Local Centers Research Articles

Regulation research on weak co-adsorption and nonsteady-state capture for C6H6/CO2 over carbon materials

With the intention of capturing both benzene (C6H6) and carbon dioxide (CO2) from indoor air, it is assuring of getting both C6H6 and CO2 simultaneously adsorbed over activated carbon materials. Thus, in this study, how adsorption of C6H6 and CO2 performs over single-wall carbon materials is minutely investigated via density function theory (DFT). Specifically speaking, direct electronic interaction between C6H6 and CO2, co-adsorption features and nonsteady-state capture processes of C6H6/CO2 over single-wall carbon nanotube (CNT) as well as regulation of CNTs towards more stable adsorption are main contents in this study. According to results, C6H6 and CO2 are weakly mutually attracted because of limited electrostatic attraction forces and hydrogen-bond effects, which are also the major reason for consequent weak co-adsorption state over pure CNT. In the meantime, owing to repulsive forces of π-orbital electrons from pure CNT to C6H6, both of C6H6 and CO2 could be only captured by pure CNT in nonsteady state. However, with phosphorus (P) and aluminum (Al) embedded as dopants, surficial electron distribution is altered to a large degree and local electron-enriched centers of modified CNTs are formed to enhance connection with C6H6/CO2, especially stronger electrostatic positron–electron attraction and faster capture speeds from free-state to adsorption-state at relatively high temperatures. Overall, this study provides plentiful information of utilizing single-wall carbon materials for fast indoor air purification in a passive way.

Development and external validation of a multimodal integrated feature neural network (MIFNN) for the diagnosis of malignancy in small pulmonary nodules (≤10 mm)

Objectives. Current lung cancer screening protocols primarily evaluate pulmonary nodules, yet often neglect the malignancy risk associated with small nodules (≤10 mm). This study endeavors to optimize the management of pulmonary nodules in this population by devising and externally validating a Multimodal Integrated Feature Neural Network (MIFNN). We hypothesize that the fusion of deep learning algorithms with morphological nodule features will significantly enhance diagnostic accuracy. Materials and Methods. Data were retrospectively collected from the Lung Nodule Analysis 2016 (LUNA16) dataset and four local centers in Beijing, China. The study includes patients with small pulmonary nodules (≤10 mm). We developed a neural network, termed MIFNN, that synergistically combines computed tomography (CT) images and morphological characteristics of pulmonary nodules. The network is designed to acquire clinically relevant deep learning features, thereby elevating the diagnostic accuracy of existing models. Importantly, the network’s simple architecture and use of standard screening variables enable seamless integration into standard lung cancer screening protocols. Results. In summary, the study analyzed a total of 382 small pulmonary nodules (85 malignant) from the LUNA16 dataset and 101 small pulmonary nodules (33 malignant) obtained from four specialized centers in Beijing, China, for model training and external validation. Both internal and external validation metrics indicate that the MIFNN significantly surpasses extant state-of-the-art models, achieving an internal area under the curve (AUC) of 0.890 (95% CI: 0.848–0.932) and an external AUC of 0.843 (95% CI: 0.784–0.891). Conclusion. The MIFNN model significantly enhances the diagnostic accuracy of small pulmonary nodules, outperforming existing benchmarks by Zhang et al with a 6.34% improvement for nodules less than 10 mm. Leveraging advanced integration techniques for imaging and clinical data, MIFNN increases the efficiency of lung cancer screenings and optimizes nodule management, potentially reducing false positives and unnecessary biopsies. Clinical relevance statement. The MIFNN enhances lung cancer screening efficiency and patient management for small pulmonary nodules, while seamlessly integrating into existing workflows due to its reliance on standard screening variables.

Spatial distribution of Japanese encephalitis cases and correlated geo-environmental factors in southern and northern counties of China

Japanese encephalitis (JE) is a mosquito-borne disease with a spatial distribution that is linked to geo-environmental factors. The spatial distribution of JE cases and correlated geo-environmental factors were investigated in two critical counties in southern and northern China. Based on maps, enhanced thematic mapper (ETM) remote sensing datasets from Landsat and spatial datasets of JE cases, spatial distribution and spatial cluster analyses of JE cases at the village scale were performed by using the standard deviational ellipse and Ripleys K-function. Global and regional spatial cluster analyses of JE cases were also performed by using Moran's index. Regression analysis was used to analyze the relationships between geo-environmental characteristics and the risk of JE cases. At the study sites, the JE cases were not spatially clustered at the village or district (global) level, whereas there was a spatial cluster at the district (local) level. Diversity-related features for JE patients at the district and village levels were detected at two sites. In the southern counties, the distance of a village from a road was related to the village-level JE risk (OR: 0.530, 95 CI: 0.297–0.947, P = 0.032), and the number of township-level JE cases was linked to the distance of the district center from the road (R =-0.467, P = 0.025) and road length (R = 0.516, P = 0.012) in the administrative area. In northern China, the modified normalized difference water index (MNDWI) in the 5 km buffer around the village was related to village-level JE risk (OR: 0.702, 95% CI: 0.524–0.940, P = 0.018), and the number of township-level JE cases was related to the MNDWI in the administrative region (R =-0.522, P = 0.038). This study elucidates the spatial distribution patterns of JE cases and risk, as well as correlated geo-environmental features, at various spatial scales. This study will significantly assist the JE control efforts of the local Centers for Disease Control and Prevention (CDC), which is the base-level CDC, particularly concerning the allocation of medicine and medical staff, the development of immunological plans, and the allocation of pesticides and other control measures for the mosquito vectors of JE.

Impact of an innovative bundled payment to TB health care providers in China: an economic simulation analysis

BackgroundTuberculosis is the second most deadly infectious disease after COVID-19 and the 13th leading cause of death worldwide. Among the 30 countries with a high burden of TB, China ranks third in the estimated number of TB cases. China is in the top four of 75 countries with a deficit in funding for TB strategic plans. To reduce costs and improve the effectiveness of TB treatment in China, the NHSA developed an innovative BP method. This study aimed to simulate the effects of this payment approach on different stakeholders, reduce the economic burden on TB patients, improve the quality of medical services, facilitate policy optimization, and offer a model for health care payment reforms that can be referenced by other regions throughout the world.MethodsWe developed a simulation model based on a decision tree analysis to project the expected effects of the payment method on the potential financial impacts on different stakeholders. Our analysis mainly focused on comparing changes in health care costs before and after receiving BPs for TB patients with Medicare in the pilot areas. The data that were used for the analysis included the TB service claim records for 2019–2021 from the health insurance agency, TB prevalence data from the local Centre for Disease Control, and health care facilities’ revenue and expenditure data from the Statistic Yearbook. A Monte Carlo randomized simulation model was used to estimate the results.ResultsAfter adopting the innovative BP method, for each TB patient per year, the total annual expenditure was estimated to decrease from $2,523.28 to $2,088.89, which is a reduction of $434.39 (17.22%). The TB patient out-of-pocket expenditure was expected to decrease from $1,249.02 to $1,034.00, which is a reduction of $215.02 (17.22%). The health care provider’s revenue decreased from $2,523.28 to $2,308.26, but the health care provider/institution’s revenue-expenditure ratio increased from -6.09% to 9.50%.ConclusionsThis study highlights the potential of BPs to improve medical outcomes and control the costs associated with TB treatment. It demonstrates its feasibility and advantages in enhancing the coordination and sustainability of medical services, thus offering valuable insights for global health care payment reform.

Life in a State of Limbo – Narratives of Place, Health, and Integration Among Later Life Female Migrants in Sweden

International migration is a prioritized domain of European aging research. Using a qualitative approach, the author has gathered accounts among Iranian later-life females in the Swedish city of Malmö, suffering from social isolation. The women in this article found themselves in a situation like that of other later-life migrants in Sweden. Several studies have shown how these groups are at risk of ending up in a social isolation which can be hard to break. The situation of the later-life migrant women discussed in this study is characterized by the loss of numerous deep-seated and natural social bonds connected to ethnicity, family, language, and culture. To cope with their exposed situation, the local Iranian-Swedish association provided some self-arranged activities, offering opportunities to social integration. The aim of the study is to demonstrate how the women described their life situation where a local day center made up the key foundation of their social life in a Swedish city in 2000–2008. Typical of that period was that solutions of the alarming situation of some foreign-born elderly citizens were discussed by local authorities, as well as volunteer organizations. Thus, the aim is not to describe the present situation among later life migrants. On the contrary, the perspective is retrospective. The theoretical inspirations used in the article derive from a broader backdrop of social-constructive assumptions that define narratives or accounts as explanations of the reality of everyday life and experiences. In the article the women’s stories are defined as small, local, erratic narratives, nevertheless explaining the reality of everyday life and experiences which in their turn reflect the state of illness, locally specific attachment and social isolation. Three salient themes emerge in the material: place bound experiences, illness and unsuccessful integration. The narratives are defined as small irregular accounts, contrasting larger narratives of later-life migration. The article shows how the women depicted their situation as a borderline between an Iranian life in exile and a Swedish society, leaving them in a state of Limbo. The women expressed ambitions of integrate into a Swedish community of senior citizens, providing privileges and civil rights. Thus, the narratives challenge common generalizing images of later-life migrants and their life conditions.

The Jahn-Teller Effects in Chemical Reactions and Materials Science

In a semi-review paper (a review with novel results included), we note first that the so-called Jahn-Teller effects (JTEs), in their presently recognized four modifications, emerge as particular cases of a more general law, stating that “Nature tends to avoid degeneracies and pseudo-degeneracies in atomic matter by means of spontaneous symmetry breaking (SSB)”. This “Law of Nature” obviously influences all the relevant properties of polyatomic systems, including those with direct applications in materials science and engineering, as well as in materials transformations, notably, in chemical reactions. The exploration to the latter is quite novel: we show that the energy barriers in chemical transformations are controlled by the pseudo-JTE (PJTE), opening uncharted ways of catalytic action. The applications of JTEs theory in materials science is already more advanced, utilizing the SSB-induced special nuclear dynamics, which is very sensitive to external perturbations. One of its novel aspects is to modify the properties of the system by means of external influence targeting its JTEs parameters, their underlying degeneracies. We show here some notable trends with illustrative examples, including the JTEs in local centers in crystals used as qubits in quantum information storage, alteration of whole crystal lattice properties by inducing the JTE in one of its sublattices, planarization of puckered (buckled) two-dimensional systems by coordination to atoms that quench their PJTE-induced out-of-plane distortion, and the origin of a whole series of solid state properties of perovskite crystals, triggered by the local PJTE.

Time to Start a New Enhanced Recovery After Surgery (ERAS): A Retrospective Cohort Study.

The enhanced recovery after surgery (ERAS®) is a multimodal perioperative care pathway designed to reduce surgical stress and ultimately improve patient recovery and outcome. It can require significant resources but with proven benefits. The main goal of this study was to perform a diagnostic assessment of perioperative practice in a local colorectal surgical center. 93 patients who underwent elective colorectal surgery from January to December 2022 were analyzed. Preadmission, preoperative, and postoperative data of all patients were collected in a database developed by the researchers, according to ERAS® guidelines. Descriptive statistics were employed to summarize demographic and clinical characteristics. Chi-square and T-test were performed to identify possible associations between categorical variables and postoperative complications. Overall analysis showed deficient preoperative patient optimization, especially regarding nutritional counseling and supplementation, smoking and alcohol cessation, anemia treatment (9%), and pre-anesthetic medication (42%). Removal of invasive devices was significantly delayed (removal of urinary catheter average on the fourthday and surgical drain average on the fifthday) in the postoperatively period and oral intake (average onset on the sixthday). Both contribute to hospital length of stay (mean of 13 days) and a significant number of complications. The results lead us to an individual and multidisciplinary reflection on current practices and outcomes. ERAS® program, already adopted by many centers, could have a positive impact on the immediate postoperative recovery of colorectal patients in Funchal Central Hospital andimplementation seems necessary.

Distribution of Intraocular Pressure in Indigenous Black Africans and Related Risk Factors: A Population-Based Study in Southwest Nigeria

Background: Elevated intraocular pressure (IOP) is a major risk factor for glaucoma and is presently the only modifiable risk factor. Even in a healthy population, IOP distribution varies among different racial groups. Objective: To determine the distribution of IOP and factors affecting it, among an indigenous African population in Southwest Nigeria. Methods: A population-based descriptive cross-sectional survey with an analytical component was performed. The study was conducted among participants 16 years and older who were residents of Akinyele Local Government Area of Oyo State and were all black Africans. A multi-stage sampling with probability proportional to size was used to identify the study population. All participants were examined at the local health center in their community, assessing the visual acuity, Goldmann applanation tonometry, central corneal thickness, anterior segment, fundoscopy, weight, height, and blood pressure. Results: A total of 1810 respondents completed the study; male patients accounted for 41.55%. Mean age was 49.43 ± 15.57 years. The mean IOP was 15.91 ± 4.74 mmHg. There was a significant association between elevated IOP and the male gender. Intraocular pressure also had a significant positive correlation with increasing age, systolic blood pressure, and central cornea thickness. There was no significant relationship between IOP and self-reported diabetes mellitus. Conclusion: The mean IOP and distribution in this study were a bit different from that observed in studies in different geographical locations but similar to studies in West Africa. It may be advisable to employ a geographical approach to normal IOP interpretation.

PENGOLAHAN NUGGET IKAN PATIN (PANGASIUS HYPOPTHALMUS) SEBAGAI MAKANAN UNTUK PENCEGAHAN STUNTING PADA BALITA DI POSYANDU MUTIARA KASIH KELURAHAN 16 ULU PALEMBANG

Stunting is a national priority health problem. Stunting prevention involves the active role of the community, households and parents with children. The national stunting prevalence in Indonesia in 2023 is 21.6%, the target the government wants to achieve in 202 is 14%. Patin fish is one of Indonesia's mainstay commodities. The nutritional value of fresh catfish contains 12.6 - 15.6% protein, 1.09 - 5.8% fat, 0.74 - 3.5% ash and 80 - 3.5% water. 85 %. Furthermore, in the form of fish protein concentrate, the nutritional value contains 75.31% protein, 2.79% fat, 2.14% ash and 6.39% water. This program was implemented in January 2023 at Posyandu Mutiara Kasih and the target of the activities was mothers with children under five in the 16 Ulu sub-district. In implementing this program, several stages were carried out, such as preparation and coordination with the posyandu, local health center, conducting counseling and demonstrations about processing catfish nuggets as food to prevent stunting in toddlers. The hope is that after conducting outreach and demonstrations, mothers in the 16 Ulu sub-district will be able to know about stunting and the processing of catfish nuggets as food to prevent stunting in toddlers. As a result of the activity, it is hoped that mothers in 16 Ulu sub-district will be able to process catfish nuggets made from catfish independently and apply them as a side dish for toddlers in everyday life. Keywords: Stunting, Catfish, Toddlers Stunting is a national priority health problem. Stunting prevention involves the active role of the community, households and parents with children. The national stunting prevalence in Indonesia in 2023 is 21.6%, the target the government wants to achieve in 202 is 14%. Patin fish is one of Indonesia's mainstay commodities. The nutritional value of fresh catfish contains 12.6 - 15.6% protein, 1.09 - 5.8% fat, 0.74 - 3.5% ash and 80 - 3.5% water. 85 %. Furthermore, in the form of fish protein concentrate, the nutritional value contains 75.31% protein, 2.79% fat, 2.14% ash and 6.39% water. This program was implemented in January 2023 at Posyandu Mutiara Kasih and the target of the activities was mothers with children under five in the 16 Ulu sub-district. In implementing this program, several stages were carried out, such as preparation and coordination with the posyandu, local health center, conducting counseling and demonstrations about processing catfish nuggets as food to prevent stunting in toddlers. The hope is that after conducting outreach and demonstrations, mothers in the 16 Ulu sub-district will be able to know about stunting and the processing of catfish nuggets as food to prevent stunting in toddlers. As a result of the activity, it is hoped that mothers in 16 Ulu sub-district will be able to process catfish nuggets made from catfish independently and apply them as a side dish for toddlers in everyday life.

Impact of Marketing Strategies of Retailers on Consumers with Specific Reference to Ramki Bandi and Local Tiffin Centres

Entrepreneurs and small business management go hand in hand in making a successful business. The study is taken up on retailers in the street food industry. The study’s objective is to analyze the impact of the marketing strategies of Ram ki Bandi , a famous street food corner in Hyderabad, India, and a comparative study between the marketing strategies of Ram ki Bandi and local street tiffin centers. Tiffin centers are small eateries put up on the street. A marketing strategy is a long-term plan for achieving a company’s goals by understanding customers’ needs and creating a distinct and sustainable competitive advantage. For the study, the data was collected through primary data sources, such as survey methods, questionnaires, and secondary data sources. The primary data was collected from a sample of 100 respondents using questionnaires and interviews. Marketing strategies are essential in the growth of a retailer’s business. Some of them are as follows: attracting more customers, analyzing competitors, understanding customers, and making optimal pricing decisions, amongst others. The findings of the study state that marking strategies impact consumer behavior when purchasing a given product.

Planning local centres in outer suburbs – The need for a proactive approach towards planning in post-socialist Poland

Chaotic post-socialist suburbs need retrofitting through planning a system of local centres. The paper is aimed at recognizing the orientation of recent suburban planning in Poland through a focus on centres and identifying conditions for and examples of a proactive approach to planning local centres. The hierarchy of centres and the set of functions assigned to them is important since it could prevent the dispersion of public facilities and strengthen the potential of higher-order centres. Documents subjected to analysis encompassed spatial policies of 27 suburban municipalities included in the Functional Area of Warsaw. The Polish spatial planning system neglects centres as a category of functional, economic, and social space, leaving municipalities complete freedom in planning them. The study proved that a system of local centres should become an urban planning standard since it helps municipalities locate public functions more reasonably. A vision of local centre development is rarely based on rational premises. The Polish case shows that in outer suburbs, a proactive approach to LC planning that involves designing a desired future and then inventing ways to create that future state is still a long way off.

Consumer meat safety knowledge and hygiene practices in a veterinary disease-controlled area of South Africa

Consumers’ practices and knowledge play a significant role in ensuring meat safety and hygiene application. This is important in an environment where the slaughter and release of such meat is restricted and not always controlled and monitored. This could have been contributed by the lack of slaughter facilities; the controlled movement of live animal restrictions applicable in a typical veterinary diseases-controlled area. The aim of this investigation was to identify meat hygiene practices and general meat safety knowledge applied by consumers of central Bushbuckridge, South Africa. Structured interviews (n=81) were conducted with consumers observed purchasing meat from local meat supply centres. Data analysis was achieved by SAS Statistical software (Version 26) SAS and graphs were drawn using MS Excel 2020. The majority (84.2%, σ=29.4) of the consumers indicated that meat supplied in the region were from registered facilities. The general belief amongst the consumers was that routine hygiene inspection was conducted by authorities at all meat distributing or butchery facilities (74.1%, σ=39.7). None of the facilities or/and butcheries in the study area was registered and therefore, no formal regulated practices could have been conducted. Slaughter and distribution of meat within the area were seen as a good business by 78.6%, σ=18.9 of the consumers, and as a result, the consumers did not have a problem with widespread slaughter and release of this meat to the public outside of those facilities. The extent of hygiene application practices at household level varied. These included the assurance that perishable products were properly handled after purchase (84.1%, σ=8.3), and the handling or transportation of sourced meat did not comply with cold chain management prescripts (39.9%, σ=44.9). The likelihood of consumers feeling the same about meat hygiene concerns and practices is undoubtedly low as represented by a high standard deviation (σ) of the responses. These results show that consumers were relying on authorities for meat safety assurances. This ought to caution authorities on consumer practices and needed interventions such as animal movement policies enforcement. The adoption of such policies by consumers lies with the development and rollout of consumer awareness and meat safety assurances training programs. Key words: abattoir, consumer practices, illegal slaughter, meat safety, meat hygiene

Promoting Education and Literacy through the Preservation of Yongning River Boatman Work Songs

Yongning River Boatman Work Songs are traditional folk music from the Yongning River region, performed by boatmen for practical purposes during laborious tasks. The study’s objective is to investigate the promotion of education and literacy through the preservation of the Yongning River Boatman Work Song. Three key informants, including an inheritor of intangible cultural heritage, an academic expert, and a cultural heritage preservationist, provide comprehensive insights into this multifaceted topic. Data was analyzed thematically using a mixed-methods approach, including in-depth interviews, document analysis, and observations. The findings highlight the transformative power of these songs as educational tools, bridging the past and present, fostering cultural identity, and enabling multifaceted learning. Additionally, community collaboration among local individuals, cultural centers, educational institutions, and government authorities plays a pivotal role in preserving and promoting these songs. Successful initiatives for engaging the younger generation ensure the intergenerational transmission of this cultural heritage. This research suggests that cultural preservation, education, and community involvement are intertwined elements that can enrich education and enhance literacy while safeguarding intangible cultural heritage.

RinRK1 enhances NF receptors accumulation in nanodomain-like structures at root-hair tip

Legume-rhizobia root-nodule symbioses involve the recognition of rhizobial Nod factor (NF) signals by NF receptors, triggering both nodule organogenesis and rhizobial infection. RinRK1 is induced by NF signaling and is essential for infection thread (IT) formation in Lotus japonicus. However, the precise mechanism underlying this process remains unknown. Here, we show that RinRK1 interacts with the extracellular domains of NF receptors (NFR1 and NFR5) to promote their accumulation at root hair tips in response to rhizobia or NFs. Furthermore, Flotillin 1 (Flot1), a nanodomain-organizing protein, associates with the kinase domains of NFR1, NFR5 and RinRK1. RinRK1 promotes the interactions between Flot1 and NF receptors and both RinRK1 and Flot1 are necessary for the accumulation of NF receptors at root hair tips upon NF stimulation. Our study shows that RinRK1 and Flot1 play a crucial role in NF receptor complex assembly within localized plasma membrane signaling centers to promote symbiotic infection.

Development and organization of omental milky spots.

The milky spots in omentum are atypical lymphoid tissues that play a pivotal role in regulating immune responses in the peritoneal cavity. The milky spots act as central hubs for collecting antigens and particles from the peritoneal cavity, regulating lymphocyte trafficking, promoting the differentiation and self-renewal of immune cells, and supporting the local germinal centre response. In addition, the milky spots exhibit unique developmental characteristics that combine the features of secondary and tertiary lymphoid tissues. These structures are innately programmed to form during foetal development; however, they can also be formed postnatally in response to peritoneal irritation such as inflammation, infection, obesity, or tumour metastasis. In this review, I discuss emerging perspectives on homeostatic development and organization of the milky spots.

Generalized molecule-like structure in atomic nuclei

Starting from a |ϕ|4 field theory with universal pn interacting angular and distance coordinates (θ,r) to depict nuclear long-range correlations, we have derived a cubic Schrödinger equation for NpNnpn interacting virtual bosons, which are believed to dominate the generic evolution of nuclear structure from spherical multi-nucleon shell-model states to deformed collective rotational states. It is shown that two-soliton solution in θ space manifests two opposite pn-type Ising-like chains existing in ground states and their gradual alignment responsible for nuclear rotational excitations. Of particular prominence is two-soliton solution with respect to r: the mutual relative motion of valence protons and neutrons around valence-nucleon mass centers considered as the dynamic equilibrium positions of a non-linear Schrödinger breather. And the resulting non-vanishing root mean square 〈r2〉 divides half the valence nucleons belonging to a chain into four local mass centers and proposes two chain-corresponding molecule-like tetrads outside inert cores pairwise hidden in ground states. Such solitons turn out to be an analogue of opposite axion fluids around a local mass center in the galactic dark-matter halo outside the soliton core (Garnier et al. (2021) [67]) and the present study facilitates making the latter more clear. The generalized molecule-like structure arouses a requisite to the addition of cluster-interior and cluster-to-core electric dipole moments in particular to pear-shaped nuclei, whose variants Schiff moments play an important role in measuring diamagnetic atomic electric dipole moments and therefore understanding CP-violating new physics beyond the standard model. We put additional parts in evidence by befitting the NpNn scheme verified already by electric quadrupole moments in same nuclei.

Best practice transfer by public health nurses in Japan: actual conditions and related factors

BackgroundThe workload of public health nurses (PHNs) working for local governments has been increasing as health issues become more diverse and complicated. Even amidst the ongoing administrative and fiscal reforms, there is an urgent need to ensure how effectively and efficiently public health nurses can practice in health service development. The objective of this research was to clarify the actual conditions of best practice transfer (BPT) and its related factors.MethodsAn anonymous postal and self-administered questionnaire survey was conducted among PHNs working at 334 sites, including the local government offices and health centers across Japan, and analysed mainly through logistic regression analysis.ResultsOne hundred eighty-five of the 334 institutions (55.4%) agreed to participate, and of the 966 questionnaire forms distributed, 709 forms (73.4%) were collected, of which 702 responses (72.7%) were valid. Although less than half (43.2%) have experience in BPT in health service development, more than 80% are willing to perform going forward. Significant factors for both the group with experience in BPT and the group with willingness to perform include an organizational culture that promotes BPT, as well as multiple elements of the workplace environment and facilitating factors related to knowledge and learning. The experienced group recognised the needs for criteria to evaluate the adaptability of best practice, while the willing group, to evaluate the quality of practice.ConclusionsThrough a nationwide survey, this research elucidated for the first time the actual conditions of BPT by PHNs in Japan and related factors. The results indicated the importance of developing a system to promote BPT at the workplace level, also highlighted the importance for practitioners and experts, including researchers, to work together to develop practical guidelines to ensure evidence-based practices. Urgent actions are needed for the national and local governments to develop a system to promote BPT from diverse perspectives, building on the findings of this research.

Current practices of craniospinal irradiation techniques in Turkey: a comprehensive dosimetric analysis

ObjectiveThis study evaluates various craniospinal irradiation (CSI) techniques used in Turkish centers to understand their advantages, disadvantages and overall effectiveness, with a focus on enhancing dose distribution.MethodsAnonymized CT scans of adult and pediatric patients, alongside target volumes and organ-at-risk (OAR) structures, were shared with 25 local radiotherapy centers. They were tasked to develop optimal treatment plans delivering 36 Gy in 20 fractions with 95% PTV coverage, while minimizing OAR exposure. The same CT data was sent to a US proton therapy center for comparison. Various planning systems and treatment techniques (3D conformal RT, IMRT, VMAT, tomotherapy) were utilized. Elekta Proknow software was used to analyze parameters, assess dose distributions, mean doses, conformity index (CI), and homogeneity index (HI) for both target volumes and OARs. Comparisons were made against proton therapy.ResultsAll techniques consistently achieved excellent PTV coverage (V95 > 98%) for both adult and pediatric patients. Tomotherapy closely approached ideal Dmean doses for all PTVs, while 3D-CRT had higher Dmean for PTV_brain. Tomotherapy excelled in CI and HI for PTVs. IMRT resulted in lower pediatric heart, kidney, parotid, and eye doses, while 3D-CRT achieved the lowest adult lung doses. Tomotherapy approached proton therapy doses for adult kidneys and thyroid, while IMRT excelled for adult heart, kidney, parotid, esophagus, and eyes.ConclusionModern radiotherapy techniques offer improved target coverage and OAR protection. However, 3D techniques are continued to be used for CSI. Notably, proton therapy stands out as the most efficient approach, closely followed by Tomotherapy in terms of achieving superior target coverage and OAR protection.

Food resources and kitchen skills plus aerobic training (FoRKS+) for black adults with hypertension: A pilot trial protocol

BackgroundMidlife hypertension is associated with cognitive decline and Alzheimer's disease and related dementia (ADRD), suggesting that blood pressure control may be a therapeutic target for dementia prevention. Given excess hypertension in non-Hispanic Black (NHB) adults, blood pressure control may also reduce ADRD disparities. We describe a pilot randomized controlled trial (RCT) to evaluate the feasibility and preliminary efficacy of a multicomponent lifestyle-based intervention versus enhanced usual care on cognition among middle-aged NHB adults. Methods and study designThe Food Resources and Kitchen Skills plus Aerobic Training (FoRKS+) study is a 2-arm, single-blinded trial that compares those receiving the FoRKS+ program (target N = 64) versus those receiving enhanced usual care (target N = 64) in local federally-qualified health centers. Key eligibility criteria include self-identified NHB adults between ages 35–75 with a mean systolic blood pressure ≥ 130 mm/Hg obtained from 24-h ambulatory blood pressure monitoring. The FoRKS+ program includes 5 weeks of hypertension self-management courses, 11 weeks of nutrition courses, and 12 weeks of aerobic training in dietitian and health coach-led virtual groups. We will collect data on primary cognitive outcomes, feasibility, hypothesized intervention mediators and moderators, and demographic and health covariates at baseline, near intervention weeks 16-, and 28 (primary outcome assessment), and week 52 follow-up. We will use mixed-effects modeling to examine intervention effects on cognition. DiscussionThis pilot RCT will examine the feasibility and preliminary effects of a multicomponent lifestyle intervention on cognitive function in NHB adults, which may have implications for reducing health disparities in ADRD.

Body mapping as a site to negotiate eating struggles and food insecurity for street-involved and homeless youth

Inspired by critical trauma and embodiment theories, this study aims to illustrate how an arts-based approach such as body mapping assists in exploring the lived experiences of youth, potentially serving as a trauma-informed approach. This qualitative study collaborated with street-involved and homeless youth (SIHY) who have eating struggles while living in situations of food insecurity and other forms of oppression. Eleven participants partook in three individual face-to-face interview sessions and one arts-based body map activity, respectively, at a local SIHY resource centre in a metropolitan city in Canada. Guided by Interpretative Phenomenological Approach (IPA), our findings illustrated how body mapping (1) enabled a deepened understanding of SIHY’s eating struggles as both a form of suffering and an embodied means of coping with food insecurity and other systemic and relational trauma(s); (2) provided a transformative experience leading to greater self-compassion and healing; and (3) served as a trauma-informed method that fostered choice and validation. We attest that, as a creative and supportive clinical and research tool, body mapping taps into the unspoken, expressive, embodied, and somatic aspects of eating struggles, food insecurity, poverty, and other forms of oppression deepening knowledge and informing social work research and practice.