Multistage Study Research Articles

The Impact of Social Well-Being on Population Diet Nutritional Value and Antiradical Status.

The paper presents the result of assessing the antiradical status of consumers (in the context of Russia) in connection with their well-being. This approach is based on a multistage study, in which the results of sociological surveys were applied, as well as estimates of the antiradical potential (ARP) of diets obtained using neural networks, bootstrapping the chemical composition of diets, and calculating reference values using mathematical models. The paper presents data collected from residents living in the territories of at least 21 regions and cities of Russia: Magadan, Saint Petersburg, Moscow, Krasnodar, Lipetsk, Vladivostok, Novosibirsk, Omsk, Voronezh, etc. A total of 1001 people were interviewed, which, according to our calculations, gives a margin of error in value of approximately 3.1%. To calculate the lack of vitamins in the diets of residents of the Russian Federation, data on the chemical composition of food products from the FNDDS database were used. The assessment of dietary habits showed a lack of vitamins below the recommended level in 73% of Russians for vitamin D, 59% for retinol, 38% for β-carotenes, 13% for vitamin E, and 6% for ascorbic acid. The study showed that at least 36% of the Russian population has a low antiradical status, while it was found that "poor" consumers are more likely to consume economically more expensive foods (in terms of their nutritional value). The "poor" segments of the population consume 180-305% more canned food and 38-68% more sweet carbonated drinks than other social groups, but their consumption of vegetables is 23-48% lower. On the contrary, "wealthy" consumers consume 17-25% more complex (varied) dishes, 10-68% more fresh vegetables, and 8-39% more fish. From the obtained values it follows that consumers with low levels of ARP in their diets are in a group with an increased probability of a number of "excess" diseases (diseases of the cardiovascular system, obesity, etc.). In general, the ARP values of food consumed for low-income segments of the population were 2.3 times lower (the ratio was calculated as the percentage of consumers below the level of 11,067 equivalents necessary for the disposal of free radicals generated in the human body per day) than for those who can afford expensive food (consumers with high income). A simple increase in consumption of unbalanced foods, in our opinion, will only contribute to the entry of these consumers into the "average diet trap". All this makes it imperative to develop comprehensive measures to create a new concept of public catering; otherwise, we can expect a reduction in both the health of the population and the performance of the economy of the whole country.

Effect of initial failure geometry on the progress of a retrogressive seepage-induced landslide

Natural and man-made slopes can undergo a retrogressive landslide when subjected to seepage. Studying the mechanism of retrogressive landslides contributes greatly to the employment of effective mitigation approaches. A multi-stage limit equilibrium-based study was performed to explore how the geometry of initial failure affects the progress of a retrogressive, multiple-rotational landslide caused by seepage flow. Seepage-stability analyses were carried out on two silty sand slopes which were previously found to experience successive rotational failures upon raising the water table in centrifuge tests. Analyzed in prototype dimensions were the slope models with the height of 24 cm and inclinations of 45° (1V:1H) and 63.4° (2V:1H) tested at different centrifugal accelerations. According to the tests, the initial shallow failures were assumed to be circular initiating from the face and emerging from the toe of the slopes in the stability analyses. The impact of curvature and length of the initial failure surface (referred to as IFS) as well as the height of the scarp shaped at each failure episode were investigated. The results show that the landslide continues until the slope profile finds a stable curvature. For the landslides that occur in the 45° inclined slope, when the initial failure initiates at a higher elevation on the slope face, the landslide retrogresses further. In addition, with an increase in the length or curvature of IFS, the final retrogression distance decreases. Further, it was observed that the progress of landslides depends on the height of the scarp exposed at each failure episode.

Geriatric depression: prevalence and its associated factors in rural Odisha.

The world's population is aging rapidly, and the epidemiological transition has led to increased mental disorders worldwide. Geriatric depression is masked by multiple comorbidities or the natural process of aging. Our study aims to estimate the prevalence of geriatric depression and find the risk factors associated with geriatric depression in rural Odisha. The study was a multistage cross-sectional study conducted in the Tangi block, district Khordha, Odisha, from August 2020 to September 2022, among 520 participants selected by probability proportional to size sampling. From the selected participants, eligible 479 older adults were interviewed using a semi-structured interview schedule, Hindi Mini Mental Scale, Geriatric Depression Scale-15, and Hamilton Depression Rating Scale. The step forward multivariable logistic regression was used to assess the associated factors of depression among older adults. Among our participants, 44.4% (213) of older adults were depressed. Substance abuse in family members [AOR: 16.7 (9.1-30.9)], history of elder abuse [AOR: 3.7 (2.1-6.7)], physical dependency [AOR: 2.2 (1.3-3.6)], and financial dependency [AOR: 2.2 (1.3-3.6)] are significant independent risk factors associated with geriatric depression. Living with children [AOR: 0.33 (0.18-0.59)] and recreational activity [AOR: 0.54 (0.34-0.85)] are significant protective factors of geriatric depression. Our study found that geriatric depression is highly prevalent in rural Odisha. Poor quality of family life and physical and financial dependency was found to be the most significant risk factor for geriatric depression.

Long lasting anti-IgG chikungunya seropositivity in the Mayotte population will not be enough to prevent future outbreaks: A seroprevalence study, 2019.

Chikungunya is an arboviral disease causing arthralgia which may develop into a debilitating chronic arthritis. In Mayotte, a French overseas department in the Indian Ocean, a chikungunya outbreak was reported in 2006, affecting a third of the population. We aimed at assessing the chikungunya seroprevalence in this population, after over a decade from that epidemic. A multi-stage cross sectional household-based study exploring socio-demographic factors, and knowledge and attitude towards mosquito-borne disease prevention was carried out in 2019. Blood samples from participants aged 15-69 years were taken for chikungunya IgG serological testing. We analyzed associations between chikungunya serological status and selected factors using Poisson regression models, and estimated weighted and adjusted prevalence ratios (w/a PR). The weighted seroprevalence of chikungunya was 34.75% (n = 2853). Seropositivity for IgG anti-chikungunya virus was found associated with living in Mamoudzou (w/a PR = 1.49, 95%CI: 1.21-1.83) and North (w/a PR = 1.41, 95%CI: 1.08-1.84) sectors, being born in the Comoros islands (w/a PR = 1.30, 95%CI: 1.03-1.61), being a student or unpaid trainee (w/a PR = 1.35, 95%CI: 1.01-1.81), living in precarious housing (w/a PR = 1.30, 95%CI: 1.02-1.67), accessing water streams for bathing (w/a PR = 1.72, 95%CI: 1.1-2.7) and knowing that malaria is a mosquito-borne disease (w/a PR = 1.42, 95%CI: 1.21-1.83). Seropositivity was found inversely associated with high education level (w/a PR = 0.50, 95%CI: 0.29-0.86) and living in households with access to running water and toilets (w/a PR = 0.64, 95%CI: 0.51-0.80) (n = 1438). Our results indicate a long-lasting immunity from chikungunya exposure. However, the current population seroprevalence is not enough to protect from future outbreaks. Individuals naïve to chikungunya and living in precarious socio-economic conditions are likely to be at high risk of infection in future outbreaks. To prevent and prepare for future chikungunya epidemics, it is essential to address socio-economic inequalities as a priority, and to strengthen chikungunya surveillance in Mayotte.

Off‐host survival of blacklegged ticks in eastern North America: A multistage, multiyear, multisite study

AbstractClimatic conditions are widely thought to govern the distribution and abundance of ectoparasites, such as the blacklegged tick (Ixodes scapularis), vector of the agents of Lyme disease and other emerging human pathogens. However, translating physiological tolerances to distributional limits or mortality is challenging. Ticks may be able to avoid or tolerate unsuitable conditions, and what is lethal to one life history stage may not extend to others. Thus, even after decades of research, there are clear gaps in our knowledge about how climatic conditions determine tick distributions or patterns of abundance. We present results from a 3‐year study combining daily hazard models and data from field experiments at three sites spanning much of I. scapularis' current latitudinal distribution. We examine three predominant hypotheses regarding how temperature and vapor pressure deficits affect stage‐specific survival and transition success and consider how these results influence population growth and distribution. We found that larvae are sensitive to temperature and vapor pressure deficits, whereas mortality of nymphs and adults is consistent with depletion of energy reserves. Consistent with prior work, we found that overwinter survival was high and successful stage transitions (e.g., fed nymphs molting to adults) were sensitive to temperature. Collectively, results from this comprehensive, multiyear, multistage field study suggest that population growth of I. scapularis is less limited by restrictive climatic conditions than has been broadly assumed, although influences on larval survival may slow tick population growth and establishment in some desiccating conditions. Further studies should integrate climate effects on stage‐specific survival to better understand these effects on population dynamics and range expansion in a changing climate.

Perceptions of the key components of effective, acceptable and accessible services for children and young people experiencing common mental health problems: a qualitative study

BackgroundChildren and young people’s (CYP) mental health is a major public health concern internationally and the recent Covid-19 pandemic has amplified these concerns. However, only a minority of CYP receive support from mental health services due to the attitudinal and structural barriers they and their families encounter. For over 20 years, report after report has consistently highlighted the shortcomings of mental health services for CYP in the United Kingdom and attempts to improve services have been largely unsuccessful. The findings reported in this paper are from a multi-stage study that aimed to develop a model of effective, high-quality service design for CYP experiencing common mental health problems. The aim of the stage reported here was to identify CYP’s, parents’ and service providers’ perceptions of the effectiveness, acceptability and accessibility of services.MethodsCase studies were conducted of nine different services for CYP with common mental health problems in England and Wales. Data were collected using semi-structured interviews with 41 young people, 26 parents and 41 practitioners and were analysed using the Framework approach. Patient and Public Involvement was integrated throughout the study with a group of young co-researchers participating in data collection and analysis.ResultsFour key themes defined participants’ perceptions of service effectiveness, acceptability and accessibility. Firstly, open access to support with participants highlighting the importance of self-referral, support at the point of need and service availability to CYP/parents. Secondly, the development of therapeutic relationships to promote service engagement which was based on assessment of practitioner’s personal qualities, interpersonal skills and mental health expertise and underpinned by relational continuity. Thirdly, personalisation was viewed as promoting service appropriateness and effectiveness by ensuring support was tailored to the individual. Fourthly, the development of self-care skills and mental health literacy helped CYP/parents manage and improve their/their child’s mental health problems.ConclusionsThis study contributes to knowledge by identifying four components that are perceived to be central to providing effective, acceptable and accessible mental health services for CYP with common mental health problems irrespective of service model or provider. These components could be used as the foundations for designing and improving services.

Understanding changing public transit travel patterns of urban visitors during COVID-19: A multi-stage study

COVID-19 has caused huge disruptions to urban travel and mobility. As a critical transportation mode in cities, public transit was hit hardest. In this study, we analyze public transit usage of urban visitors with a nearly two-year smart card dataset collected in Jeju, South Korea – a major tourism city in the Asia Pacific. The dataset captures transit usage behavior of millions of domestic visitors who traveled to Jeju between January 1, 2019 and September 30, 2020. By identifying a few key pandemic stages based on COVID-19 timeline, we employ ridge regression models to investigate the impact of pandemic severity on transit ridership. We then derive a set of mobility indicators – from perspectives of trip frequency, spatial diversity, and travel range – to quantify how individual visitors used the transit system during their stay in Jeju. By further employing time series decomposition, we extract the trend component for each mobility indicator to study long-term dynamics of visitors’ mobility behavior. According to the regression analysis, the pandemic had a dampening effect on public transit ridership. The overall ridership was jointly affected by national and local pandemic situations. The time series decomposition result reveals a long-term decay of individual transit usage, hinting that visitors in Jeju tended to use the transit system more conservatively as the pandemic endured. The study provides critical insights into urban visitors’ transit usage behavior during the pandemic and sheds light on how to restore tourism, public transit usage, and overall urban vibrancy with some policy suggestions.

Integrating human values in software development using a human values dashboard

There is a growing awareness of the importance of human values in software systems. However, limited tools are available to support the integration of human values during software development. Most of these tools are focused on concepts related to specific, well-known human values (e.g., privacy, security) in software engineering. This paper aims to (partially) address this gap by developing a human values dashboard. We conducted a multi-stage study to design, implement and evaluate a human values dashboard. First, an exploratory study was conducted by interviewing 15 software practitioners to investigate the possibility of using a human values dashboard to help address human values in software development, its potential benefits, and required features. Second, we experimented with four Machine Learning approaches to detect the presence of human values in issue discussions. We used the best approach to develop a human values dashboard for software development. The dashboard displays whether any human values are present in each issue discussion. Finally, we interviewed ten different practitioners to investigate the usefulness of the dashboard in practice. This study found that the human values dashboard could help raise awareness, focus attention, and prioritise issues based on the presence of values. This study also identified two potential challenges to the adoption of the dashboard. First, the possible incorrect issues description that can mislead the automated values identification in the dashboard. Second, the lack of willingness of a company to adopt the dashboard.

Coverage, Apparent Consumption, and Monthly Use of Packaged Maize Flour in Morogoro Region, Tanzania.

Tanzania aimed to reduce micronutrient deficiencies and neural tube defects by introducing mandatory fortification of large-scale packaged wheat and maize flour but not for small- and medium-scale mills. Ascertain the proportion of the population in Morogoro region, Tanzania, that consumes packaged maize flour from small-, medium- and large-mills; and understand the impact of monthly apparent purchase and consumption of packaged flour. In 2018, a regional, multistage cluster probability study was conducted among residents in Morogoro region living in households that reported consuming maize flour. Interviews collected information on sociodemographic factors and patterns of household flour consumption. Weighted medians estimated daily apparent flour consumption and the estimated average requirement (EAR), according to age. Information was collected on 711 households. Packaged maize flour was purchased 10-12 months of the year by 22.9% of households, 6-9 months by 17.6% of households, 1-5 months by 25.1% of households, and 34.4% did not purchased maize flour. Median apparent daily consumption of maize flour was 209.7 g/d/adult male equivalent (AME). Apparent median daily consumption of maize flour was 230.1 g/d/AME in rural areas and 176.2 g/d/AME in urban areas; 228.7 g/d/AME among males and 196.4 g/d/AME among females. If all packaged maize flour were fortified according to standards, those consuming packaged maize flour 10-12 months of the year would apparently consume 199.9 µg folic acid/d representing 49.7% of daily EAR requirements. Fortifying packaged maize flour at small-, medium- and large-mills is a promising strategy for increasing access to micronutrients, including folic acid.

Development of a Shifting and Receiving Performa for ICU Patients: Reducing Communication Errors-A Delphi Study.

Critically ill patients are frequently transported between intensive care units (ICUs) and other sections of hospital, which may cause communication error. The aim of this study was to reduce errors while shifting and receiving of patients in and from the ICU. The present study was aimed to develop a Shifting and Receiving Performa for the patients admitted in the ICU of a tertiary care hospital. A multistage developmental study was conducted in ICUs. Eleven experts were selected by a purposive sampling technique, and the study was conducted in 4 phases. From the pool of items, a preliminary draft of the performa was prepared and the draft was given to experts to evaluate its content and face validity by conducting 2 Delphi rounds. The mean I-CVI of the shifting performa increased from 0.92 to 0.95, S-CVI/AVG exceeded from 0.88 to 0.96, and S-CVI/UA exceeded from 0.48 to 0.7 after Delphi round 2. In the case of the receiving performa, the mean I-CVI and S-CVI/AVG remained the same, that is, 0.98 in Delphi rounds 1 and 2. The mean S-CVI/UA also remained the same (ie, 0.9). The interrater reliability of the performa was found to be 0.95. Almost all the staff nurses found the performa to be beneficial, provided complete information, and reduced communication errors.

Prevalence and Associated Factors Related to Computer Vision Syndrome among Bank Employees in Peshawar

Computers are vital, but in banking, they are essential. Long-term computer screen exposure harms the eyes. This study examined CVS prevalence and associated variables in Peshawar City Bank employees. This descriptive-analytical investigation was done across Peshawar city. Commuter bankers were the study population. This multistage study attracted 289 people. A complete tailored questionnaire using SPSS version 24 analyses collected data. Time exposure and CVS were examined. The chi-square test determined significance. A sample of 289 bank workers (mean age 32.72 ± 7.02 years) included 266 (92.0%) men and 23 (8.0%) women. 24.2% of employees had yes illnesses and 77.2% had CVS. Most of them had simple eye health issues due to computer screen overexposure. These symptoms included eye strain, pain, headache (68.9%), blurriness (67.5%), dryness (49.1%), blinking (46.7%), redness and irritations (44.3%). The prevalence of diagnosed eye diseases was high at 24.2% while CVS was positive in 77.2% for at least one symptom.

The Performance of Brazilian Air Traffic Controllers in Radiotelephony Communications in English: the Controllers’ Perspective

Following the argument-based validity framework (M.E. Kane 2006, 2013), this paper aims at analyzing controllers’ perspectives of their performance in radiotelephony communications in English, utilizing data generated through the ongoing validation process of EPLIS, the Aviation English Proficiency Exam for Brazilian Air Traffic Controllers. This paper reports one phase of a broader multistage mixed-methods study and focuses on the consequences inference. Part of the data generated from a 65-item questionnaire answered by Brazilian Air Traffic Controllers who got proficiency Level 3 (considered non-operational) and Level 4 (considered by ICAO as the minimum level necessary to control aircraft using the English language) is analyzed. The questionnaire was divided into 3 parts: test-takers’ perceptions of the rating scale established by ICAO; test-takers’ perceptions of their proficiency while controlling aircraft in English; and problems they faced while controlling in English.

A health communication campaign for prevention of osteoporosis in rural elderly women

BackgroundOsteoporosis, as the most common metabolic disease and the leading cause of death among older people, affects more than 200 million women throughout the world. This study aimed to evaluate the effect of a health communication campaign on knowledge, attitude, and practice of older women towards prevention and control of osteoporosis.MethodsIn this multi-stage mixed methods study, 30 days’ health communication campaign for prevention of osteoporosis was conducted on 60- 75-year-old women, in rural areas of Fasa, Iran. Subjects were divided into two groups, control (n = 103) and intervention (n = 98). Data were collected using a researcher-made questionnaire and analyzed by SPSS 25.0. The significance level was set at < 0.05.ResultsInter-group group analysis revealed that the mean scores of knowledge, attitude, and practice were not significantly different between the two groups before the intervention, but after the intervention, unlike the behavior (P = 0.569), mean scores of knowledge (p < 0.001) and attitude (p < 0.001) of the intervention group were significantly more than the control group. Intra-group comparisons showed that, unlike the control group, the mean scores of knowledge (p < 0.001), attitudes (p < 0.001), and behavior (P < 0.001) increased significantly in the intervention group.ConclusionsHealth communication campaign is an effective way to change the knowledge and attitude and to a lesser extent the practice of the eldery toward prevention and control of osteoporosis.

Why school context matters in refugee education

Education plays an important role in the successful settlement and life outcomes of young people from refugee backgrounds. Because of this, research into young people from refugee backgrounds in education systems tends to focus on examples of “good practice” in terms of how these young people experience education. Yet, examples of good practice commonly fail to take into account that schools are engaging in particular practices from very different contexts. This article contributes to the study of refugee education by drawing attention to the role that school contexts play in how different schools enact “good practice”. It presents data from a large multi-stage study which explored how the schooling experiences of students from refugee backgrounds are shaped by educational policies and school practices. By outlining case studies of seven schools, it highlights the impact of differing school contexts on how schools respond to the needs of students from refugee backgrounds. In this way, this article highlights that the notion of “good practice” within refugee-background education is always nuanced and contextual.

Descriptive Epidemiology of Occupational Injuries among urban construction workers – an observation from Eastern India

Introduction Bhubaneswar, Odisha, is seeing a boom in construction activities, with workers from remote areas coming for work. Poverty, and illiteracy, coupled with employment and regular payments make them oblivious to unsafe working conditions. Long hours of heavy work in bad postures affect their musculoskeletal system leading to work-related musculoskeletal injuries. This study aimed to understand the epidemiology of the above injuries among the construction workers in Bhubaneswar Methods It was a work-site-based multistage cross-sectional study, where the sites engaging &gt;=15 workers were selected randomly. A total of 520 workers (consented, &gt;=21 years of age, and in this profession for at least 3 years) were recruited randomly. Data was collected by interviewing the study participants with the help of a pre-tested questionnaire focusing on sociodemographic profiles and relevant epidemiological variables related to occupational injury of urban construction workers. Data entry and analysis were done using SPSS version 20. Results Over 95% of the participants were heavy workers, 23.1% were laborers, 28.1% had &lt; 10 years of experience, and 72.3% were satisfied with their job. A little more than 19% had work-related injuries in the last 3 months. Age, gender, alcohol abuse, better education, lesser work experience, skilled work and job dissatisfaction were found to be statistically significant when associated with workplace injuries. Multivariate analysis revealed only age and lesser duration of working experience in the construction industry were associated with an increase in occupational injuries. Conclusion This study found that younger age, less work experience, male gender, use of alcohol, nature of work and lack of job satisfaction, and a few other factors were associated with work-related injuries. Often their occupational health and injuries get overlooked. Employers should be primarily responsible for their health, safety, and well-being. Suitable legislation and proper implementation would probably facilitate this.

Abstract MP23: Circulating Gut Microbiota-Related Metabolites and Risk of Coronary Heart Disease: A Prospective, Multiethnic, Metabolomic Study

Introduction: Despite the importance of gut microbiota in human cardiometabolic health, the associations between circulating levels of gut microbiota-related metabolites and incident coronary heart disease (CHD) remain largely unexplored. Hypothesis: Certain circulating microbial metabolites are associated with incident CHD. Methods: This is a multi-stage and multiethnic metabolomics study. We first conducted a global, semi-quantitative assay for discovery among 900 incident CHD cases and 900 age-/sex-/race-matched controls (300 pairs of Black Americans, White Americans, and Chinese adults, respectively) selected from the Southern Community Cohort Study and Shanghai Men’s and Women’s Health Studies. We focused on 226 metabolites that were potentially related to gut microbiota and applied conditional logistic regression to estimate odds ratios (ORs) of CHD associated with a 1-SD increase of log-transformed metabolites adjusting for traditional CHD risk factors. Then, an in-silico validation was conducted using existing metabolites data of 9,264 participants from the Multi-Ethnic Study of Atherosclerosis and Atherosclerosis Risk in Communities Study. Results: In the discovery stage, we identified 73 named microbial metabolites related to incident CHD risk with a false discovery rate&lt;0.10 or nominal p &lt;0.05 and a large effect size (ORs &gt;1.5 or &lt;0.5). These metabolites were from super pathways of amino acids (n=28), lipids (n=24), nucleotides (n=6), carbohydrates (n=4), energy (n=4), xenobiotics (n=4), and cofactors/vitamins (n=3). Of them, 61 metabolites were available for the in-silico validation, and 30 showed a significant association ( p &lt;0.05) with the same direction as the discovery results. After further adjustments for established CHD risk factors (e.g., glucose and LDL-cholesterol), 25 metabolites remained significant. A 14%-48% increased risk was observed for N-acetylglutamate (OR=1.48), sphingomyelin (1.42), imidazole propionate (1.37), hypoxanthine (1.29), guaiacol sulfate (1.28), glutamate (1.22), 2-hydroxyphenylacetate (1.20), 3-hydroxybutyrate (1.19), 3-hydroxy-2-ethylpropionate (1.17), 1-methyl-4-imidazoleacetate (1.16), urea (1.16), urate (1.16), 4-hydroxyphenylacetate (1.15), choline (1.15), isoleucine (1.14), and glycerol (1.14). Meanwhile, a significant inverse association was found for taurine (OR=0.64), asparagine (0.75), serotonin (0.78), histidine (0.79), threonine (0.81), glutamine (0.83), glycine (0.84), oxalate (0.85), and N-methylproline (0.89). Conclusions: Among ethnically and geographically diverse populations, we identified and validated some circulating gut microbiota-related metabolites as potential novel biomarkers for incident CHD. Targeted quantitative assays to confirm these results are ongoing, which are essential to inform potential clinical utility.

Internet-Based Mental Health Survey Research: Navigating Internet Bots on Reddit

This study was a multistage process of recruiting participants through Reddit with the intent of increasing data integrity when facing an infiltration of Internet bots. Approaches to increase data integrity centered around preventing the occurrence of Internet bots from the onset and increasing the ability to identify Internet bot responses. We attempted to detect bots in a study focused on understanding social factors related to autism and suicide risk. Four recruitment rounds occurred through Reddit on mental health-related subreddits, with one post made on each subreddit per recruitment round. We found high presence of bots in the initial rounds-indeed, using location data, one third of the total responses (33.4 percent; 118/353) came from just eight locations (i.e., 4.7 percent of all locations). The proportion of detected bots was significantly different across the rounds of recruitment (χ2 = 150.22, df = 3, p < 0.001). In round 4, language advertising compensation was removed from recruitment posts. This round had significantly lower proportions of detected bots compared with round 1 (χ2 = 33.01, df = 1, p < 0.001), round 2 (χ2 = 129.14, df = 1, p < 0.001), and round 3 (χ2 = 46.6, df = 1, p < 0.001). Through a multistage recruitment process, we were able to increase the integrity of our collected data, as determined by a low percentage of fraudulent responses. Only once we removed advertisement of compensation in recruitment posts, did we see a significant decrease in the quantity and percentage of Internet bot responses. This multistage recruitment study provides valuable information regarding how to adapt when an online survey study is infiltrated with Internet bots.

Multi-Stage Study of Wastewater from Bakery Enterprises for the Ability to Clean Using Chemical Coagulation Processes and Combined Methods of Biological Treatment

Multi-Stage Study of Wastewater from Bakery Enterprises for the Ability to Clean Using Chemical Coagulation Processes and Combined Methods of Biological Treatment

Disruption, Slowness, and Collective Effervescence: Children's Perspectives on COVID-19 Lockdowns.

The COVID-19 pandemic represented not only a health crisis, but a social crisis for children, one that has disrupted notions of what a good childhood is. However, the longer-term implications of the pandemic are still to be seen, for children, their families and communities. This article is concerned with what these ongoing changes may be, based on a qualitative multi-stage study that asks children about their experiences of well-being before the pandemic, during lockdowns and post-COVID-19 lockdowns. This included asking seven children in online semi-structured interviews about what aspects of life brought on by COVID-19 restrictions they would like to see continue post-lockdown. We outline some of our findings. We describe new rituals and ways of organising time developed by children, facilitated by the use of digital technologies. We describe these new ways of managing time as task-based rather than rule-based, with children experiencing slowness of and greater control over their time. We found that lockdowns provided a possibility for children to assert a public agency through banal acts of sociability, for example, by conforming to public health measures such as mask-wearing and hand-washing. Whilst small acts, children discussed these in terms of being moral agents (protecting the safety of others) and as part of a larger civic attitude they observed around them. Thus, their acts can be seen as expressions of larger forms of social solidarity that contributed to a sense of collective effervescence.

Post-discharge follow-up system in psychiatric patients: A case study of Farabi Hospital in Isfahan.

Mental illness is one of the most common problems in human societies and the continuation of care and post-discharge follow-up. This study was conducted to define a post-discharge follow-up framework for Farabi Hospital in Isfahan. This was a multistage study, including, interviews literature review, and focus group discussions. Participants included 18 purposefully selected nurses, physicians, and managers, directly involved in the discharge process of Farabi Hospital in Isfahan. The interviews were semi-structured. Data were organized using MAXQDA10 software. The initial framework was set through the extraction of semantic main and secondary codes. The framework was finalized through three several focus group discussion sessions. Results included of 17 sub-categories and seven main categories as "education," organizational arrangement," "team-building," "patient and family participation and trust," "engaging some supportive institutions of community," "process management" and "information management." To implement a post-discharge follow-up system for psychiatric patients in Farabi Hospital of Isfahan must be concentrated to patient and family education, team building, organizational arrangements, participation, and trust of patients and family, while engaging community health centers and notice to information and management and process management.