TCS as illustrated by the portion (50%) of GPs that reported to prescribe TCS of only mild potency for infants with severe AD, compared to dermatologists (9%). Dermatologists had lowest TOPICOP-P scores (median: 19, IQR:12-28). GPs and pharmacy assistants had highest scores (GPs median: 36, IQR:31-44, pharmacy assistants: median: 36, IQR:31-42). More corticophobia was significantly associated with prescription of a lower TC potency class (B -0.04, 95%CI: -0.07-0.01, P=0.01), and a trend was found between more corticophobia and longer perceived durability of one TCS tube. This study shows the differences in management of AD and reluctance towards TCS in HCPs. Furthermore, corticophobia among HCPs and its effect on management of AD was confirmed. To reduce corticophobia and improve care for AD, more education is needed.

Biophysical and socioeconomic characterization of Agewmariam experimental watershed in Northern Ethiopia: insights and management options.

Watershed characterization is essential for sustainable watershed management and effective resource utilization, particularly in assessing changes resulting from interventions. This study investigates the biophysical and socio-economic conditions of the Agewmariam watershed, aiming to develop land capability and suitability maps while identifying viable management options. Biophysical data, including land slope, soil properties, erosion severity, stoniness/rockiness cover, and vegetation cover, were collected through field surveys and analyzed using overlay analysis in ArcGIS. Socio-economic data, encompassing population demographics, income, and expenditure, were gathered via individual interviews, complete census, and focus group discussions and summarized using descriptive statistics. The study identified 259 households with an average family size of 4 and a demographic dependency ratio of 96.6%. The major sources of income are crop production and livestock rearing supplemented by casual labor and food aid. The average farmland holding size is 0.5ha, with sorghum, barley, teff, and wheat as the dominant crops. The watershed is characterized by six land capability classes (classes II, III, IV, VI, VII, and VIII). The suitability analysis indicated that the watershed is not currently suitable for wheat and teff crops unless physical, chemical, and biological management improvements are implemented. The study revealed that the major limiting factors for land capability and suitability were slope, erosion severity, stoniness, soil organic matter, and soil texture. The socio-economic characterization enhanced awareness about the local socio-economic condition, informing appropriate planning and management strategies. The study recommends intensive soil and water conservation intervention, afforestation on hillsides, changing the land use system, and the addition of organic matter and fertilizers to enhance land capability and suitability for sustainable agricultural practices.