Key Message Research Articles

Anti-epileptic Drugs Use and Increased Risk of Stroke: A Systematic Review.

Background: Antiepileptic drugs (AEDs), the predominant treatment for epilepsy, are also utilised for migraine, neuropathic pain, and bipolar disorders, accounting for 1% of usage among the common population. There is a greater risk of stroke, heart attack, and arrhythmia among AED users particularly those with enzyme-inducing properties. Summary: This systematic review aimed to look into the ischemic stroke risk among AED users, particularly in patients who had never had a cerebrovascular accident before. English-language literature was searched in the databases of PubMed, EMBASE, and Google Scholar between 2000 and 2021. Studies should report the association between AEDs and the ischemic stroke risk. The outcomes for assessing efficacy and safety were: event ratio, hazard ratio, odds ratio, and risk ratio. Seven of the eight studies showed an increased risk of ischemic stroke associated with AEDs among individuals without a history of cardiovascular accidents Phenytoin, sodium valproate, oxcarbamazepine, levetiracetam, phenobarbital, and carbamazepine were all linked to an increased risk of stroke. Adequate data on the association between the duration of AED exposure and stroke was missing. Key message: Not all AEDs are enzyme inducers. We conclude significant stroke risk with AEDs (mainly enzyme inducers), and dose dependency need to be assessed. The risks and benefits of AEDs should be weighed among the patients, especially with vascular risk factors to limit the risk of ischemic stroke.

Healthcare workers’ perceptions of strategies supportive of their mental health

BackgroundThe COVID-19 pandemic exacerbated existing stressors and created additional challenges for healthcare workers, such as increased workload, rapidly changing policies and procedures, resource and workforce shortages and work-life imbalance. This study examined what frontline healthcare workers consider to be the organisational strategies needed to support their mental health and wellbeing during crisis events. Methods: The Australian COVID-19 Frontline Health Workers Survey, a national, anonymous online survey of health care workers, was conducted between August-October 2020, during the second wave of the Australian COVID-19 outbreak. Drawing on participant responses collected as part of this survey, we analysed thematically the free-text question, ‘What strategies might be helpful to assist frontline healthcare workers during future crisis events like pandemics, disasters, etc.?’ Results: A total of 5527 healthcare workers responded to the free-text question asking about support strategies for future crises. Findings highlighted the challenges experienced by frontline workers during the COVID-19 pandemic and outlined suggestions for organisational strategies to support the mental health of the health workforce long-term. Specifically, four key themes that linked organisational support strategies to organisational culture were identified. These were: Workplace structures to support a mentally healthy work environment; Supportive leadership and management; Strengthening a sense of community to support mental health; and Organisational culture normalising mental health support. Conclusions: The key message from this research is that organisational strategies that enact a supportive work culture, rather than a focus on individuals alone, are required to protect the mental health of healthcare workers in the future.

Quantum Privacy Query Protocol Based on GHZ-like States

The rapid development of telemedicine technology has brought great convenience to people’s lives. Alongside generating great convenience, protecting patients’ privacy has become increasingly important. Therefore, to solve the above problems, this paper proposes a quantum privacy query protocol based on GHZ-like states. The protocol first utilizes existing diagnostic information for classification to encode symptom attributes. Then, the correlation after measurement using GHZ-like entangled states is utilized so that the querying party can only obtain a key message with the assistance of a third party. Through the above operation, the database cannot know the address of the message queried by the querying party, and the querying party is also unable to obtain more information. The protocol not only adds decoy factor detection but also adds the process of authentication while checking for illegal eavesdropping. It makes the protocol sufficiently resistant to joint attacks, participant attacks, and external system credit attacks. This database privacy query protocol ensures that the database service is more effective and its environment is more secure.

Not all men: the debates in social networks on masculinities and consent

Evidence shows the role men can have to contribute to the prevention of non-consensual relationships and gender violence, mainly fostering educational and social strategies which strengthen egalitarian male models that take consent as a key aspect in their sexual and affective relationships. In this regard, social networks show the existence of discourses that reinforce these male models. However, there is a gap in the analysis of how the previously mentioned discourses on consent are linked to men’s sexual satisfaction. The present study deepened into this reality by analysing messages on Reddit and Twitter. Drawing on the Social Media Analytics (SMA) technique, conducted in the framework of the European large-scale project ALL-INTERACT from the H2020 program, the hashtags notallmen and consent were explored aimed at identifying the connections between masculinities and consent. Furthermore, three daily life stories were performed with heterosexual men. Findings shed light on the relevant positioning of men about consent as a key message to eradicate gender-based violence; in parallel, they reveal the existence of New Alternative Masculinities that have never had any relationship without consent: they only get excited by free, mutual and committed consent, while repulsing unconsented or one-sided relationships.

Stories from the Global South: the interplay of climate science, ‘action’ and the implications for development

ABSTRACT Calls for humanity to act on environmental changes are becoming increasingly critical. The growing polycrisis including the impact of ongoing conflicts in contested geopolitical spaces and the struggles for ways to sustain a livelihood in areas of precarity and poverty, are just some of the intersecting challenges which have given rise to a Code Red alarm by the United Nations surrounding issues related to climate change. Rich narratives and stories of climate actions from Africa offer examples of potential paths. This paper explores how such narratives inform local development and climate action. A key message is that stories and narratives, created by various peoples, disciplines, and systems of knowledge, can all be powerful genres and sources for agentic change that can inspire and embolden development practice and action.

Key message as a basis for strategic communication

The article has studied the essence and meaning of the key message as a component of the organization's strategic communication and defined the role of the key message in ensuring effective communication impact on its target audiences. It is noted that the process of strategic communication, like any organizational communication, involves the presence of such key elements as the sender and recipient, the message, and the channel through which it is transmitted from the sender to the recipient. But at the same time, this process is aimed at realizing the organizational mission and achieving strategic goals. The message is the key to achieving communication impact. Key messages create focus, control, and intensity of influence on the company's target audience. The development of key messages is the second most important block of a strategic communications plan, in addition to defining target audiences. Key messages define what needs to be said to each of the target audiences. They are the essence of what needs to be communicated, bearing in mind that effective communication is primarily related not to what is said or sent, but to how it is perceived by the recipient and what his actions are as a result. The broad ways of conveying key messages are written, visual, verbal, and non-verbal communication, as well as their various combinations. Key messages must be carefully planned and prepared so that they are credible and broadly applicable to the organization's goals. The main requirements for key messages are formulated and the main features of the process of their development are considered. Key messages should be concise, relevant, persuasive, accessible to the target audience, and consistent with the company's mission, values, and strategy. The process of developing a key message includes the following main stages: reviewing the organizational mission, strategy, goals, and objectives; definition of the target audience; formulation of the purpose of the message; determination of messaging needs; analysis of competitors' messages; identification of advantages that distinguish the company's offers from others; supporting claims with supporting details that differentiate the company and add credibility.

The practice of key messages for optimal breastfeeding and associated factors among lactating mothers in the Boset District, Oromia, Ethiopia.

Inadequate breastfeeding can lead to significant morbidity, mortality, and long-term adverse health outcomes. Key messages promoting optimal breastfeeding are integral to Essential Nutritional Action, aimed at improving children's nutritional status, especially those under the age of two. However, there is a dearth of data regarding the extent to which lactating mothers adhere to these key messages and the associated factors. Therefore, this study aimed to assess the level of practice of key messages for optimal breastfeeding and identify associated factors among lactating mothers living in the Boset District, Oromia, Ethiopia. A community-based cross-sectional study was conducted among 418 lactating mothers from January 1st to February 28th, 2022. The participants were selected using a systematic random sampling technique, and data were collected through interviewer-administered questionnaires. The collected data were entered into Epi Info version 7 and exported to SPSS version 25 for analysis. Binary logistic regressions were performed to examine the association between independent and dependent variables. Adjusted Odds Ratios with a 95% confidence interval were used to estimate the strength of the associations and statistical significance was declared at a p-value < 0.05. The overall level of practice of key messages for optimal breastfeeding was 63.9% (95% CI: 59.1-68.2). The odds of practicing key messages for optimal breastfeeding were higher for mothers who attended antenatal care four times or more (AOR = 2.7, 95% CI: 1.4-5.3), received counseling on breastfeeding during postnatal care (AOR = 3.7, 95% CI: 2.2-6.4), had a good knowledge of breastfeeding (AOR = 6.2, 95% CI: 3.6-10.7), and had a favorable attitude toward breastfeeding (AOR = 6.1, 95% CI: 3.5-10.6). Breastfeeding key message practices among lactating mothers in the study area fell below the recommended universal coverage of 90%. Factors identified included the number of antenatal care visits, counseling on breastfeeding, level of knowledge, and attitude toward breastfeeding. Promoting regular antenatal visits, providing thorough postnatal counseling, and enhancing knowledge and attitudes are crucial for improving optimal breastfeeding practices.

Variability and determinants of vascular plant species composition in patches of old managed oak forest stands dispersed within Scots pine monocultures

In the temperate zone of Europe, Scots pine forests are expected to occupy the poorest habitats which are unfavourable for deciduous trees. However, as a result of deforestation of the most fertile habitats and the preference for Pinus sylvestris in silviculture, pine forests have become the dominant feature of the landscape in Central Europe. As a result, the area of optimal habitat for deciduous forest flora has been significantly reduced. Nevertheless, remnant patches of deciduous forest persist as habitat islands within extensive pine forest complexes and may serve as important refugia for meso- and eutrophilic forest species. However, the factors that contribute to the variation in species composition of such habitat islands and their role in maintaining biodiversity remain poorly understood. This paper aims to fill this knowledge gap.The studied deciduous (oak) stands exhibited a diverse vegetation, with species composition influenced by overstorey attributes, oak age, patch location, and the area and circularity of the deciduous forest. Species traits related to environmental variables included mainly preferences for closed or open forests, requirements for soil moisture, reaction, and fertility, and requirements for light conditions. The key message from our research is that oak islands are not simply patches of trees that are different from the surrounding area. Instead, they represent distinct plant communities that have developed to adapt to the prevailing environmental conditions by recruiting species with particular traits. The presence of oak islands within Scots pine monocultures is therefore important for increasing the diversity of the forest complex.The most relevant recommendation from our research for forest management is to maintain as many patches of deciduous tree stands as possible within a single pine forest complex, as even small habitat islands can make a significant contribution to the biodiversity of the forest complex.

HOW IT WORKS 4: ANATOMY AND PHYSIOLOGY OF PREGNANCY – WHAT’S IN A MATERNAL HEARTBEAT?

The risk of cardiovascular disease in pregnancy has increased due to increasing age at first pregnancy and is the major cause of maternal death during pregnancy.1 Good maternal health and wellbeing is key to the best outcomes for both mother and baby. A key message from MBRRACE2 for health professionals is around heart disease. This article focuses on maternal health but as a midwife you also need to have an awareness of how poor maternal health can affect the fetus, baby, child and then ongoing adult health. There are vast amounts of additional reading that you need to do to support your knowledge around the maternal cardiac system and cardiovascular disease.

Super-Networks Shaping International Agreements: Comparing the Climate Change and Nuclear Weapons Arenas

Abstract While research on transnational advocacy networks (TANs) is well established in international relations, knowledge gaps remain concerning TAN collaboration across policy fields. To address this gap, this article highlights how super-networks (networks above individual TANs) emerge across issue areas and explores the tactics utilized to achieve their objectives and shape international agreements. We develop an analytical framework that emphasizes the important interplay between political opportunity structures, mobilizing structures, and tactics in understanding how super-networks operate. We apply this framework via a comparative case study approach, analyzing the Inter-Constituency Alliance, whose advocacy brought about the inclusion of human rights language in the 2015 Paris Climate Agreement, and the International Campaign for the Abolition of Nuclear Weapons, whose activities based on humanitarian principles resulted in the 2017 Treaty on the Prohibition of Nuclear Weapons. Contributing new knowledge to TANs research, we identify that super-networks utilize multilevel advocacy activities that draw upon a package approach tactic. Via the package approach, super-networks synthesize multiple voices from different issue areas into one key message grounded in humanitarian framing, thereby enhancing their moral leverage and legitimacy, making it more difficult for states to neglect their concerns.

Beyond quick answers: Encouraging a problem-solving mindset in assessments

In this edition of Assessment News, Charles Darr uses a case study from the National Monitoring Study of Student Achievement (NMSSA) to highlight how students can benefit from activating deliberate thinking in assessments. The key message underscores the value of using assessment information to generate insights that inform better teaching and learning.

Place and Role of Environmental Communication in Modern Environmental Policy

The issue of climate change and its impact on the sustainable development of countries and entire continents has become a key "agenda" in recent years. At the site of the United Nations (UN), international documents have been adopted, which are supported by the majority of states. They rely on them in the preparation and implementation of the national environmental policy, paying considerable attention to communication with the key subjects of the relationship. The purpose of this study is to analyze the place and role of environmental communications in the formation and implementation of environmental policies of states. To do this, the author uses the method of comparative analysis of the environmental policies of countries included in the implementation of the modern climate agenda (USA, EU, China, Russia). Results: in the practical part of the study, the author studies government strategies and laws on climate change issues, considering environmental policy from the point of view of the communication process. The key message, the main subjects of communication, mechanisms for achieving goals, tools and management structures are explored. Conclusions: Consideration of government strategies shows that climate change is at the forefront of environmental policy. And its model is formed as a reaction to the pressure of various social groups and is a consequence of eco-competitive struggle. Environmental policy is the object of environmental communication. The latter, in turn, contains two key components: regulatory and strategic, which are reflected in official documents. Achieving the strategic goals of environmental policy is possible if there are three components: economic resources, social organization and political power. The result of communication goals is to legitimize environmental policy through its approval by society. A high capacity for public participation is essential for the acceptance, credibility and sustainability of environmental programs.

Diaphragmatic Hernia in a Parturient: A Case Report

Introduction: Diaphragmatic hernia is a condition in which abdominal contents enter the thoracic cavity through an abnormal opening in the diaphragm. Though diaphragmatic hernia in pregnancy is a rare occurrence it imposes challenges in terms of mode and time of delivery along with repair of hernia. Case Report: A 34-year female G2 P1 L1 with 37 weeks 4 days gestational age presented in latent labour. Patient had undergone an Emergency LSCS with B/L Tubectomy under General Anaesthesia anda live male baby of birth weight 3.74 kgs was delivered. After extubation the patient had one episode of drop in saturation and oxygen supplementation was started immediately and patient was shifted to icu for observation. A chest x-ray was done which showed bowel loops in the thoracic cavity. Later an HRCT was done confirming large defects of 5 x 7 cm of stomach, small bowel loops, large bowel loops and mesentery herniating into the left hemithorax with mild mediastinal shift to right and complete collapse of left lung suggesting diaphragmatic hernia. There was no evidence of a gastric volvulus or bowel ischemia. Patient gives history of abdominal pain radiating to back and thigh along with fever and dry cough since 2 days. No history of chest pain, breathlessness, palpitations, epigastric pain, nausea, vomiting, headache, blurring of vision or burning micturition. No significant past or family history. General surgery and pulmonology opinion was taken which explained the need for cardio thoracic surgery intervention and the patient was referred to higher centre. Conclusion: Diaphragmatic hernia complicating pregnancies are rare in occurrence imposing severe complications. Early diagnosis clinically and radiologically should be evaluated in pregnant women having gastrointestinal symptoms not responding to standard treatments. Key Message: Usually diaphragmatic hernia presents in early childhood and needs surgical intervention. This was a rare presentation in the third trimester of pregnancy with mild gastrointestinal symptoms. In diaphragmatic hernia the most complicating symptom is obstruction which need immediate surgical intervention.

Management of urinary incontinence in females by primary care providers: a systematic review.

To describe primary care provider (PCP) practices for the assessment and management of females with urinary incontinence (UI), and appraise these practices relative to recommendations made in high-quality clinical guidelines. Studies were searched in four databases (MEDLINE, EMBASE, CINAHL, Web of Science) from their respective inception dates to 6 March 2023. All studies describing UI evaluation and management practices used by PCPs for female patients were eligible. Two reviewers independently selected studies assessed their quality and extracted data. A narrative synthesis of included studies was performed to describe practices. Relevant evaluation and management practices were then compared to recommendations that were consistent across current high-quality UI guidelines. Pharmacotherapy, referrals, and follow-ups were reported descriptively only. A total of 3475 articles were retrieved and, among those, 31 were included in the review. The majority reported a poor-moderate adherence to performing a pelvic examination (reported adherence range: 23-76%; based on eight studies), abdominal examination (0-87%; three studies), pelvic floor muscle assessment (9-36%; two studies), and bladder diary (0-92%; nine studies), while there was high adherence to urine analysis (40-97%; nine studies). For the conservative management of UI, studies revealed a poor-moderate adherence to recommendations for pelvic floor muscle training (5-82%; nine studies), bladder training (2-53%; eight studies) and lifestyle interventions (1-71%; six studies). Regarding pharmacotherapy, PCPs predominantly prescribed antimuscarinics (2-46%; nine studies) and oestrogen (2-77%; seven studies). Lastly, PCPs referred those reporting UI to medical specialists (5-37%; 14 studies). Referrals were generally made <30 days after diagnosis with urologists being the most sought out professional to assess and treat UI. This review revealed poor-moderate adherence to clinical practice guideline recommendations. While these findings reflect high variability in reporting, the key message is that most aspects of patient care for female UI provided by PCPs needs to improve.

A comparison of glance coding approaches for driver attention assessment

Eye tracking is a common tool to assess drivers’ attentional state, either in real-time with the goal to prevent incidents, or offline, to understand underlying processes. While seemingly objective, eye tracking data can be coded and interpreted in different ways, which can have substantial effects on the results. The objective of this paper is to highlight and discuss the possibilities and limitations of three different approaches to code glance data: the direction-based encoding, the target-based approach, and the purpose-based approach. The direction-based coding scheme describes glances relative to the direction of travel. The target-based approach classifies the glance targets into different categories. The purpose-based approach needs additional layers of information to deduce the reason for the glance. This information encompasses road layout, traffic rules, and the presence and relevance of other traffic. Data from a field study with 23 participants driving an instrumented vehicle on an urban route was used to illustrate differences between the three methods. The results showed that the coding approach clearly affected the interpretation of the measured glance data. A purely target-based approach is limited by its inability to account for spare visual capacity and that also the absence of a target constitutes valuable information, and a purely direction-based approach does not account for the need to scan areas located off forward. The purpose-based approach requires contextual information that can be cumbersome to integrate. Regardless of the approach used, additional layers of contextual information increase understanding and interpretability, potentially at the cost of increased complexity. The three approaches are suitable for different contexts and their feasibility also depends on the availability of additional data. A key message is that context awareness improves the accuracy of driver attention monitoring and inattention identification.

The European Political Community: A Polish perspective

This article seeks to investigate the birth and evolution of the European Political Community – a pan-European multilateral coordination format that has emerged at the initiative of France and in reaction to the Russian full-scale military aggression in Ukraine. The analysis draws on official speeches, think-tank briefs, and the Author’s participatory observation conducted during international expert meetings held in early 2023. It is argued that the EPC is still a “moving target” in the early stage of development, where both its objectives and structure are not yet fully defined. From a Polish perspective, it has so far sent a key strategic message to Russia and can serve as a vehicle to re-engage with the United Kingdom or Turkey. But it should not be used as yet another ENP-style waiting room for candidates seeking EU membership.

An Empirical Study on the Needed Employability Skills in Post-Pandemic

Abstract A problem of skill mismatch has long been a global issue. The same is true for an emerging market like Cambodia where a large number of youths enter the job market every year. This study aims to investigate the most important employability skills in post pandemic viewed by students, employees and employers. The study also explores the needed skills at private, public and non-profit sectors, and the preparation of students on those competencies for making a comparison and synthesis. To fulfil the earlier objectives, the study applies survey questionnaires and in-depth interviews with 109 participants and 6 interviewees respectively. The findings demonstrate that Being professionally ethical, Being committed to work, and Technology Use are the three main employability skills demanded in the market. However, specific institutions may prefer other skills according to the nature of their work. The study also demonstrates that students possess a few limitations, namely Adaptability to change, Communication, Commitment to work and Advanced digital skills. These weaknesses would be a key message to students and other stakeholders to reconceptualize their current practice to fulfil the gaps.

Themes In The Song Lyrics Bandaids Mini Album By Keshi And Its Contribution To Poetry Teaching

Theme is a fundamental idea that unifies a tale, song, or literary work, making it simple to comprehend and enjoy. The theme serves as a concept, element, descriptor, and attribute. A song without a theme will be dry, unclear, and unlived. This research is aimed to (1) find out the main themes Keshi tries to show through his songs in Bandaids mini album; (2) find out the kinds of themes in Bandaids mini album by Keshi; (3) explain how the song lyrics in Bandaids mini album contribute to poetry teaching. This research using characters, plots, and setting as part of the intrinsic approach. Reads the song lyrics, listen the song, understand the lyrics, taking notes, conducting a thorough analysis, and organizing the data are the methods and approaches to collect data or can be called documentation and observation data collection. Gill’s theory used to discuss the main themes and kinds of themes in the song lyrics; the approach and method of data analysis used are descriptive qualitative with secondary data and three stream (1) data reduction; (2) data display; (3) drawing conclusion. In Gill’s theory (1995), the researcher used three ways to identify main themes, there are the title was selected by the writer of the song to convey a key message to the audience about the music; the characters' interests in moral and psychological development are reflected in how they develop, alter, and come to their own conclusions; repeating symbol or one that is employed at a crucial period might communicate a song's major topic. The result of the data showed 5 are indicated as the main themes and 5 are indicated as kinds of themes, namely love; heartbreak; depression; sadness; loneliness.

Generating probability distributions on intervals and spheres: Convex decomposition

This work studies the convexity of a class of positive definite probability measures with density functionsρ=cλ∑n=0∞g(n)Cnλwλ, that are generated through the interval characteristic sequences. We discuss when such measures supported in an interval are convex and demonstrate how convexity is preserved under multiplication by certain multipliers and under the intertwining product. A key message to be delivered from this work is: any integrable function f on the interval with a polynomial expansion that has relatively fast absolute convergence, can be decomposed into a non-unique pair of positive convex interval probabilities (f+,f−)∈Eλ′×Eλ′ up to normalization, in the sense that f=f+−f−, where Eλ′ is a class of convex functions. Consequently not only the study of an interval distribution is reduced to the study of the properties of class Eλ′, but also the discontinuous probabilistic Galerkin schemes can be simplified. As concrete examples the decomposition of polynomials and truncated normal distribution are computed and graphically illustrated. Such interval measures lead to localized spherical probability measures, and as a convex expression of probability measure is a Jensen type inequality for spherical random variables. Based on the spherical information entropy models, one dependent on the domain partition and the other not, we propose three minimization formulations for the probabilistic finite element method, including one that mixes the least-squares and entropy models.

Integrating local solar energy and water recovery: Operating experiences of a systemic approach

Abstract The key message is the importance of a systemic approach to handling water and energy together, both in design and in operation. The paper demonstrates how renewable energy, solar photovoltaic (PV) and solar thermal, in combination with a small nutrient removal plant, provides a reliable solution for small-scale decentralized water recovery operations. The system is automated and can operate outside the power grid and is designed to be a fully circular system in terms of both energy and water. The system has been installed on an island in the archipelago outside Stockholm, Sweden, to replace an old-fashioned septic tank. The effluent must satisfy rather strict effluent quality criteria for the Baltic Sea. The paper describes design considerations, instrumentation aspects, automation features, and operation experiences.