Key Guidelines Research Articles

Information and communication technology-based patient education for autoimmune inflammatory rheumatic diseases: A scoping review

ObjectiveThis review aimed to map the existing the information and communication technology (ICT)-based patient education for autoimmune inflammatory rheumatic diseases and identify key effectiveness factors and guidelines for professionals. MethodsA scoping review systematically reviewed PubMed, Cochrane library, EMBASE and Web of Science. We designed search strategies to identify ICT-based patient education for autoimmune inflammatory rheumatic diseases focused on rheumatoid arthritis, ankylosing spondylitis, and systemic lupus erythematosus, published between January 2011 and October 2023. Data extraction was independently screened by two reviewers according to the eligibility criteria. ResultsOf 13,861 records, 18 met the eligibility criteria. Most studies were randomized controlled trials, primarily conducted in the USA, focusing on rheumatoid arthritis. ICT-based interventions included web-based platforms, aiming to improve self-management, medication adherence, with most interventions showing significant improvements. Digital tools such as websites, chatbots were common. Five groups representing the ICT functions were identified: digital self-management tools, multimedia learning materials, personalized educational sessions, behavior change and empathy games, and interactive online communities and peer support. Most studies lacked theoretical frameworks, or guidelines for developing patient education. ConclusionICT-based patient education has significant potential for enhancing self-management and behavior changes in patients with autoimmune inflammatory rheumatic diseases.

Addressing deficits in malnutrition care in northern Sierra Leone; an educational intervention

Abstract The 2017 Sierra Leone National Nutrition Survey reported poor practice regarding the medical management of severe acute malnutrition and the provision of emergency food to patients, particularly in the northern city of Makeni. We developed a training package for paediatric nurses, aiming to design an easily reproducible format which could be utilised nationally. Our aims were to empower and educate staff to provide more consistent care by challenging the negative cultural perception of malnourished patients and increasing knowledge of key guidelines. A two-day course based around UNICEF guidance on malnutrition was developed with the financial support of the Sierra Leonean office of the World Health Organisation. We sought the advice of local staff on issues impacting the quality of malnutrition care, including cultural barriers, educational limitations and supply issues. Lectures and practical sessions were devised covering recognition, assessment and management. Communication skills were taught using role play, focussing on the key role of nurses in parental education, and nursing skills were reinforced using practical tasks. Local staff identified for their strong teaching and leadership were recruited as instructors and to provide feedback on session design and content. 21 candidates attended from across the region, with the majority based in inpatient feeding units. Candidates completed a pre- and post-course written examination and a qualitative feedback form. Pre-course exam results ranged from 35%-85% with an average of 65%; post-course results showed improvement with a range of 55%-100% and an average of 88%. Candidates rated the course on average 9.7 out of 10 and the written feedback was positive. We subsequently observed positive changes in clinical practice in the inpatient feeding units across the region. Based on these assessments the course achieved its aims. Further study is needed to know if noted clinical improvements were sustained. Key messages • Challenging local cultural perceptions of malnourished patients is crucial to establishing improvement in medical care for this group. • Sustainable educational intervention requires local instructors who can independently deliver teaching, and establishing this cohort at the course inception is critical to its ongoing success.

Pharmacotherapy of acute ST-elevation myocardial infarction and the pharmacist's role, part 2: Complications, postrevascularization care, and quality improvement.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Key pharmacotherapeutic modalities and considerations for the patient with ST-elevation myocardial infarction (STEMI) across the later phases of inpatient care are reviewed. Published descriptions and validation of clinical pharmacist roles specific to the acute management of STEMI are limited. This high-risk period from presentation through revascularization, stabilization, and hospital discharge involves complex pharmacotherapeutic decision points, many operational medication needs, and multiple layers of quality oversight. A companion article reviewed STEMI pharmacotherapy from emergency department presentation through revascularization. Herein we complete the pharmacotherapy review for the STEMI patient across the inpatient phases of care, including the management of peri-infarction complications with vasoactive and antiarrhythmic agents, considerations for postrevascularization antithrombotics, and assessments of supportive therapies and secondary prevention. Key guideline recommendations and literature developments are summarized from the clinical pharmacist's perspective alongside suggested pharmacist roles and responsibilities. Considerations for successful hospital discharge after STEMI and pharmacist involvement in associated institutional quality improvement efforts are also provided. We aim to support inpatient pharmacy departments in advancing clinical services for this critical patient population and call for further research delineating pharmacists' impact on patient and institutional STEMI outcomes.

Using Principles of Good Governance by Educational Institution Administrators under the Jurisdiction of the Chaiyaphum Provincial Learning Promotion Office

Background and Aims: Effective public and social management Also known as good governance, it is an important guideline for organizing society which consists of the public sector. Private business sector and the public sector. The goal is to strengthen and increase the country's immunity. This research aims to: 1. study and compare the level of opinions of personnel on the application of good governance principles in the management of educational institutions by administrators under the Chaiyaphum Provincial Learning Promotion Office. Classified by educational level Position and work experience. And 2. survey the guidelines for developing educational institution administration according to the principles of good governance of educational institution administrators under the Chaiyaphum Provincial Learning Promotion Office. Methodology: The research sample consisted of 229 educational institution personnel under the Chaiyaphum Provincial Learning Promotion Office, which were obtained from stratified sampling. The research instrument consisted of a questionnaire with a 5-level rating scale, with an IOC value in the range of 0.80 – 1.00 and a reliability value of 0.91. Structured interviews were also conducted to collect data. Statistics used in data analysis include frequency, percentage, mean, and standard deviation, T-test, F-test and pairwise difference test using the Scheffé method. Results: The research results are summarized as follows (1) Using the principles of good governance by educational institution administrators Under the jurisdiction of the Chaiyaphum Provincial Learning Promotion Office. It was found that the overall level was at a high level. Especially the information technology management aspect is also at a high level. (2) Comparative analysis of the use of good governance principles by educational institution administrators under the jurisdiction of the Chaiyaphum Provincial Learning Promotion Office Classified by education level and work experience found that there was no difference. But when classified according to position and duty It was found that there was a statistically significant difference at the 0.05 level. (3) Guidelines for using the principles of good governance by educational institution administrators under the jurisdiction of the Chaiyaphum Provincial Learning Promotion Office It was found that the executives had established management guidelines that were accepted by the personnel. Adhere to the principles of correctness and goodness. Administer educational institutions according to criteria that can be verified. Provide opportunities for personnel to participate in educational institution development planning. and focus on the benefits that students will receive. By managing limited resources to provide maximum benefit to students. Conclusion: The research findings show that educational institution administrators under the Chaiyaphum Provincial Learning Promotion Office use good governance principles at a high level, particularly in information technology management. When comparing education level and work experience, no differences were found; however, significant differences emerged based on position and duty. Key guidelines for promoting good governance include establishing accepted management practices, maintaining integrity and transparency, involving personnel in planning, and prioritizing resource management to maximize student benefits.

Engaging Multidisciplinary Teams to Develop Pragmatic Clinical Practice Guidelines to Support Management of Patients With High-Risk Breast Lesions

IntroductionWe sought to develop clinical guidelines within our multidisciplinary Breast Center to support decision-making for managing high-risk breast lesions. The objective is to describe the process used to develop these guidelines and assess perceived acceptability. MethodsWe recruited clinical stakeholders to identify key “high-risk” topics. Stakeholder groups (surgery, radiology, pathology) met separately to review the topics, leveraging existing literature reviews and best available evidence. Guidelines were initially developed in 2015 and updated in 2019. We surveyed breast clinical team members in 2023 regarding the perceived acceptability of the guidelines and summarized the data. ResultsWe created clinical guidelines to address the management of atypical ductal hyperplasia, flat epithelial atypia, atypical lobular hyperplasia/lobular carcinoma in situ, radial scar/complex sclerosing lesion, and papillomas. Key guideline components included process for radiologic-pathologic correlation, patient disposition after biopsy (surgical referral needed, follow-up imaging recommended), recommendation for the role of surgical excision, and recommendation regarding imaging follow-up if excision not performed. Forty clinical team members (66% [40/60] response rate) completed the acceptability survey from varied disciplines. Most (78%) were aware of the guidelines. Respondents rated the recommendations for disposition after biopsy, surgical management, and follow-up imaging as the most helpful components. Most (> 80%) rated them to be very/extremely useful. ConclusionWe leveraged input from key stakeholders to develop clinical guidelines to support the multidisciplinary management of patients with high-risk breast lesions. Our guidelines have been successfully implemented across our academic and community practice. Future steps will assess the impact of implementation on clinical outcomes.

Key Guidelines for Responding to Reviewers

Background The process of preparing a scientific manuscript is intricate, encompassing several critical stages, including pre-writing, research development, drafting, peer review, editing, publication, dissemination, and access. Among these, the peer review process (PRP) stands out as a pivotal component requiring seamless collaboration among editors, reviewers, and authors. Reviewers play a crucial role in assessing the manuscript’s quality and providing constructive feedback, which authors must adeptly navigate to enhance their work and meet journal standards. This process can often appear daunting and time-consuming, as authors are required to address numerous comments and requested changes. Authors are encouraged to perceive reviewers as consultants rather than adversaries, viewing their critiques as opportunities for improvement rather than personal attacks. Methods Opinion article. Aim To equip authors with practical strategies for engaging effectively in the PRP and improving their publication acceptance rates. Results Key guidelines include thoroughly understanding and prioritizing feedback, maintaining professionalism, and systematically addressing each comment. In cases of significant disagreement or misunderstanding, authors have the option to refer the issue to the editor. Crafting a well-organized and scientific “response to reviews” along with the revised manuscript can substantially increase the likelihood of acceptance. Best practices for writing an effective response to reviews include expressing gratitude, addressing major revisions first, seeking opinions from co-authors and colleagues, and adhering strictly to journal guidelines. Emphasizing the importance of planning responses, highlighting changes in the revised manuscript, and conducting a final review ensures all corrections are properly documented. Conclusion By following these guidelines, authors can enhance their manuscripts’ quality, foster positive relationships with reviewers, and ultimately contribute to scholarly advancement.

Efficiency evaluation of waste management: A systematic literature review of DEA applications

This paper aims to implement a systematic literature review to survey the Web of Science scientific database and review papers with an emphasis on the application of Data Envelopment Analysis (DEA) in the efficiency evaluation of waste management. This approach includes the identification, screening, eligibility, and inclusion phase of the relevant papers. The article also provides a theoretical overview of waste management and the DEA methodology. Researching the Web of Science scientific database according to the keywords “waste management”, “waste disposal” and “data envelopment analysis” led to 12 full-text published papers written in English. Qualitative analysis of papers was carried out with an emphasis on the analyzed country, i.e. region, time frame, applied DEA model, and included input and output variables in the model. Research of this type complements the scientific literature on the importance of waste management and provides key guidelines to scientists, policymakers, and authorities on efficient waste management as one of the key problems of today's society.

Key Guidelines for Responding to Reviewers

Background The process of preparing a scientific manuscript is intricate, encompassing several critical stages, including pre-writing, research development, drafting, peer review, editing, publication, dissemination, and access. Among these, the peer review process (PRP) stands out as a pivotal component requiring seamless collaboration among editors, reviewers, and authors. Reviewers play a crucial role in assessing the manuscript’s quality and providing constructive feedback, which authors must adeptly navigate to enhance their work and meet journal standards. This process can often appear daunting and time-consuming, as authors are required to address numerous comments and requested changes. Authors are encouraged to perceive reviewers as consultants rather than adversaries, viewing their critiques as opportunities for improvement rather than personal attacks. Methods Opinion article. Aim To equip authors with practical strategies for engaging effectively in the PRP and improving their publication acceptance rates. Results Key guidelines include thoroughly understanding and prioritizing feedback, maintaining professionalism, and systematically addressing each comment. In cases of significant disagreement or misunderstanding, authors have the option to refer the issue to the editor. Crafting a well-organized and scientific “response to reviews” along with the revised manuscript can substantially increase the likelihood of acceptance. Best practices for writing an effective response to reviews include expressing gratitude, addressing major revisions first, seeking opinions from co-authors and colleagues, and adhering strictly to journal guidelines. Emphasizing the importance of planning responses, highlighting changes in the revised manuscript, and conducting a final review ensures all corrections are properly documented. Conclusion By following these guidelines, authors can enhance their manuscripts’ quality, foster positive relationships with reviewers, and ultimately contribute to scholarly advancement.

A systematic review and quality appraisal of guidelines and recommendations for home enteral tube feeding in adults.

Home Enteral Tube Feeding (HETF) is a viable option for people within primary care settings when oral intake is insufficient to meet nutritional needs. As HETF is not a risk-free therapy, guidelines exist to enable its safe provision. This review aims to summarise existing guidelines and their recommendations pertaining to the provision of HETF and appraise their methodological quality. A systematic review was conducted according to the Cochrane Handbook for Systematic Reviews, PRISMA-checklist and a 2019 methodological guide specific to the review of clinical practice guidelines (PROSPERO registration: CRD42023456223). Records were sourced from five bibliographical databases (Medline, Embase, PsychINFO, Scopus, Cinahl) and the grey literature (64 websites, seven guideline repositories). The AGREE-II tool was applied to eligible guidelines. The recommendations of guidelines meeting a predetermined threshold score (domain 3 'rigour of development' score >70%) were extracted, grouped, and assessed using the AGREE-REX tool. A total of 2707 records were screened with 15 guidelines meeting eligibility criteria. The median (IQR) overall AGREE-II score (/7) of all guidelines was 3 (3-5) and only 3/15 guidelines achieved a domain 3 score >70%. The median (IQR) overall AGREE-REX score was 33% (26-37%). No recommendation group achieved a domain score above 70%. No guideline or recommendation group was suggested for use without modification. Key limitations included suboptimal stakeholder involvement and implementability, and lack of methodological transparency. Current HETF guidelines inadequately align with methodological standards. This review highlights key areas HETF guideline developers should consider to create more relevant and implementable guidelines.

Low-Temperature Water Electrolysis Under a Sustained pH-Gradient for Electrochemically-Induced Decarbonation of Limestone into Hydrated Lime

Lime holds considerable potential in diverse environmental applications. However, its current production remains highly carbon-intensive, emitting more than one ton of CO2 per ton of lime. To address this issue, recent studies have explored the concept of electrifying the decarbonation of limestone to produce hydrated lime. In this work, a two-compartment electrolysis cell capable of producing Ca(OH)2 has been tested at different currents. Precise pH and Ca2+ concentration measurements demonstrate that the electrolysis setup is able to dissolve CaCO3 and precipitate Ca(OH)2 with near-perfect efficiencies. Notably, it highlights that Faraday’s law and the concept of transport number can be applied to predict both the equilibrium and kinetic behavior of each step of the process in each of the two cell compartments. Moreover, the use of controlled batch additions of CaCO3 in the system, as opposed to one-time excess addition, was assessed to mitigate the fouling of the cationic exchange membrane used to separate the compartments. Finally, based on the experimental findings, key guidelines are proposed to achieve a perfect reaction stoichiometry for each step. These findings pave the way for a more sustainable and environmentally friendly approach to lime production.

Evaluating the Accuracy and Completeness of Artificial Intelligence Responses Against Established Otology Guidelines

Background: The incorporation of artificial intelligence (AI), especially large language models like Generative Pretrained Transformer 4 (GPT-4), into medical practice is a burgeoning field of interest. This research evaluates the applicability of GPT-4 in otology by analyzing its responses to queries based on otologic clinical practice guidelines. Methods: Key guidelines from otology were selected, and corresponding questions were formulated to examine GPT-4’s interpretation and response accuracy. Two independent reviewers assessed the AI-generated answers for accuracy and completeness, using a structured Likert scale. A re-evaluation was conducted to evaluate the reproducibility of the results. Results: The analysis showed a high accuracy level (mean score: 4.75 of 5) and completeness (mean score: 2.88 of 3) in GPT-4’s responses. The interrater agreement, as indicated by Cohen κ, was substantial. GPT-4 consistently advised on individualized treatment plans and professional consultation, particularly for guidelines with weaker evidence, demonstrating its cautious approach to handling medical information. Conclusion: GPT-4 exhibits promising potential as an auxiliary tool in otology, providing accurate and comprehensive information. However, its role should be viewed as supplementary, with emphasis on continual updates and careful monitoring to align with evolving medical knowledge. Future studies are recommended to further explore the depth of AI application in diverse clinical scenarios and its real-time impact on clinical outcomes.

A survey on security of UAV and deep reinforcement learning

Recently, the use of unmanned aerial vehicles (UAV)s for accomplishing various tasks has gained a significant interest from both civilian and military organizations due to their adaptive, autonomous, and flexibility nature in different environments. The characteristics of UAV systems introduce new threats from which cyber attacks may benefit. Adaptive security solutions for UAVs are required to counter the growing threat surface. The security of UAV systems has therefore become one of the fastest growing research topics. Machine learning based security mechanisms have a potential to provide effective countermeasures that complement traditional security mechanisms. The main motivation of this survey is to the lack of a comprehensive literature review about reinforcement learning based security solutions for UAV systems. In this paper, we present a comprehensive review on the security of UAV systems focusing on deep-reinforcement learning-based security solutions. We present a general architecture of an UAV system that includes communication systems to show potential sources of vulnerabilities. Then, the threat surface of UAV systems is explored. We explain attacks on UAV systems according to the threats in a systematic way. In addition, we present countermeasures in the literature for each attack on UAVs. Furthermore, traditional defense mechanisms are explained to highlight requirements for reinforcement based security solutions on UAVs. Next, we present the main reinforcement algorithms. We examine security solutions with reinforcement learning algorithms and their limitations in a holistic approach. We also identify research challenges about reinforcement based security solutions on UAVs. Briefly, this survey provides key guidelines on UAV systems, threats, attacks, reinforcement learning algorithms, the security of UAV systems, and research challenges.

Author language and communication preferences, and familiarity with global publication guidelines, for English-language industry-sponsored publications in Asia-Pacific: insights from a cross-sectional survey

Objective To understand current practices and challenges for collecting author feedback for English-language, industry-sponsored publications in Asia-Pacific (APAC), and the implications for adherence to international publication guidelines. Methods A cross-sectional, internet-based survey of industry (‘internal’) authors (17 questions) and publication professionals (18 questions) supporting publications in APAC, conducted between November 18 and December 4, 2022. Results Overall, 142 survey responses were received, of which 94 (66%) were complete and included in the analysis (33 internal authors, 61 publication professionals). Almost half (45%) of internal authors preferred a non-English language for providing feedback on publications, and most (70%) would use this language whenever possible. Internal authors favored written (91%) versus spoken (73%) English, and email was the preferred mode of communication. Publication professionals said they have observed qualitative differences when authors provide feedback in a preferred non-English language versus English. Many agreed that authors tend to provide more substantive or critical feedback when they can respond in their preferred non-English language. Internal authors had low self-assessed familiarity with key publication guidelines, while most publication professionals had a moderate or high self-assessed familiarity. The main barriers to application of publication guidelines, as rated by publication professionals, were that external authors in APAC are not familiar with global publication guidelines and do not always provide feedback/responses in writing. Conclusion It is important to consider the diverse language, cultural, and communication preferences of individuals involved in English-language publication development in APAC, and to ensure that authors are aware of current publication guidelines and best practices.

Tubal Cancer Clinical Management: Two Exceptional Scenarios and a Review of the Literature.

This article provides a literature review on tubal carcinoma to offer an updated insight into its preventative strategies, diagnosis, treatment and oncological surveillance. In addition to the search string utilized, the authors' focus extended to key scientific studies, consensus statements, guidelines and relevant case reports essential for the proper clinical management of the disease, providing a methodologically well-structured literature review combined with practical expertise in the oncological field. This article also includes two special clinical cases that emphasize the importance of understanding the physiopathology and the current state of the art in the anatomopathological advancements in tubal/ovarian/peritoneal carcinoma, often assimilated into a single clinical entity and to which many of the concepts extracted from the literature can apply.

Process Modelling of Integrated Bioethanol and Biogas Production from Organic Municipal Waste

One of the key guidelines in the European waste management policy is the diversion of waste from landfills, preventing harmful effects on human health and the environment and ensuring that economically valuable waste materials are efficiently recycled and reused through proper management. The organic fraction of municipal waste is abundant and contains biodegradable ingredients such lignocellulose, starch, lipids, pectin, and proteins, making it suitable for biotechnological production. Taking into account that a large amount of organic waste is disposed of in landfills, within this work, the amount of organic waste disposed of in the landfill in Banja Luka was considered. Four simulation model scenarios of the integrated production of bioethanol and biogas are generated, and their process and economic aspects are discussed. In the first two modelled scenarios, the pretreatment conditions (1% sulfuric acid and a different neutralization agent) were varied, while in the other two, the share of the amount of raw material used for the production of bioethanol, i.e., biogas, was varied (split factor: 10–90%). The modelled plant, with a designed capacity of 6 tons/h of organic waste, is a significant bioethanol producer, generating 5,000,000 L/year. The profitability indicators, when examined, revealed that dedicating a portion of the organic municipal waste input exclusively to biogas production leads to decreased process efficiency. Based on the modeled process parameters, ethanol’s minimum feasible selling price is $0.6616 per liter, while regarding the composition of organic municipal waste, carbohydrates have the most significant impact on the viability of the process. The developed model represents an excellent basis for further development of this integrated bioprocess in such a way that it can be modified with new process parameters or economic or ecological indicators and used at all levels of bioprocess design. Additionally, the obtained sustainable integrated bioethanol and biogas production plant models could support forthcoming steps in municipal waste management by providing reliable data on the conditions under which the integrated process of bioethanol and biogas production would take place, as well as the technical feasibility and economic profitability of such organic municipal waste utilization.

Key Guidelines for Responding to Reviewers.

The process of preparing a scientific manuscript is intricate, encompassing several critical stages, including pre-writing, research development, drafting, peer review, editing, publication, dissemination, and access. Among these, the peer review process (PRP) stands out as a pivotal component requiring seamless collaboration among editors, reviewers, and authors. Reviewers play a crucial role in assessing the manuscript's quality and providing constructive feedback, which authors must adeptly navigate to enhance their work and meet journal standards. This process can often appear daunting and time-consuming, as authors are required to address numerous comments and requested changes. Authors are encouraged to perceive reviewers as consultants rather than adversaries, viewing their critiques as opportunities for improvement rather than personal attacks. Opinion article. To equip authors with practical strategies for engaging effectively in the PRP and improving their publication acceptance rates. Key guidelines include thoroughly understanding and prioritizing feedback, maintaining professionalism, and systematically addressing each comment. In cases of significant disagreement or misunderstanding, authors have the option to refer the issue to the editor. Crafting a well-organized and scientific "response to reviews" along with the revised manuscript can substantially increase the likelihood of acceptance. Best practices for writing an effective response to reviews include expressing gratitude, addressing major revisions first, seeking opinions from co-authors and colleagues, and adhering strictly to journal guidelines. Emphasizing the importance of planning responses, highlighting changes in the revised manuscript, and conducting a final review ensures all corrections are properly documented. By following these guidelines, authors can enhance their manuscripts' quality, foster positive relationships with reviewers, and ultimately contribute to scholarly advancement.

Formulation and Evaluation of Herbal Hand Sanitizer

Hands are the to begin with mode of transmission of organisms and diseases. Hand cleanliness is a key guideline and work out in the anticipation, control and lessening of contaminations. Due to COVID widespread the require of hand sanitizer has expanded which causes less dryness to hand. Considering the require, we arranged a polyherbal sanitizer utilizing seven plant extricates with other fixings counting isopropyl liquor, camphor, hydrogen peroxide, glycerol and water. The fixings were chosen on the premise of their antimicrobial property. The fixings and sanitizer were assessed for antimicrobial property and appeared strong action against gram positive microbes S. aureus, though blend of extricates appeared strong action against all the bacterial strains utilized but B. cereus. The sanitizer moreover appeared strong action against all the strains utilized in the climbing arrange of Klebsiella spp. > B. cereus > S. aureus > S. pyogenes > P. aeruginosa > Dermatophyte > E. coli and gave zone of hindrance of 18±0.05, 12±0.03, 11±0.01, 10±0.01, 9±0.5, 9±0.01 and 7±0.001 mm separately. The antimicrobial action was compared with other commercial hand sanitizer and greatest movement was appeared against Klebsiella spp. and least against E. coli and P. aeruginosa by all the sanitizer utilized. The adequacy of hand sanitizer was checked on hands of 38 volunteers of research facility specialists, patients and their relatives with composed and verbal assent. The sanitizer decreased or disposed of the development of pathogens confined from hands. Time interim impact was moreover checked at a time crevice of two hours too appeared the impact of hand sanitizer for longer time with diminishment in bacterial development. The sanitizer pH was soluble with great rack, surface and odor. No turbidity was seen when kept at higher temperature for 3 months and appeared no skin dryness with relieving impact after utilizing sanitizer on diverse volunteers.

Breaking down barriers to COPD management in primary care: applying the updated 2023 Canadian Thoracic Society guideline for pharmacotherapy.

Chronic obstructive pulmonary disease (COPD) is a highly prevalent yet under-recognized and sub-optimally managed disease that is associated with substantial morbidity and mortality. Primary care providers (PCPs) are at the frontlines of COPD management, and they play a critical role across the full spectrum of the COPD patient journey from initial recognition and diagnosis to treatment optimization and referral to specialty care. The Canadian Thoracic Society (CTS) recently updated their guideline on pharmacotherapy in patients with stable COPD, and there are several key changes that have a direct impact on COPD management in the primary care setting. Notably, it is the first guideline to formally make recommendations on mortality reduction in COPD, which elevates this disease to the same league as other chronic diseases that are commonly managed in primary care and where optimized pharmacotherapy can reduce all-cause mortality. It also recommends earlier and more aggressive initial maintenance inhaler therapy across all severities of COPD, and preferentially favors the use of single inhaler therapies over multiple inhaler regimens. This review summarizes some of the key guideline changes and offers practical tips on how to implement the new recommendations in primary care. It also addresses other barriers to optimal COPD management in the primary care setting that are not addressed by the guideline update and suggests strategies on how they could be overcome.

Landscape analysis of the Kenyan policy on the treatment and prevention of diarrheal disease among under-5 children

ObjectiveDiarrhoea remains a leading cause of morbidity and death among under-5 children in Kenya, despite multipronged policy and programme initiatives to increase access to treatment. This study interrogates the comprehensiveness...

Unveiling the Narratives of Portuguese Professionals Engaged with Domestic Violence Victims: Persistent Challenges and Novel COVID-19 Impacts.

Domestic violence remains a complex and challenging issue, particularly for professionals engaged in providing support to victims. The occurrence of emergency situations, such as the COVID-19 pandemic, further exacerbates the difficulties faced by these practitioners. This study aims to explore the lived experiences of professionals working with domestic violence victims, with a specific focus on the primary challenges encountered during interventions. It also aims to identify key guidelines that could enhance their practices. Twenty-four professionals from the domestic violence victim support in Portugal participated in this qualitative research. Through semi-structured interviews and thematic analysis, the study identified a range of challenges professionals confront in their intervention efforts. These challenges encompassed various aspects of the intervention process, vulnerabilities observed in victims, and the existing support system. Furthermore, the study uncovered specific challenges posed by the COVID-19 pandemic. Alongside these challenges, the research highlighted a set of recommendations designed to refine intervention strategies and promote better professional adaptation. The findings underscore the array of challenges that professionals grapple with, impacting both their strategies for intervention and their overall well-being. Thus, the development of effective intervention methodologies for professionals and organizations emerges as a crucial endeavor, essential for assisting domestic violence victims in their daily lives and enhancing preparedness for potential future crises.