Limited Funding Research Articles

Autonomous artificial intelligence for sorting the results of preventive radiological studies on the example of mammography

The purpose of research. Radiation diagnostics is central to the detection of malignant neoplasms. Recently, the implementation of screening programs has faced a number of obstacles, including staff shortages and limited funding. The introduction of artificial intelligence (AI)-based systems capable of absolutely accurate sorting of research into two categories - "normal" and "not normal", seems to be a promising solution to these problems. However, before they are widely used, it is critically important to verify their ability to guarantee the safety and high quality of the screening process. The aim of the study is to evaluate the possibility of using autonomous sorting of mammographic examination results in real clinical conditions. Methods. The study was carried out in 2 stages. At the first stage, 25,892 mammographic studies processed by the AI service were retrospectively analyzed. A ROC analysis of these results was carried out in order to assess the possibility of configuring the AI service for 100% sensitivity. At the prospective stage, the results of 82,372 mammograms were analyzed. All studies were processed by AI services configured for 100% sensitivity. The tasks of the AI services included the sorting of mammography results into the categories "normal" and "not normal". Next, the decisions of AI services and radiologists on categorization were compared. Results. According to the results of a retrospective study, when configuring the AI service for 100% sensitivity, the specificity was 39%. In the course of a prospective study, the proportion of defects (false attribution of research results to the "norm" category) was 0.08%, the specific weight of clinically significant defects in AI services was 0.02%, which is significantly lower than that of a radiologist. Conclusion. The use of autonomous sorting of mammographic research results in clinical practice is possible in order to optimize the diagnostic process during preventive measures, as well as under the condition of monitoring the quality of artificial intelligence technologies. Keywords: artificial intelligence, mammography, preventive examinations, radiation diagnostics. Conflict of interest: The author declares the absence of obvious and potential conflicts of interest related to the publication of this article.

Development of an optimized protocol for generating knockout cancer cell lines using the CRISPR/Cas9 system, with emphasis on transient transfection.

The clustered regularly interspaced short palindromic repeats (CRISPR) system offers cost-effectiveness, high efficiency, precision, and ease of use compared to traditional gene editing techniques. In this study, we employed findings from prestigious investigations to develop an optimized approach for generating knockout cancer cell lines using a transient transfection method. This protocol introduces a distinctive approach that follows rigorous guidelines for designing gRNA to reduce off-target effects, a major challenge in CRISPR applications. Our step-by-step instructions allow researchers, particularly those with limited laboratory equipment and funding, as well as those undertaking CRISPR projects for the first time, to generate knockout cell lines using CRISPR technology in just ten weeks. This protocol covers all needs for enhancing various yields, such as transfection efficiency, and includes leveraging robust bioinformatics tools, conducting essential assays, isolating monoclonal cells via limiting dilution, validating knockout cells, and providing comprehensive troubleshooting recommendations. Using this method, we successfully created several new generations of colorectal cancer cell lines with monoallelic and biallelic knockouts of the epithelial cell adhesion molecule (EpCAM) gene. Our method, optimized for a wide spectrum of cancer cell lines, makes CRISPR more accessible for applications in personalized and precision medicine. It expands opportunities for novel investigations into cancer mechanisms and paves the way for potential therapeutic interventions.

EGS SO06 - Emergency provision for Oesophago-Gastric Surgery in the United Kingdom: A National Survey

Abstract Background Oesophagogastric (OG) emergency conditions may require specialised intervention in centralised OG cancer surgery units. Recently published AUGIS OG commissioning guidance recommends OG units provide 24/7 on-call cover for internal and external OG emergency referrals with a formalised rota. However, there may be widespread inconsistent provision of OG emergency services across United Kingdom (UK) regions with significant workforce, capacity, and funding challenges. This may lead to barriers to provision of on-call OG services. Currently there is no research that establishes current OG on-call coverage or explores OG surgeons’ perceptions and attitudes towards providing this service. Method An 11-item electronic questionnaire was developed at an OG cancer unit to identify OG consultant emergency on-call coverage at NHS OG cancer units in the UK. The questionnaire was initially piloted among OG surgeons for refinement and subsequently disseminated through professional networks (AUGIS), direct contact, and snowballing. It was active for three weeks in January 2024. Secondary outcomes included: identifying barriers to providing an emergency OG service; defining the scope of conditions acceptable for transfer; understanding current referral mechanisms and examining OG consultant attitudes and perceptions towards providing an on-call OG service. Results 71 consultant OG surgeons from 26 UK OG cancer units responded (Figure 1). 61% (n=43) report participating in a 24/7 formalised emergency OG on-call rota, staffed by a median of 5 (range 3-8) surgeons. Among the nine respondents from three centres without a formal OG emergency service, all cited limited funding as the primary barrier. Only 31% (n=19) used auditable referral mechanisms like email or online systems. 97% percent (n=69) of respondents perceive an OG emergency service to be beneficial for patients, and 86% (n=61) agreed it should be nationally mandated for OG cancer units to provide a 24/7 service. Conclusion Consultant OG surgeons recognize the importance of delivering high-quality OG emergency services. However, the data indicates inconsistent delivery across the UK. Given the seriousness of OG emergencies, mandatory provision of this service with appropriate funding and remuneration is essential. Several workforce challenges, including potential impacts on OG cancer resection volume and provision of General Surgical on-call, need to be addressed. Ultimately, patients require timely and specialised intervention. As one respondent emphasized: "A situation where surgeons in non-OG centres can spend a whole night ringing around various OG centres looking for help with a Boerhaave perforation is unacceptable."

Core Content, Competencies, and Accreditation in US Global Health Fellowships: A Survey of Leaders' Perspectives.

The number of global health (GH) fellowships in the United States has increased over the past two decades. However, there are currently no standard requirements, shared core content, or widespread systems of accreditation. With the growth in programs, it is appropriate to consider these issues. We conducted a national survey to understand GH fellowship leaders' perspectives on the existence of core content and competencies and on the need for accreditation, including by the Accreditation Council of Graduate Medical Education (ACGME). We sent survey invitations to 123 fellowship leaders. Forty-five completed the survey (37%), representing seven specialties. Eighty-nine percent of respondents indicated that there is important core content for fellows to learn regardless of specialty; 30% indicated that accreditation would be "very" or "extremely" beneficial, whereas 21% indicated that it would be "not at all" beneficial. When asked what form of accreditation would result in training the most competent GH practitioners, 35% indicated that accreditation is unnecessary. Of those selecting a form of accreditation, the largest proportion (21%) selected accreditation from a professional society; 52% "disagreed" or "strongly disagreed" that ACGME accreditation is needed. More than 65% indicated that loss of training flexibility, funding restrictions, and increased administrative and fellow funding burdens are "very" or "extremely" important barriers. These results suggest that broad agreement on important core content exists across specialties, with a lack of consensus about the need for accreditation. More discussion with stakeholders, including international partners, is needed to understand their perceptions and build consensus before pursuing fellowship accreditation.

Annual Survey of State and Territorial Chronic Disease Prevention and Health Promotion Capacity and Organizational Development Needs—United States, 2023

Objective: The National Association of Chronic Disease Directors (NACDD) is a nonprofit organization that supports state and territorial chronic disease prevention and health promotion efforts through capacity building and technical assistance. Each year, NACDD surveys health department leaders who oversee chronic disease prevention and health promotion (hereafter, Chronic Disease Directors). We have previously used the annual survey results to inform strategic planning and resource allocation but have not historically published key findings in the peer-reviewed literature. In this paper, we report on NACDD’s 2023 survey outcomes and place those findings into the broader public health policy context. Design: State Chronic Disease Directors completed a survey about their organizational capacity and development needs. Responses were summarized in aggregate and by jurisdiction size. Results: State chronic disease units have varied staffing and responsibilities, but most address diabetes, cardiovascular diseases, and cancer screening and prevention. Chronic Disease Directors generally reported strong or improving capacity in most practice areas but ranked workforce development lower. Staffing increased slightly during 2023 compared with the 2020 baseline (median of 1.3 and 1.1 employees per 100 000 jurisdiction population, respectively). However, Chronic Disease Directors expressed ongoing concerns about turnover, hiring, and training of inexperienced staff, as well as about funding limitations and uncertainty. Looking forward to 2024, many Chronic Disease Directors expressed intentions to focus on supporting their workforce with training and development opportunities and addressing health equity. Conclusions: During this period of pandemic recovery, turnover, hiring, and training—particularly of the many new public health staff—remain key areas of concern for many chronic disease units. Continued stabilization of public health funding and increased prioritization of organizational capacity development—particularly workforce development, chronic disease data systems, and tools for addressing health equity—could help ensure chronic disease units can better address current and emerging challenges in chronic disease prevention and health promotion.

TEL Pedagogies: Gamification – Grammar Guru

The Centre for English Communication (CEC) developed and launched Grammar Guru (GG), a browser-based game application, as part of Singapore Management University’s (SMU) TEL initiative in 2023. GG is used as part of CEC’s blended learning resources, which complements our core curriculum module for undergraduates, Writing & Reasoning (WR). GG is an upgraded iteration of Power Grammar 1.0, a basic grammar game developed by students several years ago. GG is an effective TEL tool for teaching grammar as it uses gamification to make learning engaging and caters to the needs of learners with different language proficiency levels. GG improves student engagement through gamification. Gamification is the application of game design, techniques and elements in non-game contexts and activities (Deterding et al., 2011, p. 1). Research shows gamification is highly effective in increasing student engagement, attention, motivation, creativity, digital literacy and performance level (Barua & Bharali, 2023; Fernandez-Antolin et al. 2021; Skritsovali, 2023). GG includes elements such as points, leaderboards, hints, and non-playable characters (NPC) to teach grammar in a professional, corporate context. By contextualizing grammatical and linguistic forms in sentences and paragraphs, GG helps students achieve greater competence and fluency in their English language abilities. The gamification elements make learning more interactive and enjoyable which improves students’ knowledge retention and application. A primary quantitative study conducted by CEC established that “the positive correlation observed suggests that the higher level a student played, the higher the student’s English language proficiency”. CEC is currently conducting a qualitative study to gather students’ feedback. GG also addresses the requirements of learners with diverse language proficiency levels by varying the difficulty of questions. These questions include sentence and text correction, matching, re-arrangement, true/false, fill-in-the-blanks and multiple-choice questions. Players work their way through eight levels that comprises Junior and Senior Intern, Junior and Senior Management Trainee, Junior and Senior Middle Management and Junior and Senior Director. Perez (2020) and Langendah (2016) highlight how certain game elements such as storytelling, challenges, progression, and feedback can boost student drive and learning. The gamification elements in GG have a similar effect, motivating learners of different proficiency levels. GG’s interface is designed to be simple and intuitive. Regardless of students’ socioeconomic background or gaming aptitude, they would be able to navigate it effectively. One challenge GG faces is striking a balance between entertainment and education. Limited game development funds result in limited game design features and less engaging gameplay for students, especially in comparison to commercial games with substantial budgets that offer high entertainment value through advanced graphics and intricate storylines. Furthermore, as CEC instructors are not game design experts, we have limited knowledge that restricts our capacity in designing and maintaining GG. Currently, CEC outsources game design and maintenance to a third parties. This results in instructors not being able to directly make changes to the game questions and content. Moreover, the process of retrieving relevant data for analysis is tedious and time consuming. Despite these constraints, thoughtful and strategic approaches can create valuable TEL resources that improve student learning.

"All of these things interact, that's why it's such a wicked problem": Stakeholders' perspectives of what hinders low back pain care in Australia and how to improve it.

Low-quality care for low back pain (LBP) is pervasive in Australia. Drivers of low-quality care have been identified elsewhere and include misconceptions about LBP, vested interests and limited funding for evidence-based interventions. Yet, the literature that identified such drivers is not specific to the Australian context, and therefore, it is likely to represent only part of the local problem. This study aimed to determine where the most influential drivers of LBP care are in the Australian healthcare system and what could be done to address them. Clinical leaders from various disciplines, academics, hospital managers, policy-makers, consumers involved in LBP advocacy, board members of relevant health profession boards and private insurers were invited to participate in one-on-one interviews. Interviews were transcribed verbatim. Interview data were analysed using content analysis. We interviewed 37 stakeholders. Challenges that hinder LBP care in Australia included variability in care and inconsistent messages, funding models that are not supportive of appropriate care for LBP, the community's understanding of LBP, vested interests and commercial forces, difficulties in accessing timely and affordable conservative care, neglect of social determinants and health inequities, short consultations, siloed practices, uncertainties that stem from gaps in evidence and the experience of having LBP, individual and contextual variability, the mismatch between evidence and practice, the Australian healthcare system itself, the lack of political will and acknowledgement of LBP as a public health issue, stigma, the need to improve human aspects and the compensation system. When discussing factors that could improve LBP care, participants raised collaboration, changes in funding, improvement of access to - and affordability of - models of care and care pathways, public health campaigns targeting LBP, enhancement of policy and governance, increasing and better training the workforce, consideration of inequities, making improvements in information sharing and reforming the worker's compensation sector. LBP is a wicked problem, influenced by several systemic factors. An agenda for system change in the LBP landscape should be guided by a collaborative, coherent and integrated approach across sectors to enhance quality of care and system efficiency for those who seek and provide care.

Shaping Identities: The Influence of Female Filmmakers on the Portrayal of Women in 21st-Century Chinese Mainstream Cinema

Abstract: This research paper examines the portrayal of women in 21st-century Chinese mainstream cinema, particularly through the lens of female filmmakers in a male-dominated industry. Guided by case studies and comparative analysis of Chinese classical films since the early twentieth century, the paper explores how female filmmakers uplift feminine trends, breaking free from the conventional norm and male gaze to eulogize their realistic female figures in Chinese cinema based on their personal experiences and narratives. In addition, the study unveils that despite their efforts, the influence of the male gaze and deep-seated patriarchal values still confines female filmmakers to traditional and stereotypical portrayals of women. While female filmmakers have succeeded in presenting more authentic, intricate, and empowering representations of women, their impact is still hindered by long-lasting obstacles such as limited funding and fewer opportunities compared to their male counterparts. To eventually actualize justice and equality between women and men, new emerging filmmakers, regardless of gender, should therefore utilize the power of storytelling in film, arousing feminine awareness and reversing the world to be more diversified and embraced.

The New Media Art world in Turkey: Boundary-work in action

In an age marked by the Post-media condition, the term ‘New Media Art’ remains in use in reference to a professional territory not autonomous, but also different from the territory of Contemporary Art, and its members use various rhetorical tactics to maintain and expand their professional authority. This study aims at analyzing the professional ideology of the New Media Art territory in Turkey using Thomas F. Gieryn’s concept of the ‘boundary-work’. The data obtained via semi-structured in-depth interviews conducted with a purposively sampled population of artists, curators and producers are used to assess whether a common cultural repertoire exists in this territory and whether it conforms to or contradicts its global counterpart. The study finds that since the mid-1990s, the professional ideology of the New Media Art territory in Turkey has developed in parallel with the world, but not monolithically. The curators/producers’ ideology is defined by potential for democratization, intersections of art, science and technology, interaction/interactivity and interdisciplinary collaboration. However, they exhibit two repertoire variants positively correlated with the subjects’ career orientations. The artists’ common ideology is similar to the curators’/producers’, but their cultural repertoires are more flexible thanks to the variety of their individual practices. The study concludes that this duality emerges due to the limited funding sources in Turkey.

The Prospects of Phytomedicines and Nanomedicines to Treat Leishmaniasis: A Comprehensive Review.

The global shift in lifestyle has prompted health agencies to redirect their focus from poverty-related diseases to the emergence of lifestyle diseases prevalent in privileged regions. As a result, these diseases have been labeled as "neglected diseases," receiving limited research attention, funding, and resources. Neglected Tropical Diseases (NTDs) encompass a diverse group of vector-borne protozoal diseases that are prevalent in tropical areas worldwide. Among these NTDs is leishmaniasis, a disease that affects populations globally and manifests as skin abnormalities, internal organ involvement, and mucous-related abnormalities. Due to the lack of effective and safe medicines and vaccines, it is crucial to explore alternative resources. Phytomedicine, which comprises therapeutic herbal constituents with anti-leishmanial properties, holds promise but is limited by its poor physicochemical properties. The emerging field of nanomedicine has shown remarkable potential in revitalizing the anti-leishmanial efficacy of these phytoconstituents. In this investigation, we aim to highlight and discuss key plant constituents in combination with nanotechnology that have been explored in the fight against leishmaniasis.

Occupational health and safety in the construction industry: a comprehensive review with emphasis on Nigeria

The construction industry holds remarkable benchmarks of aptitude and creativity; however, it is among the most lethal industries when it comes to occupational health and safety (OHS). This study incorporates a detailed analysis of the key OHS issues within the construction sector with a special regard for developing countries such as Nigeria. The paper discusses different physical, chemical, biological, and psychological risks within the industry and highlights the importance of compliance with OHS requirements aimed at avoiding mishaps, incidents, and even fatalities. Moreover, it discusses the issues relating to poor training, funding limitations, and project pressures while highlighting the significance of maintaining a strong safety culture, workers' awareness, and compliance in enhancing OHS results. In addition to that, the review also examines current safety measures, identifies gaps, and suggests improvements, drawing on global best practices to inform future policies and strategies. This study serves as a valuable resource for policymakers, construction stakeholders, and employers to minimize health risks and optimize construction workers’ productivity and well-being.

Implementasi Program PUSPAGA Dalam Pencegahan Kekerasan Anak di Kota Serang

Children have the same rights guaranteed by the state. Fulfilling children's rights is the responsibility of local governments to improve child-friendly cities through the PUSPAGA program. But the fact is that there are still many children, especially in the city of Serang, who are still victims of violence, which is increasing every year. This research focuses on the implementation of the PUSPAGA Program in preventing child violence in Serang City and aims to find out more about the implementation of the PUSPAGA program in preventing child violence in Serang City using the A Model of Implementation theory according to Van Metter and Van Horn. This research uses descriptive qualitative research methods, then the data is analyzed based on the results of observations, interviews and documentation. The results of this research show that the implementation of the PUSPAGA Cahaya Hati Program in preventing violence against children has not been carried out optimally due to the existence of constraints and obstacles, namely the absence of counselors to provide counseling services, the absence of guidance to sub-district cadres related to the PUSPAGA Program, the facilities and infrastructure available. inadequate and there are still minimal outreach and promotional activities carried out due to limited budget funds.

Resilient education: The role of digital technology in supporting geographical education in Ukraine

AbstractThis commentary spotlights the continued impact of the Russian invasion on geography education in higher education in Ukraine. From discussions with Ukrainian geographers in institutions in contrasting regions of the country, we describe their resilience in adapting the delivery of the physical geography curriculum, especially in the essential area of fieldwork and the use of digital tools. This ‘lived experience’ perspective builds on the theoretical contributions to the discussion initiated by Klinke (2023) in this journal about the challenges posed for geographers. In the third year of the conflict, the challenges set out are considerable, long term, and we call for individuals, universities and funders to further facilitate teaching and learning collaborations despite the limited funds available for the exchange of teaching and learning support and innovation.

Transforming library systems in Africa: advancing literacy and cultural preservation through digital innovation

Transforming library systems in Africa is essential for advancing literacy and preserving cultural heritage in an increasingly digital world. The integration of digital innovation into African libraries has the potential to revolutionize access to information, promote lifelong learning, and safeguard indigenous knowledge. This review explores the role of modern technologies, such as digital archiving, e-libraries, and mobile platforms, in enhancing literacy rates and preserving Africa's rich cultural traditions. By transitioning from traditional, print-based models to digital systems, libraries can bridge the educational gap in underserved communities, offering wider access to educational resources and promoting literacy at all levels. Additionally, digitization facilitates the preservation of local languages, oral histories, and cultural artifacts, ensuring that future generations can engage with Africa's diverse heritage. The challenges of digital transformation in African library systems, including limited infrastructure, funding, and digital literacy, are also discussed. The review emphasizes the need for strategic investments in technology, capacity building, and policy frameworks to create a sustainable digital ecosystem. By harnessing digital innovation, African libraries can evolve into dynamic centers of learning and cultural preservation, contributing to both socio-economic development and the protection of African identities. This transformation is critical to fostering a more educated, culturally aware, and globally connected African society.

Pharmacological profiles of neglected tropical disease drugs

According to the World health Organization there are a group of 20 diverse infectious Neglected Tropical Disease (NTD) conditions that primarily affect populations in low-income and developing regions. Despite the limited attention and funding compared to other health concerns, significant efforts to develop drugs for treating and controlling NTDs have been made. However, there is room for developing NTD drugs with improved safety, efficacy and ecotoxicological profiles. In order to facilitate this, we have adapted our existing validated data-driven workflows for understanding disease comorbidity to systematically evaluate the approved drugs that target the major World Health Organization defined NTDs. The foundation for this work comprised assembling the physicochemical, biological and clinical properties of each NTD drug and identifying patterns that reveal the underlying cause of their efficacy and side-effect profiles. Subsequently, computational methods were employed to identify analogs with potentially improved profiles and validated in a case study focusing on the teratogenic antileishmanial drug miltefosine. The wider impact of NTD drugs with regards to a One Health cross-disciplinary perspective at the human-animal-environment interface are also discussed.

Asymptomatic bacteriuria screening for developing countries using a modified water quality test kit.

Between 2% and 15% of pregnant women unknowingly experience asymptomatic bacteriuria (ASB), defined as ≥105 CFU per milliliter of urine in the absence of symptoms. ASB increases the risk of adverse pregnancy outcomes including pyelonephritis, preterm labor, and low-birth weight infants. While pregnant women in the United States are routinely screened for ASB, those in developing countries with limited resources and funding lack an accurate mechanism for ASB screening. Aquagenx water quality test kits detect Escherichia coli, the most common causative agent of ASB, and total coliform bacteria in drinking water via colorimetric and fluorescent indicators. We found that the Aquagenx system is compatible with human urine and then proceeded to develop an ASB screening protocol using disposable inoculating loops. Our protocol diagnosed artificial ASB- samples (104 CFU/mL E. coli) with a false positive (FP) rate of 33% (n = 18) and ASB+ (105 CFU/mL E. coli) with a false negative (FN) rate of 5.6% (n = 18). Clinical sample testing with our protocol revealed a FP rate of 0% in ASB- samples (n = 28) and a FN rate of 0% in ASB+ samples caused by coliforms (n = 13). Aquagenx did not detect ASB in nine clinical samples with non-coliform etiological agents due to the limitations of the technology. However, with very high accuracy for detection of E. coli and other causative agents that collectively account for 90.1% of ASB cases, these kits could be used as a diagnostic ASB screening tool in developing countries in which there is currently no alternative to urine culture.IMPORTANCEAsymptomatic bacteriuria (ASB) affects 2%-15% of pregnant women and can result in adverse maternal and fetal outcomes if left undetected and untreated. In the United States and other developed nations, pregnant women are regularly screened for ASB via urine culture. However, in low-resource countries where bacterial culture is not available, dipstick testing is used. Although accurate in cases of symptomatic bacteriuria, dipstick detection is ineffective for detecting ASB. Here, we made use of an existing water quality field test for ASB urine screening, which would be readily deployable in low-resource settings. We optimized a dilution protocol for sampling patient urine within the detection limits of the Aquagenx kit technology. Overall, we were able to detect ASB samples with Gram-negative pathogens that collectively account for 90% of all ASB cases. Utilization of this repurposed technology for proactive medical screening may help prevent adverse pregnancy and birth outcomes due to ASB.

Exploring sustainable health financing strategies in humanitarian settings: Challenges, innovations and efforts towards Achieving Universal Health Coverage

Sustainable health financing is critical in humanitarian settings to ensure that the most vulnerable populations have access to necessary healthcare services. In crises such as conflicts, natural disasters, or prolonged emergencies, healthcare systems are often destabilized, leading to significant challenges in providing adequate care. This review explores innovative financing mechanisms designed to support health services in these contexts, focusing on their potential to achieve Universal Health Coverage (UHC). Key challenges include limited funding, high out-of-pocket costs, and the uneven distribution of healthcare resources. In response, emerging models such as impact bonds, Islamic social finance, disaster risk insurance, and digital financial solutions offer new approaches to mobilizing resources and sustaining health interventions. These strategies are essential to bridging gaps in healthcare access, promoting equity, and strengthening the resilience of health systems. Policy recommendations highlight the importance of integrating emergency and routine health services, engaging communities, and enhancing coordination among stakeholders. Strengthening health financing mechanisms is vital for long-term improvements in health outcomes, especially in fragile settings. This research underscores the need for sustainable, inclusive policies that bolster health systems in the face of humanitarian crises.

Promoting audit transparency in higher education through an internal academic quality audit application

This study aims to design and develop a web-based application for Internal Quality Audit at Universitas Ibnu Sina, replacing the conventional audit process which is currently in use. The previous manual audit process resulted in inefficiencies and increased the risk of errors. Key challenges identified include limitations in human resources, time, and funding, as well as the low effectiveness of the audit process. In order to address these issues, the proposed information system facilitates the distribution of online checklists and document uploads, thereby expediting the verification and reporting audit results. This research adopts the System Development Life Cycle (SDLC) approach in its development, utilizing methods that include use case diagrams, activity diagrams, sequence diagrams, and database design. These methods enhance interaction and workflow within the audit team. Testing results indicate that the system functions to the expected specifications. Furthermore, this study demonstrates that implementing a web-based system can accelerate reporting, improve the structure and documentation of audits, and support efforts to enhance academic quality at the university. Implementing this system is expected to increase efficiency and accuracy in the academic quality audit process at Universitas Ibnu Sina.

Assessing the use of activity trackers in clinical practice: a survey of cardiac rehabilitation clinicians from Australia, Brazil, and Canada

Abstract Background The use of wearable activity trackers has been found to significantly improve health profile and cardiorespiratory fitness, as well as to reinforce positive health behaviours in patients participating in cardiac rehabilitation (CR) programs. However, clinicians’ perceptions of activity trackers and their use in clinical practice have not been widely explored. Purpose To describe perceptions, attitudes, and behaviours of CR clinicians towards the use and usefulness of activity trackers in CR programs, and identify barriers and enablers associated with their personal and clinical use. Methods Descriptive cross-sectional survey. Data were collected using Research Electronic Data Capture (REDCap) from April to December 2023. Clinicians working in CR programs were recruited in each country via social media, email and digital flyers, group chats and author networks. A purpose-built 44-item digital survey comprising four sections was constructed: (1) socio-demographic details, (2) personal and professional use of activity trackers, (3) perspectives on the use of activity trackers for CR, and (4) perceptions of factors affecting the use of activity trackers in CR. Results In total, 199 clinicians from Australia (n=44), Brazil (n=102) and Canada (n=53) responded to the survey. Most were women (74%), physiotherapists (37%), working at a metropolitan hospital (55%), with a median age of 35 years (range 22-71). The majority found activity trackers helpful for patients with goal setting and monitoring exercise (89%) and promoting patient engagement and autonomy beyond structured, supervised CR (75%). Activity trackers were also perceived to be useful in engaging patients in their own health (94%), improving patient-provider communication (73%), boosting patient adherence with directed exercise (87%), and improving patient’s understanding of their own health conditions (79%). Furthermore, activity trackers were perceived to enable a more personalised care (69%), increase accessibility to CR (45%) and be time- and cost-effective for CR programs (49%). Sixty percent were motivated to use activity trackers and 69% recommended the use of trackers to their patients. On the other hand, the use of activity trackers was reported to be related to dependence (44%) and excessive obsession of one’s own health (55%); 50% reported a lack of relevant policies on activity trackers for clinical use in their respective institutions and limited funding for purchasing activity trackers by health services (78%). Only 30% reported that there was support from leadership and/or peers for the use of activity trackers. Conclusion In general, clinicians held positive attitudes towards the use of activity trackers in CR. However, a lack of relevant policies, funding and support from leadership are important barriers to the adoption and use of activity trackers in CR programs. Development of guidelines for the use of activity trackers in clinical practice is warranted.

How do BMI-restrictive policies impact women seeking NHS-funded IVF in the United Kingdom? A qualitative analysis of online forum discussions

Plain English SummaryIn the United Kingdom, people can access public funding for In Vitro Fertilisation (IVF) treatment if certain criteria are met. Funding restrictions differ between geographical areas, but most areas restrict treatment to women with a Body Mass Index (BMI) below 30. This study explores the unexpected and unintended harms experienced by women restricted from NHS-funded IVF due to these BMI criteria. Posts from a popular infertility online forum were collected and thematically analysed. The study found moralising discourses around body weight which emphasized that women had personal control over their bodies and needed to ‘work’ to change their bodies to show deservingness for treatment. We conclude that NHS-IVF policies in the UK overlook the emotional and moral burdens placed on individuals due to rigid BMI criteria. As the impact of BMI limits on healthcare access is an under-researched topic, we believe this work is important for demonstrating the harms of BMI-restrictive policies.