Practice Improvement Research Articles

Cutting Technique Modification: A Way to Improve Movement Quality and Develop Agility in Youth?

Abstract Thieschäfer, L, Dos’Santos, T, and Büsch, D. Cutting technique modification: a way to improve movement quality and develop agility in youth? J Strength Cond Res 38(9): 1596–1606, 2024—High-quality cutting technique is essential for agility development and safer cuttings in adolescent athletes. Certain sidestep techniques and kinematics are characteristic of high movement quality and are associated with both, faster performance and lower knee joint loading (i.e., reduced anterior cruciate ligament injury risk). The aim of this study was to determine the effects of a 6-week, side step, technique modification training intervention targeting specific kinematics on agility performance and movement quality. Twenty-two adolescent American football players were recruited for a nonrandomized, controlled, intervention study. For 6 weeks, an intervention group (IG) of 11 players participated in 25-minute cutting technique training sessions integrated into team training twice a week, whereas a control group (CG) of 11 players continued their usual training routine. Agility performance was assessed based on percentage-based change of direction deficit (CODDp) obtained during reactive agility tests at 45° and 90° angles. The Cutting Movement Assessment Score (CMAS) qualitative screening tool was used to assess 2D high-speed videos of the cuts for movement quality. The significance level was set at α = 0.01. The intervention effectively altered players' sidestep technique irrespective of cutting angle with large time × group interaction effects observed for CMAS ( = 0.82). Statistical and practical significant improvements in CMAS pre-to-post intervention were evident in the IG (−2.30 ≤ g ≤ −1.75; 313.87 ≤ BF10 ≤ 2,342.00), whereas deteriorations were found in the CG for 90° (g = 1.38; BF10 = 64.21). However, in both groups, no statistically significant differences in CODDp were observed pre-to-post intervention (0.019 ≤ p ≤ 0.586; 0.34 ≤ BF10 ≤ 3.59). The cutting technique modification training meaningfully improved movement quality, without negatively affecting agility performance, and can be used by practitioners to foster a safe technical foundation for subsequent agility development in adolescent athletes.

Transforming Hospital Housekeeping: The Kayakalp Journey

Introduction The Kayakalp guidelines for public healthcare facilities under the Swachh Bharat Abhiyan (Clean India Mission) focus on improving sanitation, cleanliness, and infection control at public hospitals in India. This study was conducted in a 960-bed tertiary-level teaching hospital in eastern India. Housekeeping has been a challenge in public institutions, with factors like overcrowding and resource constraints. Tobacco and betel nut chewing, spitting, poor sanitation practices, and open urination are major challenges in ensuring sanitation at the hospital. The research objective was to study the implementation of the Kayakalp guidelines for quality improvement in housekeeping services at the institution. Methods A pre- and post-interventional study was conducted using the Plan-Do-Check-Act (PDCA) quality tool. Plan phases included the gap assessment using the Kayakalp checklist with numerical scoring. Necessary interventions were done under three headings: structure, processes, and outcomes in the “Do” phase. The “Check” phase included monitoring of the activities followed by the “Act” phase, which included a review of the action plan. External experts nominated by the government conducted the final assessments and recommended it as one of the cleanest hospitals. Results A 360-degree improvement was observed in hospital services, with assessment score improvement from 73.68% to 95.0%. The institution received the first prize in 2020 and 2021 and runners-up Kayakalp National Award under category “B” (Institute of National Importance) Hospitals in 2019. Conclusion The implementation of Kayakalp guidelines of the Government of India proved to be efficient in the improvement of housekeeping and infection control practices in the institution.

Discharge against medical advice in rural and remote emergency departments: views of healthcare providers.

The aim of the study was to explore, in one remote hospital, emergency department healthcare providers' experience and perceptions of the factors surrounding a patient's decision to discharge against medical advice (DAMA). The secondary objective was to gain insight into staff experiences of the current protocols for managing DAMA cases and explore their recommendations for reducing DAMA incidence. This was a cross-sectional study involving a survey and semi-structured interviews exploring healthcare providers' (n=19) perceptions of factors perceived to be influencing DAMA, current practice for managing DAMA and recommendations for practice improvements. Health professionals (doctors, nurses, Aboriginal Health Workers) all worked in the emergency department of a remote community hospital, Queensland, Australia. Responses relating to influencing factors for DAMA were provided on a three-point rating scale from 'no influence/little influence' to 'very strong influence'. DAMA management protocol responses were a three-point rating scale from 'rarely/never' to 'always'. Semi-structured interviews were conducted after the survey and explored participants' perceptions in greater detail and current DAMA management protocol. Feedback from the total of 19 participants across the professions presented four prominent yet interconnected themes: patient, culture, health service and health provider, and health literacy and education-related factors. Factors that were perceived to have a strong influence on DAMA events included alcohol and drug abuse (100%), a lack of culturally sensitive healthcare services (94.7%), and family commitments or obligations (89.5%). Healthcare provider recommendations for preventing DAMA presented themes of right communication, culturally safe care (right place, right time) and the right staff to support DAMA prevention. The healthcare providers described the pivotal role the Indigenous Liaison Officer (ILO) plays and the importance of this position being filled. DAMA is a multifaceted issue, influenced by both personal and hospital system-related factors. Participants agreed that the presence of ILO and/or Aboriginal Health Workers in the emergency department may reduce DAMA occurrences for Indigenous Australians who are disproportionately represented in DAMA rates, particularly in rural and remote regions of Australia.

Comorbidity of bipolar disorder and borderline personality disorder: Phenomenology, course, and treatment considerations.

Bipolar disorder (BD) and borderline personality disorder (BPD) are both serious psychiatric conditions that elevate the risk for harmful outcomes. Although these conditions represent distinct diagnostic entities, existing research suggests that approximately 20% of individuals with BD meet the criteria for comorbid BPD. Individuals with comorbid BD/BPD appear to have a markedly more severe and phenomenologically distinct clinical course when compared with those with BD alone. However, treatments have generally not been tested in this specific population, and currently, no formal treatment guidelines exist for this subgroup of patients. In the current paper, we review the epidemiological and descriptive research characterizing those with comorbid BD/BPD and discuss the impact of this comorbidity on psychosocial treatment. We also review current findings on evidence-based treatments for BD and BPD that show promise in treating those with comorbid BD/BPD. In our review of the literature, we highlight the importance of recognizing this comorbidity and discuss avenues for developing and integrating evidence-based treatment approaches for this understudied clinical population. Although formal trials of interventions targeted to comorbid BD/BPD are limited, there is promising evidence regarding the possibility of using or integrating existing evidence-based approaches for this population. There are also several areas of clinical practice improvement and future research directions that stem from this literature.

AI'S Impact on Vocational Training and Employability: Innovation, Challenges, and Perspectives

This integrative literature review (ILR) examines the influence of artificial intelligence (AI) on vocational training, specifically focusing on unequal access to AI-powered resources and the ensuing inequities in education. The study seeks to analyze the impact of AI on vocational training and employability, offering insights into the advantages and difficulties related to integrating AI technology into educational institutions. The study's conceptual framework is grounded in three primary pillars: AI-driven innovation, challenges, and perspectives. This research is essential for providing valuable insights that can guide strategic planning and policy-making to improve vocational training programs and ensure that they remain effective in preparing students for the changing job market. The ILR methodology entailed integrating theoretical and empirical literature and collecting and evaluating relevant scholarly materials to provide a thorough comprehension of AI's function in vocational training. The results emphasize the capacity of AI to enhance educational achievements using tailored learning, adaptable platforms, immediate feedback, and simulations. However, there is a risk of widening educational inequalities due to biased algorithms. The study highlights the necessity of making significant investments in infrastructure and providing ongoing professional development for educators to incorporate AI successfully. It also suggests the establishment of distinct positions inside vocational training institutions, such as Vocational AI Curriculum Developer (VACD), Vocational AI Data Protection Specialist (VAIDPS), and Vocational AI Sustainability Facilitator (VAISF), to tackle these difficulties effectively. The conclusions highlight the revolutionary capacity of AI in vocational training, soliciting strategic investments and evoking the creation of specialized positions to promote fair and efficient deployment of AI. The study's findings underscore the significance of continuous research and improvements in practice to promote positive societal change and better educational fairness.

Relationship between civil construction companies and suppliers: comparative analysis with companies in other sectors

Strategic supplier management establishes criteria for the selection, evaluation, and development of suppliers, in addition to the administration of contracts and supplies. This type of management aims to organize all processes involving suppliers, defining criteria to support decision-making in selecting the best partners, considering those who meet pre-established requirements. Furthermore, efficient management provides closer proximity to suppliers, facilitating relationships, fostering collaborative innovation, improving product costs, and increasing the company's competitiveness. The objective of this work is to analyze the relationship of suppliers in the construction industry and compare it with companies from other sectors. To achieve this objective, an applied, quantitative, and exploratory research was developed through field research. Questionnaires were applied to employees of construction companies and companies from other sectors, such as service providers and large industrial sectors, addressing issues related to organizational characteristics and specific axes that determine the relationship, such as trust, long-term relationship, and information sharing between client and supplier. The collected data were subjected to descriptive and exploratory analyses to observe the divergent and similar characteristics between the two groups. The results indicate that construction companies have gaps in the axes of trust, information sharing, and especially in the sphere of long-term relationships compared to companies in other sectors. This indicates the need for improvements in supplier management practices in the construction industry to achieve a competitive performance more aligned with other industrial sectors. The implementation of more robust strategies and the adoption of better practices in supplier management can help overcome these gaps, resulting in a more efficient and collaborative business environment, with mutual benefits for construction companies and their suppliers.

Resuscitation following trauma & role of trauma training programmes in emergency settings: A literature review & survey.

Background & objectives Traumatic injuries, especially in low- and middle- income countries (LMICs), present significant challenges in patient resuscitation and healthcare delivery. This study explores the role of trauma training programmes in improving patient outcomes and reducing preventable trauma-related deaths. Methods A dual approach was adopted, first a literature review of trauma training in LMICs over the past decade, along with a situational assessment survey. For the review of literature, we searched the PubMed database to identify key challenges and innovative practices in trauma training programmes in LMIC's. The survey, conducted among healthcare professionals in various LMICs, collected direct insights into the challenges and the status of trauma training programmes in these countries. Results The literature review analysed 68 articles, with a significant focus on the African subcontinent (36 studies), underscoring the region's emphasis on research on trauma training programmes. These studies mainly targeted physicians, clinicians, postgraduate trainees in surgical or anaesthesia fields and medical students (86.8%), highlighting innovations like simulation-based training and the cascading training model. In our survey, we received 34 responses from healthcare professionals in India, Belarus, Azerbaijan, Nepal and Pakistan. Around 52.9 per cent reported the absence of established trauma training programmes in their settings. The majority of respondents advocated for hands-on, simulation-based training (94.1%) and emphasised the need for structured training programmes (85.3%), feedback sessions (70.6%) and updated protocols (61.8%). This combined data underlined the critical gaps and potential improvements in trauma training programmes and resuscitation practices in LMICs. Interpretation & conclusions Effective trauma care in LMICs requires the establishment of comprehensive, tailored training programmes. Key interventions should include subsidization of pre-existing trauma courses and the adoption of World Health Organization Guidelines for essential trauma care, implementation of trauma quality improvement and review processes and the incorporation of focused assessment with sonography in trauma (FAST) in emergency departments. These steps are crucial for equipping healthcare workers with vital skills and knowledge, fostering a culture of continuous learning and improvement in the realm of trauma care.

Studying the influence of engine speed on the entire process of span-lowering of the heavy mechanized bridge

The paper presents a dynamic model of the TMM-3M heavy mechanized bridge during the span lowering stage. The model is constructed as a multi-body mechanical system, taking into account the elastic deformation of the cable, rear outriggers, front tires, and front suspension system. It is a mechanical model driven by a cable mechanism. Lagrangian equations of the second kind have been applied to establish a system of differential equations describing the oscillations of the mechanical system and serve as the basis for investigating the dynamics of the span-lowering process. The system of differential equations is solved using numerical methods based on MATLAB simulation software. The study has revealed laws of the displacement, velocity, and acceleration of components within the mechanical system, especially those related to the bridge span depending on the choice of the drive speed of the engine during lowering by operator. The research results show that the lowering time increases from 52 seconds to 104 seconds when the engine speed decreases from 1800 rpm to 900 rpm. The tension force on the cable is surveyed to confirm the safety conditions during the span-lowering process. The study also provides recommendations for selecting appropriate engine speeds to minimize span-lowering time while ensuring the safety conditions of the TMM-3M bridge during the span-lowering process. This research is an important part of a comprehensive study on the working process of the heavy mechanized bridge TMM-3M to make practical improvements, aiming to reduce deployment time, decrease the number of deployment crew members, and increase the automation capability of the equipment

Empowering public relations for sustainability: examining the landscape in Turkey

PurposeThis paper examines the engagement of public relations (PR) in advancing sustainability within Turkey, exploring both current contributions and future potential. It analyzes how PR professionals and scholars conceptualize sustainability, revealing divergent perspectives within the industry. The study delves into the perceived roles and responsibilities of PR professionals in driving sustainable initiatives, highlighting the key challenges hindering their impact. Ultimately, the research identifies essential knowledge and skills needed to empower Turkish PR to effectively contribute to a more sustainable future.Design/methodology/approachThis study employs a qualitative research approach using semi-structured in-depth interviews with two distinct groups: experienced PR professionals holding director positions in agencies and corporate communication departments, and PR professors with at least five years of teaching experience in Turkey.FindingsThe findings reveal a dynamic, yet complex, landscape of sustainability within the Turkish PR industry. While PR professionals are actively integrating sustainability into strategic initiatives and emphasizing measurable impact, they face barriers to full integration, and their conceptualization of sustainability often differs from that of PR scholars. The findings point to a critical need for targeted education and professional development to better equip Turkish PR practitioners to drive sustainable development.Originality/valueMethodologically, the incorporation of representative groups, consisting of senior communication professionals and professors, offers valuable insights that can inform improvements in PR practices, enhance PR education, and advance the understanding of sustainability within the field of communication within the specific context of Turkey.

Teacher instructional practices: untangling their complex relations with self-efficacy, job satisfaction, stress, and cooperation among mathematics teachers

BackgroundTeacher instructional practices play crucial roles not only in shaping the happenings in the classrooms but also in facilitating students’ understanding and success rates in mathematics. However, previous studies on teachers’ factors that bolster or undermine instructional practices often consider the influence of these factors on instructional practices in isolation.ObjectiveOn the contrary, we took an inclusive approach in the present study to quantify and disentangle the complex relationship between self-efficacy, job satisfaction, stress, cooperation, and instructional practices with a focus on mathematics teachers.MethodsWe used structural equation modelling to analyze the generated data from 1,304 Norwegian secondary school mathematics teachers.ResultsThe results showed that teacher self-efficacy contributes the most to teacher instructional practices through direct and mediating effects. It mediates the effects of stress and cooperation on teachers’ practices. The contribution of teacher cooperation to instructional practices supersedes teacher stress while the effect of job satisfaction is not substantial. Also, instructional practices that include frequent use of techniques of cognitive activation, clarity of instruction, and classroom management are more prevalent among female than male mathematics teachers in Norway.ConclusionBy implications, these findings revealed that teacher self-efficacy and teacher cooperation are prime factors which interventions could bring about the desired improvement in classroom practices among mathematics teachers.

Municipal Energy Efficiency in Portugal: An Analysis of Electricity and Natural Gas Consumption

Analysing energy consumption efficiency is essential for understanding energy resource consumption patterns, identifying the economic consequences, and developing effective public policies. The study investigates energy consumption efficiency levels in Portuguese municipalities in order to analyse disparities in energy consumption efficiency. The aim is to observe the possible relationship between population density and the energy consumed by residents. The study uses the DEA model to detect benchmarking patterns, inefficiencies, and opportunities for improvement in energy consumption practices. The results suggest that there are serious disparities in energy consumption efficiency between Portuguese municipalities and a significant positive correlation between population density and the amount of energy consumed. The disparities can be attributed to the different levels of adoption of efficient energy consumption practices. The results point to the need to define public policies aimed at promoting more efficient energy consumption practices. The research emphasises the importance of implementing more effective public policies that encourage the adoption of sustainable energy consumption practices by residents. The conclusions have important practical implications for the formulation of public policies aimed at local energy efficiency and the development of sustainable energy consumption.

Theory of change for addressing sex and gender bias, invisibility and exclusion in Australian health and medical research, policy and practice

Sex and gender are inadequately considered in health and medical research, policy and practice, leading to preventable disparities in health and wellbeing. Several global institutions, journals, and funding bodies have developed policies and guidelines to improve the inclusion of diverse participants and consideration of sex and gender in research design and reporting and the delivery of clinical care. However, according to recent evaluations, these policies have had limited impact on the inclusion of diverse research participants, adequate reporting of sex and gender data and reducing preventable inequities in access to, and quality provision of, healthcare. In Australia, the Sex and Gender Policies in Medical Research (SGPMR) project aims to address sex and gender bias in health and medical research by (i) examining how sex and gender are currently considered in Australian research policy and practice; (ii) working with stakeholders to develop policy interventions; and (iii) understanding the wider impacts, including economic, of improved sex and gender consideration in Australian health and medical research. In this paper we describe the development of a theory of change (ToC) for the SGPMR project. The ToC evolved from a two-stage process consisting of key stakeholder interviews and a consultation event. The ToC aims to identify the pathways to impact from improved consideration of sex and gender in health and medical research, policy and practice, and highlight how key activities and policy levers can lead to improvements in clinical practice and health outcomes. In describing the development of the ToC, we present an entirely novel framework for outlining how sex and gender can be appropriately considered within the confines of health and medical research, policy and practice.

Identification of gaps in the delivery of high-quality care of patients with eosinophilic esophagitis.

Quality indicators (QIs) are standardized metrics that can be used to quantify health care delivery and identify important areas for practice improvement. Nine QIs pertaining to the diagnosis and management of eosinophilic esophagitis (EoE) were recently established. We therefore aimed to identify existing gaps in care using these QIs. This is a retrospective, multicenter study utilizing recently established EoE QIs to evaluate practice patterns among adult gastroenterologists in the diagnosis and management of EoE. Three patient cohorts of 30 patients each presenting with dysphagia, food impaction, and new diagnosis of EoE, respectively, were obtained, yielding 120 patients per site to assess for every QI. Summary statistics were reported across two main themes: diagnosis and management. Subsequent analysis of gaps in care was then performed. The domain of diagnosis of EoE (QI 1 and 2) had the most notable gap in care with only 55% of the presenting patients undergoing appropriate evaluation for EoE. The domain of management of EoE had overall higher QI fulfillment-however it also contained significant intra-category variation in care. Notably, while 79% of patients had clinical follow-up within 1year from remission, only 54% underwent surveillance endoscopy within 2years of remission. In contrast, 100% of patients with symptomatic strictures independent of histologic response underwent endoscopic dilation (QI 4). Management approaches for EoE are evolving and variation in care delivery exists. We identified significant gaps in both diagnosis of EoE especially amongst patients presenting with index food impaction and long term management of EoE, when retrospectively evaluating care patterns using newly established QIs. This is the first study of its kind to utilize these previously established QIs to objectively identify care gaps that exist in EoE amongst several institutions. These findings also highlight the importance of QIs and standardization of management of complex chronic diseases like EoE to help bridge these gaps and provide a framework to measure adherence to these best practices.

Experiences of Teaching and Learning Pediatric Pain Management in Ghana

BackgroundThe literature has revealed gaps in knowledge and attitudes regarding pediatric pain management among Ghanaian nurses and nursing students that can be attributed to inadequate education in the area. Consequently, nursing tutors teaching pain management might not have the appropriate knowledge to transfer to their students. PurposeTo explore nursing tutors’ experiences of teaching pediatric pain management as well as their students’ learning experiences before and after the tutors’ training workshop. DesignA descriptive qualitative design was employed for the conduct of the study. MethodsData were collected via focus groups from 32 tutors and 24 students before and after an educational workshop. Data analysis drew on Braun and Clarke's thematic analysis. FindingsPre-workshop themes revealed knowledge deficits regarding pediatric pain management in both tutors and students due to learning having occurred in bits and pieces. Furthermore, lack of accessibility to books and pain scales perpetuated this bits-and-pieces approach to learning. Post-workshop findings revealed gains in tutors’ knowledge and skills. Consequently, students gained new insights into pediatric pain management. ConclusionTutors and student nurses had a knowledge deficit regarding pediatric pain management. The educational workshop and the provision of learning materials resulted in enhanced knowledge and attitudes that subsequently improved tutors’ ability to effectively teach the topic to their students, with a clear implication for improvements in clinical practice. Clinical ImplicationEducating nursing tutors about pediatric pain is imperative to enable students and thus future nurses to be equipped with the necessary evidence-based knowledge of how to manage pediatric pain.

Specialized nutritious foods and behavior change communication interventions during the first 1000 d of life to prevent stunting: a quasi-experimental study in Afghanistan

BackgroundConsiderable evidence supports the effectiveness of nutritional supplementation with or without nutrition education in preventing stunting in developing countries, but evidence from Afghanistan is scarce. ObjectivesThis project aimed to assess the effectiveness of specialized nutritious food (SNF), social and behavior change communication (SBCC) intervention to prevent stunting among children under 2 y during the first 1000 d of life in Badakhshan, Afghanistan. MethodsWe used a community-based quasi-experimental pre–post study design with a control group. Pregnant and lactating women received a monthly ration of 7.5 kg of super cereal (250 g/d) during pregnancy and the first 6 mo of breastfeeding. Children aged 6–23 mo received 30 sachets of medium-quantity lipid-based nutrient supplement (50 g/sachet/d) monthly. We compared pre- and postintervention assessments of the intervention and control groups to isolate the effect of the intervention on key study outcomes at the endline by difference-in-differences (DID) estimates. ResultsA total of 2928 and 3205 households were surveyed at baseline and endline. DID estimates adjusted for child, maternal, and household characteristics indicated a significant reduction in stunting (DID: −5% (95% confidence interval [CI]: −9.9, −0.2) and underweight (DID: −4.6% (95% CI: −8.6, −0.5) among children <2 y of age. However, DID estimates for wasting among children in the intervention and control groups were not significantly different (DID: −1.7 (95% CI: −5.1, 1.6). Furthermore, exposure to the SBCC messages was associated with improvements in the early initiation of breastfeeding (DID: 19.6% (95% CI: 15.6, 23.6), exclusive breastfeeding under 6 mo (DID: 11.0% (95% CI: 2.3, 19.7), minimum meal frequency (DID: 23% (95% CI: 17.7, 28.2), and minimum acceptable diet (DID: 13% (95% CI: 9.8, 16.3). ConclusionsThe provision of SNF in combination with SBCC during the first 1000 d of life was associated with reduction in stunting and underweight and improvements in infant and young child feeding practices among children under 2 y of age.This trial was registered at clinicaltrials.gov as NCT04581993.

Views and opinions of patients with glaucoma and age-related macular degeneration on vision home-monitoring: a UK-based focus group study

ObjectiveTo investigate the views, hopes and concerns of patients living with glaucoma and age-related macular degeneration (AMD) regarding vision home-monitoring.DesignQualitative study using focus groups and questionnaires. Participants were given three...

The enhancive effect of the 2014-2016 El Niño-induced drought on the control of soil-transmitted helminthiases without anthelmintics: A longitudinal study.

Soil-transmitted helminthiases (STHs) are common in tropical and subtropical regions. Southern Thailand experiences an extended rainy season, leading to persistently moist soil. This condition supports the life cycle of STHs, hindering effective control due to reinfection and low drug efficacy. We implemented a novel STH control strategy during the dry season aimed at decreasing reinfection rates without enhancing sanitation or hygiene practices. However, there were unexpected, prolonged droughts linked to El Niño events from 2014 to 2016. Additionally, we assessed the effects of these drought conditions on further control measures without the use of anthelmintics. A longitudinal study was conducted from 2012 to 2016. Stool samples collected from 299 participants were analyzed using the Kato-Katz and agar plate culture methods. Participants who tested positive for STHs received a single 400 mg dose of albendazole. The efficacy of the treatment was evaluated three weeks later. To confirm the control measures were implemented during the dry season, we monitored the number of rainy days following albendazole treatment for 52 days, of which 38 were without rain. Follow-up stool examinations were carried out in 2013 and 2016, with no additional doses of albendazole administered. Rainfall and rainy day data, which served as indicators of unexpected droughts due to El Niño, were collected from the nearest local meteorological stations. Before the drought, there was a decrease in STH prevalence in 2013-except for trichuriasis-attributable to the dry season control efforts. Despite these efforts, STH prevalence remained high. Remarkably, in 2016, following the drought period, the prevalence of trichuriasis, which had not changed previously, spontaneously declined without further albendazole treatment compared to 2013. Furthermore, the prevalence of strongyloidiasis remained unchanged likely due to its low susceptibility to drought conditions, as it can reproduce within hosts. Conversely, the prevalence of other STHs consistently declined. The drought and possible improvements in sanitation and hygiene practices contributed to this decrease by reducing rates of reinfection and new infection and by increasing the natural cure rate. Additionally, some participants infected with hookworms or Trichuris who were not cured by albendazole experienced natural remission. Control measures implemented during the dry season, combined with a 14-month-long drought induced by the El Niño event of 2014-2016, and some improvements in sanitation and hygiene practices, contributed to a decrease in both the prevalence and intensity of STHs, except for S. stercoralis. Over time, S. stercoralis is likely to become the predominant species among the STHs.

Exploring school support stakeholders’ perceptions in identifying learning barriers: the case study of selected rural schools in the Eastern Cape

Identification of learning barriers is a critical issue for support provision in inclusive classes, as it informs individualised support plans for each learner who experiences barriers to learning. However, the school support stakeholders in Quintile 1 rural schools in South Africa face challenges in identifying learning barriers experienced by learners in their classes. Quintile 1 is a socially based ranking given to schools in poverty-stricken communities where most people are unemployed. This study focuses on identifying the perceptions of school support stakeholders in the identification of learning barriers in Quintile 1 rural schools. In this qualitative research study, a multiple case study design was used and 15 participants from three categories (teachers, principals, and school-based support team coordinators) were purposively sampled from three secondary and two primary rural schools due to the different roles expected from each category in the identification of learning barriers. Data were analysed using thematic content analysis. The findings revealed insufficient knowledge about the identification of learning barriers; lack of support in identifying learning barriers; lack of continuous in-service training on inclusive practices and education policies as barriers to the identification of learning barriers, which led teachers to perceive their roles in identifying learning barriers in a negative way. In general, this article contributes to understanding the complexities surrounding the identification of learning barriers for support provision in rural settings. It highlights areas for improvement in inclusive practices and supports structures to enhance the inclusivity and effectiveness of rural education systems.

Diabetic foot ulcers in ambulatory settings

This practice improvement project set out to achieve 50% wound closure within 4 weeks.

Interventions for Assessment and Enhancement of Pain Management Competencies among Healthcare Professionals

To pain management competencies among healthcare professionals is crucial for improving patient care and outcomes. Healthcare professionals must possess the necessary knowledge, skills, and techniques to effectively manage and treat pain in their patients. This includes understanding different types of pain, assessing pain levels, and utilizing appropriate interventions. By accurately assessing pain levels and implementing a multimodal approach to pain management, healthcare professionals can optimize patient outcomes and minimize risks. Effective communication skills and staying updated on the latest evidence-based practices are also essential. Continuous education and professional development are vital for healthcare professionals to enhance their pain management competencies and deliver the best possible care.Include training healthcare professionals in pain assessment techniques, educating them on the multidimensional nature of pain, providing resources and tools for accurate and comprehensive pain evaluation, encouraging interdisciplinary collaboration to enhance pain management strategies, fostering a patient-centered approach that values the individual's self-reporting of pain, promoting ongoing education and professional development to ensure up-to-date knowledge and skills, conducting regular assessments and evaluations to monitor the effectiveness of pain assessment training programs, and supporting a culture of continuous improvement and innovation in pain assessment practices. Additionally, technology-based solutions such as electronic pain diaries and telemedicine can be utilized to enhance pain assessment and monitoring capabilities.Include successful implementation and execution of transformative educational programs, catering to diverse learner needs. These initiatives foster holistic learning, instilling a love for knowledge in students. Outcomes show remarkable progress, enhanced critical thinking, creativity, and problem-solving abilities. Innovative teaching and cutting-edge technologies empower countless individuals, unlocking their potential and achieving academic excellence. Collaborative approach establishes a foundation for lifelong learning and personal development. Equipped with acquired knowledge and skills, individuals make a lasting impact in their fields, shaping a brighter future for themselves and society.Pain management is an incredibly crucial aspect of healthcare, and it is absolutely essential for healthcare professionals to possess the necessary competencies to accurately assess and greatly enhance their ability to provide highly effective pain management interventions. Ensuring that patients receive optimal pain relief and care should be a top priority for all healthcare providers, as it positively contributes to their overall wellbeing and enhances the quality of their medical treatment. Therefore, healthcare professionals must continuously invest time and effort in expanding their knowledge and skills related to pain management to ensure they can deliver the highest level of care to their patients. By doing so, we can strive towards a healthcare system that prioritizes pain management and empowers healthcare professionals to make a significant difference in their patients' lives.