Poor Retention Research Articles

Race, Gender, and Faculty Retention in Academic Medicine.

Poor retention may be associated with lack of faculty diversity in academic medicine. To examine differences in faculty retention by gender, degree type, and race and ethnicity using data from US medical schools. This cohort study analyzed data from 155 medical schools for 1978 to 2021, which were obtained from the Association of American Medical Colleges. Retention rates were calculated by gender, race and ethnicity, and degree type. Time to attrition was estimated using Kaplan-Meier curves and adjusted Cox proportional hazards models were used to examine the differences in retention by gender and race. Data were analyzed from March 2021 to November 2022. The duration of continuous employment in academic medicine and variations in retention based on gender, race, ethnicity, and terminal degree. Among 390 766 faculty members (232 829 [59.6%] men; 1190 American Indian, Alaska Native, Native Hawaiian, or Pacific Islander [0.3%]; 72 490 Asian [18.6%]; 14 920 Black [3.8%]; 20 345 Hispanic, Latino, of Spanish origin, or multirace Hispanic [5.2%]; 251 670 non-Hispanic White [64.4%] participants; and 30 151 [7.7%] other race), 259 628 (66.4%) had MD or MD-equivalent terminal degrees. Women left academic medicine a median of 1 year earlier (median retention, 8.33 years; 95% CI, 8.18-8.41 years) than men (median retention, 9.35 years; 95% CI, 9.25-9.42 years). Compared with White faculty (median retention, 9.91 years; 95% CI, 9.83-9.92 years), multiracial and faculty of other races had the lowest retention (median retention, 5.42 years; 95% CI, 5.33-5.55 years), followed by Alaska Native, American Indian, Native Hawaiian, and Pacific Islander (median retention, 6.00 years; 95% CI, 5.62-6.62 years), Black (median retention, 7.78 years; 95% CI, 7.50-8.00 years), Asian (median retention, 8.00 years; 95% CI, 8.00-8.11 years) and Hispanic faculty (median retention, 9.00 years; 95% CI, 8.75-9.16 years). Women faculty in the 1970s were 20% more likely than men to leave academia, whereas women in the 2010s had no greater risk of leaving, mainly due to a decline in retention of men. Gender differences in faculty retention have decreased in the most recent decade; however, men had lower retention compared with earlier cohorts. In this study, faculty who were underrepresented in medicine left academic medicine a median of 1 to 4 years earlier than White faculty. Greater attrition among men and women for recent cohorts suggests that enhanced retention efforts are imperative to maintain an experienced and diverse faculty.

Design of Highly Adhesive Urchin‐Like Gold Nanostructures for Effective Topical Drug Administration and Symptomatic Relief of Corneal Dryness

Topical instillation of cyclosporin A (an anti‐inflammatory drug) is clinically recommended as the first‐line treatment for dry eye disease. Nevertheless, it suffers from poor ocular drug retention and cannot comprehensively address corneal dryness‐related symptoms such as oxidative stress, angiogenesis, and neurodegeneration. Inspired by nanotechnology‐mediated material/biological interactions, in this study, a highly adhesive metallic nanoplatform with an urchin‐like structure is designed for topical quercetin administration in dry eye therapy. The gold nanostructures with the most pronounced branch lengths exhibit the strongest cytoadhesion and bioadhesion capabilities, which significantly enhance the corneal retention of nano‐urchins by 150‐fold at 7 days post‐instillation compared with smooth‐surfaced gold nanoparticles. In a rabbit model of corneal dryness, topical single‐dose nanoformulation (high quercetin‐functionalized gold nano‐urchins (NU‐Q(H))) demonstrated remarkable efficacy in stimulating tear production (30‐fold improvement), inhibiting inflammatory IL‐6 expression (49‐fold improvement), attenuating pathological angiogenesis (32‐fold improvement), and promoting nerve regeneration (18‐fold improvement) compared to high quercetin‐functionalized gold nanoparticles (NP‐Q(H)). In particular, the integrity of the ocular surface, tear film, and meibomian gland is restored to levels similar to those in healthy rabbits. These findings suggest the promising potential of nanobiomaterial structural engineering in developing highly adhesive metallic nanomedicines as long‐acting eye‐drop formulations for disease treatment applications.

Sustainable Wheat Cultivation in Sandy Soils: Impact of Organic and Biofertilizer Use on Soil Health and Crop Yield

Sandy soils are widespread globally and are increasingly utilized to meet the demands of a growing population and urbanization for food, fiber, energy, and other essential services. However, their poor water and nutrient retention makes crop cultivation challenging. This study evaluated the effects of integrating compost and plant growth-promoting rhizobacteria (PGPR; Azospirillum brasilense SWERI 111 and Azotobacter chroococcum OR512393) on wheat (Triticum aestivum L. var. Misr 1) grown in sandy soil under varying levels of recommended NPK (50%, 75%, and 100%) fertilization. Conducted over two growing seasons, the experiment aimed to assess soil health, nutrient uptake, microbial activity, and plant productivity in response to compost and PGPR treatments. The results demonstrated that combining compost and PGPR significantly improved soil chemical properties, such as reducing soil pH, electrical conductivity (ECe), and sodium adsorption ratio (SAR), while enhancing soil organic matter (SOM). Additionally, compost and PGPR improved soil nutrient content (N, P, K) and boosted the total bacterial and fungal counts. The combined treatment also increased urease and phosphatase enzyme activities, contributing to enhanced nutrient availability. Notably, plant productivity was enhanced with compost and PGPR, reflected by increased chlorophyll and reduced proline content, along with improved grain and straw yields. Overall, the results underscore the potential of compost and PGPR as effective, sustainable soil amendments to support wheat growth under varying NPK levels.

Examining the Barriers to Redesigning Smallholder Production Practices for Water-Use Efficiency in Numbi, Mbombela Local Municipality, South Africa

Smallholder farmers in South Africa face issues related to water shortages and poor irrigation water management. This study investigated barriers to improving water-use efficiency (WUE) in smallholder production practices in Numbi, South Africa. The objectives were to identify barriers in redesigning production practices for higher agricultural productivity and analyze the relationship between irrigation water supply and the adoption of WUE methods. From a population of 7696 people, 141 smallholder farmers were sampled using a simple random sampling technique through Taro Yamane’s sample size formula. The data were analyzed using Pearson’s correlation coefficient and descriptive statistics. Unreliable water supply (M = 3.78, SD = 0.85), poor soil water retention (M = 3.78, SD = 0.85), lack of water-efficient irrigation systems (M = 3.91, SD = 0.71), lack of water storage facilities (M = 3.85, SD = 0.93), limited access to credit (M = 4.09, SD = 0.85), income instability due to market fluctuations (M = 3.96, SD = 0.91), inadequate knowledge of irrigation management (M = 4.00, SD = 0.84), and harsh climatic factors were identified. A positive correlation (r = 0.339, n = 141, p < 0.001) between irrigation water source and WUE techniques was evident, indicating that irrigation water source had an insignificant impact on WUE methods. Resolving these barriers requires a holistic approach focusing on investments in irrigation infrastructure and targeted education initiatives by extension agents and other stakeholders, as this can enhance agricultural productivity.

Survey on the Impact of Historical Museum Exhibition Forms on Visitors’ Perceptions Based on Eye-Tracking

Exhibition design in museum space is of great significance in enhancing cultural attraction, visitor experience, and heritage conservation. With the growth of spiritual and cultural needs, the construction of museums has increased, but the quality of exhibitions has been improved to a limited extent. In order to explore visitors’ perceptual experience in terms of display forms, this paper combines eye-tracking technology and subjective evaluation to select three display forms, namely, stand-alone display form, combined picture and object form, and combined 3D object and physical form, for the research. Combining field research, eye-tracking experiments, and subjective questionnaire evaluations, this study explores the relationship between visual perception and emotional experience in different display formats. The results showed that (1) the effects of different display formats differed between visual perception and emotional experience, and (2) there is some correlation between visual perception and emotional experience. Specifically, the number of fixations sessions was negatively correlated with fun, richness, comfort, and attractiveness and positively correlated with authenticity, while the average fixation time was positively correlated with the former and negatively correlated with authenticity. Combining the two dimensions, the study concluded that visitors’ experience satisfaction and preference are high in response to the form combining 3D objects and physical objects; the exhibition form of combining pictures and physical objects produces a higher degree of cognition in a short period of time; and the stand-alone display form has the lowest degree of preference, with poor information retention among visitors. It is hoped that this study will provide some reference for the use of exhibition forms in historical museums.

Improving UV protection and retention of photosensitive agrochemicals: Innovative polyurethane-CeO2 hybrid pesticide microcapsules

Photolysis and poor retention significantly decrease the utilization efficiency of photosensitive agrochemicals, leading to considerable ecological and economic losses. We successfully prepared novel pyraclostrobin-loaded polyurethane-inorganic hybrid microcapsules (Pyr@KCeO2-PU MCs) with high adhesion and UV stability by interfacial polymerization. CeO2 nanoparticles (NPs) were incorporated as UV light absorbers, while a silane coupling agent (KH550) was employed for in situ crosslinking of PU with CeO2 NPs, facilitating their dispersion within the PU shell. Characterization results revealed a high encapsulation efficiency of 90 % and uniform sizes (D50 = 915 nm) for the Pyr@KCeO2-PU MCs. Optical property investigations using UV–vis spectroscopy indicated that the integration of CeO2 NPs within the PU shell produced stronger UV absorption bands compared to both Pyr technical (TC) and Pyr@PU MCs. This observation underscores the potential of CeO2 NPs as effective UV absorbers. The anti-photolysis performance of Pyr@KCeO2-PU MCs improved with the addition of CeO2 NPs, yielding a retention rate of Pyr in Pyr@KCeO2-PU MCs that was 1.90 and 1.27 times greater than that of Pyr TC and Pyr@PU MCs, respectively, under UV irradiation. Furthermore, KH550 not only facilitated crosslinking between PU and CeO2 NPs, ensuring uniform distribution of CeO2 NPs on the PU shell surface, but also enhanced wettability and foliar retention. The contact angle of Pyr@KCeO2-PU MCs (32°) was significantly lower than that of Pyr@PU MCs (84°), and Pyr retention on rice leaves was 17.5 mg/cm2 for Pyr@KCeO2-PU MCs, surpassing that of Pyr@PU MCs (9.3 mg/cm2). Additionally, Pyr@KCeO2-PU MCs exhibited superior efficacy against various plant pathogens compared to Pyr TC and Seltima. These findings highlight the potential of Pyr@KCeO2-PU MCs for enhancing pesticide utilization and offer valuable insights for the future development of PU-based pesticide formulations.

Development of FK506-loaded maleimide-functionalized cationic niosomes for prolonged retention and therapeutic efficacy in dry eye disease.

Tacrolimus (FK506) is widely used in ocular diseases such as corneal transplantation-host disease, uveitis, conjunctivitis, and dry eye disease (DED). However, its low aqueous solubility and poor ocular retention pose challenges for its application in the eye diseases. This study developed a novel FK506-loaded maleimide-functionalized cationic niosomes (FK506 M-CNS), aiming to prolong the retention time of FK506 in the eye and enhance its therapeutic efficacy. FK506 M-CNS had a particle size of 87.69 ± 1.05nm and zeta potential of 22.06 ± 1.01 mV. Results of histological evaluation through H&E staining and in vitro cytotoxicity of human corneal epithelial cells consistently revealed the excellent biocompatibility of FK506 M-CNS. FK506 M-CNS exhibited superior ocular retention compared to the market product Talymus®. FK506 M-CNS significantly alleviated the symptoms of DED and promoted the recovery of corneal epithelia. FK506 M-CNS group had the lowest expression levels of inflammatory factors associated with DED. These superiorities might be due to the electrostatic interaction between cationic niosomes and negatively charged mucin in the eye, and the covalent binding of maleimide with the thiol group in the mucin. The maleimide group improved the ocular retention and efficacy of FK506, but did not increase the toxicity. Results indicated that FK506 M-CNS had great potential as a nanopharmaceutical in the treatment of ocular diseases, and M-CNS could be a promising drug carrier for ophthalmic drug delivery systems.

Effect of the position of Mg replacing Ni on O3-NaNi1/3Fe1/3Mn1/3O2 on the structural stability of cathode materials

O3-NaNi1/3Fe1/3Mn1/3O2 (NaNFM) materials are susceptible to complex phase transitions during electrical cycling leading to poor structural, capacity retention and multiplicity properties. These drawbacks hinder the application of NaNFM in sodium-ion batteries. Here, Mg2+ with larger ionic radius was used to dope its transition metal layer Ni site. The effects of Mg2+ doped NaNFM crystal structure and transition metal valence states on its electrochemical properties were investigated by XRD, SEM, and XPS. The capacity retention of NaNMFM-0.02 (84.05 %) was higher than that of NaNFM (73 %) after 200 cycles of the material at 5C. In addition, NaNMFM-0.02 achieved a first discharge specific capacity of 146.5 mAh/g at high voltage. Based on structural and electrochemical analyses, this improvement is attributed to the fact that magnesium acts as a “pillar” to stabilize the crystal structure of NaNFM, while magnesium doping reduces the Jahn-Teller effect. As a result, the material has better electrochemical properties.

Bifunctional modulation of Li-rich layered oxide cathode material via W-modification for improved electrochemical performance

Lithium-rich layered oxides (LRLOs) have raised the greatest attention to the high-energy-density Li-ion batteries. Nevertheless, the undesirable interfacial side reactions and the structure transformation cause fast voltage fading and poor capacity retention of LRLO cathodes, which extremely prevent their practical application. Surface coating or lattice doping has been an effective strategy to improve its electrochemical properties. However, the general performance of the material can only be limitedly promoted. Herein, we proposed a bifunctional modulation of LRLO cathodes coupled by bulk-phase W-doping and surficial Li2WO4 nanocoating of LRLOs using a facile synchronous lithiation strategy under a high-temperature solid-state treatment. The modified material (2 mol% W6+ modified) showed a distinguished discharge capability of 260.5 mAh/g at 0.1 C after 50 cycles. Meanwhile, a competitive capacity retention of 95.38% at 1 C after 100 cycles was achieved. The splendid electrochemical performance can be the result of the increased interlayer spacing for enhancing Li+ diffusion kinetics and the stronger W–O bond for alleviating oxygen release after W-doping and Li2WO4 nanocoating, which not only accelerates the Li+ transfer rate as its fast Li+ transfer channels but also act as a transitional interface layer to restrain the interfacial adverse reactions.

Remote Sensing and Field Data Analysis to Evaluate the Impact of Stone Bunds on Rainfed Agriculture in West Africa

This study evaluates the effectiveness of stone bunds in enhancing soil moisture, vegetation health, and crop yields in Ghana’s semi-arid Upper East Region, an important area for agricultural productivity in West Africa. In this region, agricultural practices are heavily impacted by erratic rainfall and poor soil moisture retention, threatening food security. Despite the known benefits of traditional soil conservation practices like stone bunds, their effectiveness in this context has not been fully quantified. Field and remote sensing data were used to evaluate the influence of stone bunds on soil moisture dynamics, vegetation growth, and crop yield. Experimental plots with and without stone bunds were monitored for climate, soil water infiltration, and soil moisture and analyzed using the NDVI from Sentinel-2 satellite imagery over two growing seasons under sorghum production (2022–2023). The results indicated that stone bunds enhanced soil moisture retention and increased infiltration rates. The NDVI analysis consistently revealed higher vegetation health and growth in the plots with stone bunds, particularly during critical growth periods. The intermediate results of the conducted experiment indicated that stone bunds increased sorghum yields by over 35% compared to the control plots. The substantial agronomic benefits of stone bunds as a soil and water conservation strategy were evident, improving soil water infiltration, water retention, vegetation health, and crop yields. The findings support the broader adoption of stone bunds in semi-arid regions to enhance agricultural productivity and resilience against climate variability. Further research is recommended to explore the long-term impacts and the integration of stone bunds with other sustainable farming practices to optimize rainfed agricultural outcomes.

Current approaches to the identification and management of gambling disorder: a narrative review to inform clinical practice in Australia and New Zealand.

Gambling disorder is a recognised psychiatric disorder in the Diagnostic and statistical manual of mental disorders (DSM-5) and is classified as an addiction alongside alcohol and substance use disorders. The DSM-5 describes a past-year timeframe, episodic or persistent specifiers, early or sustained remission specifiers, and three gambling disorder severity specifiers (mild, moderate and severe). Although anyone can develop gambling disorder, there are known risk factors. In studies involving general adult populations, the likelihood of developing the disorder varies with the type of gambling, and is particularly high for internet gambling, casino table games and poker machines. Australia and New Zealand have shifted the focus of gambling disorder to the identification of gambling harm, in recognition that efforts targeting the prevention of harm may be more effective as they potentially influence a larger segment of the population. Temporal categories of gambling harm (crisis harms versus legacy harms) affect help-seeking and need for treatment. Crisis harms often motivate people to change their behaviour or seek help, whereas treatment addresses legacy harms, which emerge or continue to occur after gambling behaviour ceases. The evidence base and clinical guidelines recommend cognitive behavioural therapy and motivational interviewing but there are many gaps in our understanding of treatment for gambling disorder, including an absence of high quality evaluations that assess treatment effectiveness over the longer term, especially for treatment delivered in community settings. There is also an urgent need to understand how, why and for whom treatment works so that interventions can be optimised to individual needs, thereby facilitating client engagement. Because of limited access to health care and poor retention in treatment, in recent years there has been an increase in treatment choices in the form of internet therapies and smartphone applications.

Prolonged Skin Retention of Luliconazole from SLNs Based Topical Gel Formulation Contributing to Ameliorated Antifungal Activity.

The development of effective therapy is necessary because the patients have to contend with long-termtherapy as skin fungal infections usually relapse and are hardly treated. Despite being a potent antifungal agent, luliconazole (LCZ) has certainshortcomings such as limited skin penetration, low solubility in aqueous medium, and poor skin retention. Solid Lipid Nanoparticles (SLNs) were developed using biodegradable lipids by solvent injection method and were embodied into the gel base for topical administration. After in-vitro characterizations of the formulations, molecular interactions of the drug with excipients were analyzed using in-silico studies. Ex-vivo release was determined in contrast to the pure LCZ and the commercial formulation followed by in-vivo skin localization, skin irritation index, and antifungal activity. The prepared SLNs have an average particle size of 290.7nm with no aggregation of particles and homogenous gels containing SLNs with ideal rheology and smooth texture properties were successfully prepared. The ex-vivo LCZ release from the SLN gel was lower than the commercial formulation whereas its skin deposition and skin retention were higher as accessed by CLSM studies. The drug reaching the systemic circulation and the skin irritation potential were found to be negligible. Thesolubility and drug retention in the skin were both enhanced by the development of SLNs as a carrier. Thus, SLNs offer significant advantages by delivering long lasting concentrations of LCZ at the site of infection for a complete cure of the fungal load together with skin localization of the topical antifungal drug.

Exploration of the impact of different drying methods on the quality of Gastrodia elata: A study based on drying kinetics and multidimensional quality evaluation

In this study, the drying kinetics and multidimensional quality of Gastrodia elata (GE) obtained through five different drying methods were analyzed. The Page model provided the best fit. Though widely used, hot-air drying (HA-D) showed mediocre performance. Due to strong heat penetration, microwave drying (MV-D) and infrared drying (IR-D) effectively reduced drying time and energy consumption. However, they experienced Maillard and caramelization reactions, resulting in notable cell structure shrinkage, severe browning, pronounced caramel taste, and poor retention of active ingredients. Conversely, freeze-drying (F-D) and vacuum drying (V-D), due to the involvement of low-temperature or vacuum environments, demonstrated optimal performance in preserving microstructure, antioxidant activity, active ingredients, and flavor. However, F-D was time-consuming (1320 min) and had an energy consumption of 2.69 times that of HA-D, limiting its large-scale application. V-D struck the best balance between energy consumption and product quality, making it a highly promising drying method for GE.

Chromatographic Comparison of Commercially Available Columns for Liquid Chromatography in Polar Pesticide Detection and Quantification Using a Score-Based Methodology.

The detection and quantification of polar pesticides in liquid chromatography coupled with mass spectrometry present significant analytical challenges. This study compares the performance of three LC columns (Hypercarb™, Raptor Polar X™, and Anionic Polar Pesticide™) in separating and quantifying eleven polar pesticides in chicken eggs using a score-based methodology. Analytes include glyphosate, its metabolites, and other high-polarity pesticides like Ethephon, Glufosinate, and Fosetyl aluminum, included in the EU's official control plan. Polar pesticides, characterized by high polarity and hydrophilicity, lead to analytical issues such as poor retention and unconventional peak shapes with traditional reversed-phase methods. Their weak interaction with hydrophobic stationary phases complicates separation, necessitating specific stationary phases to enhance retention and selectivity. This study evaluates these columns' efficacy in complex matrices like chicken eggs and other food samples. Chromatographic separation was performed using a UPLC system coupled with a Q-TOF mass spectrometer; extraction and purification involved freeze-out, centrifugation, and filtration steps. The study highlights the critical role of column selection in achieving accurate and reliable separation and quantification of highly polar analytes in matrices of animal origin, offering in the meantime an easy-to-apply methodology of selection for the right determination of the best chromatographic column for different purposes.

β-Cyclodextrin-optimized supramolecular nanovesicles enhance the droplet/foliage interface interactions and inhibition of succinate dehydrogenase (SDH) for efficient treatment of fungal diseases

BackgroundPlant fungal diseases present a major challenge to global agricultural production. Despite extensive efforts to develop fungicides, particularly succinate dehydrogenase inhibitors (SDHIs), their effectiveness is often limited by poor retention of fungicide droplets on hydrophobic leaves. The off-target losses and unintended release cause fungal resistance and severe environmental pollution.ResultsTo update the structure of existing SDHIs and synchronously realize the efficient utilization, we have employed a sophisticated supramolecular strategy to optimize a structurally novel SDH inhibitor (AoH25), creating an innovative supramolecular SDH fungicide (AoH25@β-CD), driven by the host-guest recognition principle between AoH25 and β-cyclodextrin (β-CD). Intriguingly, AoH25@β-CD self-assembles into biocompatible supramolecular nanovesicles, which reinforce the droplet/foliage (liquid-solid) interface interaction and the effective wetting and retention on leaf surfaces, setting the foundation for enhancing fungicide utilization. Mechanistic studies revealed that AoH25@β-CD exhibited significantly higher inhibition of SDH (IC50 = 1.56 µM) compared to fluopyram (IC50 = 244.41 µM) and AoH25 alone (IC50 = 2.29 µM). Additionally, AoH25@β-CD increased the permeability of cell membranes in Botryosphaeria dothidea, facilitating better penetration of active ingredients into pathogenic cells. Further experimental outcomes confirmed that AoH25@β-CD was 88.5% effective against kiwifruit soft rot at a low-dose of 100 µg mL-1, outperforming commercial fungicides such as fluopyram (52.4%) and azoxystrobin (65.4%). Moreover, AoH25@β-CD showed broad-spectrum bioactivity against oilseed rape sclerotinia, achieving an efficacy of 87.2%, outstripping those of fluopyram (48.7%) and azoxystrobin (76.7%).ConclusionThis innovative approach addresses key challenges related to fungicide deposition and resistance, improving the bioavailability of agricultural chemicals. The findings highlight AoH25@β-CD as a novel supramolecular SDH inhibitor, demonstrating its potential as an efficient and sustainable solution for plant disease management.Graphical

Cascade Enzymes Confined in DNA Nanoanchors for Antitumor Therapy.

Cascade-enzyme reaction systems have emerged as promising tools for treating malignant tumors by efficiently converting nutrients into toxic substances. However, the challenges of poor localized retention capacity and utilization of highly active enzymes often result in extratumoral toxicity and reduced therapeutic efficacy. In this study, we introduced a cell membrane-DNA nanoanchor (DNANA) with a spatially confined cascade enzyme for in vivo tumor therapy. The DNANAs are constructed using a polyvalent cholesterol-labeled DNA triangular prism, ensuring high stability in cell membrane attachment. Glucose oxidase (GOx) and horseradish peroxidase (HRP), both modified with streptavidin, are precisely confined to biotin-labeled DNANAs. Upon intratumoral injection, DNANA enzymes efficiently colonize the tumor site through cellular membrane engineering strategies, significantly reducing off-target enzyme leakage and the associated risks of extratumoral toxicity. Furthermore, DNANA enzymes demonstrated effective cancer therapy in vitro and in vivo by depleting glucose and producing highly cytotoxic hydroxyl radicals in the vicinity of tumor cells. This membrane-engineered cascade-enzyme reaction system presents a conceptual approach to tumor treatment.

Exploring the influence of Thai private universities human resource management practices on employee retention and performance

The article examines employees' perceptions regarding human resource management practices in Thai private universities. It also analyses the effects of these practices on employee job satisfaction, quality service performance and retention within the context of Thai private universities. The study employed a cross-sectional survey research approach to ensure the inclusion of a representative sample from small and medium sized private universities within the population under investigation. The study includes 12,318 employees of the 38 Thai private universities: 6,458 from small sized private universities and 5,860 from medium size private universities. 20 private universities comprised of 14 (70%) small sized and 6 (30%) will form the sample of the study. From this sample distribution, 91 (72.8) academic staff from 14 small sized private universities and 34 (27.2%) from medium sized private universities making 125 academic staff and 20 HR managers as the sample size of the investigation. The study utilized a maximum variation deliberate (MVD) sampling method for the selection of 125 academic staff and 20 HR managers. Closed-ended questionnaires and semi-structured questionnaires were employed for the purpose of data collection. The validity of the instrument was assessed by a panel of experts to establish content validity, utilizing Lawshe's template with a ratio of 0.99. Furthermore, the homogeneity of the instrument was determined using Cronbach Alpha resulting in a reliability index of .81. The data was collected primarily via an online survey. The data underwent analysis utilizing frequency counts and percentages, chi-square at a significance level of p.05. This was done to ascertain the statistical significance of HRMP on employee retention and performance. The findings demonstrate a conspicuous and uniform association between employee responses across the institutions under scrutiny, underscoring a statistically significant connection between human resource management practices and job satisfaction, quality service performance and retention of employees. Therefore, it is essential to acknowledge that the implementation of HRM practices holds significant importance for small and medium private universities. This is primarily due to its ability to effectively address the expenses incurred from employee turnover, which can arise because of insufficient job satisfaction leading to poor job performance and retention.

Buprenorphine-Precipitated Withdrawal Among Hospitalized Patients Using Fentanyl

Buprenorphine treatment of opioid use disorder (OUD) is safe and effective, but opioid withdrawal during treatment initiation is associated with poor retention in care. As fentanyl has replaced heroin in the drug supply, case reports and surveys have indicated increased concern for buprenorphine-precipitated withdrawal (PW); however, some observational studies have found a low incidence of PW. To estimate buprenorphine PW incidence and assess factors associated with PW among emergency department (ED) or hospitalized patients. This retrospective cohort study at 3 academic hospitals in Philadelphia, Pennsylvania, included adults with OUD who underwent traditional or high-dose buprenorphine initiation between January 1, 2020, and December 31, 2021. Exclusion criteria included low-dose buprenorphine initiation and missing documentation of opioid withdrawal severity within 4 hours of receiving buprenorphine. Buprenorphine initiation with an initial dose of at least 2 mg of sublingual buprenorphine after a Clinical Opiate Withdrawal Scale (COWS) score of 8 or higher. Additional exposures included 4 predefined factors potentially associated with PW: severity of opioid withdrawal before buprenorphine (COWS score of 8-12 vs ≥13), initial buprenorphine dose (2 vs 4 or ≥8 mg), body mass index (BMI) (<25 vs 25 to <30 or ≥30; calculated as weight in kilograms divided by height in meters squared), and urine fentanyl concentration (0 to <20 vs 20 to <200 or ≥200 ng/mL). The main outcome was PW incidence, defined as a 5-point or greater increase in COWS score from immediately before to within 4 hours after buprenorphine initiation. Logistic regression was used to estimate the odds of PW associated with the 4 aforementioned predefined factors. The cohort included 226 patients (150 [66.4%] male; mean [SD] age, 38.6 [10.8] years). Overall, 26 patients (11.5%) met criteria for PW. Among patients with PW, median change in COWS score was 9 points (IQR, 6-13 points). Of 123 patients with confirmed fentanyl use, 20 (16.3%) had PW. In unadjusted and adjusted models, BMI of 30 or greater compared with less than 25 (adjusted odds ratio [AOR], 5.12; 95% CI, 1.31-19.92) and urine fentanyl concentration of 200 ng/mL or greater compared with less than 20 ng/mL (AOR, 8.37; 95% CI, 1.60-43.89) were associated with PW. In this retrospective cohort study, 11.5% of patients developed PW after buprenorphine initiation in ED or hospital settings. Future studies should confirm the rate of PW and assess whether bioaccumulated fentanyl is a risk factor for PW.

Effectiveness of Using Fun Minds Flash in Improving Vocabulary Retention Among Year 5 Remedial Pupils

Vocabulary retention is vital for learning a language and proficiency in English. This will enable effective recall and use in various contexts in which enhancing both productivity and receptiveness that are complimentary for speaking, writing, listening and reading. However, nowadays, it was found from the practicum insights that there were poor English vocabulary retention especially among remedial students that are known to require extra support for learning difficulties. The contributors’ factors were coming from focus difficulties, language proficiency problems and anxiety issues. Not only that, but traditional teachers also often overlook the diverse learning needs of these pupils. In this study, the factors of lack of interactive tools, anxiety management and multimedia integrations were analysed, and it highlighted the potential of 'Fun Mind Flash' as an interactive tool designed to enhance vocabulary retention through tactile and auditory learning experiences. It includes personalised and customised word cards with audio structures for pronunciation and contextual usage. The token reinforcement system was also used in this study to explore the innovative solutions to improve vocabulary retention among primary ESL remedial pupils. The methods used in this study were mixed approaches of quantitative and qualitative methods. As a result, based on quantitative findings, the post-test scores indicated the effectiveness of the interactive tools (Fun Mind Flash) and found to help increase the vocabulary knowledge and application of English. Qualitative findings found that observations and interviews discovered high levels of engagement, motivation and meaningful learning outcomes. Students were found to be more interested in their learning and able to cope with their anxiety during the sessions of learning. This study suggested further studies on long-term impact of Fun Mind Flash and as well comparing it with other interactive tools, the integrations of advanced technologies to adapt with the diverse cultural contexts.

The consequences of micro-discretions and boundaries in the social prescribing link worker role in England: a realist evaluation.

Social prescribing addresses non-medical factors affecting health and well-being. Link workers are key to its delivery by connecting people to relevant support, often in the voluntary, community and social enterprise sector. Funding from the National Health Service means that link workers are becoming a common part of primary care in England. To explore and understand the implementation of link workers in primary care in England. A realist evaluation addressed the question - When implementing link workers in primary care to sustain outcomes - what works, for whom, why and in what circumstances? Link workers and staff associated with seven primary care sites across England. Researchers spent 3 weeks with each link worker, going to meetings with them, watching them interact with patients, with healthcare staff and with voluntary, community and social enterprise organisations. In addition, interviews were conducted with 61 patients and 93 professionals (voluntary, community and social enterprise representatives and healthcare staff, including link workers). Follow-up interviews were conducted with 41 patients and with link workers 9-12 months later. Data were coded and developed into statements to identify how context around the link worker triggers mechanisms that lead to intended and unintended outcomes. We found that link workers exercise micro-discretions in their role - actions and advice-giving based on personal judgement of a situation, which may not always reflect explicit guidance or protocols. Our analysis highlighted that micro-discretions engender positive connections (with patients, healthcare staff, the voluntary, community and social enterprise sector) and promote buy-in to the link worker role in primary care. Micro-discretions supported delivery of person-centred care and enhanced job satisfaction. Data also highlighted that lack of boundaries could place link workers at risk of overstepping their remit. Our research focused on link workers attached to primary care; findings may not be applicable to those working in other settings. Data were collected around seven link worker cases, who were selected purposively for variation in terms of geographical spread and how/by whom link workers were employed. However, these link workers were predominately white females. Enabling link workers to exercise micro-discretions allows for responsiveness to individual patient needs but can result in uncertainty and to link workers feeling overstretched. Poor link worker retention may, in part, be associated with a lack of clarity around their role. Research to explore how this shapes intention to leave their job is being conducted by authors of this paper. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR130247.