Personal Reasons Research Articles

Modulation of Serum Metabolic Profiles by Bifidobacterium breve BBr60 in Obesity: A Randomized Controlled Trial

Obesity, a prevalent metabolic disorder in youth, leads to complications and economic strain. Gut dysbiosis significantly contributes to obesity and metabolic issues. Bifidobacterium breve, a probiotic strain, may help regulate gut dysbiosis and benefit obese individuals. However, more research is needed on its effect on serum metabolism. A total of 75 overweight or obese young adults (aged 19–45) participated in the current study, and were randomly divided into probiotic and placebo groups using a random number table. Both groups received dietary guidance and underwent twelve weeks of intervention with either oral Bifidobacterium breve BBr60 (BBr60) or a placebo. After the intervention, collection and analysis of fasting serum samples were conducted using mass spectrometry coupled with liquid chromatography. Analyses of associations were conducted in order to determine the correlations between key serum metabolites and clinical obesity indicators, aiming to understand the influence of BBr60. Due to 10 participants dropping out for personal reasons, the study included 32 and 33 participants in the placebo and the BBr60 groups, respectively. The BBr60 intervention significantly regulated 134 serum metabolites and influenced crucial metabolic pathways in obesity management (p < 0.05), including ascorbate and aldarate metabolism for oxidative stress reduction, cholesterol metabolism for lipid regulation, parathyroid hormone synthesis, secretion and action for the endocrine system, oxidative phosphorylation for enhanced energy efficiency, and glycolysis/gluconeogenesis for glucose metabolism. Analysis showed a positive relationship between fasting blood glucose (FBG), aspartate aminotransferase (AST), total protein (TP), and the content of 5-Methyl DL-glutamate (p < 0.05). Similarly, body mass index (BMI), weight, and body fat percentage (BFP) were positively linked to serum metabolites (1-Hydroxycyclohexyl) acetic acid, and 5-Oxooctanoic acid (p < 0.05). Significant associations of AST levels with key serum metabolites in cholesterol metabolism pathways further suggest BBr60’s potential to improve liver function and overall metabolic health in overweight or obese individuals. These findings support BBr60’s effectiveness in modulating serum metabolic profiles and suggest it may improve liver function and BMI in overweight or obese individuals by regulating key serum metabolites.

The efficacy and safety of the prophylactic application of PEG-rhG-CSF in radiotherapy with weekly concurrent chemotherapy for cervical cancer.

To evaluate the efficacy and safety of pegylated recombinant human granulocyte colony stimulating factor (PEG-rhG-CSF) in preventing neutropenia during concurrent radiotherapy combined with weekly chemotherapy in patients with cervical cancer. From September 2019 to November 2020, 180 patients with cervical cancer who required concurrent chemoradiotherapy (CCRT) were enrolled in this study. The patients were randomly divided into the following three groups at a ratio of 1:1:1: Group A (PEG-rhG-CSF), Group B (PEG-rhG-CSF + rhG-CSF) and the control group (rhG-CSF). Cisplatin or carboplatin was administered weekly. The primary endpoint was the incidence of grade 3/4 neutropenia. The secondary endpoints were the incidence of febrile neutropenia (FN), delay of radiotherapy, chemotherapy dose reduction, rate of PFS at 2 years and 3 years, and incidence of adverse reactions. Sixty patients were randomly assigned to each group. Two patients in Group B withdrew from the trial for personal reasons. The incidence of grade 1/2 neutropenia in the Control group was significantly lower than that in Group A and Group B (P < 0.001). However, the incidence of grade 3/4 neutropenia in the Control group was significantly greater than that in Group A and Group B (P < 0.001). There was no significant difference in the incidence of FN among the three groups (P = 0.771). The rate of platinum dose reduction in Group A (6.7%) and Group B (5.2%) was significantly lower than that in the Control group (30.0%) (P < 0.001). The delay rate of radiotherapy in Group A (10%) and Group B (13.8%) was obviously inferior to that in the Control group (31.7%) (P = 0.006). The 2-year PFS rates of Group A, Group B, and the Control group were 93.3%, 98.3%, and 91.7%, respectively, with no statistically significant difference (P = 0.270). The 3-year PFS rates were 89.8%, 94.1%, and 84.9%, respectively, with no statistically significant difference (P = 0.178). No treatment-related serious adverse events occurred in any of the patients. In Group A and Group B, The prophylactic application of PEG-rhG-CSF during conventional chemoradiotherapy combined with weekly chemotherapy for patients with cervical cancer can reduce the incidence of grade 3/4 neutropenia and does not increase the incidence of adverse reactions when compared to Control group. chictr.org.cn, ChiCTR1900026309, registered 29 September 2019-prospectively registered.

Support for pharmacy professionals returning to (clinical) practice after a break: a cross-sectional survey

Abstract Introduction The continuing expansion of clinical roles for pharmacists, combined with National Health Service workforce shortages and the COVID-19 pandemic, have significantly increased pressure on pharmacy professionals.1 These pressures have heightened stress levels, causing many to consider leaving the field.2 Addressing workforce shortages and retension is crucial, with a particular focus on the reintegration of professionals returning to practice after a break. However, those returning after extended breaks often face challenges such as decreased skills and confidence. Nevertheless, research on the effectiveness of reintegration programmes to help pharmacy professionals return remains limited. Aim To explore participants’ reasons for leaving and returning and to assess the effectiveness of the Centre for Pharmacy Postgraduate Education (CPPE)’s Return to practice (RTP) and Return to the register (RTTR) programmes in helping individuals return to pharmacy practice in England. Methods CPPE emailed an anonymous link to an online survey, with two reminders, in December 2023 and January 2024, to individuals who participated in the RTP and/or RTTR programme(s) before March 2023 (n=701) and had given consent to be contacted for evaluation purposes. The survey employed closed, Likert-type and free-text questions. Quantitative data were analysed using the Statistical Package for Social Sciences (SPSS), with inferential statistics for subgroup comparisons and thematic analysis for qualitative comments (statistical significance p≤0.05).3 Using the university’s ethical approval tool, this study did not require approval due to not collecting personal, confidentical or sensitive information, with no vulnerable groups included, or risk of disclosure. Results The valid response rate was 15% (n=106). Most respondents were female (n=67, 79.8%), aged 35 and older (n=82, 97.6%), and pharmacists (n=77, 85.6%) or pharmacy technicians (n=8, 8.9%). The primary reasons for leaving included family responsibilities, career transition, and relocation, while the main motivations for returning were career reconnection, relocation, and other personal reasons. Participants reported a high degree of satisfaction with both programmes; those who perceived high content relevance reported significantly higher satisfaction (8.90±1.47 for RTP and 8.75±1.58 for RTTR on a 10-point scale). Overall, 70.8% (n=75) successfully returned to pharmacy practice and/or the GPhC register after completing the programme(s). Of those who returned, 68.1% (n=47) took less than 6 months. It was found that those who were more satisfied and more likely to recommend the programme(s), had been off the register for less than 10 years (n=41, 78.8%), and completed the programme(s) before 2020, prior to the shift to online delivery due to COVID-19 (n=41, 83.7% for RTP and n=16, 88.90% for RTTR), were more likely to have returned. Discussion/Conclusion The CPPE RTP and RTTR programmes supported participants effectively in returning to pharmacy practice. Increasing the number of pharmacy professionals returning to practice using reintegration course(s) positively impacts workforce shortages and addresses skill gaps after a break. One study limitation is the lack of information about those who did not use or are unaware of these support programmes. Further research could explore the support needs of all those wishing to return to practice or the GPhC register.

A Netnographic Study on The Reasons Why People Fail to Learn English

In a global and digital world, learning a language, especially English is essential for people to keep up with the developments in science, business, technology, etc. Despite starting to learn English early, students might not always reach desired proficiency levels. Therefore, the present study aims to find out some of the reasons why people fail to learn English. Employing a netnographic approach, the researchers examined asynchronous comments posted in online communities on a social media platform. Within the scope of this study, 198 comments answering the question of why people fail to learn English were obtained from three online groups of English language teachers on Facebook. The findings show that 154 out of 198 comments aimed to answer the question. They were analyzed through content analysis, which revealed that there are educational, social, personal, and linguistic reasons why people fail to learn English. Educational reasons were among the most mentioned reasons by the members of the communities. In addition, the analysis indicates a balanced representation of linguistic and personal factors, with social factors slightly less prominent in comparison. Considering the existing literature review, several implications are highlighted to overcome the difficulties and challenges of learning English. Finally, this study is limited by its reliance on Facebook posts collected within a specific timeframe; future research could enhance depth and scope by incorporating longitudinal methods, diverse social media platforms, and in-depth interviews.

Analysis of TRIOBP gene in non-syndromic deafness: A case report.

Through family investigation, the genetic map was drawn and audiological characteristics were analyzed. High-throughput sequencing was used to screen the deafness genes of the proband. Sanger sequencing was used to verify the suspected pathogenic sites in the family. Identify the causes of hearing loss and treatment options. Bilateral moderate to severe sensorineural deafness. After completing the examination, the patient was recommended to wear a hearing aid or do a cochlear implant, but the patient was not treated for personal reasons. All 8 patients in this family were nonsyndromic deafness. The proband had a compound heterozygous mutation of c.A4484T/c.A4510G in the TRIOBP gene, and the patient II-6 had a heterozygous mutation of c.A4484T in the TRIOBP gene. A complex heterozygous mutation of TRIOBP gene c.A4510G/c.G59T was found in II-7, but no reports of pathogenicity of these mutations were found in relevant literatures and databases. In addition, patients II-6, III-4, and III-6 had heterozygous mutations of CHD7 gene c.T2615C and C.3202-5T >C, and patients II-6 and III-4 also had heterozygous mutations of CHD23 gene c.G5312A and c.C6250T. In this study, a new locus of the TRIOBP gene was found, which enriched the gene mutant spectrum and clarified the pathogenic gene of the proband. However, the etiology of deafness in other members of the family needs to be further analyzed.

Exploring career choice and retention among engineering undergraduate students and systems engineers: A gender perspective

The underrepresentation of women in engineering is a significant concern. This study applies the social cognitive theory and the social career cognitive theory (SCCT) to investigate gender differences in engineering career choices. We examined reasons given by 19 systems engineers and 330 undergraduate engineering students for choosing engineering and categorizing them according to SCCT themes. We compared the distribution of reasons across themes and categories by career stage and gender. For engineers, the category &lt;i&gt;self-efficacy&lt;/i&gt; correlated significantly with &lt;i&gt;challenges and opportunities&lt;/i&gt; and &lt;i&gt;current job suitability&lt;/i&gt; categories, and women engineers cited challenges mainly with work-life balance and the gender glass ceiling. Undergraduate students cited personal reasons more frequently than environmental ones, with behavioral reasons being the least common. The extended SCCT model includes the categories &lt;i&gt;challenges and opportunities&lt;/i&gt; and &lt;i&gt;current job suitability&lt;/i&gt; within the behavioral theme, with the latter pertaining specifically to career retention. This research the set of provides insights into gender-dependent engineering career choice and retention by expanding the set of SCCT categories.

Effectiveness of individualized counseling in reducing leave against medical advice among neurosurgical patients in the emergency department

Objective: Leave against medical advice (LAMA) in the emergency department (ED) is a significant challenge in low- and middle-income countries, often leading to higher rates of readmission, increased mortality, and disrupted continuity of care. This study aimed to evaluate the effectiveness of individualized counseling in reducing LAMA incidents among neurosurgical patients in the ED. Materials and Methods: This quality improvement study employed a prospective case-control design to compare LAMA rates between patients who received individualized counseling and those who did not. A “nursing-coordinator program” was introduced, focusing on patient communication and engagement. Trained staff followed a standardized checklist to address the concerns of patients and their caregivers, providing “individualized counseling.” Data collected after the intervention were compared with retrospective pre-intervention data, and the results were analyzed. Results: A total of 554 patients, ranging from 1 to 94 years of age, were included in the study, with 60.5% being male. Among the 353 patients who received the “individualized counseling” intervention, 60 opted for LAMA (study group), compared to 49 LAMA cases out of 201 patients who did not receive counseling (control group). The LAMA rate significantly decreased from 24.4% to 16.9% post-intervention (P = 0.035). The “individualized counseling” intervention effectively reduced LAMA due to factors such as misinformation about disease severity (P = 0.009), economic constraints (P &lt; 0.001), and poor prognosis (P &lt; 0.001). However, it was less effective for reasons like proximity to home (P = 0.007), inadvisable transfers for personal reasons (P = 0.023), and family problems (P = 0.293). Conclusions: This study demonstrates that individualized counseling is an effective intervention for reducing LAMA among neurosurgical patients in the ED. By addressing non-medical factors often overlooked due to inadequate counseling, this quality improvement strategy can help prevent vulnerable patients from prematurely terminating their treatment.

Repetitive transcranial magnetic stimulation as add-on therapy in persistent postural-perceptual dizziness

BackgroundThis study aims to evaluate the clinical effectiveness of repetitive transcranial magnetic stimulation (rTMS) when used as an add-on therapy for individuals with persistent postural-perceptual dizziness (PPPD). MethodsIn this randomized controlled, double-blind trial conducted at Shangluo Central Hospital, patients with PPPD diagnosed in the neurology departments were included. Participants were randomized into a rTMS treatment group and a control group in a 1:1 ratio by the randomized grouping method. Patients in both groups received conventional treatment, with the rTMS treatment group underwent daily rTMS sessions, whereas the control group received sham rTMS treatments following the same schedule. The effectiveness of the treatments was primarily assessed using the Dizziness Handicap Inventory (DHI), Hamilton Anxiety Rating Scale (HAMA), and Hamilton Depression Rating Scale (HAMD), which measured symptoms of vertigo, anxiety, and depression at baseline, after two weeks, and at the end of four weeks. FindingsOf the 46 participants recruited, 2 were excluded due to contraindications, 22 were randomly assigned to the rTMS treatment group, and 22 were assigned to the control group. Ultimately, 2 withdrew for personal reasons, and data from 42 participants were included in the outcome analysis. HAMA, HAMD and DHI scores were significantly lower in the rTMS treatment group than in the control group after 4 weeks of treatment (p<0.05). A positive correlation was also observed between DHI scores and HAMA or HAMD scores. ConclusionsThis pilot study demonstrated that rTMS is a beneficial add-on therapy for patients with PPPD.

Examining Risk Factors Related to Cardiac Rehabilitation Cessation Among Patients With Advanced Heart Failure.

Cardiac rehabilitation (CR) is beneficial in heart transplant and left ventricular assist device (LVAD) recipients, but patterns of attendance remain poorly understood. We describe CR adherence and cessation in this population. We performed a retrospective review of heart transplant and LVAD recipients who attended ≥1 CR session at a tertiary medical center (2013-2022). Complete adherence was defined as attending 36 sessions. Primary reasons for cessation before 36 sessions were recorded. We compared post-operative complications, duration of hospitalization, and readmissions between participants with and without complete adherence using logistic and linear regressions. Among participants with complete adherence, we compared changes in metabolic equivalent of task (MET), exercise time, and peak oxygen uptake using paired sample t tests. There were 137 heart transplant and LVAD recipients (median age 56.9years, 74% male) who attended CR. Among them, 91% either completed 36 CR sessions or <24 sessions. Among those without complete adherence (n=74), 72% reported medical reasons, and 15% reported personal reasons for cessation. Compared to those who completed CR, those without complete adherence experienced more post-operative complications (44% vs 24%, P =.02) and major bleeding (23% vs 7%, P =.02) prior to CR. Participants with complete adherence experienced significant improvements in exercise time (142.5seconds), MET (0.4), and peak oxygen uptake (1.4 mL/kg/min). Nearly half of heart transplant and LVAD recipients in CR completed all 36 sessions. Those with complete adherence experienced significant improvements in exercise measures, underscoring the important benefits of CR in this population.

Feasibility and Safety of Post-Transcatheter Aortic Valve Replacement Coronary Revascularization Guided by Stress Cardiac Imaging

Background: Systematic revascularization of asymptomatic coronary artery stenosis before transcatheter aortic valve replacement (TAVR) is controversial. Purpose: The purpose of this study was to evaluate the feasibility and safety of functional evaluation of coronary artery disease (CAD) followed by selective ischemia-guided percutaneous coronary revascularization following TAVR. Methods: This prospective, bi-centric, single-arm, open-label trial included all patients with severe aortic stenosis (AS) eligible for TAVR and with significant CAD defined as ≥1 coronary stenosis ≥ 70%. Patients with left main stenosis ≥ 50%, proximal left anterior descending artery (LAD) stenosis ≥ 90% or &gt; class 2 Canadian Classification Society (CCS) angina were excluded. Myocardial ischemia was evaluated by stress cardiac imaging one month after TAVR. The primary endpoint was a composite of all-cause death, stroke, major bleeding (Bleeding Academic Research Consotium ≥ 3), major vascular complication (Valve Academic Research Consortium 3 criteria), acute coronary syndrome (ACS) and hospitalization for cardiac causes within 6 months of receiving TAVR. Results: Between June 2020 and June 2022, 64 patients were included in this study. The mean age was 84 ± 5.2 years. CAD mostly involved LAD (n = 27, 42%) with frequent multivessel disease (n = 30, 47%) and calcified lesions (n = 39, 61%). Stress cardiac imaging could be achieved in 70% (n = 46) of the patients, while 30% (n = 18) did not attend the stress test. Significant myocardial ischemia was observed in only three patients (4.5%). At 6-month follow-up, fifteen patients (23%) reached the primary endpoint, including death in six patients (9%), stroke in three patients (5%) and major bleeding in three patients (5%). ACS was observed in only two patients (3%) but both had severe coronary stenosis (≥90%) and did not refer for stress imaging for personal reasons. Hospital readmission (n = 27, 41%) was mostly related to non-cardiac causes (n = 17, 27%). Conclusions: In patients with asymptomatic CAD scheduled to undergo TAVR, a selective ischemia-guided coronary revascularization after TAVR seems to be safe, with a very low rate of ACS and few cases of myocardial ischemia requiring revascularization, despite low adherence to medical follow-up in this elderly population. This strategy could be evaluated in a randomized study.

Factors affecting employment status in people with epilepsy

Aim: People with epilepsy often face difficulties finding and keeping a job in India. This study aimed to determine the employment rate of people with epilepsy, compare it with that of people without epilepsy and to assess the various factors affecting theiremployment status. Methods: A comparative cross-sectional study was done by recruiting 140 people with epilepsy and 140 people without epilepsy (relatives of patients) from an epilepsy clinic in New Delhi, India. Demographic and clinical data were collected using questionnaires. Additionally, five items were added to measure self-perceived importance of work, ability to work and family support for working. Psychometric scales were used to measure the psychosocial variables affecting employment. Questionnaires were completed by people with epilepsy. Results: The employment rate of people with epilepsy was 59.3% as compared to 70.0% in those without epilepsy (P=0.045). Gender, younger age, having fewer family members, higher educational attainment, self-perceived importance of being employed for personal and financial reasons, and the ability to work and family support for working were some of the factors associated with employment status in people with epilepsy (P&lt;0.05). Among the psychosocial variables, epilepsy stigma and perceived social support were found to be significantly associated with being employed (P&lt;0.05). None of the clinical variables were found to be associated. Of those in the study, 56 out of 83 people with epilepsy, who had a job, felt they were underemployed. Conclusions: The employment rate of people with epilepsy was lower than the control population. The majority of those with jobs felt they were underemployed. A host of factors affect employment status in people with epilepsy. This suggests the need for vocational training, raised awareness among the general population, and counselling and other services for people with epilepsy.

A concealable intervention for a concealed group: Applying self‐affirmation interventions to people with concealable stigmatized identities

AbstractPeople with concealable stigmatized identities (CSIs)—identities that are devalued by society, but membership can be hidden (e.g., sexual or gender minority, mental illness, sexual assault survivor)—report high rates of negative health outcomes (e.g., depression, anxiety, illness symptoms). The current literature on CSIs suggests that disclosing one's CSI may promote positive health outcomes, but this approach leaves behind individuals who are unable to disclose due to financial, safety, or personal reasons. The current integrative review examines how self‐affirmation –reaffirming a part of one's identity after a psychologically threatening experience—may buffer against negative health outcomes among people with CSIs; a technique that does not require disclosure to reap the benefits. The purpose of this article is to describe why self‐affirmation may be effective at targeting various factors of CSIs (e.g., anticipated stigma, internalization, centrality, salience) and to call for interventions examining self‐affirmations in this population.

Urban–rural migration in Germany: A decision in favour of ‘the rural’ or against ‘the urban’?

For many years, the debate on internal migration in Germany focused on rural out-migration. Since the early 2000s, large cities have had positive migration balances. Almost unnoticed, however, in the early 2010s the patterns of internal migration started to shift towards rural locations. It was only the COVID-19 pandemic that drew attention to these changing tendencies and the apparent new appreciation of rural living.In this paper, we will first shed light on the changes in internal migration between 2000 and 2021. We divide this period into three phases and show that the overall pattern of population centralisation transformed into a process of decentralisation. This trend further intensified during the first two years of the COVID-19 pandemic. Secondly, based on a German-wide population survey, we present findings on the reasons why households moved from urban to rural areas between mid-2015 and mid-2020, with personal, employment-related and housing-related reasons being the most relevant. To better understand urban-rural migration (or ‘counterurbanisation’), we pay particular attention to how respondents experienced cities and urban housing markets and which residential characteristics they ascribed to the rural destination. We show that urban-rural migration is a multifaceted decision in which the structural impediments of urban housing markets lacking affordable housing play a relevant part. In conclusion, we argue that research on urban-rural migration needs to more systematically pursue the idea of a complex and contingent decision that is driven by both structural factors and personal preferences. Extending the long-standing counterurbanisation debate beyond a mere residential choice for ‘the rural’ is all the more important to adequately interpret future findings on post-pandemic patterns of internal migration.

“I enjoy conversing with my professor”: relational maintenance behaviors in the undergraduate student–instructor context

ABSTRACT Scholars of communication, teaching, and learning have been calling for more research on the instructor–student relationship to be studied from an interpersonal perspective. To answer these calls, we conducted a two-step scale development study, first to derive participant-generated responses concerning undergraduate student relational maintenance behaviors and second to construct and validate a scale concerning those behaviors. Of additional interest was to explore reasons as to why students aim to maintain these relationships. A 19-item measure titled the Student Relational Maintenance Scale was created, consisting of making connections, respectful behavior, classroom participation, expressing gratitude, and classroom effort. Additionally, results revealed that both professional reasons and personal reasons motivated students to build these relationships. The results of this study provided further insight into how and why undergraduate college students build positive interpersonal connections with their instructors.

Acceptance of COVID-19 vaccine booster doses among the Adult Population in Ghana: a cross-sectional study using the Health Belief Model.

The Health Belief Model (HBM) is a widely utilised framework for understanding vaccination behaviour against COVID-19. This study assessed the acceptance of COVID-19 vaccine booster doses in Ghana and identified predictors using HBM domains, including perceived susceptibility, severity, benefits, barriers, self-efficacy, and cues to action. Additionally, it examined the sources of information about COVID-19 vaccines. We employed a cross-sectional quantitative design, using convenient and snowball sampling methods to recruit participants. Between March 20 and May 10, 2023, 822 Ghanaians completed a predesigned self-administered online survey via commonly used social media platforms (WhatsApp, Facebook, X (Twitter), and LinkedIn). The study used a binary logistic regression to predict COVID-19 booster dose acceptance. The respondents had a mean age of 29.3 ± 6.2, with 55.5 being males, 53.0% being single/never married, 93.7% having tertiary education, 83.0% being Christians, 59.1% were healthcare workers, 57.8% residing in urban areas, 95.5% having no chronic disease, 90.6% reporting negative COVID-19 history, and 78.3% reporting no reported relative/friend infected with COVID-19. The study showed that 81.1% [95% confidence interval (CI) = 78.4 - 83.8%] of respondents received the COVID-19 vaccine, and 58.3% [95% CI = 54.2 - 62.5%] of respondents were willing to accept the COVID-19 booster dose. The main reasons for non-acceptance of COVID-19 vaccine booster doses were personal reasons (41.7%) and experienced side effects or fear of side effects (32.4%). Regression analysis revealed that perceived benefits and perceived barriers (specifically worrying about serious risk factors) were the significant predictors of accepting COVID-19 booster doses in Ghana. Many respondents were willing to receive the COVID-19 booster dose. Personal reasons, fear of side effects, and experienced side effects were the main reasons for refusing COVID-19 booster doses. Perceived benefits and perceived barriers predicted COVID-19 booster dose acceptance in Ghana. Policymakers should consider these factors in designing public health interventions to increase the patronage of COVID-19 booster doses.

Factors Influencing the Selection of Dentistry as a Career Among Prospective Candidates: A Multicentre Cross-Sectional Study.

This study aimed to analyse the impact of sociodemographic factors on dental school candidates' decision to pursue dentistry as their career of choice. Candidates shortlisted by three dental schools were invited to participate in a self-administered questionnaire study, featuring a validated instrument containing sociodemographic questions and 16 motivational items grouped into four domains: economic, professional, vocational and personal background reasons. The variations in motivational item scores across sociodemographic factors were assessed using the Mann-Whitney U test (age, sex, ethnicity, having relatives in the dental profession and dentistry as the first choice) and Kruskal-Wallis test (dental school and family income). A total of 295 dental school candidates participated in the study (Universiti Teknologi MARA: 137; Universiti Kebangsaan Malaysia: 99; MAHSA University: 59). Approximately 95% of participants identified dentistry as their primary career choice, with the vocational motivation of 'I like to help people' being the most prominent motivational factor. Dental school emerged as the critical factor significantly influencing three quarters of the motivational items. Sex, ethnicity and having relatives in the dental profession were the remaining factors significantly associated with variations in certain motivational items. Both dental school and ethnicity significantly affected four motivational domains (economic, professional, vocational and personal background). This study provides an insightful overview of the sociodemographic factors that impact career decision-making among prospective dental students. The scores for most motivational items varied among shortlisted candidates in three dental schools. The findings hold implications for policy development in dentistry by universities and public policymakers.

Eğitim Yönetiminde Eleştirel Düşünmeyi Değerlendirme Yöntemlerinin İncelenmesi

Critical thinking has been an area of special interest for many people and institutions since the existence of humanity. In particular, it has followed a parallel course to the development of humanity in the educational management processes. Many scientists and thinkers related to critical thinking have been engaged in intensive and in-depth efforts. Critical thinking is a complex mental negotiation process involving various skills and attitudes. It is a cognitive activity associated with using the mind. Critical thinking; it requires applying analysis and evaluation methods that include mental skills such as learning, attention, classification, selection, judgment. Although some people may be able to develop critical thinking more effectively, they avoid it for various reasons, regardless of ability. Especially personal, emotional and affective reasons can be the basis for this situation. In the content of the study, the methods of evaluating critical thinking in educational management will be discussed in an explanatory way in the special of the relevant tables. Key Words: Educational Management, Critical Thinking, Evaluation Methods

Cell salvage techniques and obstetric haemorrhage

Over the last decade, the incidence of postpartum haemorrhage has risen because of increasing maternal age at time of delivery, multiple births, obesity and increased obstetric interventions, resulting in most of these women requiring blood transfusions. While lifesaving, blood transfusion is not without risk. Recipients may rarely develop transfusion-transmitted infections or suffer immunological sequelae. Intraoperative cell salvage is recommended by several national policy making organisations as a safe cost-effective alternative to autologous blood transfusion in both emergency and elective settings. Moreover, emerging data has also revealed that autotransfusion of vaginally shed blood is both feasible and safe. These techniques are useful in patients who decline blood transfusions for both personal and religious reasons and should therefore be taken into consideration when planning place of birth.

Juozas Šibaila-Merainis

During the investigation it was established that the case of Juozas Šibaila, one of the freedom fighters, can be regarded as an individual’s voluntary act of joining the guerrilla struggles. His decision most likely was determined by the factors between some groups. First of all, these were national and cultural values and the position on the issue of defence of the state. They are testified to by professional (teacher’s) activities and his active participation in different public organisations: the Lithuanian Riflemen’s Union, the Lithuanian National Youth Union ‘Jaunoji Lietuva’ (Young Lithuania), also, possible cooperation with intelligence of Lithuania, organising local rebel groups in 1941, membership in the Local Force. This has to be assumed that it was purely personal reasons that greatly influenced the crucial decision to become a partisan – the desire to take revenge on the Soviets for deporting his family, the perception that there was nowhere to draw back – Juozas Šibaila, as an unreliable social element, had been the focus of the repressive structures of the occupiers since 1940. After the re-occupation, he was threatened with being taken to court and sentenced to death for taking part in the persecutions of Soviet activists and for other kinds of activities carried out in the summer of 1941. Juozas Šibaila, a teacher and an active propagator of nationality, had the authority and enjoyed high reputation in the environs of his place of residence, which he always tried to maintain and justify; hence, his early joining armed resistance, organising the first groups of partisans seems quite natural. His work in the headquarters of different underground structures where he was responsible for publishing the press and proclamations, preparing documents necessary for centralisation or their drafts, successful attempts to draw as many teachers in the fights for freedom as possible, which took the greatest part of time of Juozas Šibaila as a partisan, as well as the analysis of his personal correspondence, allows us to state that this person was perfectly aware of the importance and significance of public, ideological-intellectual component to the fights for freedom. Such external attributes as codenames of Diedukas and Merainis which are atypical of a freedom fighter, the appearance resembling an ordinary peasant, suggest that the image of a fighter-hero was alien to him. He was a strict, authoritative and respected leader of partisans who managed to establish close, family relations with his brothers-in-arms. The importance and significance of Juozas Šibaila to the post-war armed underground is undeniable. In his ideological texts Juozas Šibaila-Merainis spoke mainly about political aspirations of the Union of Lithuanian Freedom Fighters (ULFF) and moral-spiritual side of the fights. According to him, close links of democracy and Christian morality relatedd these spheres. He tended to treat partisan resistance to the Soviets, first and foremost, as a struggle for the well-being of all humanity determined and inspired by the Lord. Having examined Juozas Šibaila’s written legacy in this field, as well as the way he was valued by the members of the underground, it can be stated that, on the one hand, the majority of the values and concepts fostered therein may be fundamental and inseparable from armed post-war resistance, and, on the other hand, their presentation and the chosen means of expression seemed to the majority of the partisans difficult to understand and were unacceptable. It might be that a large part of partisans, unlike Juozas Šibaila, imagined fights for freedom simply as war waged by the members of the underground for freedom of the state rather than that of an individual. Consequently, though Merainis’ above-mentioned texts were significant and valuable, in some cases it cannot be stated that they had a considerable impact on the world outlook of an ordinary partisan or a common peasant.

Abstract B122: Understanding Barriers to Equity in Early Phase Clinical Trials Participation for the – Underrepresented Populations (uBEEP-UP Project)- A single-center survey-based study

Abstract Introduction: Despite advancements in cancer therapy, health disparities persist among underrepresented populations, including racial and ethnic minorities, people of low socioeconomic status, and people in geographically isolated areas. Representation in Early-Phase Clinical Trials (EPCT) is important, as limited representation exacerbates said inequities. Underrepresentation in clinical trials (CTs) impacts the true understanding of cancer biology and its role in treatment development. We aim to identify barriers and promoting factors influencing patients’ decisions to enroll in EPCTs and identify interventions to increase minority enrollment in clinical trials using a survey-based questionnaire. Methods: Following the extensive literature review, a list of validated questions were collected to populate a questionnaire to evaluate common themes faced by patients in participation in EPCT. This survey was offered to patients with cancer seen at the University of Kansas Cancer Center. This study is IRB-approved (STUDY00150640). Descriptive analysis was performed with Chi-Square and Fisher’s Exact Tests to determine significant associations between the qualitative variables to evaluate the most pressing barriers that were perceived in access to EPCT. Results: A total of 108 responses were collected. Over 58% of patients were over 65 years old. 62.4% were white, 17.8% African American, and 19.8% others (Asian or Native American). 40% of pts did not know about EPCTs before the survey. Only 26% of responders expressed participating in EPCTs in the past. Most people believe EPCTs are accessible to the public (75%) and would benefit from disease improvement (42%). Personal reasons for participating in EPCTs include obtaining a sense of hope (62%) and expressing no other treatment options available (49%). Encouragement to join EPCTs centered around wishing to help future cancer patients (67%) and trusting the center conducting the trial (52%). Pts emphasized the greatest benefit of participation in trials was the support of family and friends (69%). The top three perceived factors impacting EPCT accessibility from the pts perspective included understanding the value of the trial (76%), poor understanding of CTs process (40%), and lack of information of CTs (39%). Significant associations were observed with previous participation of EPCTs and increased age (p-value 0.031). An association was found with the responder’s self-identified race and perceived accessibility of EPCTs for the public(p-value 0.007). Conclusion: Most responders believed that EPCTs are readily available to others though the most noted barriers included individual perspectives about attributed trial value and purpose. Many pts noted a belief that EPCT involvement would increase hope regarding therapy and a personal desire to help future cancer patients. This will provide a foundational landmark for creating initiatives and interventions that will enhance diversity and access of EPCTs to the community. This project is supported by the University of Kansas Cancer Center P30CA168524. Citation Format: Issa Jimenez Espinoza, Anusha Chidharla, Kamiyah Hicks, Dinesh Pal Mudaranthakam, Sam Pepper, Angelica Allen, Asuka Suzuki, Debra Sullivan, Jill Hamilton-Reeves, Anup Kasi, Rahul Parikh, Saqib Abbasi, Al-Ola Abdallah, Elizabeth Wulff- Burchfield, Anna Arthur, Lori Barbosa, Erin Carroll, Jennifer Heins, Hope Krebiill, Tara Lin, Gary Doolittle, Weijing Sun, Joaquina Baranda. Understanding Barriers to Equity in Early Phase Clinical Trials Participation for the – Underrepresented Populations (uBEEP-UP Project)- A single-center survey-based study [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B122.