Higher Degree Research Articles

Knowledge and factors associated with active management of the third stage of labor in sub-Saharan Africa: A systematic review and meta-analysis.

Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality in sub-Saharan Africa. Implementing active management in the third stage of labor has significantly reduced the incidence of PPH. Thus, understanding the level of healthcare providers' knowledge of active management in the third stage of labor can inform guidelines, policies, and practices for effectively preventing PPH. This review aimed to assess the level of healthcare providers' knowledge and associated factors of active management in the third stage of labor in sub-Saharan Africa. We conducted a search using PubMed, Scopus, Web of Science, Google Scholar, Cochrane Library, and the African Journals online international databases. The inclusion criteria were determined before the review of the articles and adhere to the criteria of population, intervention, comparison, and outcome. Statistical analysis was performed using STATA data analysis software version 14, while Microsoft Excel was utilized for data abstraction. We checked publication bias using a funnel plot and Egger and Begg regression tests. A P value less than 0.05 was considered statistically significant, suggesting the presence of presence publication bias. The I2 statistic was used to assess heterogeneity between studies. The study's overall effect was evaluated using the random effects model. The study included 20 studies to conduct a pooled prevalence analysis. The overall prevalence of healthcare providers' knowledge of active management of third-stage labor in sub-Saharan Africa was 47.975% (95% CI: 32.585, 63.365). Having pre- and in-service training (AOR: 2.25, 95% CI: 1.00, 5.08), having a higher degree (AOR: 1.98, 95% CI: 1.39, 2.82), and having good practices (AOR: 8.91, 95% CI: 4.58, 17.40) were significantly associated with healthcare provider's knowledge regarding active management third stage of labor. The overall healthcare providers' knowledge of active management of the third stage of labor (AMTSL) was low in sub-Saharan Africa. Obstetric healthcare providers should undertake comprehensive training covering all AMTSL components through pre- and in-service diploma training programs.

Abstract 2056: Impaired Cellular Metabolic Adaptations In Autosomal-Dominant Hyper-IgE Syndrome: Possible Implications To Deficient Angiogenesis And Wound Healing

Background: Autosomal dominant Hyper-IgE syndrome (AD-HIES; Job’s syndrome) is caused by dominant negative mutations in signal transducer and activator of transcription 3 (STAT3). Patients present with immunodeficiency accompanied by severe non-immunological features including poor post infection lung healing, subsequent pulmonary failure, and skeletal, connective tissue, and vascular abnormalities including arterial tortuosity and aneurisms which can lead to myocardial infarction and subarachnoid hemorrhage. HIF1a-dependent deficient angiogenesis has been implicated in the abnormal wound healing response of AD-HIES. Both STAT3 and HIF1a are major regulators of cellular metabolism. In this study we are testing the hypothesis that dysregulation of cellular metabolic pathways may contribute to AD-HIES pathophysiology. Methods: We used skin fibroblasts (SF) from 4 AD-HIES patients and 4 normal volunteers. To investigate ability of the cells to adapt and function in nutrient-deficient conditions (to model tissue damages disrupting normal tissue perfusion) we exposed them to a culture media lacking glucose, pyruvate and glutamine (deficient media). We used a live imaging approach (IncucyteS3 System, Sartorius) to analyze cell proliferation, reactive oxygen species (ROS), cell death, and wound closing ability (scratch-wound assay). Results: In deficient media, both AD-HIES and control SF decreased their proliferation rate. While control SF adapted, AD-HIES SF showed decreased survival after prolong nutrient deprivation. Level of ROS, measured at 12, 24, 48h in deficient media was 25% higher in AD-HIES SF (n=8, P=0.003). We used a scratch-wound assay to assess the ability of fibroblasts to migrate and close the wound after 48h of adaptation to deficient media. In full media, both control and AD-HIES fibroblast completely closed the wound within 36h. In deficient media, wound closure was delayed to much higher degree by AD-HIES fibroblasts (60±14% closure by control SF vs 18±9% by AD-HIES SF, n=4, P=0.016). Conclusions: Adaptive remodeling of cellular metabolism is impaired in AD-HIES SF that may contribute to deficient angiogenesis and poor wound healing, suggesting possible therapeutic targets within cellular metabolic pathways.

Preventing postnatal depression in new mothers using telephone peer support: protocol for the DAISY (Depression and AnxIety peer Support studY) multi-centre randomised controlled trial

IntroductionPostnatal depression affects up to one in six new mothers in Australia each year, with significant impacts on the woman and her family. Prevention strategies can be complicated by a...

Network Pharmacology Combined with Molecular Docking Approach to Investigate the Mechanism of ChuShiWeiLing Decoction against Perianal Eczema.

ChuShiWeiLing Decoction (CSWLD) is a famous classical Chinese prescription for the treatment of eczema with desirable effect in clinical practice. It has gradually exerted good curative effects on perianal eczema (PE) in recent years, but its specific mechanism is not elucidated yet. This research explores the underlying pharmacological mechanism of CSWLD in addressing PE through network pharmacology combined with molecular docking strategy. The key chemical compounds and potential target genes of CSWLD were screened by bioinformatics. The major targets of CSWLD were discovered using network modules. Functional annotation of Gene Ontology (GO) was undertaken, as well as pathway enrichment analysis using the Kyoto Encyclopedia of Genes and Genomes (KEGG). Molecular docking of core protein-ligand interactions was modeled using AutoDock software. Pymol software was used to perform a molecular dynamics simulation for the ideal core protein-ligand that was discovered by molecular docking. A total of 2,853 active compounds and 922 targets of CSWLD were collected. The target with a higher degree was identified through the PPI network, namely TNF, IL6, ALB, STAT3, EGFR, TLR4, CXCL8 and PTPRC. GO and KEGG analyses suggested that CSWLD treatment of PE mainly involves cellular activation, activation of leukocytes, and adhesion among leukocytes. The molecular docking results showed that wogonin, hederagenin and quercetin of CSWLD could bind to IL-6 and TNF, respectively. Our results indicated that the bioactives, potential targets, and molecular mechanism of CSWLD against PE.

Identifcation of Key Genes and Pathways Related to Nonalcoholic Fatty Liver Disease based on GEO Databases

Background: Non-alcoholic fatty liver disease (NAFLD) represents a growing global health crisis and is closely associated with increases in obesity and type 2 diabetes. Despite its ubiquity, its underlying biochemical mechanisms and effective therapeutic strategies remain poorly defined, hampering the development of targeted interventions. Methods: Candidate genes were obtained from the GEO database, and Kyoto Encyclopedia of Genes and Genomes enrichment analysis and gene set enrichment analysis were used to identify pathways involved in NAFLD-related pathways. The top genes with higher degree in the protein-protein interaction network were crossed with the top genes enriched in key pathways, and then the correlation analysis between key genes and chemotherapy response was performed. Result: fatty acid metabolic process, lipid transport, response to stilbenoid, etc. are key pathways related to NAFLD. Btc, Apoa4, Gdf6 AND Ifi2712b were enriched in key pathways of NAFLD. Conclusion: Fatty acid metabolic process, lipid transport, pathway are key pathways related to NAFLD.

Modulating Lipid-Polymer Nanoparticles' Physicochemical Properties to Alter Macrophage Uptake.

Macrophage uptake of nanoparticles is highly dependent on the physicochemical characteristics of those nanoparticles. Here, we have created a collection of lipid-polymer nanoparticles (LPNPs) varying in size, stiffness, and lipid makeup to determine the effects of these factors on uptake in murine bone marrow-derived macrophages. The LPNPs varied in diameter from 232 to 812 nm, in storage modulus from 21.2 to 287 kPa, and in phosphatidylserine content from 0 to 20%. Stiff, large nanoparticles with a coating containing phosphatidylserine were taken up by macrophages to a much higher degree than any other formulation (between 9.3× and 166× higher than other LPNPs). LPNPs with phosphatidylserine were taken up most by M2-polarized macrophages, while those without were taken up most by M1-polarized macrophages. Differences in total LPNP uptake were not dependent on endocytosis pathway(s) other than phagocytosis. This work acts as a basis for understanding how the interactions between nanoparticle physicochemical characteristics may act synergistically to facilitate particle uptake.

Relationship between resilience and self-efficacy among Iranian nurses: a cross-sectional study during the post-Corona era

BackgroundResilience and self-efficacy play an influential role in nurses’ clinical performance, which are considered resources for improving adaptability and promoting work engagement. This study aimed to determine the relationship between resilience and self-efficacy among nurses at Shahroud University of Medical Sciences hospitals during the post-Corona era.MethodsThis cross-sectional study was conducted on 280 nurses in all clinical departments. Nurses with a bachelor of science in nursing or higher degree and at least one year of full-time work experience were included in the study using a convenience sampling method. Participants completed a three-part tool, which included the demographic information form, the Connor-Davidson Resilience Scale, and the General Self-Efficacy Scale. The data were analyzed using descriptive statistics and inferential tests (multivariate linear regression using the backward method).ResultsIn this study, nurses reported low levels of resilience (63.64 ± 15.66) and high levels of self-efficacy (63.01 ± 9.57). Among the five resilience subscales, the highest mean item score was associated with “spiritual influences” (2.80 out of 4), while the lowest mean item score was associated with “trust in one’s instincts and tolerance of negative affect” (2.36 out of 4). Furthermore, the multivariate linear regression model results indicated that self-efficacy accounted for 33.6% of the variance in resilience (P < 0.001 and β = 0.952).ConclusionAccording to the results of the present study, it is suggested that nurses’ psychological capabilities, such as self-efficacy, should be increased to improve resilience and address the stressful conditions of the work environment.

Quantitative stability of harmonic maps from $${\mathbb {R}}^2$$ to $${\mathbb {S}}^2$$ with a higher degree

Quantitative stability of harmonic maps from $${\mathbb {R}}^2$$ to $${\mathbb {S}}^2$$ with a higher degree

Socioeconomic determinants of COVID-19 vaccine acceptance.

The aim of the paper is to evaluate the relative importance of the set of socioeconomic characteristics of population on collective decision on COVID-19 vaccine acceptance. We apply cross-section OLS methods to the municipal-level non-survey data for 145 municipalities in Serbia, on the COVID-19 vaccination rate and socioeconomic characteristics of the population, to evaluate the determinants of cross-municipal variation in vaccine uptake decision. Using the estimated coefficients from the OLS regressions, we apply the standardized beta method to evaluate the relative importance of each factor. Vaccine acceptance in municipalities rises with the average level of education (especially in the female population), age and employment, while being negatively linked to religiosity of people and the proportion of rural population. We also find some evidence on the positive impact of the overall trust in government. Education level has the single largest impact, shaping around 37% of (explained) variation in the vaccination rate across municipalities, a rise in the proportion of people with higher degree by 1% being associated with increase in vaccination rate by 0.36%. Age of population explains 21%, urban-rural structure 13% and religiosity 11% of variation in vaccine acceptance, while employment status and trust in government each explain around 9% of variation in vaccine uptake across municipalities. Effective vaccination promotion strategy should be focused on younger, less-educated, unemployed cohorts, as well as on rural areas and should involve representatives of mainstream religions. Fostering education and strengthening trust in government are some of the key structural factors that may promote efficient collective behaviour in this respect.

Sex Differences in Exercise-Induced Effects on Respiratory Infection and Immune Function

A physically active lifestyle has health benefits, including enhanced vaccination responses, improved neutrophil and macrophage function, increased T cell proliferative capacity, lower numbers of senescent T cells, and lower levels of inflammatory cytokines. Therefore, exercise or physical activity is effective for preventing and treating chronic diseases. A more robust immune response is generally thought to be exerted in females than males in response to various challenges. Sex hormones in both sexes have been suggested as mediators of immune function, but research on this topic has not been designed with a sex-specific lens. The authors reviewed and summarized the experimental and clinical evidence in the available literature linking exercise, immune function, and risk of upper respiratory infections, as well as associated mechanisms. Collectively, the available literature indicates that moderate exercise improves immune function and risk for upper respiratory infections in both sexes. In contrast, prolonged and high-intensity exercise temporarily impairs immune responses and upper respiratory infection risk at a higher degree in females than males. Therefore, moderate exercise and activity may enhance immune function regardless of sex, whereas prolonged and high-intensity exercise temporarily impairs immune responses, predominantly in females more than their male counterparts.

Abstract LB142: Implementation and efficacy of a novel multimedia tobacco cessation video to enhance cancer treatment

Abstract Background: Tobacco use is a major risk factor in cancer care. Tobacco cessation improves health outcomes. However, the specific efficacy of a targeted multimedia tobacco cessation video on cancer treatment is underexplored. Objective:This study assessed the acceptability and effectiveness of a novel tailored multimedia tobacco cessation video in facilitating cancer treatment among individuals undergoing cancer surgery. Method: A novel multimedia tobacco cessation video was developed. An implementation study was conducted with cancer patients (n=48) undergoing surgical treatment. Participants viewed the tobacco cessation video preoperatively. Outcome measures included knowledge of tobacco use and tobacco cessation, motivational and confidence levels to take steps towards living a tobacco-free life, self-reported demographic information and tobacco use rates. Results: Among all the participants, 45.8% were everyday tobacco users and 20.8% were some day users. 37.5% were living or working with a person who uses tobacco. Self-reported race/ethnicity included 56% European-American/white, Asian/Pacific Islander 8%, Blacks 6.3%, and 16.7% chose not to answer or other. Among all, 23% are Hispanic, and 71% are non-Hispanics. Educational attainment included 8% less than high school, 25% completed high school, 35% some college or associate degree, 23% a bachelor's or higher degree, and 8% chose not to answer. The reported annual incomes were: 14.6% less than $20,000, 10.4% $20,000 to $34,999, 4% $35,000 to $49,999, 12.5% $50,000 to $74,999, 2% $75,000 to $99,999, and 46% chose not to answer. Patient evaluation showed adequate knowledge (Strongly agree 51.1%, Agree 36.2%), motivation to take steps towards tobacco cessation (Strongly agree 50%, Agree 38.1%), and confidence to achieve tobacco cessation (Strongly agree 57.7%, Agree 36.6%). Importantly, 29.2% of patients reported tobacco abstinence (not using tobacco) after watching the video. Conclusion: Pilot analyses of the tobacco cessation video intervention demonstrated high feasibility with adoption and implementation preoperatively. The video promoted tobacco cessation and influenced positive changes in health behaviors preoperatively. The findings suggest the inclusion of multimedia approaches as valuable tools in addressing tobacco control preoperatively. For future steps, we will collaborate with healthcare providers to integrate and disseminate the tobacco cessation video into other cancer treatment venues. A randomized study with longitudinal follow-up assessment will be implemented to assess the sustainability of tobacco cessation and the persistence of tobacco cessation practices among participants. Citation Format: Sophia Yeung, Brenda Gascon, Cary Presant, Jonjon Macalintal, Alexis Stewart, Argelia Sandoval, Kimlin T. Ashing. Implementation and efficacy of a novel multimedia tobacco cessation video to enhance cancer treatment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB142.

The role of community pharmacists and their perception towards antimicrobial stewardship in Baghdad, Iraq

AbstractBackgroundThis study aimed to assess the role of community pharmacists and their perception toward antimicrobial stewardship, in addition to identifying factors influencing their perception and practices in community pharmacy.MethodsA cross‐sectional study was carried out among community pharmacists regarding antimicrobial stewardship. Convenience sampling was used to obtain the required sample from a community pharmacy in Baghdad. In total, 381 participants have completed the survey.ResultsThe majority of the participants (85.6%) strongly agreed/agreed that “antimicrobial stewardship programs reduce the problems of antibiotic resistance”; and 85.5% of them strongly agreed/agreed that community pharmacists required adequate training on antibiotics use. In addition, high percent of community pharmacists (88.4%) strongly agreed/agreed that pharmacists have a responsibility to take a prominent role in antimicrobial stewardship programs and infection‐control programs in the health system. The total score of perception was significantly influenced by older age groups, postgraduate degrees, and experience of 6–10 years (p &lt; 0.001). This study also showed that 65.4% of pharmacists always/often advise patients to continue the full course of antimicrobials, and 64.9% of them reported always/often considering clinical and safety parameters before dispensing antibiotics. The role of pharmacists was significantly influenced by the younger age group, females, higher degree in pharmacy, experience of 3–5 years, and medical complex pharmacy (p &lt; 0.001).ConclusionCommunity pharmacists have a good perception toward antimicrobial stewardship programs, but their role is still limited. More efforts are needed to design better strategies for antimicrobial stewardship in community pharmacy.

Fictional faces of female suicide: Qualitative analysis of selected Russian-language texts of the school reader

IntroductionIsaiah Berlin’s (1948) exploration of the self-searching of Russian thinkers includes studies of the writers – Tolstoy and others (now – Russian-language texts of the school reader). These studies refute a widespread misconception about the relations between Russian writers and thinkers: namely, that in Russia literature and radical thought form two distinct traditions related only by mutual hostility. The works of Tolstoy, Dostoevsky, Karamzin, Leskov, Ostrovsky, and of minor novelists too, are penetrated with a sense of their own time, of this or that particular social and historical milieu and its ideological content, to an even higher degree than the ‘social’ novels of the west. The personal characteristics of suicide victims, heroines of Russian literature, along with the gender aspects, deserve attention in suicidal behavior (SP) focus.ObjectivesTo study personal characteristics of suicide victims, heroines of fiction.MethodsQualitative analysis of selected Russian-language texts of the school reader.ResultsAt the dawn of literature, we have seen fiery heroines and tremulous victims in the arms of death. Аs psychology approach was developed, and we get acquainted with the tragiс backstory. Psychotypes of suicides are exaggerated and overlapped. «Hysterical»: manipulative, frigid nymphomaniac (e.g., Anna Karenina). «Freedom-loving rebel» (i.e., Katerina reincarnations from A. Ostrovsky) in conditions of excessive regulation. «She-Devil, or Rebel Without a Cause». The obsession with death turns into a criminal and a victim (e.g., «Lady Macbeth of the Mtsensk» by N. Leskov, Turgenev’s Susanna or Klara Milich). The image of a vindictively furious («velvet and tiger claws») woman descends to the Victorian view of female self-will. «Mimosa» is a sensitive, dreamy person, unable to resist the hardships of life, dependent (dies with her beloved, objection). In suicide, the strength of weakness is the outcome of a humiliating life (e.g., Karamzin’s «Poor Liza», «A Gentle Creature» by F. Dostoevsky. The meaning of suicides is the following: a call (to compassion, salvation), a «cry for help», atonement for one’s (imaginary) – someone else’s (by proxy) guilt, and release from encumbrance.ConclusionsFiction and life are united by emotionally unstable characters and/or depression as markers of unsatisfactory resilience. The cultural diversity of gender patterns and interpretations of SP challenges the essentialist view that «femininity» and marriage are protective factors. SP patterns illustrate and complement the explanatory concepts of SP. The inner world of suicidal people is fascinating and contributes to the evidence-based optimism in the «patient-centric» crisis care model.Disclosure of InterestNone Declared

Identification of apoptosis as key biochemical mechanism in nonalcoholic fatty liver disease after hepatic steatosis through bioinformatics and functional analyses

Background: Non-alcoholic fatty liver disease (NAFLD) represents a growing global health crisis and is closely associated with increases in obesity and type 2 diabetes. Despite its ubiquity, its underlying biochemical mechanisms and effective therapeutic strategies remain poorly defined, hampering the development of targeted interventions.&#x0D; Methods: Candidate genes were obtained from the GEO database, and Kyoto Encyclopedia of Genes and Genomes enrichment analysis and gene set enrichment analysis were used to identify pathways involved in NAFLD-related pathways. The top genes with higher degree in the protein-protein interaction network were crossed with the top genes enriched in key pathways, and then the correlation analysis between key genes and chemotherapy response was performed.&#x0D; Result: Apoptosis, oxidative stress, NF-kB pathway, etc. are key pathways related to NAFLD. Lcn2, Mt1, Egr1, Jun, Nqo1, Btg2, Foxq1 and Hyou1 were enriched in key pathways of apoptosis.&#x0D; Conclusion: Apoptosis, oxidative stress, NF-kB pathway are key pathways related to NAFLD.

Development of a scalable, immersive, multiplayer game for teaching engineering courses

A scalable and immersive game was developed to serve as a monthly concept review game for theory-heavy engineering courses (such as fluid dynamics or heat transfer). It was designed such that in-game items and content may be dynamically replaced easily with an Excel data table, without the need for further programming. It is expected that course instructors may use such a tool by simply updating an Excel data table to rapidly tailor the game for any course. Even room/zone designs may be parametrized using a data table. Given the automation level of such a tool, its scalability and adaptability, the results of this work demonstrate the an innovative tool for educators to use for rapid construction of fun learning environments for engineering students in fun, game worlds. Future multiplayer game development can aid with collaborative learning to an even higher degree.

Analysis of agreement between measures of subjective cognitive impairment and probable dementia in the National Health and Aging Trends Study.

Subjective cognitive impairment (SCI) measures in population-based surveys offer potential for dementia surveillance, yet their validation against established dementia measures is lacking. We assessed agreement between SCI and a validated probable dementia algorithm in a random one-third sample (n=1936) of participants in the 2012 National Health and Aging Trends Study (NHATS). SCI was more prevalent than probable dementia (12.2%vs 8.4%). Agreement between measures was 90.0% and of substantial strength. Misclassification rates were higher among older and less-educated subgroups due to higher prevalence of false-positive misclassification but did not vary by sex or race and ethnicity. SCI sensitivity (63.4%) and specificity (92.5%) against dementia were comparable with similar metrics for the NHATS probable dementia measure against the "gold-standard" Aging, Demographics, and Memory Study-based dementia criteria, implying that population-based surveys may afford cost-effective opportunities for dementia surveillance to assess risk and inform policy. The prevalence of subjective cognitive impairment (SCI) is generally higher than that of a validated measure of probable dementia, particularly within the youngest age group, females, Whites, and persons with a college or higher degree. Percent agreement between SCI and a validated measure of probable dementia was 90.0% and of substantial strength (prevalence- and bias-adjusted kappa, 0.80). Agreement rates were higher in older and less-educated subgroups, driven by the higher prevalence of false-positive disagreement, but did not vary significantly by sex or race and ethnicity. SCI's overall sensitivity and specificity were 63.4% and 92.5%, respectively, against a validated measure of probable dementia, suggesting utility as a low-cost option for dementia surveillance. Heterogeneity in agreement quality across subpopulations warrants caution in its use for subgroup analyses.

Using fuzzy cognitive map in bow tie method for dynamic risk assessment of spherical storage tanks: A case study

The present study aimed to perform a dynamic risk assessment of liquefied petroleum gas (LPG) in spherical storage tanks using the Hazard and Operability (HAZOP) method. The “LPG release from spherical storage tank” scenario was determined to be a top event based on the risk level. The causes and consequences of this scenario were then specified using the Bow-Tie method. Additionally, fuzzy cognitive mapping (FCM) was utilized to identify the most critical threats, consequences, and effective barriers in a dynamic approach. Results showed that fracture/rupture in pipelines/a storage tank due to fire had the highest output degree and was identified as the most influential threat in the occurrence of the LPG release. Fatality/injury due to fire and explosion had the highest input degree and was more influenced by the release of LPG as the main consequence in the selected scenario. The findings of this study enabled us to make a logical decision about effective barriers for avoiding and minimizing the release of LPG and its threats and consequences based on the fuzzy cognitive map. Moreover, the results of this study showed that the FCM method could determine the most critical nodes with a higher degree and represent their relationships.

Assessment of the relationship between executive Nurses’ leadership Self-Efficacy and medical artificial intelligence readiness

AimsThis study aims to assess the relationship between management nurses' leadership self-efficacy and medical artificial intelligence readiness. MethodsThe research was conducted using a descriptive-correlational design. The sample of the study consisted of 196 management nurses working in public, private, and educational research hospitals in Gaziantep, Turkey. The data collection tools included the Personal Information Form, the Leadership Self-Efficacy Scale, and the Medical Artificial Intelligence Readiness Scale. ResultsThe majority of the participants in the research were female (71.4 %), married (80.1 %) and graduates of a bachelor's or higher degree in nursing (74.5 %), had 16 years or more of work experience in the profession (39.3 %), and worked during the day shift (75.5 %). Among the participating management nurses, those who were single had a significantly higher mean score in the cognition subscale and the total score of medical artificial intelligence readiness (p < 0.05). The management nurses working in shifts had significantly higher mean scores in the cognition and ability subscales, as well as the total score of medical artificial intelligence readiness (p < 0.05). The management nurses who received leadership/management-related training after their undergraduate education had a significantly higher mean score in the cognition subscale (p < 0.05). Furthermore, there was a significant relationship (p < 0.05) between leadership self-efficacy, medical artificial intelligence readiness, and their subscales, concerning following and finding artificial intelligence applications useful, as well as informing team members about artificial intelligence applications. ConclusionsIn the research, it was determined that the leadership self-efficacy of the manager nurses was at a good level and that their artificial intelligence readiness was at a medium level in terms of cognition, skill, foresight and ethics while presenting their professional knowledge. A positive and significant relationship was found between leadership self-efficacy and medical artificial intelligence readiness.

Associations between nurse characteristics, institutional characteristics and perceived nurse knowledge and self-efficacy of reporting suspected child abuse and neglect.

To determine the association between nurse and institutional characteristics and perceived professional nurse knowledge and self-efficacy of reporting child abuse and neglect. A sample of N = 166 nurses were recruited to respond to the Reporting of Suspected Child Abuse and Neglect (RSCAN) survey. A multiple linear regression examined whether nurse characteristics and institutional characteristics were associated with the two RSCAN survey domain scores. Perceived knowledge of a workplace child abuse and neglect protocol was associated with the knowledge subscale. Education and child abuse and neglect expertise were significant predictors of the self-efficacy subscale. Nurses with a master's or higher degree and those who identified as being either forensic, paediatric or Emergency Department nurses, had less perceived institutional barriers to self-efficacy of reporting child abuse and neglect. This study provides a preliminary insight into the institutional barriers and facilitators of nurses as child abuse and neglect mandated reporters. To encourage innovative education and collaborations to support nurses as fully informed child abuse and neglect mandated reporters. This research identifies the gaps and facilitators of nurses as child abuse and neglect mandated reporters to inform healthcare professionals and academic institutions on the importance of nurse education and experience in nurse knowledge and self-efficacy in reporting suspected child abuse and neglect. The authors of this study have adhered to relevant EQUATOR guidelines: STROBE. There is no patient or public contribution as the study only looked at nurses.

Knowledge, attitude, and practices of midwives on premature rupture of membranes (PROM): A cross-sectional study in Samosir and Toba, Indonesia.

Indonesia has a significantly higher maternal mortality ratio (MMR) than other countries in Southeast Asia, and infection is one of the most common causes of maternal deaths, of which premature rupture of membranes (PROM) can be the consequence of the infections. In primary healthcare settings, midwives play an important role in identifying and managing PROM appropriately; however, studies on their knowledge, attitudes, and practices related to PROM are limited. The aim of this study was to determine the midwives' knowledge, attitude and healthcare practice on PROM in Indonesia. A cross-sectional study was conducted among midwives at primary healthcare facilities in Samosir and Toba Regency, North Sumatra, Indonesia, from July to November 2022. The knowledge, attitude and practice towards PROM were assessed. Results showed that 57.5% of midwives had poor knowledge and 35.1% had poor attitude levels. There were 4.9% of midwives referred the patients immediately to the hospital. Our data indicated that aged 31-40 or 41-50 years, having a lower than bachelor degree and having a higher monthly number of referred PROM patients were significantly associated with poor knowledge compared to younger, having a bachelor degree, and lower monthly referral patient number, respectively. Similarly, younger, having higher degree and a having lower monthly referral number of PROM cases were associated with higher chances of having a sufficient-good attitude towards PROM. This study highlights that a significant percentage of midwives had poor levels of knowledge and attitude, and age, educational level and monthly referral number of PROM cases were associated with the level of knowledge and attitude.