Preventive Actions Research Articles

Prevention of frailty in relation with social out-of-home activities in older adults: results from the Survey of Health, Ageing, and Retirement in Europe.

Out-of-home mobility and social participation have been identified as resources to postpone frailty. We aim to examine the mediating role and specific contribution of social out-of-home activities in frailty prevention. Data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) waves six (w6), seven (w7), and eight (w8) were used. Frailty was measured with the SHARE version of the Edmonton Frail Scale (EFS) with frailty states fit, pre-fail and frail. First, a mediation model with 13,456 fit participants aged ≥ 50years in w6 was specified with social network size, loneliness (UCLA3-Item Loneliness Scale), and lack of motivation (EURO-D) as predictors and number of performed social out-of-home activities in w7 as mediator variable on EFS-scores in w8. Age, education, gender, cohabitation, widowhood, urban environment, and country served as covariates. Second, we investigated the association of increasing social out-of-home activities from w6 to w7 with change in EFS-score from w6 to w8 using a linear mixed model with 17,439 participants in all frailty states. Direct effects of loneliness (w6) and lack of motivation (w6) on EFS-scores (w8) were partially mediated by social out-of-home activities (loneliness ß = 0.005; 95% CI = 0.003-0.008) and (lack of motivation ß = 0.014; 95% CI = 0.009-0.019). The linear mixed model revealed a significant effect of increasing social out-of-home activities (w6-w7) on reduction of EFS-scores (w8) (ß = - 0.21; 95% CI = - 0.29-0.04; p < 0.001). Social out-of-home activities appear to play a crucial role in frailty prevention, which could be used for future interventions.

Assessment of PM2.5 pollution features and health advantages in Northwest China.

The elevated concentration of suspended particulate matter in the atmosphere is closely associated with the morbidity and mortality of human diseases. In northwest China, fine particulate matter pollution has persistently affected local health, production, and daily life due to climatic factors and economic development. This paper first examines the distribution and variation of PM2.5 concentrations in northwest China from 2013 to 2022 to understand changes in PM2.5 exposure levels, as well as their associated health and economic benefits since the implementation of the "Air Pollution Prevention and Control Action Plan." Second, we estimated the number of premature deaths in the research region under various control scenarios based on PM2.5 concentrations recorded in 2013 and 2021, utilizing existing epidemiological studies for reference. Finally, we calculated the financial benefits resulting from variations in PM2.5 concentrations within this region. Results indicated that (1) from 2013 to 2022, the Tarim Basin exhibited the highest PM2.5 concentration among all studied areas, while northern Xinjiang and Qinghai Province had notably lower levels. Additionally, wintertime concentrations were consistently higher than those observed during summer months; however, there has been a general trend toward reduced PM2.5 content over the past decade. (2) A significant inverse relationship was found between premature mortality rates and PM2.5 concentrations; specifically, fluctuations in PM2.5 levels exerted a more pronounced impact on premature deaths attributable to cardiovascular diseases compared to respiratory conditions within this northwest region. (3) Males were disproportionately affected by increases in PM2.5 concentration relative to females-experiencing two to three times more early fatalities than their female counterparts did. (4) Over a 9-year period within this research area, fiscal benefits derived from interventions targeting PM2.5 treatment increased by approximately 891 million yuan.

The antimicrobial potential of traditional remedies of Indigenous peoples from Canada against MRSA planktonic and biofilm bacteria in wound infection mimetic conditions.

Methicillin-resistant Staphylococcus aureus (MRSA) is the leading cause of wound infections, often progressing into serious invasive bloodstream infections. MRSA disproportionately affects Indigenous peoples in Canada with higher rates of skin and wound infections, an example of persistent gaps in health outcomes between Indigenous and non-Indigenous peoples precipitated by the legacy of colonialism. Conversely, Indigenous peoples have long used natural remedies for infections and other diseases; however, their knowledge was rarely considered for modern medicine. The stagnant antibiotic discovery pipeline and alarming rise of resistance to current antibiotics prompted us to turn to Indigenous medicine as an untapped source of antimicrobials. As such, we collected and prepared 85 extracts of medicinal plants of value to Indigenous peoples spanning the Canadian Prairies. We explored the antimicrobial potential of these extracts against MRSA under wound infection-mimetic conditions compared with culture media typically used to study bacterial antibiotic responses and biofilms but not adequately representative of infection sites. We identified extracts with MRSA growth inhibitory [e.g., bergamot, dock, gaillardia, and dandelion extracts] and biofilm prevention and eradication [e.g., gumweed extracts] activities. Extracts, including those of chokecherry, hoary puccoon, and Northern bedstraw, were only active under wound infection-mimetic conditions, highlighting the benefit of antibiotic discovery under host-relevant conditions. Testing growth inhibitory extracts against an S. aureus cross-resistance platform suggested that they act through mechanisms likely distinct from known antibiotic classes. Together, through an interdisciplinary partnership leveraging Western approaches and traditional Indigenous knowledge, we identified plant extracts with promising antimicrobial potential for drug-resistant MRSA wound infections.IMPORTANCEWe explored the antimicrobial potential of traditional Indigenous remedies against MRSA under wound infection-mimetic conditions. We chose to tackle MRSA wound infections because they constitute an Indigenous health priority, ensuring mutual benefits and reciprocity, which are important principles in partnerships between Indigenous and non-Indigenous researchers. Our partnerships strive to serve as steps towards reconciliation with Indigenous peoples in Canada and a roadmap inspiring similar interdisciplinary collaborations to tackle other healthcare priorities. We identified extracts with promising antibacterial growth inhibitory, biofilm prevention, and eradication activities against MRSA. The antimicrobial potential of some extracts was only observed under wound infection-mimetic conditions, a proof-of-concept that screening under infection-mimetic conditions reveals novel activity undetected under standard conditions. The natural product antimicrobial extracts discovered herein warrant further investigation into their mode of action and chemical composition; they may address the dire need for new antimicrobial and anti-biofilm activity to counter the AMR crisis.

Nurturing care: perceptions and practices of caregivers for children under five in the Ecuadorian highlands – a qualitative study

IntroductionThe importance of nurturing care for child development is well-established, and parents play a central role in providing this care. However, cultural values and traditions can influence child-rearing practices, and there are gaps in child welfare in Ecuador. Two research questions delve into caregivers’ definitions of nurturing care for children aged 0–5 and its alignment with World Health Organization’s concept.MethodsA qualitative methodology was applied to comprehensively explore caregivers’ perspectives and application of nurturing care across diverse cultural contexts in rural areas of Cotopaxi and Loja in Ecuador. Using snowball sampling primary caregivers, healthcare professionals, childcare workers, and community leaders were interviewed and participated in focus groups, examining its congruence with WHO’s Nurturing Care Framework for Early Childhood Development.ResultsWhile there is alignment with the WHO framework, the study reveals challenges such as a lack of awareness of the term “nurturing care” among participants. Findings also indicate issues in health communication, reliance on traditional medicine, and myths around nutritional practices. The role of technology in early learning is explored, noting both its advantages and disadvantages. Notably, preventive health activities were not mentioned, emphasizing a universal need for knowledge.ConclusionThis study urges tailored interventions for nurturing care, emphasizing success tied to robust healthcare and child protection. Urgency lies in cultural sensitivity, local adaptation, and targeted training for implementation. These insights contribute significantly to the global discourse, stressing the importance of context-specific approaches. Implications are crucial for policymakers, practitioners, and researchers dedicated to elevating care quality for vulnerable populations worldwide.

Public, Private and Public-Private Partnerships (PPP) to Implement a One Health Approach to Combat Antimicrobial Resistance in Colombia

Abstract The establishment of public-private partnerships (PPPs) within Colombia, Latin America, is a recent, innovative effort within the nation’s agricultural industry to tackle antimicrobial resistance (AMR) under a One Health approach. PPPs are a formal alliance between representatives from the public and private sectors that aim to promote cross-sectoral collaboration, stewardship and accountability. Members agree on shared objectives and responsibilities, resources and risks to establish monitoring, prevention and mitigation activities against AMR within the farming industry. Key learnings of this initiative within the context of Colombia include: maximisation of results when monitoring is assigned to the private sector, and this may apply to other lower-middle-income countries (LMICs); objectives are better achieved when they are pre-defined according to time, budget and human resource constraints of member institutions; and confidentiality agreements must be consistent with the sensitive nature of surveillance information. Barriers to implementation were also identified, such as frequent changes of government personnel at decision making levels that make governance planning and adaptation challenging, while legal formalities and bureaucracy hinder formalisation of agreements. The success of this PPP is a useful example for other LMICs to aid in the control and prevention of animal diseases, promotion of food safety and reduction in poor animal health which limit commerce, while at the same time, minimising production loss and ensuring the provision of a fair income for producers. Information © The Authors 2024

A statewide system for maternal-infant linked longitudinal surveillance: Indiana's model for improving maternal and child health

Indiana, located in the Midwest region of the United States, faces significant challenges with respect to health, especially maternal and child health (MCH). These challenges include high rates of stillbirth, neonatal abstinence syndrome (NAS) and congenital syphilis (CS). Not only are these often-fatal conditions underreported, but it can also be difficult to track them longitudinally, as mothers and infants are not routinely linked through electronic health records (EHRs). This paper describes the process, structure and planned outcomes of a partnership between Indiana University, Regenstrief Institute and public health partners in support of the U.S. Centers for Disease Control and Prevention's Pregnant People-Infant Linked Longitudinal Surveillance (PILLARS) program. Together, academic, clinical and public health organisations are collaboratively developing an infrastructure and deploying novel methods to surveil stillbirth, CS and NAS longitudinally. The infrastructure includes: (a) deploying deterministic and probabilistic algorithms to link mothers and their infants using multiple, linked data sources; (b) creating and maintaining a registry of maternal-infant dyads; (c) using the registry to perform longitudinal surveillance in collaboration with Indiana public health authorities on stillbirth, NAS and CS and (d) translating information from surveillance activities into action by collaborating with public health and community-based organisations to improve and implement prevention activities in vulnerable Indiana communities. Our long-term goal is to improve outcomes for these conditions and other priority MCH outcomes by expanding our work to additional MCH use cases.

DISPUTE BOARDS COMO MEIO DE RESOLUÇÃO DE CONFLITOS NA LEI DE LICITAÇÕES E CONTRATOS ADMINISTRATIVOS (LEI N. 14.133/2021): A IMPLEMENTAÇÃO DOS DISPUTE BOARDS NOS CONTRATOS ADMINISTRATIVOS

This article analyzes the application of Dispute Resolution Committees as a means of resolving conflicts in administrative contracts, focusing on the Law on Tenders and Administrative Contracts (Law no. 14,133/2021). Dispute Boards emerge as a preventive and effective tool to deal with the complexity and high amounts involved in public contracts, such as concessions and public-private partnerships (PPPs). The study addresses the origin and concept of Dispute Boards, their preventive and resolutive action in contracts, and their increasing use in the public sector, highlighting the challenges and limitations in this context. Furthermore, it deals with Dispute Boards compared to other conflict resolution mechanisms, such as arbitration and mediation, comparing their advantages and advantages. Finally, areas for future research are suggested, such as the economic impact of Dispute Boards and the analysis of practical cases involving large-scale public contracts.

Influence of Health Literacy on Physical Activity and Sedentary Behaviors in Older Patients with Coronary Artery Disease.

Coronary artery disease is a chronic condition that requires continuous adherence to healthy behaviors. Adhering to physical activity and reducing prolonged sedentary behavior are important for the physical health of older patients with coronary artery disease (CAD). Health literacy is increasingly recognized as a key factor in secondary prevention for these patients. However, evidence regarding the associations among health literacy, physical activity, and sedentary behaviors for secondary prevention in older patients with coronary artery disease remains limited. This study aimed to identify the prevalence of limited health literacy and the influence of health literacy on physical activity and sedentary behaviors in older patients with CAD. This study was a descriptive cross-sectional study conducted from May to December 2022 in South Korea. A total of 186 patients aged 65 and older diagnosed with coronary artery disease participated. Data on health literacy, physical activity, and sedentary behaviors were collected through self-reported questionnaires and electronic medical records. The prevalence of limited health literacy in older patients was 66.7%. Hierarchical linear regression revealed that health literacy was a significant determinant of physical activity (β = -0.50, P < .001) and sedentary behaviors (β = 0.58, P < .001) after adjusting for confounding variables. Our main findings showed that health literacy can facilitate improvements in physical activity and sedentary behaviors. Health literacy can facilitate health decisions for secondary prevention in older patients with CAD. Thus, healthcare professionals should assess patient health literacy and illness severity when designing secondary prevention programs.

Multimedia-Based Education Led to Improvement in Disease Knowledge Among Patients with Cirrhosis.

Current evidence shows limited patient understanding of liver disease, coupled with no standard guidelines or methods to offer patient education in a busy clinical environment. We developed multimedia-based education (MBE) for those with cirrhosis & tested its effectiveness in improving patient knowledge from baseline to 1 month. This prospective study enrolled cirrhotic patients who had a scheduled visit with a hepatologist at an ambulatory academic practice or were admitted to the liver inpatient service. Once consented, patients completed a baseline knowledge questionnaire, and were given a link to watch the videos (text or email). Four videos were developed by the study team with input from clinicians and patients (liver function, symptoms and complications, medical management and preventive actions & nutrition). At month 1, the study coordinator confirmed with the patient that they had watched the videos at least once, and patients completed the same knowledge questionnaire. The scores between pre- and post-intervention were compared using the Wilcoxon signed rank test. Of the 120 enrolled, 113 completed baseline and 75 completed follow-up. 48% had alcohol-related liver disease as the underlying cause of cirrhosis. Mean MELD score at enrollment was 14.7 ± 8.14. There was a statistically significant improvement in knowledge scores across all domains from baseline to month 1 (p < 0.05). The overall knowledge score improved from 65 to 83% (p < 0.001), with highest improvement by 40% in the domain of liver function and causes of cirrhosis. MBE can help improve patients' knowledge about liver function, management, and prevention and can be used in both ambulatory and inpatient hepatology practice.

Associations of sugary beverage intake with type 2 diabetes and the role of physical activity: a prospective cohort study

BackgroundHigher consumption of sugary beverages (SB) has been associated with type 2 diabetes (T2D), but whether these associations are modified by physical activity remains unclear. This study aimed to examine the associations of SB intake, including sugar-sweetened beverages (SSB), artificially sweetened beverages (ASB), and natural juices (NJ) with the risk of incident T2D, and the potential role of physical activity.MethodsWe included 153,862 diabetes-free participants in the UK Biobank who completed both the International Physical Activity Questionnaire at recruitment (2006–2010) and at least one 24-h dietary recall questionnaire in 2009–2012. We assessed the associations of each SB with the risk of incident T2D using Cox proportional hazard models, and explored the interactions between each SB and physical activity.ResultsDuring a median follow-up of 11.8 years, 6631 participants developed incident T2D. Participants consuming more SSB and ASB (comparing > 2 to 0 unit/d) had a higher hazard of T2D (hazard ratio [HR]: 1.17, 95% confidence interval [CI]: 1.05–1.31 for SSB; 1.54, 1.37–1.74 for ASB), while medium intake of NJ showed an inverse association (HR> 0–1 vs. 0 unit/d: 0.87, 95% CI: 0.82–0.92; HR> 1–2 vs. 0 unit/d: 0.88, 95% CI: 0.81–0.97) with incident T2D. No significant interactions between physical activity and SSB/ASB were found (P-interaction=0.204 for SSB, 0.926 for ASB), but the protective association of medium NJ intake with T2D was stronger among participants with higher level of physical activity (P-interaction = 0.043).ConclusionsHigher intake of SSB and ASB was related to higher risks of T2D. Medium NJ intake was associated with a lower risk of T2D, particularly among individuals with higher physical activity level. These findings emphasized the importance of healthy beverage intake and adequate physical activity in diabetes prevention.

Revolutionizing plant health with machine learning for disease detection and diagnosis

The use of artificial intelligence (AI) in the detection and diagnosis of plant diseases has gained significant interest in modern agriculture. The appeal of AI arises from its ability to rapidly and precisely analyze extensive and complex information, allowing farmers and agricultural experts to quickly identify plant diseases. The use of artificial intelligence (AI) in the detection and diagnosis of plant diseases has gained significant attention in the world of agriculture and agronomy. By harnessing the power of AI to identify and diagnose plant diseases, it is expected that farmers and agricultural experts will have improved capabilities to tackle the challenges posed by these diseases. This will lead to increased effectiveness and efficiency, ultimately resulting in higher agricultural productivity and reduced losses caused by plant diseases. The use of artificial intelligence (AI) in the detection and diagnosis of plant diseases has resulted in significant benefits in the field of agriculture. By using AI technology, farmers and agricultural professionals can quickly and accurately identify illnesses affecting their crops. This allows for the prompt adoption of appropriate preventative and corrective actions, therefore reducing losses caused by plant diseases.

Contexts and complexities: a realist evaluation of integrated care system leadership.

This paper presents a realist evaluation of leadership within an integrated care system (ICS) in England. This paper aims to examine which aspects of leadership are effective, for whom, how and under what circumstances. Realist evaluation methodology was used, adopting prior realist review findings as the theoretical framework to refine explanations of how and why leadership within an ICS is effective. Between January and November 2023, 23 interviews with ICS leaders took place, alongside 7 meeting observations and documentary analysis. The Realist And Metanarrative Evidence Syntheses: Evolving Standards (RAMESES) guidance informed the study design, conduct and reporting. The findings highlight two overarching infrastructural contexts influencing leadership in ICSs: the impact of the post-COVID-19 pandemic legacy and the differences between health and social care regulatory and financial environments. Findings demonstrate that ICS leaders identified a strong sense of purpose as crucial for guiding decisions and creating a psychologically safe environment for open, honest discussions, fostering calculated risk-taking. Whilst a shared vision directed priority setting, financial pressures led to siloed thinking. Leadership visibility was linked to workforce morale, with supportive leadership boosting morale amidst evolving ICS landscapes and confidence in data-driven decisions supported prevention activities. However, financial constraints hindered responsiveness and innovation in addressing health inequalities. By examining ICS leadership post-COVID-19 pandemic and amidst varying regulatory and financial environments, this study contributes to the emerging literature on systems leadership and offers practical guidance for leaders navigating the complexities of integrated care.

An outbreak of Clostridium perfringens infection on a training ship anchored in Busan, Korea.

In September 2023, an outbreak of food-borne disease occurred among students on a training ship docked in Busan. This was an epidemiological investigation with the aim of improving infection prevention activities and group meal service practices on board ships. In this study, a case was defined as an individual who experienced diarrhea more than twice a day during their training period aboard the training ship. A total of 171 exposed individuals including 6 food handlers was well-defined; therefore, a retrospective cohort study was conducted. We administered a questionnaire and conducted laboratory tests including 38 rectal swab samples. Relative risk (95% confidence interval) for each food item was calculated. Of the 165 students and school staff members, 41 met the case definition, resulting in an attack rate of 24.8%; all cases were students. The shape of the epidemic curve was unimodal, with the peak from 0:00 to 06:00 on September 7, 2023. Clostridium perfringens was detected in 9 cases, and no other pathogens were found. Significant relative risk was shown in 11 different food items. Clostridium perfringens was the causative pathogen of this outbreak on the training ship. Due to the lack of preserved food samples, the exact source of infection could not be confirmed. Ships are not classified as collective dining facilities, leaving them in a management blind spot. Therefore, specialized guidelines, voluntary inspections by the operating entities, and continuous education for managers and staff are necessary.

A Intervenção do Serviço de Atenção Domiciliar junto ao usuário e cuidador na rede de atenção à saúde

**Introduction**: Population aging drives the development of home care practices, expanding the role of healthcare teams. The Home Care Service (SAD) is characterized by comprehensive actions in health promotion, prevention, treatment, and rehabilitation performed at home, ensuring continuity of care and effective integration with healthcare networks and the user. **Objective**: To highlight the relationship between the Home Care Service (SAD) and healthcare networks. **Methodology**: This is a descriptive study in the form of a narrative literature review, which sought to highlight the relationship between the Home Care Service (SAD) and healthcare networks. The research was conducted through online access to the PubMed, Medline, and Scielo databases, using the descriptors "home care services," "SUS," and "healthcare networks." Inclusion criteria were: articles available in full text, in Portuguese and English, addressing the topic, and published between 2019 and 2023. **Results**: The results highlight the importance of home care services in assessing, identifying, and training caregivers, promoting self-care and user autonomy. The lack of professional guidance for caregivers presents an opportunity for improvement in care practices. Furthermore, SAD stands out as an innovative strategy in healthcare, surpassing primary care and emergency services, adopting a humanized approach aligned with SUS. By replacing or complementing hospital stays, it seeks equity in resource distribution for efficient access to home care, with active intervention in caregiver training, playing a crucial role in preventing complications, and consolidating itself as a key agent for a patient-centered approach within the SUS framework. **Conclusion**: The intervention of SAD with the user and caregiver is of utmost importance in training caregivers to assist users, avoiding unnecessary complications and ensuring continuity of care within SUS. Thus, the service complements the care provided in primary care and emergency services and substitutes or complements hospital stays.

Black raspberry modulates cecal and oral microbiome at the early stage of a dibenzo[def,p]chrysene-induced murine oral cancer model.

While tobacco smoking is a risk factor in the development of oral squamous cell carcinoma (OSCC), only a fraction of smokers develop the disease. Compelling evidence shows that microbial community composition is associated with carcinogenesis, suggesting that the microbiome may play a role in cancer development of smokers. We previously showed that black raspberry (BRB) protects against OSCC induced by the tobacco constituent dibenzo[def,p]chrysene (DBP) altering genetic and epigenetic markers in a manner consistent with its cancer preventive activity. In the present study, we conducted a mouse experiment to investigate the effects of BRB and DBP individually and in combination on the oral and gut microbiota. DBP-induced DNA damage in the mouse oral cavity which is an essential step for the development of OSCC in mice. 16S rRNA gene sequencing revealed that BRB significantly increased microbial diversity and shifted microbiome composition in the gut and oral cavity, whereas DBP had no significant effect. In both gut and oral microbiota, Akkermansia muciniphila was significantly reduced after BRB treatment; however, this was not consistent with pure culture in vitro assays suggesting that the impact of BRB on A. muciniphila may be mediated through indirect mechanisms including the host or other microbes. Indeed BRB, but not DBP, was found to modulate the growth kinetics of human gut microbes in vitro including lactic acid bacteria and Bacteroides spp. The results of the current study further emphasize the interplay of microbiome and environmental factors in the development and prevention of OSCC.

Binge drinking in American Indian Alaskan Native college attending students

ABSTRACT Objectives American Indian and Alaskan Native (AIAN) populations have the highest rate of alcohol use disorder (AUD). Binge drinking is a known predecessor of AUD and is prevalent in college-attending populations. However, little is known about the prevalence and risk factors related to AIAN college student binge drinking. The current study examines prevalence of binge drinking and association with socio-demographic features, other substance use, exposure to discrimination and feelings of belonging within collegiate institutions. Design Data were collected by the Healthy Minds Study. Present analyses were restricted to 2- and 4-year college attending students in the 2021–2022 academic year who identified as AIAN (n = 1383). We used descriptive, bivariate and multivariate Poisson weighted models to evaluate distributions and associations of binge drinking, age, gender, socioeconomic status, degree program, military experience, substance use, sexual assault, discrimination, and feelings of belonging within the institution. Results In the prior 2 weeks, 26.3% of AIAN students reported binge drinking. Binge drinking commonly overlapped with other substance use. AIAN students aged 21–34 reported the highest rates of binge drinking, as did students pursuing bachelor’s degrees. AIAN students who identified as trans or queer gender were less likely to report binge drinking, while across gender identities those reporting sexual assault or racial discrimination were more likely to report binge drinking in multivariate analyses. Conclusion There are multiple factors associated with binge drinking, representing individual and contextual influences on AIAN students. Developing prevention and intervention activities to address overlap in substance use and high concurrence of sexual assault and binge drinking are critical. Additionally, colleges must make concerted efforts to reduce racial discrimination and be more inclusive of AIAN students to reduce institutional-based features that exacerbate risk.

Education in lifestyle medicine for future physicians – a strategy to reduce the burden of cardiovascular disease

ABSTRACT There is a compelling need to improve all physicians’ knowledge on lifestyle medicine (LM). This training needs to start early during medical education. This case report describes the feasibility and effects of integrating LM into an existing core curriculum of a Swedish undergraduate medical programme. A curriculum development project was organized using a six-step model: general needs assessment, targeted needs assessment, goals and objectives, educational strategies, implementation, and evaluation. New learning objectives regarding health, prevention and lifestyle medicine were formulated throughout the five-and-a-half-year programme. Learning activities and examinations were integrated in all courses with a structured progression and with focus on preventive activities in the workplace learning. The project was evaluated using student surveys of curricular quality, teacher survey of curricular content and integration in 2020, and an external review of adherence to the national qualitative target on preventive medicine. The project was executed during 2017–2018. Course evaluations and exit poll at graduation showed an overall high-quality student rating of education in prevention and in lifestyle counselling: on average, a score of 4.1/5 and 4.1/6, respectively. The teacher survey showed that over 70% of courses had a lasting increase in LM curricular content and that this content was to a large extent integrated into the existing course material. The external review concluded that the topic was well covered and integrated into the curriculum. LM could be successfully integrated into an existing medical programme curriculum with positive effects on student learning.

A Review of Cutting-Edge Sensor Technologies for Improved Flood Monitoring and Damage Assessment.

Floods are the most destructive, widespread, and frequent natural hazards. The extent of flood events is accelerating in the context of climate change, where flood management and disaster mitigation remain important long-term issues. Different studies have been utilizing data and images from various types of sensors for mapping, assessment, forecasting, early warning, rescue, and other disaster prevention and mitigation activities before, during, and after floods, including flash floods, coastal floods, and urban floods. These monitoring processes evolved from early ground-based observations relying on in situ sensors to high-precision, high-resolution, and high-coverage monitoring by airborne and remote sensing sensors. In this study, we have analyzed the different kinds of sensors from the literature review, case studies, and other methods to explore the development history of flood sensors and the driving role of floods in different countries. It is found that there is a trend towards the integration of flood sensors with artificial intelligence, and their state-of-the-art determines the effectiveness of local flood management to a large extent. This study helps to improve the efficiency of flood monitoring advancement and flood responses as it explores the different types of sensors and their effectiveness.

Development and validation of VTE prevention beliefs questionnaire for neurosurgical hospitalized patients based on HBM: a cross-sectional study

Patients hospitalized for neurosurgical procedures are highly susceptible to venous thromboembolism (VTE). It is crucial to evaluate the prevention beliefs of VTE among neurosurgical inpatients and analyse the influencing factors. This research sought to create an instrument grounded in the Health Belief Model (HBM) to evaluate the beliefs about VTE prevention and the factors influencing these beliefs among neurosurgical inpatients. A questionnaire comprising 28 questions was designed, validated, and distributed offline to 386 neurosurgical inpatients through random sampling. The data analysis was conducted using SPSS 26.0 and Amos 27.0. The measurement model was assessed through reliability, validity, and confirmatory factor analyses. Additionally, multiple linear regression analysis was utilized to identify the factors influencing VTE prevention beliefs. Statistical significance was determined by P values less than 0.05. The questionnaire encompassed six constructs, all of which exhibited strong internal consistency along with solid convergent and discriminant validity. VTE prevention beliefs score among neurosurgical inpatients was 99.56 (SD = 10.11). Among the belief dimensions, the scoring rate of perceived benefits and cues to action ranked highest, while perceived barriers were the lowest. The influencing factors of VTE prevention beliefs were educational attainment (β = 0.343, P < 0.001), receipt of VTE knowledge education from healthcare providers (β = 0.214, P < 0.001), Personal history of VTE (β = 0.175, P < 0.001), surgical history (β = 0.116, P < 0.01), sources of VTE-related information (β = 0.113, P < 0.01) and method of paying medical expenses (β = 0.112, P < 0.05). The questionnaire showed strong reliability and validity, and the results indicating that neurosurgical inpatients hold moderate beliefs about VTE prevention. While they recognize its benefits, barriers to preventive behaviors persist. Addressing these barriers and enhancing self-efficacy through targeted education and interventions is key to improving VTE prevention awareness and actions.

Carbon monoxide poisoning: assessment and actions for nurses working in service users' homes.

Carbon monoxide is a colourless, tasteless and odourless gas that is a by-product of incomplete combustion of hydrocarbons such as gas or coal. Carbon monoxide poisoning is associated with high levels of mortality and morbidity, although the symptoms of exposure are non-specific and difficult to diagnose. Historically, healthcare professionals who work directly in service users' homes have faced a higher risk of exposure to environments contaminated with carbon monoxide. Despite improved heating engineering and greater protective legislation, there still remains a tangible risk for community nurses and service users, particularly in homes still using open fires, old heating systems and poorly maintained heating appliances. This article provides a scientific summary of carbon monoxide poisoning for nurses working in the community setting. It outlines evidence-based guidance on prevention and initial treatment actions, along with safety instructions to follow in the event of exposure to carbon monoxide.