Practice Scores Research Articles

The justification and practice of the patient rights charter from the perspective of patients admitted to surgical wards during COVID-19 pandemic: evidence from Southern Iran

BackgroundHospitals, as one of the core elements of healthcare service delivery, should pave the way for more efficient compliance with the Patient Rights Charter (PRC). The COVID-19 pandemic affected the interactions between healthcare providers and patients. The present study aimed to investigate the importance and practice of PRC from the perspective of hospitalized patients in surgical wards during the COVID-19 pandemic.MethodsThe participants in this cross-sectional study were 355 patients who underwent surgery at Imam Khomeini Hospital in southern Kerman, Iran, in 2021. Data was collected by convenience sampling. The data in this study were collected using Justification and Practice of Patient Rights (JPPR). Data analysis was performed with SPSS-16 software using the Kruskal-Wallis, Wilcoxon, and Spearman correlation tests.ResultsThe total mean score for the justification of patient rights (PR) was 69.12 ± 58.44, which was significantly higher than the total mean score of PR practice (61.02 ± 1.32) (p < 0.001). In addition, the mean scores for all PR justification dimensions were significantly higher than the mean scores for PR practice (p < 0.05). A comparison of the dimensions of the PR justification showed service facilitation had the highest score and handling patient complaints had the lowest score. Furthermore, an analysis of the dimensions of PR practice indicated that handling patient complaints had the lowest score and other dimensions had the same score.ConclusionThe results of this study showed that despite the great importance of PR from the patients’ perspective, PR is not still practiced optimally. The findings from this study can have some clinical implications and help hospital managers to take measures to better adapt to the PRC with staff training and developing a strong policy to comply with the PRC, especially by paving the way for handling patient complaints.

Preparing for the Transition to Academic Practice: A Graduate Medical Education Elective.

Background Residents and fellows as educators (RFAE) programs typically focus on clinical teaching skills in single departments, which may not be sustainable for those with limited trainees or faculty. Objective To determine the feasibility and value of a 2-week interdepartmental RFAE elective for advanced teaching skill development and transition to practice as clinician educators. Methods Facilitated discussion, simulation, and critiqued peer presentations developed participants' skills in teaching, curriculum design, professional development, and scholarship. Assessments in this prospective intervention included 2 self-reported surveys addressing: (1) teaching process and motivation (Conceptions of Learning and Teaching [COLT]), and (2) skills and attitudes. We administered both surveys at baseline, immediate-post, and 3-month-post elective with data compared across time points using Kruskal-Wallis tests. Program evaluation comprised daily open-ended surveys on engagement and an end-of-course feedback survey. Results There were 79 participants from 2019 to 2023. Survey response rates were 84.8% (67 of 79) at baseline, 58.2% (46 of 79) immediate-post, and 51.9% (41 of 79) 3-month-post. Most participants were residents (89.9%, 71 of 79), female (60.8%, 48 of 79), from pediatrics and/or medicine departments (77.2%, 61 of 79), and in their final year of training (77.2%, 61 of 79). COLT factor orientation to professional practice scores increased in the immediate-post (3.3) compared to baseline (2.5) surveys (P=.008). Teaching skills attitudes scores increased for all questions in 3-month-post compared to baseline surveys. In open-ended questions, participants emphasized the importance of professional development sessions in guiding their careers toward medical education. Conclusions This interdepartmental elective was feasible, favorably received, and sustained over time, with observed changes in participants' teaching skills attitudes.

Evaluation of the impact of an integrated simulation model in basic life support training on knowledge and practice: A randomized control trial in Jordanian hospitals

This study aims to evaluate the effectiveness of simulation training (ST) in improving nurses' knowledge and practice, which is essential in the nursing field, particularly among nurses in Jordanian hospitals. ST has the potential to significantly enhance patient care outcomes. A Randomized Control Trial was conducted in five hospitals in Jordan, using three repeated measurement tests: a pre-test, an immediate post-test after the intervention, and a post-test three months later. The nonparametric Mann-Whitney statistical test showed that the control and experimental groups were similar, with no significant differences in the participants' demographic characteristics. The Independent T-test confirmed the similarity of the pre-test results in the control group's knowledge and practice and the intervention group's mean scores. The simulation intervention proved to be highly effective in enhancing Basic Life Support (BLS) knowledge and practice among nurses. It nearly doubled the knowledge pre-test percentage from 40% to 75.35% in the immediate post-test, improving the scores from poor in the pre-test to excellent in the post-test. This significant improvement highlights the importance of simulation training in enhancing nurses' knowledge and practice. Similarly, ST significantly increased the average practice score percentage from 47.5% to 70% after the intervention, demonstrating its substantial impact. In conclusion, BLS simulation is a highly efficient educational method that helps participants acquire knowledge and skills. Simulation training prepares learners to activate cardiopulmonary resuscitation (CPR) quickly and correctly in case of cardiopulmonary arrest. Therefore, simulation in training should be expanded in the nursing curriculum.

Knowledge, attitudes, and practices regarding Post-anesthesia cognitive dysfunction in patients undergoing gastrointestinal endoscopy

BackgroundThe administration of anesthesia during gastrointestinal endoscopy potentially contributes to post-anesthesia cognitive dysfunction (PACD), with detrimental impacts for cognitive function. This study aimed to assess the knowledge, attitudes, and practices (KAP) towards PACD among patients undergoing gastrointestinal endoscopy in Wenzhou region.MethodsThis cross-sectional study was conducted between June and August 2023, and recruited individuals undergoing gastrointestinal endoscopy. Demographic data and KAP scores were collected through questionnaires. Pearson correlation analysis was applied to evaluate correlations between KAP scores, and logistic regression was utilized to identify influential factors.ResultsWe collected 405 valid questionnaires, with 54.57% being male and 29.88% aged 31–40 years. Mean KAP scores were 13.99 ± 4.80, 16.19 ± 2.35, and 15.61 ± 2.86, respectively (possible range: 0–16, 0–25, and 0–25). Pearson correlation analysis demonstrated significant positive correlations between knowledge and practice (r = 0.209, P < 0.001), attitude and practice (r = 0.233, P < 0.001), and knowledge and attitude (r = 0.328, P < 0.001). Multivariate logistic regression revealed negative associations of opting for standard gastrointestinal endoscopy (without anesthesia) with knowledge (OR = 0.227, 95%CI: 0.088–0.582, P = 0.002) and practice scores (OR = 0.336, 95%CI: 0.154–0.731, P = 0.006). Additionally, the presence of cognitive-related diseases or symptoms before undergoing gastrointestinal endoscopy was negatively associated with knowledge scores (OR = 0.429, 95%CI: 0.225–0.818, P = 0.010).ConclusionPatients undergoing gastrointestinal endoscopy demonstrated good knowledge, neutral attitudes, and moderate practices regarding PACD. Educational interventions and behavior modification are recommended, particularly for individuals with lower monthly income, undergoing standard gastrointestinal endoscopy, or experiencing cognitive-related conditions.

Effectiveness of school and communication-based interventions for the prevention of burns among secondary school students in Vu Thu district, Thai Binh province

The study aimed to evaluate the effectiveness of school- and community-based interventions in improving knowledge and practice of burns prevention for secondary school students in Vu Thu district, Thai province. We conducted a controlled community trial in the Vu Thu district, Thai Binh province. The self-administered structured questionnaire, which was developed under the instruction of experts in burn injury prevention, and the information page of the Ministry of Health and the Ministry of Education and Training, was used in this study. The effectiveness of the intervention was evaluated by comparing the effectiveness index before and after the intervention between the intervention group and the control group. Among 2028 secondary school students, the score of knowledge about burn prevention in the control group and the intervention group increased after intervention (from 6.238±2.050 to 6.847±2.033 and from 6.257±2.112 to 7.314±1.824, respectively). Knowledge scores on recognizing the causes and ways to prevent burns tend to increase after the intervention, especially in students with higher knowledge scores on these two topic groups than the control group. It is similar to the score of practice in preventing burn injuries, from 6.047±3.582 to 6.247±3.660 in the control group and from 6.638±3.411 to 7.342±3.207 in the control group. The effectiveness of the intervention has contributed to increasing secondary school students’ knowledge and practice of preventing injuries caused by burns. Therefore, it is necessary to continue research in secondary schools, especially in suburban areas and other provinces, to obtain reliable evidence for policy development and planning for injury prevention - burning injuries.

Simple biliary atresia score-a validated diagnostic aid for infantile cholestasis.

The workup of jaundiced infants may be variable and protracted, thereby delaying the diagnosis and timely intervention for biliary atresia (BA). This potentially leads to inferior outcomes. We developed a practical score to stratify infantile cholestasis according to the risk of having BA. The score (0-7) [gallbladder length ≤ 15mm (+ 1), common bile duct (CBD) diameter < 0.5mm(+ 1), pre-portal vein (PV) echogenicity(+ 1), direct-to-total bilirubin ratio (D/T) ≥ 0.7(+ 2), and gamma-glutamyl transferase (GGT) ≥ 200IU/L(+ 2)] are derived from logistic regression of data from a retrospective cohort of cholestatic infants (n = 58, 41 BA) in our institution. It was then validated with a separate retrospective cohort (n = 28, 17 BA) from another institution. Final diagnoses were as per intraoperative cholangiogram (IOC) and liver histopathology. A cutoff score of ≥ 3 diagnosed BA with 100% and 94% sensitivity in the derivative cohort (area under receiver operating characteristic curve, AUROC 0.869) and validation cohort (AUROC 0.807), respectively. D/T ratio was the most sensitive (93%) and CBD diameter was the most specific (88%) parameter. The score accurately predicted non-BA in 11(65%) and 7(63%) infants in the derivative and validation cohorts, respectively, with one missed BA in the latter. We propose a validated, simple, yet sensitive diagnostic score to risk-stratify cholestatic infants, aiming to expedite definitive management of BA.

Upaya Peningkatan Kemampuan Literasi melalui Buku Cerita Bergambar Berbasis Kearifan Lokal untuk Siswa Kelas II SD

Purpose – This research aims to determine the characteristics, validity, practicality, and effectiveness of illustrated children's story books based on local wisdom to improve the basic literacy skills of reading and writing in class II elementary school students.Method – This type of research is development (Research and Development). The data collected is in the form of validity, practicality, and effectiveness data. The research instruments used include questionnaires and tests. Validation sheets are used to collect data about the validity of the book. Response questionnaires are used to collect data about teacher responses to measure the practicality of books, Question Instruments are used to collect data about students' reading and writing skills to measure the effectiveness of books. Data was analyzed quantitatively descriptively.Findings – The results of this research show that the product developed is categorized as very valid both in terms of content, graphics, presentation, and language, this is proven by a CV value of 1. The product in the form of the story book "Ready Selem" is categorized as practical. In general, the practicality value of the interest aspect received a score of 24.8 which was categorized as very good, the material presentation aspect received a score of 24.4 which was categorized as very good, and the language aspect received a score of 24.5 which was categorized as very good. In general, the average practicality score is 24.5 in the very practical category. Research Implications – The story book product "Ready Selem" is categorized as effective. This can be seen from the increase in the score obtained before being given the picture story book media compared to after being given the picture story book to class II students at SD Negeri 1 Jatiluwih, with a significant value.

Knowledge and practice of essential nutrition actions among pregnant women in Ibadan, South-western Nigeria

Background: Maternal nutrition during the first 1,000 days has important influences on children’s nutrition and pregnancy outcomes. This study therefore assessed the knowledge, attitude and practice of essential nutrition actions among pregnant women utilizing antenatal care services in Ibadan municipality, South-western Nigeria. Methods: A descriptive cross-sectional study was conducted among pregnant women (15-49 years) receiving antenatal care (ANC) services across selected private and public health facilities. A semi-structured questionnaire was used to collect data on optimal dietary intake, prevention and control of anaemia and promotion of supportive lifestyle and care, according to the essential nutrition actions framework. Results: The mean age of respondents was 29.85±4.89 years while the mean gestational age of pregnancy at respondents’ ANC booking was 18.33±6.12 weeks. About one-third (33.60%) of the respondents had poor knowledge scores (mean knowledge score 5.70±1.50 out of 10), with no significant difference across type of health facility. Mean attitude score was 13.76±2.44 out of 20, while practice was generally poor (mean practice score 4.80±1.34 out of 10). Respondents attending larger tertiary hospitals for ANC had higher knowledge and practice compared to those who attended smaller primary health care centers/mission homes. Additionally, the time of booking, parity, and type of antenatal care center were statistically significant to knowledge and practice (p&lt;0.05). Conclusions: Antenatal care is still a valid platform for delivering maternal knowledge and encouraging practice of essential nutritional actions. It is recommended that expertise in tertiary hospitals be diffused to lower cadre of health care facilities to further strengthen ANC service delivery.

Knowledge, Attitudes, and Practices Towards COVID-19 Infection among Oral Healthcare Workers at a Tertiary Dental Hospital in Sri Lanka

Oral healthcare workers are at a higher risk of contracting COVID-19 due to the nature of their work. Therefore, the present study aimed to assess the knowledge, attitudes, and practices towards COVID-19 among all categories of oral healthcare workers (OHCWs) at a tertiary dental hospital in Sri Lanka. This was a descriptive cross-sectional study conducted towards the end of COVID-19 pandemic in December 2022. A self-administered questionnaire was used as the study instrument. The knowledge, attitudes and practices were categorised as poor- &lt;60%, moderate- 61-80%, excellent -&gt;80% according to the score. The mean knowledge score, attitude score and practice score of OHCWs regarding COVID-19 infection was 6.7 (SD1.5), 35.5 (SD 3.7), and 13.6 (SD 2.8) respectively. Only 6.4% of the participants had excellent level of knowledge and it was significantly associated with the sex, OHCW category, and having children less than 10 years. Only 1.7% of participants exhibited excellent attitudes, and 75.5% of participants showed excellent practices. The practice score was significantly associated with sex, OHCW category, and marital status. OHCWs in a tertiary dental hospital, Sri Lanka had a moderate level of knowledge and attitude but excellent practices towards the COVID-19 infection. Continuous in-service training programs should be conducted among all OHCWs to improve the level of knowledge and attitudes as well as to maintain good practices for any future pandemic situations. Keywords Oral healthcare worker, Knowledge, Attitude, Practices, COVID-19, Sri Lanka

Evaluating the public's readiness to combat vector-borne disease threats in Jazan, Saudi Arabia: A cross-sectional survey.

Vector-borne diseases (VBDs) pose a significant public health challenge in Saudi Arabia, particularly in the Jazan region. This study aimed to assess the knowledge, attitudes, and practices regarding VBDs among the population of Jazan and to identify factors associated with these variables. A cross-sectional survey was conducted among 642 adult residents of Jazan using a convenience random sampling technique. The survey tool consisted of 6 domains: demographics, knowledge of VBDs, preventive practices, care-seeking behavior, knowledge of specific VBDs, and attitudes towards VBDs. Data were analyzed using descriptive statistics, chi-square tests, t tests, ANOVA, and multivariable logistic regression. The majority of participants (60.0%) had high knowledge scores, while (75.5%) and (77.7%) had high attitude and practice scores, respectively. However, knowledge gaps were identified in specific areas, such as the transmission of leishmaniasis and Rift Valley fever. Gender was a significant predictor of both knowledge and practice scores, with males having higher knowledge and females demonstrating higher levels of preventive practices. Age, education, income, and working status were also associated with knowledge scores. The findings highlight the need for targeted interventions and educational campaigns to address the identified gaps in knowledge, attitudes, and practices. Future research should focus on exploring the effectiveness of different intervention strategies and investigating the integration of VBD prevention and control measures into existing healthcare systems. By employing a multi-disciplinary approach, evidence-based strategies can be developed to prevent and control VBDs, ultimately improving public health outcomes in Jazan and other endemic regions worldwide.

Knowledge, attitude, and practice toward sarcopenia among older adults in two cities in Zhejiang province, China

ObjectiveTo explore the knowledge, attitudes, and practice (KAP) towards sarcopenia among older adults in Zhejiang province, China. MethodsThis cross-sectional study was conducted between April 2023 and January 2024 among older community residents who participated in a physical examination in Shaoxing People’s Hospital Physical Examination Center, Shaoxing Yuecheng District Fushan Street Community Health Service Center, Shaoxing Yuecheng District Beihai Street Community Health Service Center, Shaoxing City, and Outpatient Department of Yongkang First People’s Hospital. Their demographic characteristics and KAP towards sarcopenia were collected by a self-designed questionnaire. Structural equation modeling (SEM) was used to explore the relationship among KAP dimensions. ResultsA total of 1092 valid questionnaires were included. The median knowledge, attitude, and practice scores were 0 (0, 0) (possible range: 0–22), 31 (30, 31) (possible range: 8–40), and 17 (15, 21) (possible range: 6–30), respectively. The SEM showed that knowledge directly positively influenced attitude (β = 0.121, P < 0.001) and practice (β = 0.171, P < 0.001). Attitude directly positively influenced practice (β = 0.116, P < 0.001); therefore, the knowledge showed an indirect influence on practice via attitude. ConclusionOlder adults in two cities in Zhejiang province, China, showed insufficient knowledge but moderate attitude and practice towards sarcopenia. It is imperative to design interventions to improve knowledge about sarcopenia and improve self-management and patient outcomes.

Developing Android App-Based Interactive Learning Media for Mechanical Engineering Basics: Enhancing Vocational School Student Learning Outcomes

This study is to provide valid, practical, and effective Android application-based interactive learning media for the Basics of Mechanical Engineering subject in class X Mechanical Engineering at SMK Dhuafa Padang. This medium is intended to boost students' comprehension, motivation, and independence, allowing them to achieve better learning outcomes. The research approach employed is Research and Development (R&amp;D), using a 4D development model (define, design, develop and disseminate). The primary data utilized in this study came from validators, teachers, and students. Data was analyzed descriptively to characterize the validity, practicality and effectiveness of the learning media developed. The validity test findings show that this learning medium, which had a media aspect score of 0,892 and a material aspect score of 0,950, was deemed valid by expert review. This media was also declared practical with a practicality score of 96,94% from teacher responses and 92,25% from student responses. In the effectiveness test, the Gain Score was 0,68, placing it in the medium category. Meanwhile, the t-test shows a Sig value (2-tailed) of 0.002 (2-tailed &lt; 0,05) and a tcount value of 3,372 (tcount ˃ ttable), indicating a significant difference in learning outcomes between students who use this learning media (experimental class) and those who do not use the media (control class). Thus, this Android application-based interactive learning media is declared valid, practical and effective for use in the DDTM learning process.

Nurses’ knowledge, attitude and practice regarding non-pharmacologic interventions for behavioral and psychological symptoms of dementia

BackgroundTo evaluate the knowledge, attitude and practice of nurses regarding non-pharmacologic therapies for behavioral and psychological symptoms of dementia (BPSD).MethodsThis cross-sectional, questionnaire-based study enrolled nurses at Peking Union Medical College Hospital (Beijing, China) between September 2022 and October 2022. Correlations between knowledge, attitude and practice scores were evaluated by Pearson correlation analysis. Factors associated with knowledge, attitude and practice scores were identified by multivariable linear regression. Based on a cross-sectional questionnaire survey, this study designed a questionnaire according to the Guidelines for Diagnosis and Treatment of Dementia in China, and randomly selected nurses from Peking Union Medical College Hospital to fill in the questions through the Wen-Juan-Xing online platform from September 2022 to October 2022.ResultsThe analysis included 210 nurses (202 females). The average knowledge, attitude and practice scores were 11.06±2.61 (total score: 18), 53.51±5.81 (total score: 60) and 64.66 ± 10.35 (total score: 80) points, respectively. Knowledge score was positively correlated with attitude score (r = 0.416, P < 0.001) and practice score (r = 0.389, P < 0.001); attitude and practice scores were also positively correlated (r = 0.627, P < 0.001). Multivariable analysis demonstrated that age ≥ 40 years-old (vs. ≤30 years-old) was associated with higher knowledge score (β = 1.48, 95% confidence interval [95%CI] = 0.42–2.54, P = 0.006). Age ≥ 40 years-old (β = 1.43, 95%CI = 0.35–2.51, P = 0.010 vs. ≤30 years-old) and bachelor’s degree or higher (β = 1.11, 95%CI = 0.12–2.10, P = 0.028 vs. college degree or lower) were associated with higher practice score.ConclusionsOlder age and higher education level were associated with higher knowledge, attitude and/or practice scores. The findings of this study may help guide the development and implementation of education and training programs to improve the management of BPSD by nurses in China.

Knowledge, attitudes, and practices of orthopedic operating room personnel regarding the use of pneumatic tourniquets.

Pneumatic tourniquets (PTs) play a crucial role in hemostasis during orthopedic surgery. This study aimed to investigate the current knowledge, attitudes, and practices (KAP) of orthopedic operating room personnel concerning the use of PTs. This cross-sectional study was conducted from Jul. 2023 to Aug. 2023. An online questionnaire was used to collect demographic information and KAP score data of the orthopedic operating room personnel from Hangzhou Regional Hospitals. A total of 336 participants included orthopedic physicians (37.8%), orthopedic nurses (31.5%), anesthesiologists (8.9%), operating room nurses (19.9%) and medical students (1.8%). The median knowledge score was 28.5 (24, 32), with a maximum score of 38; the median attitude score was 31 (28, 35), of a maximum of 35; the median practice score was 41 (36, 44), of a maximum of 45. Correlation analysis showed links between knowledge and attitude (r = 0.388, p<0.001), knowledge and practice (r = 0.401, p<0.001), and attitude and practice (r = 0.485, p<0.001). Multivariate logistic regression analysis confirmed that female gender (OR = 0.294, 95% CI: 0.167-0.520; p<0.001), working in a specialized hospital (OR = 0.420, 95% CI: 0.219-0.803; p = 0.009), and occupation as a surgical anesthesiologist (OR = 3.358, 95% CI: 1.466-7.694; p = 0.004) were associated with better knowledge scores. A higher educational degree (OR = 0.237, 95% CI: 0.093-0.608; p = 0.003) was associated with better practice scores. No previous training was associated with lower knowledge (OR = 0.312, 95% CI: 0.187-0.520; p<0.001) and practice (OR = 0.325, 95% CI: 0.203-0.521; p<0.001) scores. Orthopedic personnel in this study had acceptable knowledge, attitude, and practice concerning the use of PTs; additional training and guidance might enhance proficiency.

Real-World Treatment Patterns and Patient-Reported Outcomes in Chronic Obstructive Pulmonary Disease in Japan: The REMIND Study.

Symptom status and treatment changes among patients with chronic obstructive pulmonary disease (COPD) using inhaler treatment in real-world clinical settings are not well understood, particularly according to class of treatment. We investigated the proportion of symptomatic patients among those with COPD using inhaler treatment, based on COPD Assessment Test (CAT) scores in clinical practice, and changes in inhaler treatments and symptoms at 1-year follow-up. This was a retrospective analysis of data from a multicenter, prospective cohort study conducted at medical institutions with respiratory specialists in Japan. The primary endpoint was the proportion of patients with CAT scores ≥ 10 or < 10 in each inhaler treatment group at registration. Of 414 patients in the full analysis set, 76 (18.4%), 261 (63.0%), and 77 (18.6%) were using long-acting muscarinic antagonist (LAMA), LAMA + long-acting β2-agonist (LABA), and inhaled corticosteroids (ICS) + LABA, respectively, at registration. The proportions of patients with CAT scores ≥ 10 or < 10 per inhaler treatment group at registration, respectively, were 32.9% and 67.1% in the LAMA group, 55.0% and 45.0% in the LAMA + LABA group, and 50.0% and 50.0% in the ICS + LABA group. Most patients (> 75%) in each inhaler treatment group showed no change in inhaler treatment at 1year, regardless of their CAT score at registration. Approximately 70-80% of patients with CAT scores ≥ 10 at registration still had CAT scores ≥ 10 at 1year; 10-30% of patients with CAT scores < 10 at registration had CAT scores ≥ 10 at 1year. In real-world Japanese clinical practice, a considerable proportion of patients have persistent symptoms (CAT score ≥ 10) despite using mono or dual inhaler treatment; > 75% of symptomatic patients with COPD using inhaler treatment did not undergo treatment escalation at 1-year follow-up and remained symptomatic. ClinicalTrials.gov identifier, NCT05903989.

Correlation of cardiotocography with combined APGAR scores and diagnostic performance of umbilical cord parameters in predicting low combined APGAR scores – A prospective Cohort study

ObjectivesCombined Apgar score includes utilization of interventions such as Continuous positive airway pressure, Oxygen, Mask and Bag ventilation, I ntubation and ventilation, Ne onatal chest compression, Drugs, and newborn assessment. It has been proposed as a substitute for conventional Apgar score which is the gold standard for evaluating newborns right after birth but is impacted by medical interventions and preterm. Combined Apgar scores were examined to check for correlation with CTG tracing and umbilical cord blood parameters which gives an objective assessment of fetal hypoxia, in response to the demand for a more accurate tool for evaluating the neonate and to be used for medico-legal purposes. The study's objectives were to (1) determine the association of combined Apgar scores with suspicious and pathological CTG (2) the association of umbilical cord parameters with low combined Apgar scores and the diagnostic performance of these parameters in predicting low combined Apgar scores. Study designA prospective observational cohort study was conducted in a tertiary care center in East India. 2350 consecutive laboring mothers who had completed 34 weeks of gestation underwent cardiotocography according to institutional protocol and those with suspicious and pathological CTG who delivered within 1 h of abnormal CTG were recruited. Arterial blood was analyzed and the newborn was evaluated immediately after delivery with a combined Apgar scoring system ResultsOf the 2350 women, 50.7 % and 49.3 %, respectively, exhibited suspicious and abnormal CTG tracings. CTG was reported to have low diagnostic accuracy and specificity, with a sensitivity of 66.7 % and 88.9 %, respectively, in detecting combined Apgar at 1 and 5 min. The combined Apgar score at five minutes showed a strong association with acidosis. There was a statistically significant correlation between low combined Apgar and excess lactate and base at one and five minutes. With 100 % sensitivity and 95 % specificity, high lactate levels > 4.1 mM/L were found to predict newborn encephalopathy. ConclusionUmbilical cord blood parameters were found to be correlated with low combined Apgar scores. Combined Apgar scores may be a more useful tool for neonatal assessment and long-term morbidity of newborns. Additional research is required to determine whether it can take the role of conventional Apgar scores in clinical practice.

First aid training using virtual reality

This work considers the use of virtual reality (VR) technology to self-teach first aid training. It is known that VR provides realistic experiences to train individuals. We created interactable first aid lessons using the Unity engine and a VR interaction framework, and provided hands-on experience, with tests based on practical exercises. The VR application materials, with the first aid knowledge gathered from many government and hospital websites, consisted of 10 lessons and 7 tests. The lessons were appraised by 14 learners, resulting in a total average satisfaction score of 9.1. The post training first aid knowledge test scores increased by 35% from pre-course level. All learners reported having greater confidence, with their practical test scores improving by an average of 22% after multiple tests, demonstrating that the application could be effectively used for learning and practice purposes.

Associations of Socio-Demographic Characteristics of Dairy Goat Farmers in Greece with Biosecurity-Related Practices in the Farms.

Given the significance of goat farming in Greece, our study aimed to explore biosecurity conditions on goat farms and refers to an investigation performed on 119 farms countrywide in Greece. The objective of the present work was to evaluate and report on potential associations between the socio-demographic characteristics of goat farmers and practices that play a role in biosecurity on farms. Data were obtained during a large cross-sectional study performed across Greece in 119 goat herds. The socio-demographic characteristics of farmers, as well as 16 variables related to biosecurity, were recorded; these were practices or events that could potentially enhance or compromise biosecurity on farms. A score based on all the biosecurity-related variables was devised by assigning a '1' or '-1' mark for each variable recorded on a farm that could enhance or compromise, respectively, biosecurity. Among variables potentially enhancing biosecurity on farms, the application of disinfections on the farm and the maintenance of isolation for sick animals were practiced more frequently; among variables potentially compromising biosecurity on farms, the presence of hunters in the area around the farm and grazing practices for animals were recorded more frequently. The median overall score for biosecurity-related practices for all farms in the study was 1 (interquartile range: 2.5; minimum: -4; maximum: 5). Among socio-demographic characteristics, the presence of working staff on a farm was associated with five individual biosecurity-related practices and the length of farming experience with three individual biosecurity-related practices. In the multivariable analysis, female farmers (p = 0.007) and the presence of working staff on the farm (p = 0.025) emerged as the two significant socio-demographic characteristics with an association with the overall biosecurity level on farms. This knowledge can be useful when developing biosecurity programs on goat farms. Recognition of locally applied farm-level practices enhancing biosecurity could form a basis for farmers to apply more rigorous and effective relevant plans.

Assessment of the Knowledge and Practice on Safe Handling of Anticancer Drugs among Pharmacists in Iraqi Healthcare Settings

Background: Occupational exposure to hazardous drugs occurs in all aspects of anticancer drug handling. Proper recommendations and guidelines should be applied to control and reduce exposure. Objective: To assess pharmacists' knowledge and practice regarding the safe handling of anticancer drugs. Methods: A cross-sectional study was conducted at seven major hospitals in Baghdad City, Iraq, from December 2023 to February 2024. A pre-designed questionnaire was given to pharmacists who handled anticancer drugs in chemotherapy units. The questionnaire comprises sociodemographic data, knowledge of the safe handling of cytotoxic drugs and thoughts about exposure and risk, practices for safely handling cytotoxic drugs, and challenges for safely handling cytotoxic drugs. Results: A total of 126 pharmacists were enrolled in the study. Less than half of the participants (46%) received training on anticancer drugs. While more than a third (42.9%) of the pharmacists were handling more than 100 cytotoxic preparations weekly, the total knowledge score was 7.14, while the total practice score was 73.36, with less than half of the pharmacists having good knowledge (44.44%) or practice (48.41%). Pharmacists who received training had significantly higher total practice scores than those who did not. Pharmacists with more than 100 weekly preparations were more knowledgeable than those with 50–99 preparations. Conclusions: The majority of participating pharmacists had fair to excellent knowledge and practice regarding the safe handling of cytotoxic medications. However, there were some gaps regarding important knowledge and practice issues. To improve knowledge and practices regarding anticancer handling, training is necessary.

Improving Concepts Understanding Of Class V Students With The Utilization Of Geogebra Learning Media

The purpose of this research is to create a learning media for the concept of geogebra to improve students' mathematical understanding of the material of spatial structure. The things tested in this study were validity, practicality, and effectiveness. This research method is RD with a 4-D model, namely defining, designing, developing and distributing. However, in this study only up to the development stage. Based on the research that has been done, the result is that the average score of media experts is 3.6, material experts are 3.6, which means the results are very good. Furthermore, the practicality score obtained from the teacher's response questionnaire is 89,93% and the student's is 78,67%. Furthermore, the results of the effectiveness of learning media get 90% of students who get complete learning using geogebra learning media.