Infrastructure Support Research Articles

Implantable Medical Device Security

Implantable medical devices, or IMDs for short, are medical instruments that are placed into the human body through surgery. IMDs are typically used for treating chronic diseases. Currently available IMDs are capable of communicating using wireless channels with other devices, either in close proximity or even connected to the Internet, making IMDs part of the Internet of Medical Things. This capability opens the possibility of developing a wide range of services, like remote patient data control, localization in case of emergency, or telemedicine, which can improve patients’ lifestyle. On the other hand, given the limited resources of such tiny devices, and the access to the Internet, there are numerous security issues to be considered when designing and deploying IMDs and their support infrastructures. In this paper, we highlight security problems related to Internet-connected IMDs, and survey some solutions that have been presented in the literature.

Associations Between State Policies Facilitating Telehealth and Buprenorphine Episode Initiation and Duration Early in the COVID Pandemic : State Telehealth Policies and Buprenorphine.

State policies facilitating telehealth implemented early in COVID may support buprenorphine treatment of opioid use disorder. However, little empirical information is available about those policies' effects. Examine association between state policies that may facilitate telehealth use and buprenorphine treatment. Retrospective cohort study using 2019-2020 national pharmacy data on dispensed buprenorphine prescriptions. State policies implemented after March 3, 2020, public health emergency declaration requiring private insurers' telehealth reimbursement to be commensurate with in-person service reimbursement, authorizing Medicaid reimbursement for audio-only telehealth, allowing physicians to provide cross-state telehealth services, and allowing psychologists to provide cross-state telehealth services. (a) Duration of treatment episodes started between March 1 and March 13 in both 2019 and 2020, and (b) daily numbers of new buprenorphine treatment episodes from March 13 through December 31 in each year. We found little change in the number of new buprenorphine treatment episodes started in 2020 compared to 2019 and an increase in treatment duration of 10.3days (95%CI 8.3 to 12.2days) for episodes started in March 2020 before the public health emergency declaration compared to the comparable 2019 period. States implementing a telehealth parity policy in 2020 had 7.3% (95%CI - 13.3% to - 0.4%) fewer new buprenorphine treatment episodes. States joining the psychologist interstate compact in 2020 after the public health emergency declaration had treatment episodes 7.97days longer (95%CI 0.78 to 15.16) than other states. None of the other policies examined was associated with changes in new treatment episodes or treatment duration. Policies undertaken during the pandemic we examined were associated with few significant changes in buprenorphine treatment initiation and duration. Findings suggest realizing the benefits of telehealth and other policy changes for buprenorphine may require more extensive implementation and infrastructure support.

Exploring the attitudes and experiences of Hungarian primary care physicians on the utilisation of digital health solutions.

During the COVID-19 pandemic, digital health solutions ensured the continuity of care especially in primary healthcare practices. COVID-19 accelerated the adoption of digital health solutions. The aim of this study is to describe the digital health-related attitudes and experiences of Hungarian Primary Care Physicians (PCPs) and also analyse the socio-demographic effects on digital health attitudes among PCPs. This study used a quantitative and qualitative mixed methodological approach to examine the digital health-related attitudes and experience of Hungarian PCPs. As part of the "E-physicians and E-patients in Hungary" survey, we conducted an online survey among medical doctors working in Hungary between July 2021 to May 2022. A total of 1,774 questionnaires were received, consisting of 1,576 medical doctors and 198 dentists. Among the medical doctors there were 415 primary care physicians (PCPs). In addition to the online questionnaire survey, qualitative research in the form of semi-structured interviews with doctors was also conducted. These interviews took place between October 2021 and June 2022. A total of 62 interviews were conducted,19 with PCPs. Primary care physicians are more open to technologies that facilitate communication and collaboration with patients, while showing less interest in technologies that support clinical work. Of the demographic variables (age, gender, type of settlement), age was found to have the most significant effect on digital health knowledge, use and intended use. Both the interviews and the multivariate analysis indicate that individuals with greater knowledge, expertise, and experience are more likely to perceive the advantages of digital solutions. This highlights the importance of training, especially given the significant aging population among Hungarian primary care physicians, who may not be accustomed to using these tools naturally. The way PCPs perceive patient expectations regarding the use of digital health tools has a significant impact on the PCPs' use and intended use of digital tools. When looking at perceived patient needs among PCPs the effect of age and municipality type of PCPs is significant. As age increases, the perception of patient needs decreases (from 5.02 to 4.47), and by municipality type, the average number of perceived needs decreases as one moves from larger cities to smaller municipalities (from 4.85 to 4.14). Digital health solutions have the potential to enhance the work of PCPs, but successful implementation requires addressing specific needs, demographic differences, and challenges faced by PCPs. Development of infrastructure, education, and institutional support is necessary to ensure more efficient and higher-quality healthcare delivery through the use of digital technologies.

The Strategy of the Yogyakarta City Government in Implementing a Sustainable Zero Inorganic Waste Policy

This research aims to analyze the implementation of the Zero Inorganic Waste policy enacted by the Yogyakarta City Government, focusing on waste sorting strategies, infrastructure support, and challenges encountered in managing inorganic waste. The qualitative methodology involves field observations, in-depth interviews, and focus group discussions with various stakeholders. The research findings indicate that while this policy has successfully raised public awareness about waste separation, significant challenges remain, such as low public participation, limited infrastructure, and insufficient education efforts. Therefore, the government must increase resource allocation for waste management infrastructure and develop more effective educational programs to encourage behavioral change. This study’s contribution to urban waste management literature lies in its emphasis on the importance of a participatory and systematic approach to waste management and the need for public behavioral change to achieve sustainability goals. The conclusions of this study provide valuable insights for policymakers and practitioners in formulating more effective waste management strategies in Yogyakarta and other urban areas. This research also offers substantial theoretical contributions, particularly regarding the importance of participatory and systematic approaches in urban waste management and the necessity for societal behavioral changes to achieve sustainability objectives.

The Evolution of Cameroonian Cooperation with the Soviet Union and the Russian Federation: A Historical and Geopolitical Analysis

This paper investigates the historical and evolving relationship between Cameroon and the Soviet Union and later, the Russian Federation, focusing on political, military, economic, and cultural dimensions. Positioned strategically at the crossroads of West and Central Africa, Cameroon has balanced longstanding ties with France against a growing partnership with Russia. Since the Soviet Union’s formal recognition of Cameroon's independence in 1964, Soviet support in education, infrastructure, and ideological alignment contributed to a foundational relationship grounded in anti-colonial and socialist values. Following the dissolution of the Soviet Union in 1991, relations were reestablished with the Russian Federation, shifting from ideological alignment to pragmatic cooperation, particularly in defense and economic engagement. Key findings indicate that Russia cooperation with Cameroon cut across education, reciprocal visa exemption agreement for holders of diplomatic and service passports, food trade and military defense. The study uses a qualitative methodology, incorporating primary sources such as government records, treaty documents, and public statements, alongside secondary sources including academic articles and policy analyses. This approach allows for an examination of key historical milestones, the role of security concerns, and economic priorities that have shaped Cameroonian-Russian relations over the years.

Working from Home During and After COVID-19: A Narrative Review of Its Multifaceted Impacts

The COVID-19 pandemic accelerated the global adoption of working from home (WFH), fundamentally altering organizational practices and employee experiences. This narrative review synthesizes current research on the multifaceted impacts of WFH during and after the pandemic, focusing on job satisfaction, productivity, work-family balance, collaboration, innovation, and motivation. A comprehensive literature search was conducted across multiple academic databases, encompassing studies from January 2020 to July 2024 and covering diverse industries and employee demographics. Findings indicate that WFH offers numerous benefits, including increased flexibility, autonomy, and potential productivity gains. However, challenges persist, such as reduced social interaction, blurred work-life boundaries, and potential declines in collaboration and innovation. The effectiveness of WFH is influenced by factors like individual circumstances, job characteristics, technological infrastructure, and organizational support. Hybrid work models are emerging as potential solutions, balancing the advantages of remote work with the need for in-person collaboration. This review highlights the complexities of WFH and underscores the necessity for organizations to develop flexible, inclusive policies that address both employee preferences and operational needs. Further research is recommended to explore long-term impacts and best practices for integrating WFH into sustainable organizational strategies.

Evaluating VR-Based Learning Experiences for Enhanced Engagement

Abstract: This research paper investigates the role of Virtual Reality (VR) in transforming educational experiences and enhancing student engagement. As educational institutions increasingly incorporate immersive technologies into their curricula, this study evaluates how VR-based learning environments can facilitate deeper engagement and improved learning outcomes. Through a qualitative approach, the research includes qualitative insights from interviews and focus groups assessing learner perceptions of VR experiences. The findings reveal that VR significantly enhances engagement by providing immersive, interactive, and contextually rich learning experiences, thereby promoting active participation and motivation. Additionally, the study highlights the potential of VR to cater to diverse learning styles and foster collaboration among students. However, challenges such as technical limitations, accessibility issues, and the need for adequate teacher training are also addressed. The paper concludes with practical recommendations for the effective implementation of VR in educational settings, emphasizing the importance of creating a supportive infrastructure to maximize its educational benefits.

Artificial Intelligence and Employment Transformation: A Multi-Sector Analysis of Workforce Disruption and Adaptation

This academic investigation examines the bifurcated impact of artificial intelligence (AI) on contemporary labor markets, analyzing both displacement effects and employment generation across multiple sectors (n=327) during 2020-2024. Through a mixed-methods approach combining econometric analysis of industry-level data, semi-structured interviews with key stakeholders (n=142), and longitudinal case studies of AI-implementing firms (n=47), we demonstrate that while AI automation has led to a 23.4% reduction in traditional middle-skill jobs across manufacturing, logistics, and administrative sectors, it has simultaneously generated a 31.7% increase in new employment categories, particularly in AI development, human-AI collaboration, and digital transformation roles. The findings reveal significant sectoral variations in job displacement rates (ranging from 8.2% to 37.6%) and identify critical factors influencing successful workforce transition, including the timing of reskilling initiatives, the nature of institutional support, and the elasticity of labor market responses. Notably, organizations that implemented proactive reskilling programs achieved a 64% higher retention rate of displaced workers compared to those utilizing reactive approaches. The article also uncovers an emerging "adaptation gap" wherein 42% of displaced workers face significant barriers to transitioning into new roles, primarily due to misaligned skill development programs and insufficient support infrastructure. These findings have important implications for policymakers, business leaders, and educational institutions in developing targeted interventions to facilitate effective workforce adaptation in an AI-driven economy.

Harnessing Artificial Intelligence to Transform Secondary Education in India: Innovations, Challenges, and Future Directions

India's National Education Policy (NEP) 2020 envisions a comprehensive education system that is inclusive, fair, and geared towards lifelong learning. Artificial Intelligence (AI) has a pivotal role in achieving these goals by enhancing personalized learning experiences, streamlining assessments, and promoting inclusivity within secondary education. This paper explores the integration of AI in Indian secondary education, analyzing its alignment with NEP 2020 objectives. It highlights AI innovations, such as adaptive learning platforms and automated grading systems, while also addressing challenges like data privacy, infrastructure limitations, and the need for teacher training. Through a review of recent literature and case studies, this paper offers recommendations for the responsible adoption of AI in India, underscoring the importance of policy support, ethical standards, and regional infrastructure development.

Analysing the Impact of Natural Disasters, Pandemics and Other Crisis on Employment and Workforce Dynamics

This study investigates the impact of recent crises such as natural disasters and pandemics on employment and workforce dynamics using a Random Forest machine learning model. The data was collected through a detailed questionnaire analyzing various factors, including demographic information, employment status, the impact of crises, job security, coping mechanisms, and future outlook. The findings reveal that most respondents are young adults, with a higher percentage engaged in full-time or self-employment roles. Crises, notably COVID-19, led to significant financial impacts such as reduced salaries and layoffs, with many experiencing jobs in security and moderate to high stress levels. A substantial portion of the workforce transitioned to remote work, though many reported inadequate employer support. The analysis of the Random Forest model indicates a moderate performance in predicting workforce dynamics, with accuracy, precision, recall, and F1 scores highlighting the complexity of this issue. The study provides practical recommendations such as enhancing remote work infrastructure, improving financial and mental health support, and promoting workforce adaptability to mitigate the adverse effects of future crises and ensure a resilient workforce.

The Role of the Internet of Things in Enhancing Sustainable Urban Energy Systems: A Review of Lessons Learned from the COVID-19 Pandemic

ABSTRACT The Internet of Things (IoT) has emerged as an indispensable technology enabling the efficient management of energy consumption and deployment of renewable energy solutions within urban energy systems. While urban energy systems can be made sustainable in both smart cities (SC) and traditional cities, the former provide a more advantageous environment for achieving sustainability thanks to advanced technology integration, data-driven decision-making, integration of renewable energy, as well as policy and infrastructure support. Across the globe, cities are evolving into SCs through the implementation of sustainable urban energy systems and adaptation to the latest IoT technologies. For them, advanced cutting-edge technologies such as digital twins, artificial intelligence (AI), Big Data, and IoT are all positioned to underpin the civic platform for new forms of a city that is simultaneously sustainable and prosperous. The COVID-19 pandemic brought about significant challenges, emphasizing the need for resilient and sustainable urban environments and demonstrating that IoT became a must for the modern cities in energy generation, transmission, and the efficient use of energy sources by cities. This bibliometric review focuses on the new role of IoT in the development of post-COVID sustainable urban energy systems. It demonstrates how IoT can help to efficiently manage energy consumption and to deploy novel renewable energy solutions in the cities using the experience from the two years of the COVID-19 pandemic. The article explores the role of IoT in the post-COVID urban energy development highlighting how the technology can contribute to sustainable urbanization. It employs the extended literature review including both 151 publications retrieved from the Web of Science (WoS) database selected based on the relevant keywords and the analytical tools based on Google Trends as well as the enhanced network dynamics VOSviewer v.1.6.15 software (the latter being frequently used for identifying the dominant trends in intersectoral bibliometric research). The findings stemming from this research can contribute to the clustering of the discussion of the strategies required for boosting SCs’ development and growth. Therefore, the results and outcomes can provide many useful insights for academics and stakeholders alike on the role of the IoT in the development of sustainable urban energy in post-pandemic cities.

Tantangan Perkembangan Pencak Silat di Kota Tangerang Selatan: Analisis Keterbatasan Fasilitas dan Pendidikan

Pencak silat is a form of traditional martial arts that has high cultural and philosophical values in Indonesia. However, in South Tangerang City, the development of pencak silat faces significant challenges. This study aims to identify and analyze the obstacles faced in the development of pencak silat in this area, focusing on the lack of facilities and infrastructure as well as the lack of lesson time in schools. Through in-depth interviews with five figures from various martial arts institutions, namely Deni Asmara from Tapak Suci, Ahmad Maulana from Perguruan Silat Al Qoyyum, Fitrah Febri Salam from MS Jalan Enam Pengasinan, Gufron from Pencak Silat Padjajaran Cimande, and Delima Bungsu Andy, Chairman of IPSI Kota Tangerang Selatan, this research reveals that limited infrastructure and inadequate educational support are the main obstacles. The results of this study are expected to provide insights for stakeholders in formulating pencak silat development strategies in the city.

Improving the quality of postgraduate training in educational science and teacher training in Viet Nam

Introduction. Higher education plays a pivotal role in addressing the demands of socio-economic development and aligning with the needs of the labor market. To achieve this strategic objective, higher education institutions in Vietnam are redefining their pedagogical approaches, curriculum frameworks, and professional development initiatives. In response, some universities in the Mekong Delta region have introduced more postgraduate training programs in educational science and teacher training. However, these initiatives face challenges that impede their effectiveness. A significant gap exists between actual needs and the prevailing conditions necessary to ensure the quality of these training programs. This study aims to evaluate the effectiveness of quality assurance measures in these programs and highlight key areas for improvement to better align with contemporary educational standards. Materials and Methods. This research employs a convenience sample consisting of 235 participants, comprising managers such as presidents, vice presidents, principals, vice principals, deans, vice deans, and department heads, as well as lecturers from 8 universities offering educational science and teacher training programs in the Mekong Delta region of Vietnam. Notably, approximately 45% of the participants are female. Furthermore, nearly all participants, both managers and lecturers, hold doctoral degrees. Participants completed a comprehensive survey assessing various aspects of postgraduate training. The assessment used a Likert scale with 38 observed variables to quantify perceptions of quality across different facets of the educational experience. Results. Our result showed that there are 8 universities offer programs in educational sciences and teacher training. Postgraduate programs: 19 master's majors across 4 universities and only 4 doctoral majors across 3 universities; Teaching staff: the region has 2 professors, 39 associate professors, and 217 PhDs involved in training. Despite these efforts, challenges remain due to the limited number of postgraduate programs available. Evaluation of postgraduate training quality in the Mekong Delta region highlights areas of strength and opportunities for improvement. Key findings from 136 lecturers and 99 managers include: a) quality of teaching staff: average rating around 2.8 to 2.9, indicating room for improvement; b) research capacity: average rating around 2.7 to 2.8, highlighting the need for enhanced research initiatives; c) facilities and resources: rated positively with averages around 3.5 to 3.6; e) areas of concern: collaboration on scientific research and document compilation received lower ratings (2.2 to 2.4), indicating immediate need for improvement. Conclusion. The study underscores the necessity for continuous development in postgraduate training programs within the Mekong Delta's educational institutions, Vietnam. It recommends the adoption of integrated strategies that encompass upgrading faculty skills, revising curricula to include contemporary educational needs, and bolstering infrastructural and administrative support to foster a conducive learning environment. These enhancements are vital for preparing educators who are capable of navigating the complexities of modern educational demands and contributing effectively to the region's educational advancements.

Trends in the incidence of young-adult-onset diabetes by diabetes type: a multi-national population-based study from an international diabetes consortium

Population-based incidence data on young-adult-onset type 1 diabetes and type 2 diabetes are limited. We aimed to examine secular trends in the incidence of diagnosed type 1 diabetes and type 2 diabetes with an age of onset between 15 and 39 years. In this multicountry aggregate data analysis, we assembled eight administrative datasets from high-income jurisdictions and countries (Australia, Denmark, Finland, Hungary, Japan, Scotland, South Korea, and Spain [Catalonia]) that had appropriate data available from an international diabetes consortium (GLOBODIAB) describing incidence by diabetes type among people aged 15-39 years from 2000 to 2020. We modelled type 1 diabetes and type 2 diabetes incidence rates using Poisson regression including age and calendar time by sex. During the years 2000-20, there were 349 591 incident diabetes (both types) cases from 346 million person-years of follow-up among people aged 15-39 years. Over time, there was no statistically significant change in the incidence of type 1 diabetes in Hungary and Japan. The incidence of type 1 diabetes significantly increased in Australia, Denmark, Finland, Scotland, South Korea, and Spain, with annual changes ranging from 0·5% to 6·0%. The incidence of type 2 diabetes significantly increased in four of eight jurisdictions (Denmark, Finland, Japan, and South Korea), with annual increases from 2·0% to 8·5%. The magnitude of increase in incidence of type 2 diabetes was greater in Asian than non-Asian jurisdictions. There was no statistically significant change in type 2 diabetes incidence in Australia and Hungary. The incidence of type 2 diabetes significantly decreased in Scotland and Spain, with annual changes of -0·7% and -1·5%, respectively. There is variability in the trajectory of the incidence of young-adult-onset type 2 diabetes among high-income countries or jurisdictions, with a greater evidence of increase in Asian than non-Asian countries. Evolving trends in the incidence of type 1 and type 2 diabetes in young adults call for the ongoing surveillance of diabetes incidence and a greater research focus on this population. US Centers for Disease Control and Prevention, Diabetes Australia Research Programme, and Victoria State Government Operational Infrastructure Support Programme.

A Comparison of Medical Education Policies in Japan and Singapore with a Focus on Governance: Implications for Korea

Among Asian nations, Japan, Singapore, and South Korea exemplify countries with high standards of medical quality. This review explores the differences in medical education policies between Japan and Singapore, particularly concerning governance, and discusses the implications for South Korea’s medical education policies. Relevant documents were analyzed by referencing scholarly articles and data from governmental and expert organizations in each country. In Japan, advances in medical education policies include initiatives such as the regional quota system and the core curriculum model, which emphasize stakeholder engagement and transparency. However, challenges persist due to limited stakeholder participation, necessitating a transition toward a more equitable governance paradigm. Singapore’s model features robust public-private partnerships with minimal direct governmental intervention, emphasizing innovation and community integration, as seen in the Healthier SG project. These case studies demonstrate effective governance involving significant stakeholder collaboration and strategic financial investments. Conversely, South Korea’s medical education policies face challenges from a predominantly government-centric approach, with an absence of cohesive governance structures and inadequate involvement from essential professional stakeholders. This situation has led to policy inconsistencies and a deficit of strategic direction, exacerbated by insufficient financial support for educational infrastructure and program development. The experiences of Japan and Singapore indicate that it would be beneficial for South Korea to adopt integrated governance frameworks that prioritize transparency and collaboration. Furthermore, increasing financial investment in medical education could mitigate existing deficiencies and improve the quality and effectiveness of its healthcare education system.

The Impact of Social Media Influence and Online Shopping Habits on Consumer Behavior and Social Identity in the Digital Economy in Indonesia

This study examines the impact of social media influence and online shopping habits on consumer behavior and social identity in the context of Indonesia’s digital economy. Using a quantitative approach, data were collected from 280 respondents through a Likert-scale questionnaire, and Structural Equation Modeling with Partial Least Squares (SEM-PLS) was employed to analyze the relationships. The results reveal that both social media influence and online shopping habits significantly affect consumer behavior and social identity. Additionally, consumer behavior and social identity were found to contribute strongly to the growth of the digital economy. The findings highlight the pivotal role of digital platforms in shaping consumer actions and identities, driving Indonesia’s digital economy. The study provides practical insights for businesses to leverage social media and e-commerce in influencing consumer behavior and for policymakers to foster a supportive digital infrastructure.

Socio-Cultural Approach through Digital Teaching Modules: A Solution to Improve Beginning Reading Skills in Elementary Schools

The low level of early reading skills among primary school students in Indonesia is one of the significant challenges in education. International evaluations such as PISA show that Indonesian students' basic literacy skills are still below average, affecting their overall academic development. One of the contributing factors to these low results is learning that is less relevant to students' socio-cultural context. Therefore, this study aims to investigate the effect of a socio-cultural-based digital teaching module on primary school students' beginning reading skills. This study used a quasi-experimental design with a sample of 200 grade 1 students divided into experimental and control groups. The experimental group learned using socio-cultural-based digital teaching modules, while the control group applied conventional learning methods. The instrument used was a beginning reading test with 20 questions that measured the ability to recognize letter symbols, distinguish words based on the same initial letter or syllable, and compose syllables into words. Independent Sample T-Test analyzing an independent sample, ensuring that the ty and homogeneity tests were met. The results revealed significant differences between the experimental and control groups, with the experimental group showing more significant improvement in all indicators of beginning reading ability. Further discussion showed that the socio-cultural-based approach in this module made learning more relevant, exciting and interactive for students, ultimately improving their reading comprehension and motivation. In addition, integrating digital technology in this module supports flexibility and continuity of learning, allowing students to learn according to their pace and needs. This research has important implications, namely the need for broader implementation of Socio-Cultural Based Digital Teaching Modules in primary schools to improve basic literacy. However, to ensure its successful implementation, adequate technological infrastructure support and teacher training are needed to optimize this digital-based learning in the classroom.

Nurse leaders’ recommendations for implementing LGBTQ+ inclusive practices in health systems: A qualitative descriptive study

BackgroundDiscrimination against lesbian, gay, bisexual, transgender, queer or questioning, and other sexual and gender diverse (LGBTQ+) individuals in healthcare settings remains a priority issue. Nurse leaders, who oversee the largest healthcare workforce, are critical in implementing inclusive practices to address LGBTQ+ discrimination, yet implementing LGBTQ+ inclusive practices and effective strategies is inconsistent. This qualitative descriptive study explored nurse leaders’ perceptions of LGBTQ+ inclusive practices across the United States to inform recommended strategies within health systems. MethodsTwenty-one nurse leaders (e.g., chief nurse executives) from diverse healthcare settings (e.g., children's hospitals and public health centers) in 12 states across the United States participated in semi-structured interviews from October to December 2023. Interview transcripts were analyzed using content analysis to (1) describe nurse leaders’ definitions of LGBTQ+ inclusive practices and (2) identify effective strategies for their implementation. ResultsNurse leaders defined LGBTQ+ inclusive practices to include delivering culturally responsive and competent care, fostering safe and affirming environments, integrating inclusivity into daily interactions and organizational culture, and supporting the needs of both LGBTQ+ staff and patients. Key implementation strategies included fostering a flexible organizational culture through open communication; a diverse workforce; and inclusive mission statements, policies, and strategic plans. Supportive infrastructure involved effective LGBTQ+ training and adapting electronic health record systems to include information on sexual orientation and gender identity. Active and interdisciplinary engagement from staff and leadership, as well as systematic data collection on patient and staff experiences, were essential for driving inclusivity. The advocacy highlighted included legislative support, discourse within the nursing profession, and the incorporation of LGBTQ+ inclusion into healthcare regulations and accreditation standards. Additionally, multisectoral partnerships with LGBTQ+ health experts and external organizations, along with multilevel evaluations, were recommended to develop tailored interventions and promote LGBTQ+ inclusive practices. ConclusionImplementing LGBTQ+ inclusive practices in healthcare is a multifaceted effort influenced by strategies at various levels. Promoting a supportive organizational culture, establishing comprehensive support structures, encouraging active engagement, and fostering community partnerships can address the needs of LGBTQ+ individuals more effectively. Future implementation efforts should tailor strategies to accommodate variability across healthcare settings and regions, ensuring that practices are both adaptable and sustainable.

Knowledge, attitudes, and referral practices for smokers to a state tobacco quitline in a federally qualified healthcare center: Healthcare provider perspectives.

Federally qualified healthcare centers (FQHC) treat a large population of low-income patients disproportionately burdened by tobacco use. This study investigated healthcare providers' knowledge, attitudes, and referral patterns of patients who smoke to a state tobacco quitline. The study used a descriptive-qualitative design. In-depth interviews were conducted in 2021 with a sample of healthcare providers recruited from a federally qualified healthcare center (FQHC) in a large city in the Midwest. The interviews were guided by a standardized moderator's guide and lasted 30-45 minutes. Written informed consent was obtained before each interview, and participants completed a brief self-administered survey. Among the 25 participants, 92% were female and 44% were Black. Participants included medical providers (52%), behavioral health providers (16%), and other types of providers (32%). Participants' age and work experience averaged 41.5 and 5.25 years, respectively. Only 32% of providers reported having specialty training in smoking cessation or addiction counseling. Over half (52%) of the participants never or rarely referred patients to the Illinois Tobacco Quitline (ITQL). Providers reported several barriers to referring patients to the ITQL, including limited knowledge about services offered, time constraints, difficulties with the referral process, and lack of feedback between providers and the ITQL. Further, providers described patient-related barriers, including low motivation to quit smoking, language barriers, and failure of patients to respond to calls from the quitline. Recommendations were described for improving patient and provider education, referral processes, and increasing bi-directional communication between providers and the quitline. Providers identified numerous barriers to referring patients for smoking cessation treatment. Addressing the identified barriers requires a multi-faceted approach involving education, streamlined processes, supportive infrastructure, and patient-centered interventions to strengthen provider use and satisfaction with the available resources.

Cellular Internet of Things: Principles, Potentials and Use Cases

Internet of things (IoT) can either be deployed over existing cellular networks or their own custom-built standalone networks. Based on the infrastructure, IoT can be classified into two types: cellular and non-cellular categories. In the cellular form, IoT network needs the support of cellular infrastructure of the mobile service providers. Currently, three forms of cellular IoT are being deployed across the world. They are: narrowband Internet of things (NBIoT), extended coverage GSM (EC-GSM) and long term evolution for machines (LTE-M). Out of these three, NBIoT and EC-GSM are low energy and low resource consuming versions of cellular IoT. They need narrow bandwidths for their operations. Their energy consumption is also very low and thus suitable for low energy applications. Both NBIoT and EC-GSM are compatible with all types of cellular communication infrastructure such as 2G, 3G, 4G and 5G. They can cover a large area with a very small amount of power. Both these forms are popular low power wide area (LPWA) technologies. Due to their LPWA features, they are popular for the connected living applications at home and workplace surroundings. Their LPWA features make them popular green technology for digital transformation. LTE-M uses comparatively larger bandwidth and higher power. It is suitable for higher bandwidth and higher data rate applications. We survey the recent literature on cellular IoT and present their key principles, potentials and applications. We provide their main characteristics, deployment options, standards, and some specific applications in different sectors.