Related Environmental Factors Research Articles

Pandemic Pedagogy: Perception of Nursing students’: A cross-sectional study

Coronavirus disease 2019 pandemic impacted across the globe disrupting all sectors including the higher education universities. Nursing institutions faced various challenges due to the pandemic restrictions, of which the abrupt shift of implementing the curriculum to online mode posed a major challenge to both the teachers and the students. To assess nursing students' perception of pandemic pedagogy and the challenges faced in remote teaching-learning, this cross-sectional survey was conducted among 982 undergraduate nursing students from three Deemed to be University nursing institutions of Southern India. Institutional Ethics Committee approval (IEC 444/2020), permission from the heads of the institutions and study participant’s consent was obtained. Data was collected using an online survey questionnaire which had three domains, including student-related (19 items), teacher-related(5 items), and physical learning environment-related factors (11 items). The reliability was established using Cronbach’s Alpha (0.86). Explored the favouring, hindering factors and challenges faced during the emergency remote instruction with open-ended items. The overall mean score of perceptions on pandemic pedagogy was 89.03±10.03. Sixty-three percent of students had a total perception score above 87 which indicates that they preferred remote learning (synchronous) during the pandemic whereas 45% preferred face-to-face classes. There was a significant difference in the total perception scores and the years of study( F (3, 978) = 4.96, p = 0.002). The factors favouring remote learning were, an opportunity to view the recorded classes even after the live classes’ (n=165), and ‘more time to spend for learning activities’ (n=152). Factors that hindered the learning or the challenges faced were poor network connectivity (n=451), and lack of opportunity for group study (n=326). Students favoured remote learning during the pandemic; however, there were several challenges. The educational institutions need to prepare themselves to overcome this and focus on a blended learning curriculum.

Patterns of presentation of adults with hearing impairment in a peri-urban community in South Africa: a qualitative study

BackgroundThere is a wealth of research, globally, on the help-seeking behavior patterns of individuals with a variety of chronic medical conditions. Contextually relevant findings have been reported describing the influence of a disease and/or disorder together with the related personal, social, environmental, and region-specific factors. However, research related to help-seeking behavior patterns in hearing impairment is mostly found in high income countries (HICs) and tells a one-sided story indicating a knowledge gap in other contexts. As part of a bigger study titled “In pursuit of preventive audiology: Help-seeking behavior patterns of adults with hearing impairment in a peri-urban community in South Africa”, the main aim of this study was to describe the patterns of presentation of symptoms in adults with hearing impairment from a peri-urban community in South Africa.MethodsThrough a non-probability purposive sampling method, 23 adults with hearing impairment participated in semi-structured interviews using an interview guide from April – June 2021. Thematic analysis through a deductive analysis approach was adopted for data analysis.ResultsParticipants’ patterns of presentation indicated a belief in a Western bio-medical causation to explain their hearing impairment. Help-seekers sought help mostly from healthcare workers at all levels of healthcare in the public (primary, secondary, and tertiary) and private healthcare sectors, followed by a few participants consulting their social networks. Only one participant used a traditional healthcare provider to resolve his hearing difficulties.ConclusionsIn a diverse country like South Africa, with a majority African population, the influence of cultural practices and beliefs proved to have a minimal influence on participants’ help-seeking behavior for their ear and hearing challenges. However, an interplay of factors related to one’s context at the time played a significant role in the patterns of presentation to the ear and hearing clinic. There is therefore a need to understand the perspectives of adults with hearing impairment from their environments to facilitate more contextual relevancy in healthcare provision within the preventive audiology field. Hearing health policymakers should also endeavor to consider the realities of health-seeking in each context and environment.

Risk Factors for Breast Cancer-Related Lymphedema: An Umbrella Review.

Identification of risk factors facilitates the prevention of breast cancer-related lymphedema (BCRL). Several published systematic reviews have already addressed the risk factors for BCRL. This study aimed to systematically identify potential risk factors for BCRL and evaluate the quality of evidence. The study followed methodologic guidance from the Joanna Briggs Institute, and the Cochrane Handbook. The following electronic databases were systematically searched from inception to 15 November 2022: PubMed, Embase, CINAHL, Web of Science, Scopus, CNKI, SinoMed, Wanfang, JBI Database, Cochrane Database, ProQuest, and PROSPERO. Two authors independently screened studies, extracted data, and assessed methodologic quality using AMSTAR2, risk of bias using ROBIS, and evidence quality using GRADE. The study evaluated overlap, assessed the small-study effect, and calculated the I2 statistic and Egger's P value as needed. The study included 14 publications comprising 10 meta-analyses and 4 systematic reviews. The authors identified 39 factors and 30 unique meta-analyses. In the study, 13 innate personal trait-related risk factors, such as higher body mass index (BMI) and axillary lymph nodes dissection, showed statistically significant associations with BCRL incidence. Breast reconstruction was found to be a protective factor. The methodologic quality was low or critically low. The majority of the systematic reviews and/or meta-analyses were rated as having a high risk of bias. Evidence quality was low for 22 associations and moderate for 8 associations. The currently identified risk factors for BCRL all are innate personal trait-related factors. Future well-designed studies and robust meta-analyses are needed to explore potential associations between behavioral-, interpersonal-, and environmental-related factors and BCRL, as well as the role of genetic variations and pathophysiologic factors.

Microbial Density and Diversity and Lead Loads in Selected Street- Hawked Foods in Akure Metropolis, Nigeria

Microbial density and diversity, as well as concentrations of lead, in selected street-hawked foods in Akure metropolis were investigated in this study. Street-vended/hawked foods offer numerous advantages to food security; nevertheless, the safety of street foods has been an issue of serious concern, mainly because of the poor sanitary standards and inadvertent contaminants. Seven selected food samples (zobo drink, rice and stew, African star apple, meat pie, cucumber, white pap, smoked fish) were purchased from vendors at three busy road intersections within the city. Metals were analyzed with atomic absorption spectrophotometry. The metals determined are Ca, Cu, Pb, Fe, Zn. The concentrations of the metals in mg/kg were in the range of Ca (24.50±0.10 to 32.00±0.10), Cu (0.75±0.03 to 1.12±0.01), Pb (0.05±0.01 to 0.30±0.01), Fe (0.19±0.01 to 0.31±0.01), and Zn (1.40±0.01 to 2.33±0.01). Lead values were well above permissible limits set by WHO, EU and USEPA, indicating a significant health risk. On the other hand, the presence of high concentration of calcium in the street hawked food indicates that the food is of good value. The microbial density of the street-hawked foods were as follows: zobo, rice and stew, African star apple and meat pie (52 x 102, 54 x 102, 2 x 102, 25 x 102 cfu/g), respectively. Only zobo drink had viable fungal counts (34 x 102 cfu/g) on Potato Dextrose Agar. The microbial isolates observed in this study were Escherichia coli, Klebsiella pneumonia, Shigella spp, Staphylococcus aureus, Bacillus cereus, in varied proportions which could be attributed to the utensils, exposure of food product environment and other related factors. Among the various microorganisms isolated from the street-hawked foods, Escherichia coli, Staphylococcus aureus and Bacillus cereus were quite prevalent. Some of the hawked street foods in Akure metropolis were of poor microbial quality, which is of public health concern.

A Qualitative Study of Drivers for Use of the Primary Care Exception Among Internal Medicine Teaching Faculty.

The Primary Care Exception (PCE) is a billing rule from the Centers for Medicare and Medicaid Services (CMS) that allows supervising physicians to bill for ambulatory care provided by a resident without their direct supervision. There has been increased focus on entrustment as a method to assess readiness for unsupervised practice. To understand the factors influencing attending physicians' use of the PCE in ambulatory settings and identify common themes defining what motivates faculty preceptors to use the PCE. This was a qualitative exploratory study. Participants were interviewed one-on-one using a semi-structured template informed by the entrustment literature. Analysis was conducted using a thematically framed, grounded theory-based approach to identify major themes and subthemes. Twenty-seven internal medicine teaching faculty took part in a multi-institutional study representing four residency training programs across two academic medical centers in Connecticut. Four predominant categories of themes influencing PCE use were identified: (1) clinical environment factors, (2) attending attitudes, (3) resident characteristics, and (4) patient attributes. An attending's "internal rules" drawn from prior experiences served as a significant driver of PCE non-use regardless of the trainee, patient, or clinical context. A common conflict existed between using the PCE to promote resident autonomy versus waiving the PCE to promote safety. The PCE can serve as a tool to support resident autonomy, confidence, and overall clinical efficiency. Choice of PCE use by attendings involved complex internal decision-making schema balancing internal, patient, resident, and environmental-related factors. The lack of standardized processes in competency evaluation may increase susceptibility to biases, which could be mitigated by applying standardized modes of assessment that encompass shared principles.

Analysis on the Current Situation of Phytoplankton in the Typical River-Lake Ecotone of Lake Poyang

The typical river-lake ecotone (tail end area) of Poyang Lake, which is a sensitive area and prone to outbreaks of cyanobacteria bloom, is vulnerable to frequent human activities. To explore the diversity of phytoplankton community structure and the relevant driving mechanism in the typical river lake junction area of Poyang Lake, the water quality and phytoplankton at seven sampling points in the typical river lake junction area of Poyang Lake, at six sampling points in the middle section of Poyang Lake River, and at one sampling point in the main lake area were investigated in the field from 2019 to 2020 (dry season), April (flood season), July (wet season), and October (recession period). The results showed that there were seven phyla and 64 genera of phytoplankton in the typical river-lake ecotone of Poyang Lake, and the biomass and relative abundance of phytoplankton were dominated by diatoms and cyanobacteria. The biomass and abundance in the east of the typical river-lake ecotone of Poyang Lake were generally higher than those in the west, and the biomass and abundance in the river-lake ecotone were higher than those in the middle of the river. The dominant degree of cyanobacteria in the lake area and the river-lake ecotone was large, and the dominant degree of diatoms in the middle section of the river was large. The Monte Carlo test results showed that total nitrogen (TN), total phosphorus (TP), orthophosphate phosphorus (PO43--P), water depth (WD), water temperature (WT), and transparency (SD) were significantly related environmental factors affecting the distribution of the phytoplankton community. Redundancy analysis results showed that the typical river-lake ecotone in the west of Poyang Lake was highly affected by the hydration factors (TN, TP, and PO43--P), and the hydrological factors (WT, WD, and SD) in the typical river-lake ecotone in the east were highly significant. The impact factors of phytoplankton in the typical river-lake ecotone of Poyang Lake were seasonal, being greatly affected by hydration factors in winter and hydrological factors in summer.

A Study of Professional Quality of Life and Environmental Factors among Pediatric Registered Nurses

Aim. This research study aims to investigate the professional quality of life (ProQOL) among pediatric registered nurses. Background. Professional quality of life encapsulates two fundamental components, namely, compassion satisfaction and compassion fatigue, which comprises burnout and secondary traumatic stress. Methods. A descriptive cross-sectional design was used in this study, which included 217 pediatric registered nurses. Self-administered questionnaires compiled sociodemographic and occupational characteristics before measuring Professional quality of life (Version 5) items were used to collect data. Results. Most respondents were 30 to 35 years of age (65%), female (99%), and hold a diploma certificate (63%). The ProQOL scores for compassion satisfaction was 35.9 (SD = 9.7), compassion fatigue (burnout) was 21.8 (SD = 9.64), and compassion fatigue (secondary traumatic stress) was 23.5 (SD = 9.7). A significant mean difference ( p < 0.001 ) were found in the ProQOL level based on environmental factors related to pediatrics and family. Conclusion. The results of this study show a moderate compassion satisfaction level, a low burnout level, and a moderate secondary traumatic stress level among pediatric registered nurses. Different related environmental factors that can impact the professional quality of life of pediatric registered nurses. Implications for Nursing Management. Pediatric nurses will benefit from a supportive work environment, which fosters collaboration and respect among nurses and their pediatric patients’ families to improve the health outcomes of pediatric patients. Hospitals should offer specialized training programs that address the unique needs of pediatric nursing, encompassing areas such as child development, communication techniques with children, and age-specific healthcare interventions. This will equip nurses with the necessary skills and knowledge to provide optimal care for pediatric patients. Also, the following support systems, such as regular debriefing sessions and counseling services, are established to help nurses cope with the emotional challenges they may encounter in their work and to foster a collaborative work environment that encourages effective teamwork among nurses and promotes positive relationships between nurses and the families of pediatric patients. This can be achieved by implementing interdisciplinary team approaches, regular team meetings, and open communication channels. In addition, to ensure that pediatric nurses have access to the necessary resources, such as up-to-date medical literature, technological tools, and equipment, to provide the best care possible. Adequate staffing levels should also be maintained to prevent excessive workloads, which can contribute to burnout and decreased job satisfaction.

Variation of carbon source and sink along the environmental gradient from lakeside to highlands in Yuanchi swamp wetlands, Changbai Mountains, China.

Lacustrine wetlands have long-term carbon storage capacity and contribute significantly to regional carbon cycle, but it is unclear how its carbon sinks respond to climate change. We measured soil heterotrophic respiration carbon emissions (CO2 and CH4), vegetation carbon sequestration, and related environmental factors (temperature, water level, etc.) of five kinds of natural swamps (Phragmites marsh-L, Carex schmidtii marsh-C, Rhododendron capitatum swamp-D, Betula fruticose swamp-H, Larix olgensis swamp-LT)by using static chamber gas chromatography and relative growth equation methods, along the water environmental gradients from lakeside to highlands in Yuanchi of Changbai Mountains. We quantified the carbon source/sink function (CSS) and global warming potential (GWP) of various swamp types by estimating ecosystem net carbon balance, and revealed the variation patterns and formation mechanisms of CSS and GWP along the environmental gradients, aiming to explore the response of carbon source/sink of lakeside wetland in high altitude area to climate change. The results showed that marshes (L and C) were weak sources (-1.018 and -0.090 t C·hm-1·a-1) at the lower habitats of the water environment gradient, shrub swamps (D and H) were strong or weak sinks (1.956 and 0.239 t C·hm-1·a-1) at the middle habitats, forest swamp (LT) was strong source (-3.214 t C·hm-1·a-1) at the upper habitat. The spatial changes were promoted by water level and suppressed by soil temperature. For GWP, strong thermal radiation for marshes (from 44.682 to 59.282 t CO2·hm-1·a-1), cold radiation for shrub swamps (from -0.920 to -7.008 t CO2·hm-1·a-1), and weak thermal radiation for forest swamp (11.668 t CO2·hm-1·a-1), and their GWP was only promoted by soil temperature. Under current climate change background, marshes and forest swamp at both ends of the water environment gradient from lakeside to highlands played a positive feedback effect due to the increases of CH4 or CO2 emissions, while the middle shrub swamp still maintained a negative feedback effect in Yuanchi located the high-altitude area of the temperate Changbai Mountains.

Development of a patient-centred medication management model for polymedicated home-dwelling older adults after hospital discharge: results of a mixed methods study

ObjectiveThis study aimed to investigate medication management among polymedicated, home-dwelling older adults after discharge from a hospital centre in French-speaking Switzerland and then develop a model to optimise medication management...

Sex difference and risk factors in burden of urogenital congenital anomalies from 1990 to 2019

Urogenital congenital anomalies (UCAs) is defined as “any live-birth with a urinary or genital condition” and affects millions of men and women worldwide. However, sex differences and related environmental risk factors in UCAs burden on a global scale have not been assessed. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated prevalence, incidence, mortality and disability-adjusted life years (DALYs) of UCAs from 1990 to 2019 by sex, region, and socio-demographic Index (SDI) in 204 countries and territories. The disease burden of UCAs was also estimated attributable to each risk factor were estimated according to risk exposure. In 2019, UCAs caused 10,200 all-ages deaths (95% UI 7550–13,400). The combined global incidence rate was 8.38 per 1000 (95% UI 5.88–12.0) live births. The ASIR increased slightly, while the ASDR decreased from 1990 to 2019.The UCAs burden varies greatly depending on the development level and geographical location. The UCAs burden was significantly higher in men than in women, and the sex differences showed an enlarging trend. Health risks and issues, including pollution, child and maternal malnutrition, diet habits, unsafe sanitation and water source, were detected to be positively related to UCAs burden. Albeit the age-standardised prevalence, mortality, incidence, and DALYs of UCAs have decreased, they still cause a public health challenge worldwide. The high deaths and DALYs rates in low and low-middle SDI countries highlight the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for enhancing water safety, reducing pollution, and healthy diets are crucial steps in reducing the burden of UCAs.

Relationships of person-related, problem-related, and environment-related factors to self-care behaviours and the mediating role of self-confidence among patients with heart failure: Cross-sectional analysis of structural equation modelling

BackgroundPromoting self-care behaviours in heart failure management is an important goal and challenge for healthcare systems worldwide. Using the situation-specific theory of heart failure self-care, this study examined the relationships of person-related, problem-related, and environment-related factors to self-care behaviours and the mediating role of self-care confidence in these relationships. MethodWe analysed the baseline data from a previous randomised controlled trial study involving 213 patients with heart failure. Structural equation modelling was used to test our hypothesised model that included age, income, education, depression, anxiety, number of comorbidities, social support, self-care confidence, and self-care behaviours. Depression and anxiety were measured by the Hospital Anxiety and Depression Scale. Social support was measured by the Short Form of the Social Support Questionnaire satisfaction subscale. The Self-Care of Heart Failure Index (version 6.2) was used to assess self-care confidence and self-care behaviours (i.e., self-care maintenance and self-care management). ResultThe final model included age, depression, social support, and self-care confidence as independent variables. Age had a direct relationship with self-care maintenance (β = 0.235, p < 0.001) but not self-care management (β = 0.067, p = 0.179); better social support was directly associated with higher levels of self-care confidence (β = 0.267, p < 0.001); and higher levels of self-care confidence were associated with better self-care maintenance (β = 0.573, p < 0.001) and self-care management (β = 0.683, p < 0.001). The result showed an indirect relationship between social support and self-care maintenance through the mediator of self-care confidence (β = 0.153, p < 0.001), as well as an indirect relationship between social support and self-care management through self-care confidence (β = 0.182, p < 0.001). ConclusionSatisfactory social support can increase self-care confidence, thereby increasing self-care maintenance and management. The findings of this study also implied that self-care maintenance can increase with increasing age. Future interventions directly targeting assessment and management of self-care confidence, available social support, and the age of patients may help enhance their heart failure self-care behaviours.

The effects of environmental factors associated with childhood urbanicity on brain structure and cognition.

Urbanization is a trend lasting for more than one century worldwide. Four hundred ninety male and female adult Chinese Han participants with different urban and rural childhoods were included in this study. Early-life urban environment was found benefit for total grey matter volume (GMV), dorsolateral prefrontal cortex (DLPFC) GMV, temporal pole (TP) GMV and cognition function, and negatively correlated with medial prefrontal cortex (MPFC) GMV. Regression analysis showed that maternal education was a protective factor for total and DLPFC GMVs, while having siblings was better for MPFC GMV. Total, DLPFC and TP GMVs acts mediation effects between childhood urbanicity and different cognitive domains. These findings may suggest some pros and cons on brain structure associated with childhood urbanicity and related environmental factors.

Selected environmental factors determining motor abilities and physical fitness in adolescents

Introduction. Physical fitness is defined as the ability to undertake motor tasks in various life situations. Its development is determined by genotype, health, and lifestyle, but also by many socio-economic and environmental factors. The aim is to determine the environmental factors affecting motor abilities and physical fitness in adolescents. Material and Methods. The authors enrolled 235 high school students aged 16-17 years to participate in this study. The study procedures included Zuchora’s Physical Fitness Index and a survey containing questions regarding general personal information and social-, family- and environment-related factors. Results. No differences occurred in motor abilities and physical fitness between adolescents according to the place and type of residence. In girls, a positive correlation appeared between the number of working people in the family with abdominal muscle strength and general physical fitness. In boys, a positive correlation occurred between arm strength and the number of family members, the number of working people in a family, and the number of children in a family. There was also a positive correlation between the number of children in a family and general physical fitness. In boys with different levels of activity in childhood, differences were found in speed, jumping ability, arm strength, and general physical fitness. In girls with different levels of physical activity in childhood, differences occurred in abdominal strength and general physical fitness. Conclusions. The number of family members, working people and children in a family, and childhood activity seem to be factors determining motor abilities and physical fitness in adolescents while living conditions such as place and type of residence and sharing the bedroom do not.

Microbial Risks Caused by Livestock Excrement: Current Research Status and Prospects.

Livestock excrement is a major pollutant yielded from husbandry and it has been constantly imported into various related environments. Livestock excrement comprises a variety of microorganisms including certain units with health risks and these microorganisms are transferred synchronically during the management and utilization processes of livestock excrement. The livestock excrement microbiome is extensively affecting the microbiome of humans and the relevant environments and it could be altered by related environmental factors as well. The zoonotic microorganisms, extremely zoonotic pathogens, and antibiotic-resistant microorganisms are posing threats to human health and environmental safety. In this review, we highlight the main feature of the microbiome of livestock excrement and elucidate the composition and structure of the repertoire of microbes, how these microbes transfer from different spots, and they then affect the microbiomes of related habitants as a whole. Overall, the environmental problems caused by the microbiome of livestock excrement and the potential risks it may cause are summarized from the microbial perspective and the strategies for prediction, prevention, and management are discussed so as to provide a reference for further studies regarding potential microbial risks of livestock excrement microbes.

Using geographically weighted logistic regression (GWLR) for pedestrian crash severity modeling: Exploring spatially varying relationships with natural and built environment factors

Although a large number of studies have tried to explore the relationship between built environment and pedestrian crash severity in developed countries, there is a lack of similar studies in the context of developing countries. Methodologically, the contributory factors influencing pedestrian crash severity are commonly identified through global logistic regression (GLR) models. However, these models are unable to capture the spatial variation in the relationships between the dependent and independent variables. The local logistic regression model, such as geographically weighted logistic regression (GWLR), can potentially overcome this issue. The application of local logistic regression to model pedestrian crash severity is absent in the literature. Therefore, this study aimed to apply the GWLR technique to explore spatially heterogeneous relationships between natural and built environment-related factors and pedestrian crash severity in Dhaka, the capital city of a developing country: Bangladesh. First, using secondary pedestrian crash data, a GLR model was developed to identify significant contributory factors influencing pedestrian crash severity. Results of the model showed that the probability of fatal pedestrian crash occurrence increased at night, in unlit locations, and during adverse weather conditions. In addition, the likelihood of a fatal crash decreases when medians exist on roads and around institutional land use. Also, the chance of fatal crashes increased on straight and flat roads and at locations with more bus stops. Finally, this study explored spatial variation in the effect intensity of these significant variables across the study area using the GWLR technique. High intensity variation across the study area was found for road geometry and institutional land use factors. On the other hand, low intensity variation was found for light conditions and the presence of median factors. This technique can be applied in any area, and the results would help provide insights into the spatial dimension of traffic safety.

Student and Teacher Perspectives on Equity in Clinical Feedback: A Qualitative Study Using a Critical Race Theory Lens.

The authors aimed to gain a better understanding of students' and teachers' perspectives about whether clinical clerkship feedback is provided equitably irrespective of a student's race/ethnicity. A secondary analysis of existing interview data was conducted, focusing on racial/ethnic disparities in clinical grading. Data had been acquired from 29 students and 30 teachers at 3 U.S. medical schools. The authors performed secondary coding on all 59 transcripts, writing memos focused on statements related to aspects of feedback equity and developing a template for coding students' and teachers' observations and descriptions specific to clinical feedback. Using the template, memos were coded, and thematic categories emerged describing perspectives on clinical feedback. Forty-eight (22 teachers and 26 students) participants' transcripts provided narratives about feedback. Both student and teacher narratives described how students who are racially/ethnically underrepresented in medicine may receive less helpful formative clinical feedback needed for professional development. Thematic analysis of narratives yielded 3 themes related to feedback inequities: 1) teachers' racial/ethnic biases influence the feedback they provide students, 2) teachers have limited skill sets to provide equitable feedback, and 3) racial/ethnic inequities in the clinical learning environment shape clinical and feedback experiences. Narratives indicated that both students and teachers perceived racial/ethnic inequities in clinical feedback. Teacher- and learning environment-related factors influenced these racial/ethnic inequities. These results can inform medical education's efforts to mitigate biases in the learning environment and provide equitable feedback to ensure every student has what they need to develop into the competent physician they aspire to be.

Perceived Communication Barriers by Caregivers of Psychiatric Patients.

Caregivers have significant role in effective treatment and recovery during hospitalization. Communication barriers in health care lead to poor treatment outcome of patients and caregiver's dissatisfaction. The aim of study was to find out perceived communication barriers by caregivers of psychiatric patients. A cross-sectional study was conducted among 120 caregivers of psychiatric patients admitted in psychiatric ward of Patan Hospital who were selected by purposive sampling and interviewed using self-developed structured questionnaire. Data was analyzed with SPSS version 16 using descriptive statistics and Chi- square test was used to find out association between personal characteristics of caregivers and extent of perceived communication barriers. Low extent of communication barrier was perceived by 29.17%, great extent by 25.83%, moderate extent by 24.17% and no barriers were perceived by 20.83% caregivers. There was association between duration of hospital stay (p= .006) and extent of perceived communication barrier. Most barriers were due to caregiver's related factors (31.2%) and least perceived barriers were due to environment related factors (17.1%). More than one fourth caregiver's perceived low extent of communication barrier, almost one fourth perceived great extent and less than one fourth perceived moderate extent. There was association between duration of hospital stay and extent of perceived communication barrier. Effective communication may help to minimize perceived barriers resulting in better treatment outcome of patients and caregiver's satisfaction. Most perceived barriers were due to caregiver's related factors like feeling of not being educated, not knowing what to ask with health personnel, unaware of whom to approach and so on for which it is crucial to develop awareness among health personnel while delivering healthcare services. Nurses and doctors need to be effectively trained in communication skills to minimize various perceived barriers resulting in better treatment outcome and satisfaction.

The rate and quality of post-mortem hair root changes in relation to melanin content

Hairs is a relatively environmentally resistant biological material that is often found at crime scenes. Human hair is more durable than other biological traces such as blood or urine, and its collection and storage does not require specific preservation procedures. Melanin is the hair pigment, which is the main determinant of hair colour. There are two pigments present in human hair: eumelanin, predominant in dark hair, and pheomelanin, responsible for red colour. Eumelanin is more resistant and has photoprotective properties, while pheomelanin is phototoxic and shows lower resistance to environmental factors. The differences in the properties of eu- and pheomelanin are the basis of the present study, which aimed to examine the rate and quality of taphonomic changes in hair roots in relation to the predominant melanin type, under the influence of selected environmental factors, such as soil pH, degree of exposure to solar radiation, temperature and water from a natural watercourse (river) and chemically pure water. Therefore, changes in blonde, dark, grey, red and dyed hair roots were microscopically documented for six months under the influence of the above factors. The results of the study indicated the strongest degradation potential among acidic soil and a riverine environment, as well as the protective role of eumelanin against environmental taphonomic factors. Degradation occurred most rapidly in the river environment, where microbial activity was additionally observed. Distilled water, exposure to sunlight and low temperature did not lead to decomposition changes. The results of our team's research provide the basis for an extended analysis of the changes occurring in hair under the influence of environmental factors in relation to melanin content.

Fuel Use Reduction and Economic Savings from Optimization of Road Transportation of Coniferous Roundwood

One of the 10 priorities of the Green New Deal is sustainable transportation. It should be considered in the perspective of long-term ecological and economic sustainability, according to the trend of opportunities for sustainable development. The economic and environmental aspects of transportation related to the harvesting and movement of timber play a special role in the energy cost and their environmental impact per distance of raw material supply. The principles of rational and energy-efficient use of transportation equipment play a key role in the movement of raw timber. These are influenced by the availability of timber resources, limitation of vehicle payloads, reduction of energy consumption expressed in terms of reduction of fuel combustion, or current legal and road regulations for timber transportation. The paper evaluates economic and environmental factors in relation to the demand for fuels necessary for the implementation of road transportation of softwood timber. The aim of this paper was to present the current situation of the use of transportation means in the movement of bulky timber, as well as opportunities to optimize fuel consumption and CO2 emissions, affecting the economic and environmental effects. Previous studies on fuel consumption in the transportation of roundwood indicate irrational use of vehicles. This indicates unused payload capacity increasing energy inputs expressed in fuel consumption. It has been empirically investigated that this is the result of improperly approved transport sets adapted to the material being transported. In addition, it was shown that there is a clear correlation between the vehicle payload utilization rate and economic and environmental factors. The results of this study point to the potential to increase the use of transportation vehicles for timber transportation and reduce fuel combustion and CO2 emissions by 7–20%.

The Role of Circadian Rhythm in Autism Spectrum Disorder

With the development of technology and gradual enrichment in life, there is a significant increase in attention towards neurodevelopment and child health. Autism Spectrum Disorder (ASD) is defined as a neurological and developmental disorder that affects how people speak, behave, and interact with others. Communication and social interaction issues, sensory abnormalities, repetitive habits, and varying degrees of intellectual disability are some of the symptoms of autism. ASDs influences about 1 in 44 children in the USA, with the number of incidents sharply increasing over the years. Epigenetic neurobiology factors and environment related factors should both be considered when interpreting the pathophysiology that lies behind ASD. The 24-hour physiological cycle that displays an endogenous and entrainable oscillation is known as the circadian rhythm, which is generated by a molecular clock system. Mounting evidence are linking circadian rhythm disorder and autism. This includes sleep chaos as a common epiphenomenon of ASD, melatonin level disorder in ASD and circadian gene dysfunction in ASD. This article revolves around three perspectives: 1) Sleep Disorder in ASD 2) Role of Circadian Biomarkers in ASD 3) Variants and deficiency of circadian genes in ASD. In conclusion, the article reveals the important role circadian rhythm plays in neurodevelopmental processes. Through examining the circadian rhythm not only as an epiphenomenon but also as a possible indicator for ASD, the article anticipates the implication of circadian rhythm in novel treatments of ASD as a conclusion.