Management Program Research Articles

Biosynthesized silver nanoparticles mediated by Ammi visnaga extract enhanced systemic resistance and triggered multiple defense-related genes, including SbWRKY transcription factors, against tobacco mosaic virus infection

BackgroundTobacco mosaic virus (TMV) is a highly infectious plant virus that affects a wide variety of plants and reduces crop yields around the world. Here, we assessed the effectiveness of using Ammi visnaga aqueous seed extract to synthesize silver nanoparticles (Ag-NPs) and their potential to combat TMV. Different techniques were used to characterize Ag-NPs, such as scanning and transmission electron microscopy (SEM, TEM), energy-dispersive X-ray spectroscopy (EDS), fourier transform infrared spectroscopy (FTIR), and dynamic light scattering (DLS).ResultsTEM demonstrated that the synthesized Ag-NPs had a spherical form with an average size of 23–30 nm and a zeta potential value of -15.9 mV, while FTIR revealed various functional groups involved in Ag-NP stability and capping. Interestingly, the Pre-treatment of tobacco plants (protective treatment) with Ag-NPs at 100–500 µg/mL significantly suppressed viral symptoms, while the Post-treatment (curative treatment) delayed their appearance. Furthermore, protective and curative treatments significantly increased chlorophyll a and b, total flavonoids, total soluble carbohydrates, and antioxidant enzymes activity (PPO, POX and CAT). Simultaneously, the application of Ag-NPs resulted in a decrease in levels of oxidative stress markers (H2O2 and MDA). The RT-qPCR results and volcano plot analysis showed that the Ag-NPs treatments trigger and regulate the transcription of ten defense-related genes (SbWRKY-1, SbWRKY-2, JERF-3, GST-1, POD, PR-1, PR-2, PR-12, PAL-1, and HQT-1). The heatmap revealed that GST-1, the primary gene involved in anthocyanidin production, was consistently the most expressed gene across all treatments throughout the study. Analysis of the gene co-expression network revealed that SbWRKY-19 was the most central gene among the studied genes, followed by PR-12 and PR-2.ConclusionsOverall, the reported antiviral properties (protective and/or curative) of biosynthesized Ag-NPs against TMV lead us to recommend using Ag-NPs as a simple, stable, and eco-friendly agent in developing pest management programs against plant viral infections.

Transformation of knowledge and skills by entry-level graduates: Perception of logistics and supply chain managers in Oman

This study aimed to examine and assess the impact of the logistics industry’s environment, entry-level graduates’ characteristics and the logistics and supply chain management (LSCM) program design on the transformation of knowledge and skills at Sohar port in the Sultanate of Oman. The study employed a pragmatic research philosophy involving a structured questionnaire. The sample size included 49 mid-managers from the logistics industry who were working at Sohar Port. The study found that entry-level graduates’ characteristics and LSCM program design positively and significantly influenced the transformation of knowledge and skills. However, the organisational environment had a negative and insignificant impact on the transformation. This study revealed several dimensions that may require further research. It is pertinent to broaden the research scope to other towns, ports, and other countries in the Gulf Council Countries (GCC) to broaden the scope and generalisability of the results. According to the study findings, several recommendations are proposed for the logistics and supply chain sector in Oman to enhance the transformation of knowledge and skills by entry-level graduates, as well as for higher education institutions (HEIs). To meet the sector requirements, HEIs may improve the current university-industry collaborations by increasing the inputs of the industry in designing and developing the LSCM program. The organisational environment must reconsider the knowledge and skills transformation by entry-level graduates in their strategic plan of resources management, which must be emphasised by the remuneration system and career paths incentive. While other studies have explored knowledge and skill transformation in the context of employee training, this study aims to fill a specific research gap by focusing on the transformation of knowledge and skills by entry-level graduates, an area which has not been extensively studied before. Furthermore, this study is unique as it examines the impact of the industry’s environment, entry-level graduates’ characteristics and the LSCM program on the transformation of knowledge and skills within the unique context of Oman. This novel approach provides an opportunity to understand the specific challenges and opportunities faced by entry-level graduates in Oman and suggests strategies for addressing them.

Home-office implementation: challenges and changes in people management

PurposeThis paper investigates how organisations responded to the home office imposition during the recent global health crisis and its impacts on people management, detailing the organisational factors crucial for effective home-office implementation.Design/methodology/approachWe used an exploratory design based on a multiple case study with four companies from two contrasting sectors (manufacturing and information technology (IT)). We interviewed a total of 12 managers, including one HR manager (HRms) and two team managers from each company. We also conducted an online questionnaire with open questions, reaching out to 128 home-office workers from the four participating companies. This diverse group consisted of 67 workers from the IT sector and 61 workers from the manufacturing sector. To ensure a comprehensive analysis, we opted for a qualitative approach to examine the data.FindingsFindings enabled detail of the organisational factor of the Belzunegui-Eraso and Erro-Garcés (2020) extended Baruch and Nicholson’s (1997) model into people management issues: organisational culture, team management and human resources management (HRM) practices, as well as the technological support. The results also revealed that people management benefits from the successful home-office implementation, which boosted the digitalisation of human resources (HR) processes.Originality/valueConsidering the lessons learned from the home-office imposition, this research provides original insights into the field by exploring the roles of supervisors and HR managers, in non-health organisations, with different previous remote work experiences, in a recent global disruptive moment, based on a rich qualitative approach. The paper offers concrete guidelines for companies that intend to implement remote work management programs and contributes to deepen the knowledge of home-office experience, offering a model focusing on managers’ roles (HRms and TMs) and HRM practices.

Compliance with MAB-UNESCO Functions and Management Effectiveness Evaluation between 2017 and 2024: Case Study of the El Cielo Biosphere Reserve, Mexico’s Only State-Run Reserve Belonging to MAB-UNESCO

UNESCO’s MAB Programme promotes a people-centered conservation strategy to strengthen the sustainability of social and ecological systems. However, there exist knowledge gaps regarding its implementation in specific contexts. For this study, a mixed-methods sequential exploratory design was employed. In the first phase, an initial content analysis of the management program of the El Cielo Biosphere Reserve (CBR) and the functions of the statutory framework of UNESCO’s MAB program was conducted. This analysis, which was human-driven but facilitated by artificial intelligence tools, underwent rigorous triangulation and expert validation to strengthen the reliability and robustness of the findings. Subsequently, the Management Effectiveness Tracking Tool (METT3) was issued to researchers, community members, civil servants, and former civil servants related to the management of the CBR. The 2024 results (n = 15) were contrasted with those obtained in 2017 (n = 15) using a quantitative approach consisting of descriptive, non-parametric, and Bayesian statistical techniques. We identified some problems in the implementation of the MAB-UNESCO Programme in the CBR, mainly due to the outdated management program and lack of effective governance, as well as the lack of understanding of the implications of being a MAB-UNESCO biosphere reserve. A numerical trend of deterioration in the effectiveness of the CBR’s management was detected, with overall ratings of 44.78% and 29.62% in 2017 and 2024, respectively. This was associated with a lack of regulation, weak coordination among key actors, and a progressive reduction in funding. The findings of this study are useful to guide the transition of the CBR towards a conservation model that responds to current problems and contributes to the advancement of knowledge on the implementation of the MAB Programme in specific contexts.

Spatiotemporal analysis of tropical vegetation ecosystems and their responses to multifaceted droughts in Mainland Southeast Asia using satellite-based time series

ABSTRACT Drought ranks among the costliest of all climate-related phenomena and manifests in various forms, posing significant challenges in understanding its influence on agriculture and natural ecosystems. Mainland Southeast Asia (MSEA), a significant region of tropical agriculture and vegetation ecosystems, has become increasingly susceptible to drought hazards. In this study, we characterized and assessed vegetation dynamics and their drought impacts using correlation analysis and explainable machine learning methods under different vegetation types and elevation zones during the dry growing seasons from 2000 to 2022. Specifically, we characterized the vegetation dynamics and their trend in space and time. Next, we assessed vegetation-drought responses in consideration of meteorological, hydrological, and agricultural droughts under different land cover types and elevation characteristics. Lastly, we used an explainable machine learning method to quantify the drivers and impacts of multifaceted droughts on natural and undisturbed vegetation ecosystems. Our findings revealed that nearly 70% of the MSEA region experienced a greening trend despite large areas of vegetative damage during the drought years. Vietnam witnessed increasing vegetation condition in most observed years while the declining trend was mainly found in Cambodia and southern Laos. Vegetation-drought responses showed that tropical vegetation had a high sensitivity to drought conditions, and stronger responses were observed in rainfed crop, mixed forest, and deciduous forest at lower altitude areas. In natural and undisturbed ecosystems, short-term meteorological and agricultural drought disturbances accounted for nearly 93% of variations in tropical vegetation. Among the different examined drought indices, the 3-month Standardized Precipitation Evapotranspiration (SPEI-3) and Temperature Condition Index (TCI) were identified as the factors having the largest influence, together explaining about 55% of the observed natural undisturbed vegetation variations. These findings deepen our understanding of tropical vegetation-drought responses and the underlying drivers of natural and undisturbed ecosystems. Such insights could provide valuable information to assist national and local governments in the MSEA region in developing effective drought management and adaptation programs to safeguard tropical agricultural production and natural ecosystems amidst growing climate challenges.

Lifestyle Intervention Modulates the CD4+ T Cell Profile in the Blood of Crohn's Disease Patients.

Crohn's disease (CD) significantly affects patients' well-being and is influenced by stress and lifestyle factors, highlighting the importance of improving quality of life in CD management. An imbalance between pro- and anti-inflammatory CD4+ T cell responses is a key factor in CD, and stress has been shown to alter the function of CD4+ T cells. Therefore, this study aimed to evaluate the effect of a mind-body medicine stress management and lifestyle modification (MBM) program on the CD4+ T cell profile in CD patients. Circulating CD4+ T cells from CD patients were analyzed by flow cytometry following the MBM program. Patients were randomly assigned to either a guided intervention group (IG) or a self-guided waitlist control group (CG) over a 9-month trial and compared with healthy blood donors. Lifestyle intervention reduced regulatory T cell (Treg) frequencies in the blood of CD patients. Notably, we observed a significant correlation between the quality of life improvement and Treg frequencies in the IG but not in the CG. Furthermore, differential activation and expression of the gut-homing molecules G protein-coupled receptor 15 and CCR9 on circulating Tregs and CD4+ effector T cells were detected in both the IG and CG. The MBM program, whether guided or self-directed, has the potential to restore the CD4+ T cell profile of CD patients to levels comparable to healthy blood donors. Lifestyle interventions may benefit CD progression, symptoms, and immunological status, but further analysis is needed to substantiate these findings and to fully understand their clinical implications. (ClinicalTrials.gov: NCT05182645).

About managing the number of simultaneously functioning software robots of different types

Objectives. The study sets out to justify the relevance and investigate approaches for solving the problem of managing the number of simultaneously functioning software robots of various types under conditions of limited computational resources and changes in sets of executable tasks.Methods. A proposed solution is based on models and methods of scenario management, linear programming, inventory management, queuing theory, and machine learning. The described methods are valid for different compositions and preconditions for generating initial data, as well as ensuring the relevance horizons of the obtained solutions.Results. The initial data is obtained via the presented approach for determining the computational resource parameters for operating a single software robot. The resources are determined by analyzing the composition of the software and information services used by an actual software robot. Problem statements and mathematical models are developed for cases involving scenario management and linear programming methods. Methods for real-time management of the number of software robots and their sequential local optimization are proposed based on the abovementioned solution sequences. The developed method for generating statistical data based the results of applying the sequential local optimization method is used to identify deficient and non-deficient computational resources. Some results of working in the multi-functional center of RTU MIREA software robots developed on the Аtоm.RITA platform are outlined.Conclusions. The emerging problem of managing the number of simultaneously operating software robots of various types for cases involving scenario control methods and linear programming is formalized. This problem is relevant in the field of automation of business processes of organizations. The use of mathematical methods for solving this problem opens up opportunities for expanding the functional capabilities of robotic process automation platforms, as well as increasing their economic efficiency to create competitive advantages by optimizing the use of IT infrastructure components.

Impact of genotypic mixture on soybean (Glycine max) pest population

An experiment was conducted during rainy (kharif) seasons of 2018 and 2019 at the ICAR-Indian Institute of Soybean Research, Indore, and Madhya Pradesh to study the impact of genotypic mixture on soybean [Glycine max (L.) Merr.] pest population. A total of 16 soybean genotypes and 4 genotypic mixtures were evaluated for relative efficacy in management of insect-pests of soybean. Among the 20 treatments, the plots with genotypic mixtures had lowest population of Spodoptera exigua Hubner and at par with each other. In case of Spodoptera litura Fabricius, tussock moth, blue beetle and grey weevil management, a mixture of the genotypes JS-9560, JS-20-34, MAUS-47 and MACS-1460 was found most effective treatment. The plots with the genotypic mixtures of NRC-37, JS-9752, RSC-1046 and RKS-113 supported the least population of semiloopers. However, lowest population of leaf miner and girdle beetle was recorded in plots of JS-20-34 while the least population of stem fly was recorded in RSC-1046. The differences observed due to the genotypic combinations may be used for developing inset-pest management programmes in soybean.

Two-Way Perspectives and Attitudes about Environmentally Friendly Agro-Food Production and Consumption: An Empirical Survey for Greece

Relying on pesticides to safeguard crops has led to pest resistance and detrimental environmental and health consequences. Many integrated pest management programs focus on producers’ decision-making processes when selecting and implementing pest management interventions. Alternative approaches such as integrated pest management and biological control have been implemented to address these challenges, with Greece as the research area. A quantitative study was oriented to consumers and producers to investigate their views on the effectiveness of pesticides, aiming to assess whether these perspectives influence their attitudes toward adopting pest management practices. Primary data were gathered through structured questionnaires to consumers and producer associations (focusing on tomatoes, olives, and citrus fruits) and analyzed through multivariate methods. The findings unveiled varying preferences and concerns regarding plant protection tools, with considerations such as product effectiveness, method awareness, and sustainability. Specifically, the study revealed aspects like the popularity and demand for specific plant protection tools, the knowledge of these experts about products and pest control methods, and their stance on sustainable agriculture and environmental aspects of pest control.

A smart building energy management incorporating clustering-based tariffs in the presence of domestic solar energy, battery, and electric vehicle

Smart buildings play a crucial role in optimizing energy management within the power network. As end-users of the power network, they have the ability to not only reduce economic costs for householders but also modify the technical indices of the power network. To promote efficient device management in smart homes (SH), demand response programs are recommended for consumers. This research investigates the application of clustering-based electricity pricing strategy aimed at effectively managing the energy devices of a residential smart home. The utilized method categorizes the electricity tariff into five rates according to the clustering of the real-time pricing program. Ward’s clustering method is utilized to cluster and determine new electricity tariffs. The primary goal of the energy management program is to minimize the building’s energy cost, which is accomplished through the utilization of the multi-verse optimizer. The smart home consists of essential and manageable appliances, a photovoltaic panel (PV), a sodium-sulfur (NaS) battery, and an electric vehicle (EV). The initial parameters of the PV and EV are modeled stochastically by their probability distribution functions and calculated using the Latin hypercube sampling algorithm. The smart building’s performance is assessed by taking into account various demand response programs. The numerical results present that the application of the clustering-based management method has resulted in a significant reduction of 23–43 % in the electricity cost of smart homes. Additionally, the smart home exhibits a more linear consumption pattern when considering the electricity tariffs based on the clustering approach.

Night-time sleep of intensive care patients: A qualitative study.

The quality of the sleep in the intensive care unit (ICU) is generally poor. It is known that several factors contribute to this situation. To describe the experiences of adult patients during night-time sleep in the ICU. A qualitative study using a phenomenological approach was conducted from May to October 2021. Patients were intensive care patients (n = 10) who were treated for at least 24 h in tertiary ICUs. The data were obtained through semi-structured interviews based on an interview guide. A qualitative content analysis using an inductive approach was performed. The analysis resulted in three main themes: (a) inadequate sleep at night; (b) factors negatively affecting night-time sleep; and (c) patient expectations for improved night-time sleep. Night-time sleep of patients treated in intensive care were determined to generally have inadequate and be interrupted. Patients associated the cause of this situation with the physical environment conditions in the ICU, loud noises made by health employees and emotional reactions. It was stated that some physical environment changes that can be made in ICUs and psychological support will positively affect sleep. Intensive care patients may not have quality night-time sleep because of multifactorial reasons. Noise in the ICU is a significant factor preventing patients from sleeping. In addition to reorganization of the physical environment to ensure adequate sleep, there is a need for an integrated approach dealing with patients' feelings and concerns. Each patient has their own unique sleep pattern. To ensure effective management of sleep problems, health professionals should organize care and physical conditions in line with guidelines and create patient-specific night-time sleep management programmes.

Derivation and validation of the Ottawa weight loss prediction model for patients on a low-calorie diet

Accurate weight predictions are essential for weight management program patients. The freely available National Institutes of Health Body Weight Planner (NIH-BWP) returns expected weights over time but overestimates weight when patients consume a low-calorie diet. This study sought to increase the accuracy of NIH-BWP predicted weights for people on low-calorie diets. People enrolled in a weight management program were included if they received meal replacements with defined caloric content for the 3 months of the weight loss phase of the program. The Ottawa Weight Loss Prediction Model (OWL-PM) modelled the relative difference between observed and NIH-BWP predicted weights using longitudinal analysis methods based on patient factors. OWL-PM was externally validated. 1761 people were included (mean age 46 years, 73.3% women) with a mean (SD) baseline weight in pounds and body mass index of 271.9 (55.6) and 43.9 (7.4), respectively. At the end of the program’s weight loss phase, people lost a median (IQR) of 17.1% (14.8–19.5) of their baseline weight. Observed weight relative to NIH-BWP predicted weights had a median value of − 4.9% but ranged from − 32.1% to + 28.5%. After adjustment, weight overestimation by NIH-BWP was most pronounced in male patients, people without diabetes and with increased observation time. OWL-PM returned expected weights at 3 months that were significantly more accurate than those from NIH-BWP alone (mean difference observed vs. expected [95% CI] 6.7lbs [6.4–7.0] vs. 12.6lbs [12.1–13.0]). In the external validation cohort (n = 106), OWL-PM was significantly more accurate than NIH-BWP (mean squared error 24.3 vs. 40.0, p = 0.0018). OWL-PM incorporated patient-level covariates to significantly increase weight prediction accuracy of NIH-BWP in patients consuming a low-calorie diet.

Nutritional Aspects for Modulation of Poultry Immune Stimulation

The immune system's defense mechanism has been affected by the management and nutrition conditions in poultry production. In biological aspects, Bursa Fabricius and Thymus are primary lymphoid organs that defend the body against diseases. The spleen, cecal tonsils, immunoglobulins, and various forms of mucosal immunity, BALT (bronchus-associated lymphoid tissue), MALT (mucosa-associated lymphoid tissue), CALT (conjunctiva-associated lymphoid tissue), and GALT (gut-associated lymphoid tissue), are also vital to their overall health. The management program (environmental conditions, heating, lighting practices) and nutritional supplementation (feed ingredients, composition, and feed additives) significantly affect birds' immunity and performance. Dietary supplementation enhances immune system activation by improving the lymphoid tissues and beneficial immune modulators and responses. During the past fifteen years, alternative feed additives (amino acids, minerals, vitamins, probiotics, prebiotics) have impacted animal production performance and immunity. Besides, feed additives, such as probiotics, prebiotics, vitamins, minerals, and organic acids, are essential for sustaining hormonal, physiological, and immunological processes. These additives, probiotics, vitamins (A, C, D, E), mineral (selenium) supplementations, and organic acids boost the immune system's activity against microbial pathogens and physiological stress mechanisms. At the last point, this paper aims to review the current improvement in the relationship between nutrition and immunity in poultry.

Lived experiences and perspectives of women who had undergone perinatal loss in Nairobi county, Kenya: a qualitative study

BackgroundThis study explored the lived experiences and perspectives of women who had suffered a perinatal loss in Nairobi county, Kenya. Existing research works have established that perinatal loss often comes...

Behavioral and electrophysiological responses of the male medfly, Ceratitis capitata, to thymol and carvacrol ethers.

The Mediterranean fruit fly, Ceratitis capitata, is one of the most economically important insect pests attacking fruits and vegetables in tropical and subtropical areas of the world. Semiochemical-based pest management programs are being used to provide environmentally friendly control methods for medflies. The goals of the current study were to discover potential new, attractive, kairomones by designing, synthesizing, and testing simplified ethers of thymol and carvacrol along with their ether derivatives in short-range attraction assays and electroantennogram (EAG) assays with male C. capitata. To the best of our knowledge, this study represents the first investigation of thymol and carvacrol, and their respective ethers for attractancy to C. capitata, a major agricultural pest worldwide. In short-range attraction bioassays, parent compounds, thymol and carvacrol, along with their propyl, butyl, benzyl, and octyl ethers captured the most male C. capitata. The attraction patterns changed over time and captures were only significant if they were greater than the positive controltea tree oil (TTO) at 90 min. In EAG assays, thymol benzyl, octyl ethers, and carvacrol benzyl ether evoked significantly greater antennal responses than their parent compounds. The EAG responses did not correlate with short-range male attraction. The aliphatic side chains of thymol and carvacrol had a small effect on the activity. Future studies will investigate the long-range attraction of the ethers that elicited large EAG responses. This report provides new information for discovering potential kairomones through synthesis and structure-activity studies for sterile male medflies. Thymol, carvacrol, and several of their ether derivatives displayed improved longevity of attraction compared with TTO (a strong medfly attractant), with significantly higher captures than TTO observed at 90 min in laboratory bioassays. Further chemical synthesis of thymol and carvacrol ethers within this series may lead to the development of ethers that are more attractive or persistent than their parent compounds, thymol and carvacrol. © 2024 Society of Chemical Industry. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.

Simulated herbicide mixtures delay both specialist monogenic and generalist polygenic resistance evolution in weeds.

Evolution of herbicide-resistant weed populations is a major challenge to world food production. Using different herbicides in rotation and/or using different herbicides together as mixtures are strategies that may delay the selection of resistance. This study used simulation modelling to investigate whether mixtures and rotations can delay the selection of both generalist polygenic and specialist monogenic herbicide resistance, and whether these strategies are more likely to lead to the selection of generalist resistance in weed types with varying biological characteristics. Our simulations suggest that well-designed effective herbicide mixtures should delay evolution of both polygenic and monogenic resistance better than rotations and single herbicides across all weed types. Both mixture and rotation strategies increased the likelihood of polygenic resistance compared to single-herbicide use, and the likelihood of polygenic resistance increased as the fecundity and competitiveness of the weed increased. Whether monogenic or polygenic resistance occurred in each case depended most on the relative initial allele frequencies. We did not find that herbicide mixtures were more likely than rotations to lead to the selection of generalist polygenic resistance. The simulated efficacy of mixtures over rotations decreased if components were used at reduced rates or when individual components had already been used solo. Herbicide rotations and particularly well-designed mixtures should delay evolution of both polygenic and monogenic resistance, especially if used as part of an effective integrated weed management programme. However, herbicide mixtures and rotations may also increase the risk that resistance will be generalist polygenic rather than specialist monogenic. © 2024 The Author(s). Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Telehealth-Supported Exercise or Physical Activity Programs for Knee Osteoarthritis: Systematic Review and Meta-Analysis.

The integration of telehealth-supported programs in chronic disease management has become increasingly common. However, its effectiveness for individuals with knee osteoarthritis (KOA) remains unclear. This study aimed to assess the effectiveness of telehealth-supported exercise or physical activity programs for individuals with KOA. A comprehensive literature search encompassing Embase, MEDLINE, CENTRAL, Web of Science, PubMed, Scopus, PEDro, GreyNet, and medRxiv from inception to September 2023 was conducted to identify randomized controlled trials comparing telehealth-supported exercise or physical activity programs to a control condition for KOA. Data were extracted and qualitatively synthesized across eligible studies, and a meta-analysis was performed to evaluate the effects. The study was reported according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020. In total, 23 studies met eligibility criteria, with 20 included in the meta-analysis. Results showed that telehealth-supported exercise or physical activity programs reduced pain (g=-0.39; 95% CI -0.67 to -0.11; P<.001), improved physical activity (g=0.13; 95% CI 0.03-0.23; P=.01), and enhanced physical function (g=-0.51; 95% CI -0.98 to -0.05; P=.03). Moreover, significant improvements in quality of life (g=0.25; 95% CI 0.14-0.36; P<.001), self-efficacy for pain (g=0.72; 95% CI 0.53-0.91; P<.001), and global improvement (odds ratio 2.69, 95% CI 1.41-5.15; P<.001) were observed. However, self-efficacy for physical function (g=0.14; 95% CI -0.26 to 0.53; P=.50) showed insignificant improvements. Subgroup analyses based on the World Health Organization classification of digital health (pain: χ22=6.5; P=.04 and physical function: χ22=6.4; P=.04), the type of teletechnology in the intervention group (pain: χ24=4.8; P=.31 and function: χ24=13.0; P=.01), and active or inactive controls (pain: χ21=5.3; P=.02 and physical function: χ21=3.4; P=.07) showed significant subgroup differences. Telehealth-supported exercise or physical activity programs might reduce knee pain and improve physical activity, physical function, quality of life, self-efficacy, and global improvement in individuals with KOA. Future research should consider longer implementation durations and assess the feasibility of incorporating wearables and standardized components into large-scale interventions to evaluate the effects. PROSPERO CRD42022359658; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=359658.

Patient Blood Management Program Implementation: Comprehensive Recommendations and Practical Strategies.

Blood transfusion is one of the most common medical practices worldwide. However, current scientific literature has shown that the immunomodulatory effects of blood transfusion are associated with an increased likelihood of infection, prolonged hospitalization, and morbimortality. Also, it means high costs for healthcare systems. In this context, acknowledging that blood transfusions are essentially heterologous cell transplantations, the use of therapeutic options has gained strength and is collectively known as the patient blood management (PBM) program. PBM is an approach based on three main pillars: (1) treating anemias and coagulopathies in an optimized manner, especially in the preoperative period; (2) optimizing perioperative hemostasis and the use of blood recovery systems to avoid the loss of the patient's blood; (3) anemia tolerance, with improved oxygen delivery and reduced oxygen demand, particularly in the postoperative period. Current scientific evidence supports the effectiveness of PBM by reducing the need for blood transfusions, decreasing associated complications, and promoting more efficient and safer blood management. Thus, PBM not only improves clinical outcomes for patients but also contributes to the economic sustainability of healthcare systems. The aim of this review was to summarize PBM strategies in a comprehensive, evidence-based approach through a systematic and structured model for PBM implementation in tertiary hospitals. The recommendations proposed herein are from researchers and experts of a high-complexity university hospital in the network of the Sistema Único de Saúde, presenting itself as a strategy that can be followed as a guideline for PBM implementation in other settings.

A case management strategy to reduce falls in older people with a history of falls: A randomized controlled trial

The present study aimed to determine whether a remotely delivered intervention, based on an individual case management, can reduce falls and their consequences in community-dwelling older people with a history of multiple falls. In this randomized controlled trial, 32 participants were randomized to the intervention group, which comprised a 16-week case management program involving a multidimensional assessment, targeted interventions according to the identified fall risk factors, and development of individualized care plans. The intervention was performed by trained gerontologists, under weekly supervision of professionals with experience in falls. The control group (n = 30) received usual care. Falls were monitored over 12 months with monthly falls calendars and telephone calls. Remotely delivered case management presented an 82 % uptake of recommendations. There was a trend toward a reduced fall incidence in the intervention vs control group, with lower fall, fall injury and fracture rates in the intervention group compared with the control group at both the 16-week and 12-month time-points, with the difference statistically significant for injurious fall rates at 12 months - IRR=0.18 (95 % CI = 0.04 to 0.74).

Proportion and factors influencing healthcare-seeking behavior among older people in Motta town, East Gojjam: a community-based cross-sectional study, Ethiopia, 2023

BackgroundIn resource-limited countries, older people who are at risk and face numerous health problems, often receive insufficient attention regarding their healthcare-seeking behavior. Assessing the proportion of healthcare-seeking behavior and associated factors among older people in Motta town, was the aim of the study.MethodA community-based cross-sectional study was carried out from April 22 to May 22, 2023. The study subjects were chosen using a systematic random sampling technique. To identify candidate variables for multivariable analysis, a bivariable logistic regression analysis was performed. Variables having a P-value of < 0.05 were considered statistically significant.ResultsFrom the total, 161 (39.3%) of respondents had good healthcare-seeking behavior with 95% CI [35%, 44%]. Secondary school [AOR = 2.69, 95% CI = 1.27, 5.68], Education college and above [AOR = 4.6, 95% CI = 2.27, 9.33], Family support during their illness [AOR = 1.39, 95% CI = 1.05, 3.09], Members of CBHI [AOR = 2.02, 95% CI = 1.21, 3.36], and presence of chronic illness [AOR = 2.55, 95%, CI = 1.64, 3.97] were significantly associated with good healthcare-seeking behavior.Conclusion and recommendationThis study found that good healthcare-seeking behavior among older people is significantly associated with higher education, strong family support, Community-Based Health Insurance (CBHI) membership, and chronic illnesses. Improving health literacy through education, strengthening family support systems, expanding CBHI participation for better healthcare access, and developing targeted chronic disease management programs to enhance this behavior is recommended. These strategies can collectively improve healthcare utilization and outcomes for older people.