Evidence-based Decision Research Articles

Analysis of Fertility Determinants and Regional Disparities in Nigeria using Geo-Additive Regression

This study applied geo-additive regression modelling on high-dimensional data with metrical and categorical predictors, using data from the latest Nigeria Demographic and Health Survey (NDHS-6). The sampled data comprises ninety-three predictors of total children ever born by eighty women of age group between fifteen and forty-nine years. Three penalty-based variable selection criteria—Elastic Net, Smoothly Clipped Absolute Deviation (SCAD), and Minimax Concave Penalty (MCP) were employed to reduce the dimensionality of the data. Geo-additive regression model were thereafter applied on the selected predictors to determine the impact of metrical, categorical and spatial predictors on the response variable. Findings revealed that predictors such as contraceptive use, age at first birth, and marital status are major determinants of total children ever born by a woman in Nigeria. Furthermore, spatial analysis revealed regional disparities in fertility rates within Nigeria, with notably higher fertility rate in northeastern states. This study’s findings have broad applications across disciplines. By providing robust methodologies for handling complex datasets, this research supports evidence-based decision-making in public health, agriculture, and environmental policy. Ultimately, these findings contribute to efforts aimed at promoting sustainable development and enhancing maternal and child health outcomes in Nigeria and similar contexts globally.

The Consideration of Appropriate Surrogate Endpoint in Premarket Clinical Trials of Drug-Coated Balloon Catheter for the Treatment of Femoropopliteal Artery Stenosis.

Most clinical trials of drug-coated balloon (DCB) for the treatment of femoropopliteal artery stenosis chose 12-month primary patency rate (PPR) or 6-month late lumen loss (LLL) as the primary endpoint. It is still debatable whether 6-month LLL can be served as an appropriate surrogate endpoint for 12-month PPR. This study aimed to identify whether LLL can serve as an appropriate surrogate endpoint in peripheral DCB clinical trials, and shed light on the selection of primary outcome for subsequent confirmatory clinical trials of DCB in the treatment of femoropopliteal artery stenosis. The linear regression model was used to evaluate the correlation between 12-month PPR and 6-month LLL. Pooled standardized mean differences (SMDs) and relative gain between the DCB and plain old balloon angioplasty (POBA) group were computed to assess the consistency and surrogacy, using fixed or random effect model as appropriate. The coefficient of variation (CV) was calculated for both endpoints to compare their degree of variation overall and at study level. A total of 34 studies are eligible for this study. A significant negative linear correlation was found between 12-month PPR and 6-month LLL (R2=0.67, slope=-0.309, p=0.007). The SMD (DCB-POBA) of LLL and PPR was -0.76 (95% confidence interval [CI]: -0.98, -0.54), and 0.59 (95% CI: 0.46, 0.72) (p=0.18). The pooled relative gain of PPR (43%, 95% CI: 35%, 50%) was significantly lower than that of LLL (72%, 95% CI: 61%, 84%) (p<0.001). Coefficient of variation of LLL was larger than that of PPR overall in DCB and POBA groups. Although a significant moderate correlation was observed between 12-month PPR and 6-month LLL, PPR shows more conservative and robust than LLL, which may exaggerate clinical benefits. Late lumen loss should be used discreetly depending on different situations and clinical benefits for patients. This study addresses the critical issue of primary endpoint selection in clinical trials of drug-coated balloon for femoropopliteal artery stenosis. By elucidating the moderate correlation between 6-month late lumen loss (LLL) and 12-month primary patency rate (PPR), the findings underscore the limitations of LLL as a surrogate endpoint due to its variability and potential to overstate clinical benefits. The study advocates for the use of 12-month PPR as a more robust and conservative endpoint in pivotal trials, particularly for novel devices. These findings provide clinicians with a nuanced understanding of outcome measures, promoting evidence-based decision-making and regulatory alignment to ensure patient benefits in vascular interventions.

Assessing the quality of data for selected reproductive health indicators in designated public health facilities in Bangladesh.

An effective health management information system plays a pivotal role in evidence-based decision-making and strengthening health service delivery in a country. The Directorate General of Health Services and the Directorate General of Family Planning of Bangladesh have adopted digital health management information system platforms named district health information system and management information system, respectively. Despite its significance, health management information system data has numerous issues, such as missing values, inaccuracies, lack of internal consistency, and the presence of outliers. This study aims to assess the data quality of reproductive health indicators in the health management information system of the Directorate General of Health Services and the Directorate General of Family Planning. The study examined two aspects of data quality: a) completeness of data, subdivided into completeness of facility reporting (report submission rate) and completeness of indicator data (presence of missing values); b) internal consistency of reported data, subdivided into presence of outliers, inter-indicator consistency, and consistency between reported data and original records (accuracy rate). The study utilised retrospective monthly data gathered from July 2021 to June 2022, covering 21 reproductive health indicators. Multi-stage cluster sampling was employed to select 112 health facilities for data collection, including 48 facilities from Directorate General of Health Services and 64 from Directorate General of Family Planning, representing various administrative levels across the country. The report submission rate for Directorate General of Health Services facilities was 98%, while for the Directorate General of Family Planning facilities, it was 86%. However, 35% of data points were missing in the district health information system server of Directorate General of Health Services, whereas no missing values were observed in the management information system server of Directorate General of Family Planning. Less than 3% of outliers were detected in the server data of both directorates. Inter-indicator consistency was maintained at a high rate of 98% in health facilities under both directorates. The accuracy of reported data varied across indicators and facility types: Directorate General of Health Services facilities showed accuracy rates ranging between 75 and 92%, with an aggregated rate of 86%. Different tiers of the Directorate General of Family Planning facilities had accuracy rates ranging from 92 to 96%. This research emphasises the significance of rectifying missing values, ensuring consistency, and improving reporting systems, with a particular focus on lower-tier health facilities, to enhance the validity and reliability of reproductive health data in Bangladesh.

Analyzing Financial Planning with SPSS Statistical Software

Financial planning is the strategic process of managing and optimizing one's financial resources to achieve long-term goals and secure a stable financial future. It involves assessing current financial situations, setting objectives, and developing a roadmap to attain those objectives through prudent money management. The primary aim is to align income, expenses, investments, and savings in a harmonious manner. Effective financial planning encompasses various aspects, including budgeting, saving, investing, tax planning, retirement planning, risk management, and estate planning. It begins with a comprehensive evaluation of income sources, expenditures, debts, and assets. By understanding individual financial aspirations and risk tolerance, a tailored plan can be crafted to ensure financial security during different life stages. Financial planning provides several benefits, such as enabling individuals to prioritize goals like buying a home, funding education, or retiring comfortably. It also aids in mitigating unforeseen financial hardships through emergency funds and insurance coverage. Regular reviews and adjustments to the plan ensure its relevance over time, accommodating changing circumstances and economic conditions. In essence, financial planning empowers individuals to make informed decisions about their money, work towards their dreams, and navigate economic challenges with confidence. It serves as a dynamic process that empowers individuals to take control of their financial destinies and achieve a more secure and prosperous future. Financial planning research holds significant importance as it enhances our understanding of effective strategies for managing money, investments, and resources. Through empirical studies and analyses, researchers identify trends, evaluate investment options, and uncover innovative approaches to wealth management. This research informs financial professionals, policymakers, and individuals, enabling them to make informed decisions based on evidence and best practices. By exploring the intricacies of financial markets, risk management techniques, and behavioral finance, such research contributes to improved financial literacy, better investment outcomes, and overall economic stability. SPSS (Statistical Package for the Social Sciences) is a widely used software tool for statistical analysis in various fields, including social sciences, business, and research. It provides a user-friendly interface for data management, manipulation, and advanced statistical computations. Researchers and analysts use SPSS to perform tasks such as data cleaning, descriptive statistics, hypothesis testing, regression analysis, and more. With its graphical outputs and reporting capabilities, SPSS aids in interpreting complex data patterns and making informed decisions. It plays a crucial role in transforming raw data into meaningful insights, facilitating evidence-based decision-making and research outcomes. Evaluation preference taken as Competitive Analysis and Industry Mapping, Cross-Cultural Communication, Global Strategic Partnerships and Alliances, Mergers and Acquisitions (M&amp;A) Expertise, Digital Transformation in a Global Context. The calculated Cronbach's Alpha reliability coefficient for the model is .574, suggesting a reliability of 57%. Based on the insights from the literature review, the model with a Cronbach's Alpha value slightly above 58% is suitable for further analysis.

The impact of creatine levels on musculoskeletal health in the elderly: a mendelian randomization analysis

BackgroundMusculoskeletal health among the elderly emerges as a pivotal public health concern against the backdrop of a globally aging population. Creatine, popular within fitness circles, has emerged as a subject of scientific inquiry for its potential benefits on elderly’ musculoskeletal well-being. Despite extensive documentation of its effects on athletic performance, investigations into creatine’s long-term contributions to the musculoskeletal health of the elderly are comparatively limited. Utilizing publicly accessible genetic datasets, this study aimed to explore the potential causal link between creatine levels and a variety of musculoskeletal health markers in the elderly population, such as osteoarthritis (OA), rheumatoid arthritis (RA), osteoporosis (OP), bone-specific alkaline phosphatase, bone mineral density(BMD), serum calcium levels, and reduced hand grip strength in individuals aged 60 and above.MethodsOur methodological approach was grounded in Mendelian Randomization (MR) analysis, with a primary emphasis on the Inverse Variance Weighted (IVW) technique, to explore potential causal links under specific assumptions and limitations inherent to MR analysis.ResultsA significant inverse relationship was observed between creatine levels and reduced hand grip strength in individuals aged 60 and above (OR = 0.64, b=-0.44, p = 0.01), suggesting higher creatine levels might be beneficial in maintaining hand grip strength. Conversely, analysis of other bone health parameters, including bone-specific alkaline phosphatase, bone mineral density, serum calcium levels, and conditions such as osteoarthritis, rheumatoid arthritis, and osteoporosis, yielded p-values exceeding 0.05, denoting no statistically significant associations.ConclusionsThis study provides preliminary evidence indicating a link between creatine levels and decreased hand grip strength among the elderly, notably in individuals aged 60 and older. This finding is significant for understanding the potential impact of creatine supplementation on elderly Musculoskeletal health and underscores the need for evidence-based decision-making in nutritional supplementation. To robustly validate these observations, it is essential to conduct future randomized controlled trials with large sample sizes.

Evaluating a transitional housing program for people who use substances (PWUS) who experience homelessness and live with a mental health issue: a mixed-methods study protocol in Sudbury Ontario

BackgroundA new transitional housing program was established in Sudbury, Ontario, Canada, in response to the escalating global prevalence of substance use and homelessness, and the specific challenges faced in Northern Ontario. This protocol outlines a comprehensive program evaluation to assess its impact on patient outcomes, healthcare utilization, and client perspectives.MethodsWe will conduct a parallel mixed-method study that includes the analysis of single-center-level administrative health data and primary data collection. This includes a longitudinal observational study (target n = 1,200), pre- and post-admission quantitative interviews (target n = 40), and qualitative interviews (target n = 40). We will implement a participatory approach to this evaluation collaborating with people who use substances, frontline staff, and decision-makers. Data analysis methods include a range of statistical techniques, including logistic regression models, Cox proportional hazards models, Kaplan-Meier curves, Generalized Estimating Equations, and thematic qualitative analysis, ensuring a robust evaluation of patient outcomes and healthcare utilization.DiscussionThis protocol underpins a comprehensive assessment aimed at providing insights into the program’s effectiveness in addressing substance use-related challenges, reducing healthcare disparities, and improving patient outcomes, such as stable housing and increased social capital. All study procedures adhere to the ethical principles outlined in the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans. Findings will be disseminated progressively through established committees and working groups and subsequently published in peer-reviewed journals. Anticipated outcomes include informing evidence-based healthcare decision-making and driving improvements in addiction treatment practices within healthcare settings.

Protocol for a prospective observational cohort study of cutaneous leishmaniasis in Ethiopia

Background Cutaneous leishmaniasis (CL) is a skin neglected tropical disease, with an estimated 40,000 new cases each year in Ethiopia. CL causes ulcers, nodules, and plaques on the skin, and in some instances the destruction of the nasopharyngeal mucosa and cartilage. Some CL lesions may heal spontaneously, whilst other lesions may require therapies which are associated with discomfort, adverse effects, prolonged treatment, and a frequent lack of a complete response. Scarring, a sequela of CL, causes permanent disfigurement and is associated with stigma linked with a reduction in health-related quality of life. The choice of treatment for CL is based upon factors including the causative species; the number, extent, size, and location of lesions; and the availability of treatments. The development of robust evidence for CL treatment is hindered by a lack of validated and appropriate outcome measures and few data to support hypothesis-generation and trial design. There is a paucity of prospective data with well-defined treatment outcomes for CL caused by L. aethiopica. Aim The overall aim of this study is to improve the understanding of the health and economic burden of CL. Methods We have designed an observational, multi-centre cohort study to examine treatment outcomes for CL in Ethiopia which includes clinical outcomes, laboratory outcomes, patient reported outcome measures, scar assessments and cost effectiveness. We aim to recruit up to 750 participants across two hospital sites. We present here the protocol for this cohort study with a 12-month follow up period for each participant. Conclusions These data will inform the design of randomized controlled trials to evaluate new treatment strategies, with appropriate economic evaluations. This will help improve evidence-based guidelines and support evidence-led policy decisions, not only in Ethiopia but also globally.

Inflation-adjusted analysis of ICER’s Unsupported Price Increase reports: contextualizing drug spending changes

Objective The Institute for Clinical and Economic Review (ICER) publishes annual Unsupported Price Increase (UPI) reports on prescription drugs, which have gained attention from policymakers and healthcare stakeholders. These reports do not adjust for inflation in their analyses of net price changes. This study aimed to evaluate the economic context of reported drug price increases in ICER’s UPI reports by applying inflation adjustments to the estimated impact on healthcare spending. Methods Separate inflation adjustments using the Medical Consumer Price Index (Medical CPI) and the Consumer Price Index for All Urban Consumers (CPI-U) were applied to unadjusted UPI findings. The study analyzed data from four most recent UPI reports spanning pricing data from 2018 to 2019 (report year 2020) to 2021 to 2022 (report year 2023), focusing on drugs classified as having “unsupported” price increases. Results Inflation-adjusted analyses showed lower estimates of real changes in spending compared to ICER’s unadjusted figures across all drugs analyzed. Across the four UPI reports, the average report-year difference in Medical CPI inflation adjustment spending versus unadjusted findings was 53%, whereas the average report-year difference in CPI-U inflation adjustment spending versus unadjusted findings was 80%. In the most recent report year of 2023, ICER’s unadjusted estimate of a $1.3 billion increase in healthcare spending transformed to a $134 million decrease when adjusted by Medical CPI and a $1.51 billion decrease when adjusted by CPI-U. Conclusion This study demonstrates that inflation adjustment can alter not only the findings but also the interpretation of drug spending changes in UPI reports. The findings highlight the importance of considering economic context in evaluating drug pricing trends and suggest that unadjusted figures may overstate the impact of real price changes. Given the influence of these reports on policy discussions, incorporating inflation adjustments into analyses is one of many steps toward informing evidence-based policy decisions.

CFD Investigation of Mechanical Heart Valve Orientations in Modulating Left Ventricular Hemodynamics

This study provides a comprehensive computational analysis of how mechanical heart valve orientations impact left ventricular (LV) hemodynamics, with potential implications for surgical valve placement. Focusing on monoleaflet valves (MLV) and bileaflet valves (BLV), the research explores how different valve angles influence blood flow patterns within the LV chamber. The analysis includes velocity contours, streamline patterns, vorticity contours, and temporal velocity fluctuations to elucidate the effects of valve orientation on LV performance. Findings indicate that valve orientation significantly influences flow coherence and blood velocity. For instance, a 20-degree orientation in the MLV alters jet flow in ways that could affect wall shear stress distribution. At a 45-degree angle, the MLV produces a more centralized jet flow, enhancing flow uniformity and aligning more closely with physiological conditions. In contrast, a 55-degree angle skews the jet flow, potentially leading to adverse hemodynamic effects. Similarly, BLV orientations at 45, 55, 60, and 70 degrees showed that lower angles improved flow efficiency, reducing energy losses and minimizing the risk of regurgitation, while higher angles led to turbulent and potentially damaging flow patterns. Comparative results at a 45-degree orientation demonstrated the superior performance of BLV in regulating normal velocity, with BLV reducing average blood velocity by 38.77% compared to a 29.53% reduction with MLV. These results underscore the importance of optimizing mechanical heart valve orientations to enhance left ventricular hemodynamics. The findings carry significant clinical implications, supporting evidence-based valve placement decisions that can substantially improve patient outcomes, survival rates and long-term cardiovascular health.

Metagenomics: An Unbiased Tool for Understanding and Preventing Pandemics

Metagenomics is a branch of genomics that involves sequencing genetic material directly from environmental samples. Metagenomic data could facilitates evidence-based decisions while providing a more complete view of the microbial ecosystem in a pandemic setting. It would provide critical knowledge for future pandemic preparedness programs

Evidence-based Nursing and Improving Patient Satisfaction: A Systematic Evaluation

Objective: This study aims to explore the effect of evidence-based nursing (EBN) on improving patient satisfaction by systematically evaluating the impact of EBN implementation through the analysis of 40 hospital-related literature articles. Methods: A review of 40 studies published from January 2022 to December 2023 related to EBN and patient satisfaction was conducted. The selection was based on specific inclusion and exclusion criteria, focusing on studies that involved EBN interventions. Data were extracted and statistically analyzed using patient satisfaction scores and nursing quality assessments to compare satisfaction before and after EBN implementation. Results: Literature analysis showed that patient satisfaction significantly improved after the implementation of EBN, with average satisfaction scores increasing from 82.5% before intervention to 91.3% after intervention (P &lt; 0.05). The application of EBN enhanced patients’ care experience, reduced nursing errors, and significantly improved the efficiency and professional competence of healthcare staff. Conclusion: This study confirms that EBN has a significant effect on improving patient satisfaction, particularly in personalized care and evidence-based decision-making. Future efforts should promote EBN and standardize nursing processes to continuously improve care quality and patient satisfaction.

Unraveling the complex relationship between weather conditions and traffic safety

Understanding the impact of different weather conditions on crash frequency and crash severance is essential for developing effective strategies and interventions to mitigate road crashes. Extensive research has been conducted worldwide over the past few decades to investigate the relationship between weather conditions and traffic crashes. By synthesizing this collective body of work using the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), this paper seeks to provide a valuable resource for practitioners, policymakers, and researchers in their quest for evidence-based strategies to enhance traffic safety and minimize the adverse effects of weather conditions on road users. This systematic literature review establishes eligibility criteria for selecting relevant studies that span diverse geographical regions, climates, and methodologies. The objective is to present a comprehensive analysis of the intricate relationship between weather conditions and traffic safety, shedding light on the direct influence of weather phenomena like rain, snow, fog, winter, and extreme temperatures, as well as the underlying mechanisms and contributory factors. This study contributes to the advancement of transportation safety research, leveraging a credible foundation for evidence-based decision-making and guiding strategic development to safeguard road users and promote traffic safety amidst diverse weather challenges.

Exploring Music-Based Interventions for Executive Functioning and Emotional Well-Being in Stroke Rehabilitation: A Scoping Review

Purpose: Stroke is one of the leading causes of disability with life-long implications requiring assessment and treatment of several functional domains. This review identifies the results from research into music-based interventions (MBIs), including music therapy (MT), for executive functions (EFs) and emotional well-being (EWB) in adults with stroke and highlights opportunities for clinical practice and future research. Methods: APA PsycInfo (EBSCOhost), and CINAHL (EBSCOhost) were searched, in addition to grey literature. Results: A total of 49 studies were included and encompassed experimental, analytic, and descriptive observational studies, and case reports, involving a total of 1663 participants. In total, 32 studies included MT interventions, and 17 were MBIs. EFs were an outcome in 20.41%, and EWB in 61.22% of studies, for which active interventions were the most utilized. Overall, 73.47% of the studies reported positive results. Conclusions: This scoping review indicates that music interventions can be beneficial for the improvement of different aspects of EFs and EWB at different stages of stroke recovery. Further research may benefit clinical practice by including standardized protocols, outcome and self-reported measures, and brain imaging data to determine the effects of interventions and support evidence-based decisions for treatment policies for stroke survivors.

A practical approach to multifaceted perspectives for sustainable international collaboration on mosquito-borne diseases in Southeast Asia

The coronavirus disease 2019 pandemic highlighted the necessity and limitations of scientific collaboration and equitable and effective international research partnerships. The spread of mosquito-borne diseases (MBDs) presents severe public health challenges, particularly in Southeast Asia. Addressing these threats requires establishing regional priorities, bridging research gaps, and strengthening long-term international collaboration. We propose a practical approach to multifaceted perspectives to enhance collaboration across Asia. This study examines MBD-related scientific publications from nine Southeast Asian countries between January 2017 and June 2024, utilizing bibliometric analysis and data visualization to identify research trends, research capacities, key institutions, and international collaborative partners. Thailand and Singapore led the dengue research, followed by Malaysia and Indonesia. Vietnam and the Philippines demonstrated moderate research capabilities, whereas Cambodia, Laos, and Myanmar had lower capacities. Relationships with high-income countries drove international collaboration, whereas intra-regional collaboration in Southeast Asia increased. Furthermore, we identified directions for cooperative opportunities between South Korea and other Southeast Asian countries by analyzing their relative research capacities for infectious MBDs. We propose a practical approach to bridge research-capacity gaps and strengthen collaboration between low- and middle-income countries. These findings provide fundamental information for developing future infectious-disease-response strategies and international-collaboration research partnerships and facilitate the implementation of effective global public health preparedness policies and evidence-based decision-making, such as knowledge-transfer and resource-sharing.

Knowledge mobilisation of rapid evidence reviews to inform health and social care policy and practice in a public health emergency: Appraisal of the Wales COVID-19 Evidence Centre processes and impact, 2021-23.

The Wales COVID-19 Evidence Centre (WCEC) was established from 2021-23 to ensure that the latest coronavirus (COVID-19) relevant research evidence was readily available to inform health and social care policy and practice decision-makers. Although decisions need to be evidence-based, ensuring that accessible and relevant research evidence is available to decision-makers is challenging, especially in a rapidly evolving pandemic environment when timeframes for decision-making are days or weeks rather than months or years. We set up knowledge mobilisation processes to bridge the gap between evidence review and informing decisions, making sure that the right information reaches the right people at the right time. To describe the knowledge mobilisation processes used by the WCEC, evaluate the impact of the WCEC rapid evidence reviews, and share lessons learned. Our knowledge mobilisation methods were flexible and tailored to meet stakeholders' needs. They included stakeholder co-production in our rapid evidence review processes, stakeholder-informed and participatory knowledge mobilisation, wider dissemination of outputs and associated activities including public engagement, capacity building and sharing of methodologies. Feedback on processes and evidence of impact was collected via stakeholder engagement and a stakeholder survey. Findings indicate that knowledge mobilisation processes successfully enabled use of the WCEC's rapid evidence reviews to inform policy and practice decision-makers during the COVID-19 pandemic in Wales. Realising actual public and patient benefit from this 'pathway to impact' work will take further time and resources. The WCEC knowledge mobilisation processes successfully supported co-production and use of rapid evidence review findings by scientific advisors and policy and practice decision-makers during the COVID-19 pandemic. Identified barriers and facilitators are of potential relevance to wider evidence initiatives, for setting up similar Centres during crisis situations, and supporting future evidence-based policy and practice decision-making.

Comprehensive assessment of COVID-19 case fatality rate and influential factors in Khuzestan Province, Iran: a two-year study

BackgroundThe emergence of a new pandemic SARS-CoV-2 (COVID-19) resulted in a high mortality rate across the world. This study sought to comprehensively analyze the Case Fatality Rate (CFR) associated with COVID-19 in the Khuzestan province of Iran”. The primary objective was to discern patterns and determinants influencing CFR, shedding light on the evolving impact of the pandemic on morbidity and mortality.MethodsA retrospective examination was performed on a dataset encompassing confirmed COVID-19 cases and related fatalities in Khuzestan. Data, spanning from December 2020 to April 2022, underwent rigorous statistical analysis. Demographic variables, comorbidities, and temporal trends were scrutinized to identify key factors influencing CFR.ResultsPreliminary findings revealed dynamic shifts in CFR, capturing the nuanced nature of the pandemic over time. Demographic nuances, particularly age and gender, emerged as significant determinants impacting CFR, the reported CFR of COVID-19 in Khuzestan province was 1.79%.ConclusionThis study contributes critical insights into the CFR landscape of COVID-19 in Khuzestan, providing a foundation for evidence-based decision-making in public health. The identified factors influencing mortality rates offer valuable information for tailoring interventions and optimizing resource allocation. Continuous monitoring and further investigations are recommended to adapt strategies to the evolving nature of the pandemic.

Forecasting the relative abundance of Aedes vector populations to enhance situational awareness for mosquito control operations.

Aedes-borne diseases represent a major public health threat and mosquito control operations represent a key line of defense. Improving the real-time awareness of mosquito control authorities by providing reliable forecasts of the relative abundance of mosquito vectors could greatly enhance control efforts. To this aim, we developed an analytical tool that forecasts Aedes aegypti relative abundance 1 to 4 weeks ahead. Forecasts were validated against mosquito surveillance data (2,760 data points) collected over multiple years in four jurisdictions in the US. The symmetric absolute percentage error was in the range 0.43-0.69, and the 90% interquantile range of the forecasts had a coverage of 83-92%. Our forecasts consistently outperformed a reference "naïve" model for all analyzed study sites, forecasting horizon, and for periods with medium/high Ae. aegypti activity. The developed tool can be instrumental to address the need for evidence-based decision making.

&lt;b&gt;Human Resource Management System (HRMS): Enhancing Efficiency and Accuracy in Workforce Management&lt;/b&gt;

Human Resource Management Systems (HRMS) have become indispensable for modern organizations aiming to streamline workforce operations and optimize resource allocation. By integrating employee data into a centralized platform, HRMS enhances transparency, ensures compliance, and supports evidence-based decision-making. In the context of the Khyber Pakhtunkhwa (KP) government, the implementation of HRMS has revolutionized the management of public sector employees, particularly within the healthcare domain. This initiative addresses challenges such as data discrepancies, resource inefficiencies, and policy compliance gaps, ensuring a more efficient and accountable workforce. My tenure as a Monitoring &amp; Validation Officer at Palladium Group, Islamabad, between June 2024 and December 2024, provided first-hand insights into the transformative potential of HRMS in improving workforce management practices

Cesarean Delivery and its Determining Factors: A Hospital-Based Study in Jashore District, Bangladesh

BackgroundThe rising prevalence of cesarean deliveries (CD) is a major public health problem worldwide, especially in Bangladesh. This study aims to investigate the prevalence and factors associated with cesarean deliveries in the Jashore district of Bangladesh. Study designThis cross-sectional study, conducted from December 2022 to February 2023 in Jashore district, Bangladesh, involved face-to-face interviews with 662 mothers during hospital visits. MethodsA pretested, structured, and validated questionnaire was employed to gather information on socioeconomic characteristics, obstetric history, maternal healthcare utilization, and factors influencing the choice of delivery method. Multinomial logistic regression models were employed to assess and predict determining factors influencing cesarean delivery. ResultsThe study revealed a high cesarean delivery (CD) prevalence of 70.5 %, exceeding the WHO-recommended threshold. Key socioeconomic factors associated with increased CD rates included rural residence, younger maternal age (15–20 years), nuclear family structure, and husbands in business. Additionally, private hospital deliveries, a history of previous CD, maternal self-preference, and doctor's influence were significant predictors of CD. The majority of participants believed CD enhances maternal safety (74.6 %) and alleviates pain (74.8 %). ConclusionThe high rate of cesarean deliveries in Jashore highlights the need for public health interventions that improve access to quality maternal care and promote evidence-based decision-making. Reducing unnecessary cesarean procedures, particularly in private hospitals, and enhancing patient education can significantly improve maternal and neonatal health outcomes.

Health professions students’ acceptance and readiness for learning analytics: lessons for educators

BackgroundLearning analytics (LA) is a tool for gathering, analysing, and interpreting data related to student’s learning behaviour, engagement, and performance. As the student data collected by the institutions are used to construct LA, it is essential to understand the acceptance and readiness of the students regarding the implementation of LA.MethodsA sequential mixed method research design was used in this study. A validated questionnaire was distributed to undergraduate students of Medicine, Dentistry and Pharmacy programmes to collect their general views on LA. Focus group interviews with a total of 18 students were conducted to explore their perceptions in depth, followed by thematic analysis of the transcribed data.ResultsGenerally, the students were aware of their demographic data, utilisation of learning management system and academic performance data being collected by the university. They were agreeable for collection of those data which had direct association with their learning to be used for LA. However, they expressed concerns about the privacy, confidentiality, and security of the collected data. Three themes emerged from the interviews, i.e., self-regulated learning, evidence-based decision making and data management. The students perceived that LA could help them to monitor achievement of learning outcomes and provide support for individualised learning paths through recommendations of learning resources and learning motivation. They also opined that LA could help educators and institutions by providing feedback on teaching and learning methods, resource allocation and interventions to create conducive learning environment.ConclusionsLA is a useful tool to support self-regulated learning, however, precautions should be exercised during implementation to ensure data privacy and security.