Insufficient Knowledge Research Articles

Psychiatrists’ beliefs, awareness, and attitudes toward gender variance: A French cross-sectional study

ObjectivesThe evolution of knowledge and recommendations concerning transgender health has led to various representations, especially for health professionals, that can influence the medical management of transgender individuals. The main objective of this study was to explore the representation of psychiatrists in France regarding gender variance. The secondary objective was to compare these data based on their characteristics. MethodsThis is a cross-sectional observational study based on the distribution in April 2022 of a questionnaire to psychiatrists and psychiatric residents in France. The questionnaire was developed after exploring the results of qualitative studies in the scientific literature. ResultsAmong 359 respondents, 181 were psychiatric residents and 178 were senior psychiatrists. Ninety percent had already met a transgender person in their professional practice. The representations observed among the respondents were heterogeneous. Most respondents did not consider “transgenderism” a symptom of a psychiatric disorder, and nearly all respondents used the gender and name their patients ask for. About 60% reported insufficient knowledge about “transgenderism”, with 86% considering that they had not been trained to adequately support transgender people. ConclusionsThe study reveals that representations, although weakened by a lack of knowledge recognized by psychiatrists, favor a non-pathologizing apprehension of gender variance and recognition of the importance of respecting gender diversity and self-determination. The heterogeneity of representations, as well as the high prevalence of professionals who describe a lack of knowledge, skills, and training, support the need for guidelines and the integration of evidence-based knowledge about gender variance into the psychiatric curriculum.

DevOps Adoption Guidelines, Challenges and Benefits: A Systematic Literature Review

The DevOps methodology in software engineering is currently trending and many software development organisations are adopting it to stay competitive. However, these organisations face difficulties in adopting DevOps due to a lack of common standard guidelines and methodology. We argued that guidelines across multiple platforms are needed to succeed in DevOps implementation. This paper aims to identify the benefits, challenges, and guidelines associated with DevOps adoption using a systematic literature review. The search spanned over ten digital libraries such as ACM Digital Library, ScienceDirect, EBSCOhost, SAGE Journals, Wiley Online Library, and so on. The review also included keyword searches in relevant studies i.e DevOps guidelines, DevOps and guidelines, DevOps benefits, DevOps and benefits, DevOps challenges, DevOps and challenges. Papers written in English and published from 2011 through July 2020 were considered. 33 studies passed the two-step quality assessment. Finally, the data were extracted and analysed based on the themes and research questions, revealing the benefits and challenges of DevOps adoption guidelines. The findings show that improved software delivery speed increases code quality and application quality with frequent releases. It also shows that there was no transparent scientific approach to determining the DevOps capabilities regarding the process, practice, tools, and implementations, cost implications, and insufficient knowledge of the automation process. Finally, the reviewed studies indicated that software quality increases whenever DevOps best practices are adopted. DevOps is about continuous software delivery. Previous studies have not considered the guidelines for scientifically adopting DevOps for organisations that want to migrate. The present review identified the DevOps adoption guideline model represented in a cyclic format that indicates an infinite process representing continuous integration, continuous delivery, and continuous deployment, with an understanding of benefits and challenges.

Factors Associated with Health-related Quality of Life in Moroccan Adults with Asthma

Introduction: The assessment of asthmatics’ health-related quality of life (HRQOL) has become an important outcome measure of the disease’s effects from the patient’s perspective. This study aims to assess the asthmatics’ QOL and determine the factors affecting it. Methods: A cross-sectional study was conducted among 220 adult people with asthma attending the Pneumology Department of Hassan II University Hospital in Fez from March to May 2022. Patients were questioned by a face-to-face questionnaire, an asthma control test, an observance questionnaire, a knowledge questionnaire, and a specific asthma QOL questionnaire. The influence of the variables was evaluated by bivariate analysis and multiple linear regression. Results: The mean age was 48.4 ± 15.4. 71.8% were women, half were not attending school, and 77.7% lived in urban areas. 67.7% were nonsmokers, and 72.73% were passive workers. Only 42.27% complied well with treatment, and 41.82% have well-controlled asthma. The majority of people had insufficient knowledge. The QOL was considered good for 20% of the participants, poor for 11.8%, and average for 68.2% of the patients. The mean of the global QOL score was 5.1 ± 0.9. The most significant factors associated with a higher QOL were good asthma control (ß = 0.70; P ≤ 0.001), good knowledge score (ß = 0.125; P = 0.013), insurance coverage (ß = 0.144; P = 0.005), and work activity (ß = 0.133; P = 0.007). Conclusion: Our study found multiple factors affecting asthma patients’ QOL, including asthma control, knowledge, and socioeconomic status. We can take some measures to improve the situation through patient education.

The Hypocritical Oath? Unintended Consequences of Prenatal Substance Use Policies and Considerations for Health Care Providers.

Prenatal substance use (PSU) is a serious perinatal health issue in the United States with consequential health effects. To address this issue and protect children from the detrimental effects of substance exposure during pregnancy, the US government amended the Child Abuse Prevention and Treatment Act to provide funding to states with protocol to notify child protective services of PSU cases and develop treatment plans for affected families. Although well-intentioned, this statute resulted in diverse inter- and intrastate interpretations and implementation of PSU regulations nationwide, ultimately leading to mass confusion about who the policy applies to and when it should be applied. PSU policies are largely punitive in nature, which has led to null or adverse effects on perinatal outcomes. Treatment-prioritizing policies present hope for supporting birthing parents who use substances; however, their potential benefits are obstructed by fear and confusion instilled by coexisting punitive policies, stigma of disclosing substance use during pregnancy, variable or lack of screening methods, and insufficient knowledge about PSU health risks and counseling methods. Precis: Punitive prenatal substance use policies may result in adverse perinatal outcomes. Treatment-oriented protocols and legislation should be prioritized.

Clinical Approach to STRIDE-II in Real-Life Settings: Analysis and Practical Recommendations.

We aimed to (1) analyze the applicability of the updated Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE-II) recommendations in real-world clinical practice, (2) identify barriers to their implementation, and (3) propose practical measures to overcome these obstacles. This qualitative study was based on a survey, a literature review, and expert opinions. Nine inflammatory bowel disease (IBD) experts identified 7 areas likely to be controversial or potential implementation barriers in daily clinical practice: endoscopy, histology, ultrasound, quality of life, biomarkers, symptom control, and patient-reported outcomes (PROs). Based on this, a survey was carried out among educational course participants. The experts discussed the literature review and survey results and proposed several statements and practical actions. A total of 55 gastroenterologists answered the survey. The reported difficulty level in reaching STRIDE-II treatment goals in clinical practice was high. Only 22% of participants performed clinical remission assessments using clinical indexes and PROs. Seventy percent of responders did not use fecal calprotectin cutoffs and considered changes from the previous levels instead. Mucosal healing as a long-term therapeutic goal was considered necessary to be individualized in specific patient subgroups (eg, elderly/fragile patients, multiple treatment failures, and last-line therapies). Other barriers, like the lack of access to imaging techniques or insufficient knowledge and skills among healthcare professionals, were detected. The experts suggested adding less stringent treatment goals and measurements, patient stratification, local adaptations, educational activities, and research. STRIDE-II recommendations face various implementation barriers needing careful evaluation in order to enhance their adoption in clinical practice, and ultimately improve outcomes in IBD patients.

Analytical Study on the Impact of Teaching-Learning of ‘Transformation Geometry’ in Secondary Schools in General using Van Hiele’s Model

An analysis of the methods involved in the teaching-learning of the topics related to Transformation Geometry’ is one of the topics in mathematics in which learners have not been performing very well. The purpose of the study is aimed to identify the difficulties of the learners encounter when learning transformation geometry using Van Hiele’s model. Data was analysed through a process of coding, categorizing, clustering and performance indicators corresponding to the Van Hiele’s model were used in the analysis of data. The result of the study indicated that learners, experienced difficulties to solve problems involving enlargement transformation geometry problems. Learners struggle to grasp the fundamental concepts of enlargement, particularly with the concept of the centre and scale factor. The study findings revealed the challenges faced by the students in comprehending geometrical figures that were transformed to a larger dimension. The Learners inability to understand the steps of transformation geometry because they had insufficient background knowledge on the topic is taken to relevance in this paper writing. The study focuses on the limitations, challenges and remedies being intended for better learning prospects.

Knowledge, Behavior, and Influencing Factors of Coarse Grain Consumption among Chinese Adults: A Focus Group Study in Xi’an

BackgroundCoarse grains are rich in fiber, minerals, and other beneficial nutrients but are consumed at low levels in modern populations. The factors that influence coarse grain consumption in current living and dietary environments are not fully understood. ObjectiveThis study aimed to explore the knowledge and behavior related to coarse grain consumption and identify the influencing factors among Chinese citizens. MethodSix focus group discussions were conducted with 39 participants aged 18–65 years from diverse social backgrounds in Xi'an, China. All discussions were transcribed verbatim and analyzed using inductive thematic analysis. ResultsThe majority of participants demonstrated insufficient knowledge about coarse grains, including their definitions, health benefits, and recommended intake. A small number of the participants reported regular consumption. The barriers to coarse grain consumption were poor sensory properties, insufficient cooking skills and time, limited availability of ready-to-eat foods, established dietary habits, and high price. Additionally, the new barriers included psychological burden, concerns about food safety, the impact of processing methods on health benefits, and special health conditions. Health benefits and family influence emerged as the two primary factors motivating coarse grain consumption. Most participants expressed a positive attitude toward partially replacing staple foods with coarse grains. Enhancing health education, innovating food processing methods, improving labeling systems, and strengthening safety supervision have been recommended for increasing coarse grain consumption. ConclusionA gap exists between health awareness and healthy behaviors regarding in coarse grain consumption, thus, collaborative efforts among government agencies, educational institutions, nutrition societies, the food industry, policymakers, and health professionals are essential to overcome these challenges.

Knowledge, Attitudes, and Practices Among Guardians of Boys Toward Concealed Penis.

Concealed penis (CP) is a condition involving a congenital abnormality of the external genitalia, wherein the penile shaft is partially or completely obscured by surrounding skin tissues, negatively affecting the psychological and physical health of children. The guardians, who are primarily responsible for the daily care of children, play a crucial role in the early detection of this condition. Therefore, this study aims to explore knowledge, attitude, and practices (KAP) toward CP among guardians of young boys; results would provide a theoretical basis for the development of health education programs. This web-based cross-sectional study was conducted among guardians of boys in the Department of Pediatric Surgery, local hospital between June 2023 and September 2023. A self-designed questionnaire was developed to collect demographic information of the guardians and to assess their knowledge, attitudes and practices toward CP. A total of 394 questionnaires were collected. Among the guardians, 143 (36.29%) of them were male, 375 (95.18%) were the parents of the children, 279 (70.81%) had a junior college or bachelor's degree, and 46 (11.68%) reported their children had CP. The knowledge, attitudes and practices scores were 4.00±2.00 (possible range: 0-7), 35.63±3.40 (possible range: 9-45), and 23.03±6.97 (possible range: 9-45), respectively. The structural equation model demonstrated that knowledge had direct effects on attitudes (β=0.63, p<0.001), and practices (β=0.81, p<0.001). Moreover, attitudes had direct effects on practices (β=0.43, p<0.001). This study found insufficient knowledge, positive attitudes, but poor practices toward the CP in guardians of boys, especially among participants from rural areas of families with lower income. It is recommended to tailor educational initiatives and implement strategies to bridge the knowledge-practice gap toward concealed penis in boys.

Speed dependence, sources, and directivity of small vessel underwater noise.

Small vessels (<10 m) radiate underwater noise in sensitive coastal environments, but there is insufficient knowledge of their noise radiation. Through detailed measurements of seven small boats and a jet ski in a shallow water environment on the Swedish west coast, this study presents results on the speed dependence of small vessel underwater noise, its sources, and its directivity. For vessels with planing hulls, broadband source levels increase with speed until planing is attained. When planing, source level dependence on speed is weak. A detailed noise source analysis of one vessel showed that at low speed, tonals from the engine dominate the noise radiation, whereas at higher speeds, propeller tonals and broadband noise dominate. Noise radiation into different horizontal angles shows little angle dependence, and noise levels relative to the closest point of approach show a similar pattern across all investigated vessels. Received noise levels at approximately 100 m range are not high enough to cause hearing impairment in marine animals, but fast-moving small vessels may cause behavioural reactions or stress responses across several marine animal groups.

Study of chemiluminescence of methane–air flame stabilized on a flat porous burner

In this work, the spatial distribution and spectral characteristics of the chemiluminescence of chemically excited species, OH∗ and CH∗, are experimentally and numerically studied by using a stationary premixed methane–air flame stabilized on the surface of a flat porous burner for various equivalence ratio and normal pressure. Numerical simulations are carried out using detailed reaction mechanisms, and the experimental study includes high-resolution spatial and spectral optical measurements. Despite the data reported in the literature, it is found that (i) the rotational degrees of freedom of OH∗ and CH∗ are not in thermal equilibrium with the surrounding gas and therefore cannot be used to measure flame temperature; (ii) there is no direct correlation between the heat release rate and the distribution of OH∗ and CH∗; (iii) the detailed reaction mechanisms not only quantitatively, and also qualitatively differ in description of the OH∗ and CH∗ concentrations. Since the chemically excited species are well localized in a direction normal to the flame surface, they are demonstrated to be a very accurate markers of flame location. The shape of the combustion front can be reconstructed and resolved up to the accuracy of tens of microns, which is very important for estimation of blow-off critical parameters and measurement of the laminar burning velocity.Novelty and significance statementCurrently, there is a growing interest in the development of sensors for combustion control systems, including active control and suppression of instabilities, in combustion chambers of various devices and engines based on chemiluminescence of excited reaction species. The possibility of non-invasive determination of parameters such as flame temperature, stoichiometry, heat release rate location, etc. using this technique is discussed. We have found that most of these parameters cannot be estimated either due to fundamental limitations or insufficient knowledge of the reaction kinetics involved in the production of these species. Nevertheless, since OH* and CH* are well localized in the direction normal to the flame surface, they can be used as very accurate markers of flame shape and position, allowing us to reconstruct the flame surface to within tens of microns resolution, which is very important for estimating blow-off critical parameters and measuring laminar burning velocity.

Knowledge, practices, and perceived barriers on breast self-examination of female college students: Experience from a local higher education institution

BACKGROUND: Breast self-examination (BSE) is an inexpensive, harmless screening tool for finding breast cancer. This study examines the knowledge, practices, and perceived barriers of female college students from a local higher education institution (HEI) regarding BSE, focusing on those in the reproductive age group. MATERIALS AND METHODS: Three hundred sixty (360) female college students, including 226 health sciences majors and 134 non-health sciences majors, were selected through criteria sampling. Data were collected using a self-administered questionnaire to assess knowledge, practices, and perceived barriers. RESULTS: Key findings reveal that despite excellent BSE practices (52.5%), a significant proportion of respondents (51.7%) demonstrated insufficient knowledge about BSE. The main barriers to BSE execution were fear of discovering concerning findings and fear of being diagnosed with breast cancer. Health science majors exhibited significantly higher knowledge and practices than non-health science students, perceiving lower barriers. Age was found to have no significant impact on the variables examined. Majors and perceived barriers were not associated with BSE, but knowledge showed a significant association. Despite their excellent practices, participants’ unsatisfactory knowledge regarding BSE suggests the need for effective interventions. Barriers primarily stemmed from fear, including the fear of a breast cancer diagnosis and the fear of learning about potential issues. CONCLUSION: The study highlights the association between knowledge and BSE practices, emphasizing the importance of knowledge development and overcoming perceived barriers to improve BSE practices and encourage greater engagement.

Olfactory-based powered descent guidance for Mars methane plume exploration in long-time-average wind environment

This paper investigates an olfactory-based powered descent guidance method that enable a lander to autonomously locate and target the vent source of any methane plume in long-time-average wind environment on Mars. The episodic methane plumes emanating from the Martian surface invite the possibility of direct access to the subsurface methane reservoir to acquire pristine organic materials. Constrained by the insufficient knowledge of the accurate plume vent location, Mars landers must infer the target location — the plume source — autonomously during the powered descent. However, existing powered descent guidance methods require the target location as a terminal constraint, rendering them ineffective in plume exploration missions. We propose an olfactory-based powered descent guidance method that could steer a lander to target the methane vent source by tracking the gradient of methane concentration in long-time-average wind environment, imposing sub-optimal fuel consumption. A novel olfactory navigation method based on tracking the negative logarithmic concentration gradient, and the corresponding gradient measurement method, is proposed. By implementing the negative logarithmic gradient field, gradient-dependent dynamic equations for the powered descending lander are proposed. The gradient-dependent equations provide a way to transform the original optimal guidance problem, which is non-convex and terminal-free, into a convex and terminal-fixed problem. A suboptimal guidance law, similar to E-guidance, is then derived by solving this problem. The proposed guidance could target the vent source of any methane plume in long-time-average wind environment, imposing modest fuel consumption by feeding back the concentration gradient. Numerical simulations illustrate that, in comparison to the terminal-fixed E-guidance and the open-loop fuel-optimal guidance, the lander imposes additional fuel consumption of 2.57% and 12.15% respectively, using the proposed guidance law.

Immediate allergies to chlorhexidine: A series of pediatric cases from the French pharmacovigilance database: Immediate allergies to chlorhexidine: series of pediatric cases from the French pharmacovigilance database

BackgroundImmediate allergic reactions to chlorhexidine have been clearly identified in numerous countries, generating governmental warnings worldwide. ObjectivesThe aim of our study was to characterize (i) these allergies, which are less reported in pediatric populations, and (ii) the patient-at-risk profile so as to suggest preventive measures. MethodsIn association with the allergy department and the regional pharmacovigilance center in Rennes University Hospital, France, a multicenter retrospective, descriptive, and observational study was conducted using data from the national pharmacovigilance database for the period of January 1, 2010 to June 30, 2020. Immediate allergies to chlorhexidine cases based on a clinical history compatible with an immunoglobulin E (IgE)-mediated reaction, along with positive allergic testing, were analyzed. ResultsOf the 478 cases identified, 17 pediatric cases of immediate allergic reaction to chlorhexidine (13 cases of grades II–IV anaphylaxis) were retained for the analysis. For 58.8 % of these cases, a history of a previous more moderate reaction to the substance was identified. The reactions occurred most frequently in cases of domestic misuse (88.2 %, n = 15/17) of chlorhexidine to dress a wound. Recurrence was reported for two cases, later leading to severe reactions at each new exposure to the allergen, suggesting an aggravation mechanism. ConclusionThe number of pediatric cases of immediate allergies to chlorhexidine has possibly been underestimated on account of insufficient knowledge of the allergy and in view of its common usage. Information on the method of caring for wounds among children and on the risk of allergic sensitization as well as exploring any unusual reaction to chlorhexidine application could reduce the number of allergic reactions.

Exploring perceptions and attitudes towards pregnancy danger signs among childbearing age women in the Al-Baha Region, Saudi Arabia.

The World Health Organization (WHO) estimates that complications related to pregnancy and childbirth affect approximately 300 million women in developing countries, causing both acute and chronic illnesses. Direct obstetric complications such as hemorrhage, sepsis, hypertensive disorders during pregnancy, obstructed and prolonged labor, and unsafe abortion account for approximately 75% of maternal deaths. This study aimed to assess the perceptions and attitudes towards pregnancy danger signs among women of childbearing age in the Al-Baha Region, Saudi Arabia. A descriptive cross-sectional hospital-based study was conducted using simple random sampling to select 446 pregnant women. After outlining the study's goal and ensuring confidentiality, data were gathered through a pre-tested, well-designed questionnaire. Data were analyzed using Excel and SPSS version 28. The assessment of the study participants about perceptions of pregnancy danger signs revealed that many were aware of signs such as bleeding, abdominal pain, and lack of fetal movement, indicating a comprehensive understanding of potential pregnancy complications. The study participants exhibited good knowledge and relatively positive attitudes towards pregnancy danger signs. However, a significant fraction showed negative attitudes and insufficient knowledge, suggesting room for improvement in maternal health literacy. The study also found a significant relationship between sociodemographic characteristics and knowledge.Most participants had good knowledge and perceptions about pregnancy danger signs, and their attitudes were relatively positive. However, there is a need to increase awareness and improve attitudes towards pregnancy danger signs among women in the Al-Baha Region.

Hubungan Pengetahuan dengan Peran Kader Posyandu Balita dalam Capaian Imunisasi Dasar Lengkap di Wilayah Kerja Puskesmas Bahaur Hilir Kabupaten Pulang Pisau

Knowledge and the role of posyandu (integrated service post) cadres are crucial and strategically important in providing health education to the community. According to 2023 data, the coverage of complete basic immunization at posyandu is significantly below the target. Surveys revealed that some cadres have insufficient knowledge and a minimal role in immunization services, such as providing counseling, encouraging, and motivating mothers to immunize their children. This study aims to determine the relationship between knowledge and the role of posyandu cadres in achieving complete basic immunization in the working area of Puskesmas Bahaur Hilir, Pulang Pisau District. Method: This research is a correlational study with a quantitative method using a cross-sectional approach. The sampling technique employed was total sampling, with 65 respondents. Data were collected using a questionnaire, and statistical analysis was performed using the Spearman correlation test. Results: The data analysis revealed a significant relationship between knowledge and the role of cadres, with a significance value (p-value) of 0.000 &lt; 0.05 and a strong correlation coefficient of 0.642. Conclusion: There is a significant relationship between knowledge and the role of cadres, with a strong correlation coefficient. It is recommended that posyandu cadres enhance their knowledge and active participation in posyandu activities and communicate information to the community to improve health outcomes.

KAP ANALYSIS AND DECISION-MAKING OF NURSES REGARDING SEPSIS ASSESSMENT AND MANAGEMENT IN CRITICALLY ILL PATIENTS

Sepsis is a life-threatening condition that requires prompt identification and management, particularly in critically ill patients. Nurses play a pivotal role in sepsis management, and their knowledge, attitudes, and practices directly impact patient outcomes. However, there is limited data on the awareness and competency of nurses regarding sepsis assessment and management, especially in low-resource settings. Objective: This study aimed to evaluate the knowledge, attitudes, and practices (KAP) of nurses towards the assessment and management of sepsis in critically ill patients. Methods: A cross-sectional study was conducted in the Intensive Care Unit (ICU) and emergency department of DHQ Hospital, Narowal, from July 2023 to July 2024. A total of 100 ICU and CCU nurses were selected using convenience sampling. Data were collected through a 32-item questionnaire that assessed knowledge, attitudes, and practices related to sepsis. Additionally, the 24-item Nursing Decision-Making Instrument (NDMI) was used to evaluate decision-making skills. Descriptive statistics were calculated, and relationships between variables were analyzed using t-tests and ANOVA. Results: The mean knowledge score was 5.1 ± 1.8, with 83% of nurses demonstrating poor awareness of sepsis. The mean attitude score was 2.0 ± 0.9, with 85% of nurses displaying negative attitudes toward sepsis management. The mean practice score was 79 ± 17.8, with 72% of nurses showing poor practice skills. The mean decision-making score on the NDMI was 63.3 ± 19.6. Qualifications (p=0.010, p=0.00) and work experience (p=0.005, p=0.050) significantly influenced knowledge and practice scores. Moreover, knowledge and practice scores varied significantly with different modes of decision-making (p&lt;0.001, p=0.020). Conclusion: The study revealed that ICU and emergency department nurses had insufficient knowledge, negative attitudes, and inadequate practices concerning sepsis assessment and management. Training programs, targeted educational interventions, and policy reforms are urgently required to improve nurses' competency and decision-making skills in sepsis management, ultimately enhancing patient outcomes.

The intersection between transgender identity and migrant background: experienced barriers and facilitators to healthcare in The Netherlands

Background Transgender and gender-diverse (TGD) people, particularly those with migrant backgrounds (mTGD), face health inequalities and barriers to care globally. Aim Examine barriers and facilitators to accessing and continuing healthcare within and beyond gender-specialist centers among mTGD people in the Netherlands. Methods TGD community researchers conducted in-depth interviews with 32 mTGD individuals from twenty-seven countries. Interviews were inductively thematically analyzed. Results Healthcare barriers relating to being TGD and being migrant compounded and interacted. Unmet transition needs, low socioeconomic status, and mental health issues were prevalent, and affected whether healthcare was a priority and access to healthcare. Having a supportive social network facilitated healthcare access. Beyond life circumstances, participants reported that providers outside gender-specialist settings had insufficient knowledge about TGD-related healthcare, and newcomers had difficulty bridging these gaps. The anticipation and experience of discrimination based on any facet of a participant’s identity formed a healthcare barrier, while identity validation was highly meaningful for participants and facilitated trust in providers. Continuity of caregivers was important to avoid having to re-explain one’s identity and needs, but alternating providers was often the reality - especially in refugee settings. Care models with TGD staff facilitated trust, and the integrated health and social care helped participants access healthcare whilst navigating complex life circumstances. Discussion mTGD individuals face unique barriers to accessing healthcare owing to their intersecting migrant and gender identities. Key improvements are enhancing cultural competency and knowledge on TGD healthcare among providers, ensuring equitable access to GAMC for migrants, and integrating gender-affirming care with other healthcare and social support.

Sistem Pakar Diagnosis Penyakit Gigi pada Anak Usia 5-12 Tahun Menggunakan Metode Forward Chaining

Children's dental health is a crucial aspect that must be carefully attended to, as despite being the hardest tissue in the human body, teeth are highly susceptible to bacterial attacks. Many parents neglect their children's dental health, mainly due to limited economic resources and insufficient knowledge about the importance of early dental care. Dental diseases in children can lead to more severe health problems if not properly treated. Therefore, a system is needed to help detect dental problems in children at an early stage. This expert system for diagnosing dental diseases in children is designed to replicate the thought process of a dentist in diagnosing dental issues based on symptoms inputted by the user. This study uses the forward chaining method, which is reliable in accurately identifying dental problems and providing early treatment recommendations, as well as oral health information. The system is expected to assist parents in detecting their children's dental issues and offering appropriate recommendations before consulting a dentist. Furthermore, this system has the potential to be used in clinics or health centers to support the dental diagnosis process more quickly and efficiently.

Botulinum toxin-related blepharoptosis in emergency department admissions

The use of Botulinum Toxin Type A (BoNT-A) has become prevalent not only for therapeutic purposes but also for cosmetic applications. Among healthcare professionals, there has been an increase in BoNT-A administration within familial or friend circles. This rise has corresponded with a notable increase in cases of unilateral blepharoptosis presenting in emergency department admissions. This trend may be attributed to insufficient knowledge and experience regarding the proper dosing of BoNT-A, inadequate understanding of facial anatomy, or anatomical variations of the supraorbital foramen or neurovascular pedicle. While BoNT-A administration for reducing facial wrinkles may appear straightforward for a healthcare professional, a thorough understanding of anatomy and the causes and treatment of blepharoptosis is essential.

Правовой инфантилизм как явление современной правовой реальности

Introduction. Legal infantilism being one of the varieties of legal conscience deformation is characterised by insufficient legal knowledge and the lack of well-defined legal attitudes. It has been widely spread throughout the world in the XXI century and can be defined as a social pandemic. Despite the fact that legal infantilism, along with legal nihilism and legal idealism is more frequently described in Russian scientific and educational publications and has become a matter of concern in court proceedings, so far this socio-legal phenomenon has not received proper attention in legal science. Methods. The methodology of the research of legal infantilism as a phenomenon of modern legal reality is based on dialectics. The main methods of the research were the principle of comprehensive study of legal processes and phenomena, the principles of unity of theory and practice, consciousness and activity, the principle of determinism. The research was carried out on the basis of system and value approaches. Methods of integrity and retrospective analysis made it possible to determine the development of the research topic, to identify the ideas of various scientific areas concerning the determinants of the formation of legal infantilism, its characteristics and manifestations in modern Russia during the historiographical analysis. The sociological method was an important one, it enabled to characterise the subjects - bearers of legal infantilism. General scientific (analysis, synthesis, generalisation, abstraction, historical) and special (historical-legal, interpretation of normative legal acts) methods were used. Results. Legal infantilism is examined as the manifestation of legal conscience deformation being a type of social infantilism. The paper defines the prerequisites for the development of legal infantilism, its distinctive features. It gives examples of manifestation in everyday, professional and scientific activities; and reveals the peculiarities of legal infantilism of the youth as a special social group. The study reveals the need for a comprehensive scientific analysis of legal infantilism as a phenomenon of modern legal reality, as the result of a gap or insufficient systematic assimilation of legal norms and legal values by an individual and a social group. It is proved that legal infantilism is a threat to the progressive development of the state and society, in this regard, in the context of determining the ways to improve the state-legal system of modern Russia, legal infantilism should be considered as a public danger.