Efficient Intervention Research Articles

Grading of Recommendations of psychological interventions in the rehabilitation of patients with schizophrenia

IntroductionAs part of the intervention, patients with severe schizophrenia who are cared for in psychiatric rehabilitation units need psychological treatments. However, there is great variability within the psychotherapy alternatives that are proposed for rehabilitation in schizophrenia, and it is necessary to know which are the most efficient interventions in order to prioritize their inclusion in intervention programs.Objectives To know the level of evidence of the existing psychotherapy alternatives for the rehabilitation treatment in schizophrenia through the systematic review of recently published studies.Methods Consecutive systematic searches in the scientific literature were used in a sensitive and specific way, aimed at identifying the existence of documents in databases and clinical practice guidelines based on evidence of psychological treatment in schizophrenia. Psychosocial and social approaches and family members interventions were excluded, and the search was limited to the last 5 years. The PICO format has been used, and a subsequent critical reading using the AGREE II tool, considering the inclusion criteria of presenting a score >60% in 4 domains.ResultsThe following interventions have been found to be therapeutically effective: Level 1B (Early intervention in Psychosis; Patient and Family psychoeducational intervention; Basic ando social skills training; Social cognition and Metakognition training; Cognitive Remediation; Cognitive Behavioral Individual Therapy; Assertive Community treatment; Supported employment). Level 2B (Family Problem Solving Therapy, Dynamic Psychotherapy; Cognitive Behavioral Group Therapy); Level 2C (Horticultural, Art, Music, Animals Therapies).ConclusionsSeveral psychotherapy alternatives are proposed for rehabilitation in schizophrenia, with known level of evidenca in order to prioritize their inclusion in intervention programs.Disclosure of InterestNone Declared

Role of Enhancing Aerobic Capacity in Countering COVID-19-induced Liver Injury in Elderlies.

COVID-19 is still a world disaster; however, its vaccination is globally available. Liver and gastrointestinal disturbances occur in patients infected with COVID-19 at varying incidences. Aging decreases the functions of the liver. Thus, the elderly have a weaker response to the COVID-19 virus. The COVID-19 virus affects the liver directly through direct and indirect mechanisms. It directly affects the renin-angiotensin system or indirectly causes sepsis, uncontrolled immune reactions, drug-related hepatic injury, and cytokine storm. Also, COVID-19 vaccines and anti-drugs have adverse effects on the liver too. Thus, this review explores the effect of enhancing aerobic capacity as a nonpharmacological intervention on decreasing COVID- 19-induced liver injury. Enhancing aerobic capacity decreases COVID-19-induced liver injury through the following: 1) downregulating systemic and tissue ACE/ANG II/AT1R axis, upregulating ACE2/ANG 1-7/Mas axis, and moving the renin-angiotensin system to the direction of the ACE2/ANG (1-7)/Mas axis, 2) Improving mitochondrial function and oxygenation to body and lung tissues, causing a decrease in harmful oxidative reactions, 3) Increasing the processing of accumulated free radicals and inhibiting the acute respiratory distress syndrome, 4) Acting as an antioxidant to protect the liver from oxidative stress, 5) Increasing the effect of antiviral drugs and COVID-19 vaccines, which improves the function of immune biomarkers, decreases the viral load, and increases the body's defense against the virus, 6) Decreasing coagulation abnormalities and thrombosis. In conclusion, enhancing aerobic capacity may be an efficient nonpharmacological intervention to decrease COVID-19-induced liver injury in elderlies and regenerate the liver to its normal status after being infected by the COVID-19 virus. It also helps to strengthen the body's immunity for better effects of both COVID-19 vaccination and drugs.

Benefits of ULV Application to Control Locusts in Caucasus and Central Asia

This paper discusses the state-of-the-art of Ultra-Low Volume (ULV) spray application with rotary atomisers in the Caucasus and Central Asian (CCA) region to control locusts. The technology is widely used around the world for locust control and promoted by the UN Food and Agriculture Organisation (FAO) as an effective and efficient control intervention that meets the scale and challenge posed by large area locust outbreaks. The technology utilises precisely controlled spray droplets in the range 50–100um using ready-to-use oil-based ULV formulations to target locusts more efficiently. Volume rates as low as 0.5–1.0 l/ha are utilised which greatly improves productivity of ground and aerial spray applications, timeliness, and reduces cost and waste of pesticide and water. ULV has become more widely adopted in CCA during recent years to control major economic pests such as Moroccan, Italian, and Asian migratory locusts. Its further adoption is hampered by the lack of available ULV formulations in the region and need for investment and training in the technology. ULV technology is highly appropriate for use of biological products to reduce risks to operators and the environment and efforts to increase regional cooperation and the registration of safer pesticides across the region present opportunities for its wider adoption.

Functional Neurologic Disorders: The Role of Limbic System

IntroductionFunctional Neurological Disorders (FND), also called hysteria or conversion disorder, have represented a challenge over the centuries in terms of comprehension of the mechanisms responsible for symptoms which mimic neurological diseases without organic damage. Charcot considered hysteria primarily a hereditary disorder, but also considered that environmental factors including physical and emotional stress served as provoking factors. The prevailing etiologic theories of FND are psychosocial and still strongly dominated by the Freudian concept of conversion – a psychologic symptom is converted into a somatic symptom as a way of dealing with the distress of the symptom. However, physiologic studies with fMRI are necessary to understand the neurological mechanisms involved in FND symptoms. Convergent neuroimaging findings have implicated abnormal limbic-motor interactions in response to emotional stimuli in FND patients, demonstrated a possible role of the limbic system (LS) in FND neurophysiology.ObjectivesUnderstand the role of LS in the neurophysiologic mechanisms involve in FND.MethodsSystematic review of the literature published in PubMed, using the terms “Functional Neurological Disorders”, “Limbic System”, “Emotions”.ResultsPhysiologic studies of functional weakness and sensory loss reveal normal functioning of primary motor and sensory cortex, but abnormalities of premotor cortex and association cortices. This suggests a top-down influence creating the dysfunction during the action control. Indeed, fMRI studies with FND motor patients show a hypoactivation of cortical and subcortical motor pathways, and a hyperactivity in limbic areas related with an abnormal limbic regulation with increased amygdala activity. In fact, studies have found a dysfunction in the medial prefrontal areas in FDN patients suggesting that they might have an abnormal affective representation (AR) of self-relevant information encoded in this region, which can later induce specific behavioral patterns of thought interaction with sensorimotor circuits. The abnormal AR could be influence by a dysfunction in LS regulation. Indeed, emotions are one of the major factors influencing movement choice. Moreover, limbic structures, such as the amygdala, can be influenced by genetic factors and/or early life stress. Thus, abnormal functioning of LS could lead to functional disorders by deranged top-down control.ConclusionsIn conclusion, FND patients may have an abnormal AR and/or emotion regulation mechanisms possibly due to prior experience or partly genetically determined which interact with lower-order functions leading to the production of the functional symptoms, where LS have an important role. However, much further empiric research is needed to better understand this fascinating and debilitating condition, as well as to derive new perspectives for more efficient therapeutic interventions in these patients.Disclosure of InterestNone Declared

Current Challenges and Future Directions of Research in Cell Phone Addiction

IntroductionBehavioral addictions (BAs) are intensely explored during the last decades due to their impact on the quality of life, functionality, socio-economical negative consequences, and high risk of mental health negative consequences. BAs are new challenges for clinicians and researchers due to a lack of well-defined diagnostic criteria, very few available epidemiological data, and scarce information about efficient therapeutic interventions. Cell phone addiction (CPA) has been raising a significant interest for mental health specialists because of its increasing prevalence and potential long-term physical and mental complications. Therefore, an analysis of the available data about the main characteristics of this pathology seems granted.ObjectivesThe main objective of this review was represented by the need to find relevant reports about the epidemiological, clinical, and therapeutic interventions in CPA.MethodsA narrative review focused on the available treatments for food addiction was performed through a search in four electronic databases (PubMed, Cochrane, EMBASE, and Web of Science/Clarivate) using the paradigm “cell phone addiction” or “smartphone dependence” and “treatment” or “epidemiology” or “diagnostic criteria” or “risk factors.” No inferior time limit for published papers was established, and the superior limit was July 2023.ResultsA relatively large number of papers regarding this topic were found (n=772), but after applying the inclusion and exclusion criteria, only 29 articles remained. Female gender and adolescents, but also high anxiety levels, insomnia, excessive Internet use, less physical activity, and a higher level of dependence have been correlated with CPA. Six validated scales have been identified as possible instruments for monitoring the CPA evolution. Different diagnostic criteria have been suggested, but they still lack clinical validation. Cognitive-behavioral therapy could be helpful, and smartphone applications that limit online time could also be efficient. Treatment of previously mentioned vulnerability factors is also recommended to obtain long-term favorable effects.ConclusionsCPA is an increasingly explored BA, but validated diagnostic criteria are still missing. The treatment is also based on extrapolations from other addictions. Therefore large sample-based therapy trials are needed.Disclosure of InterestNone Declared

Reciprocal and Dynamic Associations between Social Isolation, Loneliness, and Disability among Chinese Older Adults

ObjectivesThis study aimed to examine reciprocal and dynamic associations between Social Isolation (SI), loneliness, and disability among Chinese older adults. DesignThis is a prospective cohort study. Setting and ParticipantsThe global trend of population aging has resulted in a significant rise in the prevalence of disabilities, SI, and loneliness among older adults. These factors can severely impact the health and well-being of older adults. Therefore, it is crucial to implement more efficient interventions aimed at reducing disabilities, addressing SI, and combating loneliness among older adults in order to improve their overall health and well-being. MethodsUsing a large, nationally representative sample spanning 16 years, we employed the general cross-lagged panel model to explore the relationships among 50,348 older adults with a mean age of 81.83 at baseline. Disability was measured by a comprehensive index tool that incorporated multiple dimensions. SI was measured using an SI index, and loneliness was evaluated using a single-item measure. ResultsSI emerged as a stronger predictor of disability than loneliness. Longitudinal analysis revealed accumulative disadvantages in the association between SI and disability. Additionally, disability was found to contribute to increased SI and loneliness. However, our study did not detect any variance in the strength of the cross-lagged effects between social isolation and disability. Conclusions and ImplicationsThe findings suggest that reducing SI is crucial for reducing disability among older adults. Initiating early interventions to minimize initial SI could aid in preventing later-life disability. Additionally, addressing disabilities may positively impact the reduction of loneliness and SI within this population.

Thinking you're different matters more for belonging than being different.

Belonging to a community is essential for wellbeing, but potentially unattainable for those dissimilar from a group. In the present work, we ask whether belongingness is better predicted by acting and thinking like peers or believing you act and think like peers. Students (N = 1181) reported their belonging and how much they, their friends, and an "average student" endorsed local behavioral norms and general values. We calculated difference scores for behaviors and values capturing perceived similarity to the average, actual similarity to the average, and accuracy around the norm. Key results indicate that perceived behavioral similarity to the average, when controlling for other differences, predicts belonging and most robustly mediates between identity and belonging. Using social network analysis, we find behavioral differences from friends are meaningfully linked to network density and racial homophily. Efficient interventions for enhanced belonging could highlight similarities between students and their peers.

Uterine Balloon Tamponade in Management of Postpartum Hemorrhage

Aim. To evaluate the efficacy and safety of uterine balloon tamponade for the management of postpartum haemorrhage.Materials and Methods. We have screened the Cochrane Library and PubMed for the following keywords: “intrauterine balloon tamponade”, “controlled balloon tamponade”, “controlled balloon tamponade” AND “postpartum bleeding/haemorrhage” during 5 years (2018-2023). In total, we have identified 358 publications including 3 meta-analyses, 6 systematic reviews, and 13 randomized controlled trials. After checking titles and abstracts to remove duplicates, we selected 38 sources which met the selection criteria.Results. Postpartum haemorrhage remains the leading cause of maternal mortality in both developing and developed countries. In most cases, postpartum haemorrhage occurs due to atony and is controlled by administration of uterotonics. However, if uncurbed, postpartum haemorrhage requires blood transfusion and surgery. Currently, uterine balloon tamponade is considered as one of the most efficient and safe technologies for controlling postpartum haemorrhage and preventing hysterectomy, yet a number of studies have reported negative results. Several investigations showed an advantage of double-balloon tamponade as it provides an additional benefit of vascular compression of the lower uterine segment. Generally, uterine balloon tamponade is an efficient intervention which allows to avoid additional surgeries (uterine artery embolization or hysterectomy) in 87.3 – 100.0% of cases with a relatively low complication rate (< 6.7% – 9.4%).Conclusion. The effectiveness of uterine balloon tamponade and the risk of complications are probably determined by the type of device, the learning curve effect, and the regularity and quality of training of medical personnel. Further in-depth multicenter studies in this direction are required.

Using causal mediation to examine self-efficacy as a mechanism through which continuing care interventions reduce alcohol use.

Understanding the causal mechanisms through which telephone and mobile health continuing care approaches reduce alcohol use can help develop more efficient interventions that effectively target these mechanisms. Self-efficacy for successfully coping with high-risk alcohol relapse situations is a theoretically and empirically supported mediator of alcohol treatment. This secondary analysis aims to examine self-efficacy as a mechanism through which remote-delivered continuing care interventions reduce alcohol use. The study included 262 adults (Mage = 46.9, SD = 7.4) who had completed 3 weeks of an intensive outpatient alcohol treatment program. The sample was predominantly male (71%), African American (82%), and completed a high school education (71%). The four-arm randomized clinical trial compared three active continuing care interventions (telephone monitoring and counseling [TMC], addiction comprehensive health enhancement support system [ACHESS], and combined delivery of TMC and ACHESS) to usual care and assessed longitudinal measures of alcohol use and self-efficacy. Analyses employed the potential outcomes framework and sensitivity analyses to address threats to causal inference resulting from an observed mediator variable. Relative to usual care, the two intervention conditions that included TMC reduced alcohol use through improvements to self-efficacy. There was no evidence that self-efficacy mediated the effect of ACHESS on alcohol use. Based on our findings, self-efficacy is an important mechanism through which telephone continuing care interventions affect alcohol use. Future research to identify which components of TMC influence self-efficacy and factors that mediate ACHESS effects could enhance the effectiveness of remote delivery of continuing care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Biomimetic tri-layered artificial skin comprising silica gel-collagen membrane-collagen porous scaffold for enhanced full-thickness wound healing

Full-thickness wounds are severe cutaneous damages with destroyed self-healing function, which need efficient clinical interventions. Inspired by the hierarchical structure of natural skin, we have for the first time developed a biomimetic tri-layered artificial skin (TLAS) comprising silica gel-collagen membrane-collagen porous scaffold for enhanced full-thickness wound healing. The TLAS with the thickness of 3–7 mm displays a hierarchical nanostructure consisting of the top homogeneous silica gel film, the middle compact collagen membrane, and the bottom porous collagen scaffold, exquisitely mimicking the epidermis, basement membrane and dermis of natural skin, respectively. The 1-(3-Dimethylaminopropyl)-3-ethylcarbodiimide/N-Hydroxysuccinimide-dehydrothermal (EDC/NHS-DHT) dual-crosslinked collagen composite bilayer, with a crosslinking degree of 79.5 %, displays remarkable biocompatibility, bioactivity, and biosafety with no risk of hemolysis and pyrogen reactions. Notably, the extra collagen membrane layer provides a robust barrier to block the penetration of silica gel into the collagen porous scaffold, leading to the TLAS with enhanced biocompatibility and bioactivity. The full-thickness wound rat model studies have indicated the TLAS significantly facilitates the regeneration of full-thickness defects by accelerating re-epithelization, collagen deposition and migration of skin appendages. The highly biocompatible and bioactive tri-layered artificial skin provides an improved treatment for full-thickness wounds, which has great potential in tissue engineering.

A COMPARATIVE ANALYSIS OF DIRECT STENTING VERSUS PRE-DILATION IN ST-ELEVATION MYOCARDIAL INFARCTION

A major cardiovascular emergency, ST-Elevation Myocardial Infarction (STEMI), needs prompt and efficient intervention to restore blood flow to the ischemic myocardium. The decision between direct and pre-dilation stenting, two of the many techniques used in primary percutaneous coronary intervention (PCI), has been a topic of continuous discussion. This comparative study was performed at Ayub Teaching Hospital Abbottabad after obtaining approval from the ethical review committee for six months. A total of 75 patients were included in this study and were divided into two groups. The documented procedural outcomes were the use of Gp IIb/IIIa inhibitors, procedure time, total procedure cost, and procedural problems. The rates of the left ventricular ejection fraction (LVEF) at discharge, ventricular fibrillation, all-cause death, and a composite of major adverse cardiac events at 30-day follow-up were documented. The results have shown that Group A has 2.44% cases of no re-flow and no abrupt closure or dissection occurrences. Group B's incidence rates were 5.88%, 2.94%, and 5.88%, respectively. The procedural time, Group A had an average of 33 ± 19 minutes, while Group B recorded a longer procedural time of 41 ± 17 minutes. Postoperatively, Group A showed a mean LVEF of 49.2 ± 8.8, no cases of cardiogenic shock or stroke, and a mortality rate of 2.44%. In contrast, Group B had a mean LVEF of 48.9 ± 9.2, encountered cardiogenic shock in 5.88% of cases, experienced a stroke in 2.94%, and recorded a mortality rate of 2.94%. Additionally, both groups exhibited ST-segment resolution, with rates of 80.49% in Group A and 67.64% in Group B. The analysis of patients undergoing coronary intervention for ST-elevation myocardial infarction (STEMI) suggests that direct stenting may yield more favorable results compared to pre-dilation.

Drought propagation across meteorological, hydrological and agricultural systems in the Lancang‐Mekong River Basin

AbstractDrought produces cross‐system impacts, and these interactions between multiple systems are also referred to as drought propagation. However, the complex natural processes and anthropogenic disturbances lead to the drought propagation process being non‐linear and systems feedback, which is still lack of knowledge in large‐scale basins. To address these challenges, we propose a hydro‐economic coupled model and investigate drought propagation across meteorological‐hydrological‐agricultural systems. The results from the Lancang‐Mekong River Basin show that drought propagates from the meteorological system to the hydrological system and is weakened by the basin buffer and storage capacity. This propagation process shows spatial heterogeneity caused by basin characteristics, highlighting that the upstream (CS location) and downstream (KR and KC locations) are more prone to hydrological drought vulnerability. As drought further propagates to the agricultural system, water abstraction behaviours can alleviate the drought situation, leading to crop yield increases ranging from 4.6% to 39.2% through irrigation pathways. Unfortunately, irrigation behaviour also worsens hydrological drought in a feedback loop, where downstream VT (annual discharge decreases by around 1346 m3/s) shows more intense variation than upstream LP (annual discharge decreases by almost 135 m3/s), illustrating the feedback among multi‐systems and accumulation in spatial. Moreover, upstream hydropower and downstream agricultural water use show synergistic relationships, revealing that efficient anthropogenic interventions can positively mitigate the impact of drought on human well‐being. This paper provides an in‐depth understanding of the complex drought propagation process in nature‐human highly coupled Lancang‐Mekong, which may help policymakers and basin managers to better cope with drought.

Toward the elimination of NTDs: application of cost-effective and sensitive molecular environmental surveillance tools—a pilot study

Neglected tropical diseases (NTDs) affect over a billion people worldwide. The 2021–2030 NTD road map calls for innovative and highly efficient interventions to eliminate or significantly reduce the burden of NTDs. These include sensitive and cost-effective diagnostic techniques for disease surveillance. Environmental surveillance has been employed effectively in this regard to measure and track infectious diseases such as polio on a population-wide scale. In this study, environmental surveillance was used as a cost-effective tool for the detection of soil-transmitted helminths (STHs) in Accra, Ghana, in an area that is populated by urban vegetable farmers. The activities of urban farmers expose them to the risk of STH infection, as well as impact the transmission in urban areas since leafy vegetables could carry infective stages of STHs. A total of 32 wastewater samples were collected from eight points on the Nima Creek (the main source of irrigation for the farmers) over a 7-week period. Real-time PCR and melt peak analysis were used to screen four STHs (i.e., Ascaris lumbricoides, Necator americanus, Ancylostoma duodenale, and Trichuris trichiura). This study revealed that A. lumbricoides (17 out of 32 wastewater samples, 53.3%) was the most prevalent STH, followed by A. duodenale (31.2%), T. trichiura (21.9%), and N. americanus (12.5%). Environmental surveillance helps in the detection of the types of STH pathogens circulating within the community and in the design of mass drug administration (MDA) strategies. This surveillance technique can also provide preliminary information for environmental modifications to help reduce STH transmission in line with the One Health approach recommended in the 2021–2030 NTD road map.

A Comprehensive Analysis of Academic Stress among Students: A Review By IJISRT

Stress is undeniably a significant term with a profound impact, but it can be effectively addressed through minor adjustments in our daily lives. Stress affects individuals across various professions such as managers, financiers, government officials, administrators, politicians, and housewives. However, it is particularly prevalent among students in today's society. It is crucial to identify the root cause of stress in order to address it meticulously and develop efficient interventions. Stress is always perceived as a subjective process, influenced by an individual's personal analysis and response to a threatening event. It can lead to detrimental conditions such as depression, anxiety, and various other health issues. The increasing number of workshops, articles, and research reports on stress management reflects the growing number of stress- related cases in recent decades. This study focuses on the conceptual framework of stress, the causes of stress among students, and strategies for stress management. Additionally, it provides a comprehensive review of existing literature on the subject.

Abstract 3411: Health-related quality of life trajectories in older breast cancer survivors and noncancerous controls over ten years: SEER-MHOS analysis

Abstract Background: The adverse effects of cancer treatment on health-related quality of life (HRQOL) are the primary concern of older women diagnosed with breast cancer. The interplay of transient and progressive functional impairments caused by cancer therapies alongside the accelerated physical declines associated with the normal aging process are all negatively correlated to HRQL, yet it remains unclear whether this is an effect of cancer or solely aging; therefore, this study examined HRQL trajectory over ten years after diagnosis between cancer cases and controls. Methods: The cancer group included 1467 women (age ≥ 65) diagnosed with primary breast cancer in 1998 - 2012, registered in the Surveillance, Epidemiology, End Results (SEER) cancer registry, and completed Medical Health Outcomes (MHO) surveys before and after cancer diagnosis. Propensity score-matched controls were randomly selected with a 1:1 ratio. Participants reported their HRQOL using SF-36/VR-12. It was summarized into two summary scores (Physical Component Summary [PCS] and mental component summary [MCS]) and eight domain scores (physical functioning [PF], role limitation due to physical health [RP], bodily pain [BP], general health [GH], vitality [VT], social functioning [SF], mental health [MH], and role limitation due to emotional problem [RE]). Hierarchical linear modeling was utilized to assess the main effects of time and group and the interaction effect between time and group on HRQOL trajectory. Results: At diagnosis, cases fared worse than controls for all HRQOL domains and summary scores. Over the ten years, PCS, PF, GH, RP, SF, and VT worsened over time (all P for time < 0.05), while MCS, MH, and RE remained relatively constant over time (all P for time ≥ 0.05). Older women with breast cancer had lower HRQL over time than controls in PCS, GH, and RP domains, while they showed higher HRQOL than controls post 4 - 7 years in PF, SF, RE, and VT domains (all P for group < 0.05). However, only RE showed a statistically significant interaction effect (P =0.035), improving over time in cases but worsening in controls. Conclusions: This research shows both older women with breast cancer and propensity-matched controls experiencing deterioration of HRQOL, particularly physical health domains, over ten years after baseline, with cases’ HRQOL kept lower than controls over time. Needs assessment and more efficient interventions to improve physical health HRQOL among older women are warranted. Citation Format: Eunkyung Lee, Maria Azevedo Daruge, Katia Ferdowsi, Jianbin Zhu. Health-related quality of life trajectories in older breast cancer survivors and noncancerous controls over ten years: SEER-MHOS analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3411.

Validating ‘GIS-UBEM’—A Residential Open Data-Driven Urban Building Energy Model

The study of energy consumption in buildings, particularly residential ones, brings with it significant socio-economic and environmental implications, as it accounts for approximately 40% of CO2 emissions, 18% in the case of residential buildings, in Europe. On a number of levels, energy consumption serves as a key parameter in urban sustainability indicators and energy plans. Access to data on energy consumption is crucial for energy planning, management, knowledge generation, and awareness. Urban Building Energy Models (UBEMs), which are emerging tools for simulating energy consumption at neighborhood scale, allow for more efficient intervention and energy rehabilitation planning. However, UBEM validation requires reliable reference data, which are often challenging to obtain at urban scale due to privacy concerns and data accessibility issues. Recent advances, such as automation and open data utilization, are proving promising in addressing these challenges. This study aims to provide a standardized UBEM validation process by presenting a case study that was carried out utilizing open data to develop bottom-up engineering models of residential energy demand at urban scale, with a resolution level of individual buildings, and a subsequent adjustment and validation using reference tools. This study confirms that the validated GIS-UBEM model heating and cooling demands and consumption fall within the confidence bands of ±15% and ±12.5%, i.e., the confidence bands required for the approval of official alternative simulation methods for energy certification. This paves the way for its application in urban-scale studies and practices with a well-established margin of confidence, covering a wide range of building typologies, construction models, and climates comparable to those considered in the validation process. The primary application of this model is to determine the starting point and subsequent evaluation of improvement scenarios at a district scale, examining issues such as massive energy rehabilitation interventions, energy planning, demand analysis, vulnerability studies, etc.

Successful demand management in diagnostic immunology testing

AimsWe investigated whether we could have a material and sustained impact on immunology test ordering by primary care clinicians by building evidence-based and explanatory algorithms into test ordering software.MethodsA service...

Abstract P238: A Multinational Analysis of Perceptions of Non-Communicable Diseases

Introduction: Understanding perceptions of non-communicable diseases (NCDs) is pivotal for enhancing primary prevention programs and health literacy. Objective: To assess perceptions and attitudes toward NCDs in five distinct countries. Methods: A cross-sectional study was conducted using the "Measuring Public Perceptions of Noncommunicable Diseases" survey by Gallup (2022). The sample encompassed 7,029 participants from the United States, Colombia, Jordan, Tanzania, and India, selected through probability-based sampling. The survey involved 15 sociodemographic variables and 97 questions related to knowledge, perceptions, and attitudes toward NCDs. We focused our analysis on cardiometabolic diseases and cancer. Results: Over 89% of respondents across all countries considered NCDs to be harmful, although perceptions were lower in India and Jordan, particularly for diabetes and stroke. Gender-based differences were notable in these countries; women in India and men in Jordan were less likely to view stroke as harmful. Support for public policies varied by country; participants from Jordan showed greater support for alcohol taxes, whereas India demonstrated lower support for tobacco control. Cancer was generally perceived as highly harmful, but along with stroke showed the least perceived empowerment for risk reduction. Television was the preferred source of health information, and high levels of trust were placed in healthcare personnel across countries. Individuals with higher education and income were more aware of the detrimental impacts of NCDs and felt more empowered to mitigate them, and older participants showed a diminished perception of their harm (Table 1). Conclusion: The data highlights varied perceptions of harm and empowerment across countries, affecting receptivity to different public policies such as taxation and advertising restrictions. Understanding these disparities is crucial for crafting efficient healthcare interventions tailored to specific populations.

Current knowledge of human Mpox viral infection among healthcare workers in Cameroon calls for capacity-strengthening for pandemic preparedness.

An increased incidence of human Monkeypox (Mpox) cases was recently observed worldwide, including in Cameroon. To ensure efficient preparedness and interventions in the health system, we sought to assess the knowledge of Mpox's transmission, prevention, and response among healthcare workers (HCWs) in Cameroon. A cross-sectional online survey was conducted among HCWs in Cameroon using 21-item questions adapted from the United States Centers for Disease Control and Prevention (US-CDC) standard questionnaire on Mpox. The overall knowledge of Mpox was assessed by cumulative score and categorized as excellent (≥80%, 17/21) or good (≥70%, ≥15/21) knowledge. The regression analysis was used to identify the predictors of Mpox knowledge. The survey enrolled 377 participants, but only responses from 342 participants were analyzed. Overall, 50.6% were female participants, and 59.6% aged 30 years or younger. The majority of the participants were medical doctors (50.3%); most worked in central-level hospitals (25.1%) and had 1-5 years of experience (70.7%). A total of up to 92.7% were aware of Mpox, with social media (58.7%) and radio/television (49.2%) as the main sources. The mean knowledge score was 14.0 ± 3.0 (4 to 20), with only 12.9% having excellent knowledge (≥80%) and 42.1% having good knowledge of Mpox. Younger age (26-30 years old) was associated with good knowledge, while workplace type was associated with excellent knowledge of Mpox (aOR [95% CI]: 4.01 [1.43-11.24]). Knowledge of treatment/management of Mpox was generally poor across the different professional categories. Knowledge of Mpox among HCWs is substandard across different professionals. Thus, for optimal preparedness and immediate interventions for Mpox and similar emerging pathogens, capacity-strengthening programs should be organized for HCWs while encouraging scientific literature and organizational social media websites.

The epidemiological and economic burden of diabetes in Ghana: A scoping review to inform health technology assessment.

Diabetes remains one of the four major causes of morbidity and mortality globally among non-communicable diseases (NCDs. It is predicted to increase in sub-Saharan Africa by over 50% by 2045. The aim of this study is to identify, map and estimate the burden of diabetes in Ghana, which is essential for optimising NCD country policy and understanding existing knowledge gaps to guide future research in this area. We followed the Arksey and O'Malley framework for scoping reviews. We searched electronic databases including Medline, Embase, Web of Science, Scopus, Cochrane and African Index Medicus following a systematic search strategy. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews was followed when reporting the results. A total of 36 studies were found to fulfil the inclusion criteria. The reported prevalence of diabetes at national level in Ghana ranged between 2.80%- 3.95%. At the regional level, the Western region reported the highest prevalence of diabetes: 39.80%, followed by Ashanti region (25.20%) and Central region at 24.60%. The prevalence of diabetes was generally higher in women in comparison to men. Urban areas were found to have a higher prevalence of diabetes than rural areas. The mean annual financial cost of managing one diabetic case at the outpatient clinic was estimated at GHS 540.35 (2021 US $194.09). There was a paucity of evidence on the overall economic burden and the regional prevalence burden. Ghana is faced with a considerable burden of diabetes which varies by region and setting (urban/rural). There is an urgent need for effective and efficient interventions to prevent the anticipated elevation in burden of disease through the utilisation of existing evidence and proven priority-setting tools like Health Technology Assessment (HTA).