Proper Guidelines Research Articles

1260. A Retrospective Observational Study on Assessing the Use of Antibiotic Prophylaxis for Outpatients in the Dental and Ophthalmic Department in a Tertiary Care Hospital

Abstract Background Antibiotics are most commonly used in outpatient setting when compared to inpatient setting. Inappropriate antibiotics prescribing in dental and ophthalmic outpatient setting without following any proper guidelines has been identified as a potential driver for antimicrobial resistance especially in the developing world. As there is no sufficient data in India regarding efficient prophylactic use of antibiotics in dental and ophthalmic department, this study is aimed to address this by assessing the antibiotic prophylaxis among outpatients. Methods This retrospective observational study was conducted in the Dental and Ophthalmic outpatient’s department in a tertiary care hospital in South India for 3 months from April 2022 to June 2022. The data regarding the Antibiotic prophylaxis were collected from records of the patients’ prescription and analyzed using simple statistics. Results A total of 395 prescriptions are collected. Mean age was found to be 53.5 years. The key findings are summarized in Table 1 below. Conclusion 85% of patients were prescribed with antibiotics in Dental OP whereas 90% of patients were prescribed with antibiotics in Ophthalmic OP in which 56% of patients were found to have inappropriate duration of Antibiotic therapy. Understanding the current patterns of antibiotic prophylaxis in outpatient setting is necessary to implement antibiotic stewardship and large multicentric studies in the future will help to reduce unnecessary antibiotic use in the developing world. Disclosures All Authors: No reported disclosures

THE IMPLEMENTATION OF INTEGRATED MANAGEMENT SYSTEMS (IMS) IN CONSTRUCTION ORGANIZATIONS IN MALAYSIA

An Integrated Management System (IMS) combines different management systems into one complete system. This paper aims to determine the intention and effectiveness of the IMS being implemented in construction organizations in Malaysia. The problem statement in this study is the number of documents in IMS still needs to be more prominent since the adoption of the standard still needs to be improved. This study aims to give awareness to the company so that they understand their intention to implement the IMS and the effect that will get on the implementation process. This study also will provide a framework that will be a guideline for the company to start with the implementation process and be certified as an IMS company. This study used quantitative and qualitative study methods. The study takes place on the construction company in Klang Valley that implemented the IMS. The survey has been done for the quantitative study to check on the understanding of the company for the intention and effectiveness of the IMS implementation. Meanwhile, for the qualitative study, the semi-structured interview session was done with five subject matter experts (SMEs) in the IMS implantation. The interview validates the research process and the framework's effectiveness. As a result, the study helps the companies to clearly understand their intention to implement the IMS and the effectiveness of IMS in their companies. The framework design also will help the company to have proper guidelines starting from the implementation until the continuous improvement after certification by the certification body.

The AI generation gap: Are Gen Z students more interested in adopting generative AI such as ChatGPT in teaching and learning than their Gen X and millennial generation teachers?

This study aimed to explore the experiences, perceptions, knowledge, concerns, and intentions of Generation Z (Gen Z) students with Generation X (Gen X) and Generation Y (Gen Y) teachers regarding the use of generative AI (GenAI) in higher education. A sample of students and teachers were recruited to investigate the above using a survey consisting of both open and closed questions. The findings showed that Gen Z participants were generally optimistic about the potential benefits of GenAI, including enhanced productivity, efficiency, and personalized learning, and expressed intentions to use GenAI for various educational purposes. Gen X and Gen Y teachers acknowledged the potential benefits of GenAI but expressed heightened concerns about overreliance, ethical and pedagogical implications, emphasizing the need for proper guidelines and policies to ensure responsible use of the technology. The study highlighted the importance of combining technology with traditional teaching methods to provide a more effective learning experience. Implications of the findings include the need to develop evidence-based guidelines and policies for GenAI integration, foster critical thinking and digital literacy skills among students, and promote responsible use of GenAI technologies in higher education.

An Observational Study on Type 2 Diabetes Mellitus Related Risk Factors and Complications in In-patient Department at a Tertiary Care Centre in Telangana, India

Aims: To identify the risk factors and complications of type 2 diabetes mellitus (T2DM).
 Study Design: It is a single-centre, prospective, observational study.
 Place and Duration of Study: This study site includes in-patient departments of Gandhi Hospital, Secunderabad done for a period of six months between December’2022 to May’2023.
 Methodology: In-patient cases diagnosed with T1DM, T2DM and pre-diabetes were included in study. A data collection form was drafted that included patient demographics (age, sex, height, weight, history in family, risk factors, past medication history, past medical illnesses- HTN (hypertension), dyslipidemia. Lifestyle of patients if physically active/ sedentary and social history as smoker/ alcoholic noted. Fasting Blood Sugar (FBS) was recorded for T2DM along with BMI in kg/m2. Any micro or macro-vascular complications noted during study period. Medications prescribed were assessed for appropriateness in treating Diabetes Mellitus. Case sheets with complete information regarding patient details were only analyzed.
 Results: 70 cases were collected and analyzed for diabetes out of which 58 cases comprised of T2DM. The majority study population was males 63.79% and with age group 53-69 years (25 cases, 43.10%) being higher. As per WHO-Diabetes Criteria, Pre-Diabetes was highly prevalent of 58.57% at this study site. Higher cases of T2DM (82.85%) was noted which shows the importance of implementing lifestyle changes to prevent macro and micro vascular complications. Symptoms of T2DM were abdominal pain (15, 25.86%) followed by excessive thirst (20.68%), and tiredness (10%). Major risk factors for T2DM were hypertension (15, 25.86%), smoking habit (22.41%), alcohol and obesity (17.24% each) which may have lead to complications associated with T2DM as Nephropathy in 2 cases followed by retinopathy, ischemic stroke, and diabetic foot each 1 case. Metformin as monotherapy (82.75% cases) was preferred treatment for T2DM at this site followed by Glimepiride (12, 20.68%).
 Conclusion: Study observations conclude that various risk factors can lead to T2DM, hence it is essential to create awareness among the general population on this. Strategies for preventing DM should also be highlighted such as lifestyle changes and following proper dietary guidelines that would avert any life-threatening conditions.

Oral Complications Associated with the Piercing of Oral and Perioral Tissues and the Corresponding Degree of Awareness among Public and Professionals: A Systematic Review.

This study systematically reviews the literature to evaluate the potential relationships between oral/perioral piercing and consequent oral complications in the corresponding society. The second objective was determining public/professional sectors' awareness of the subject. This research followed PRISMA and Cochrane guidelines for conducting systematic reviews and searching scientific databases, including PubMed, Scopus, Cochrane, and Google Scholar, until April 2023. Cross-sectional, cohort, and case-control studies in English were deemed eligible. The methodological quality of the included studies was assessed using proper quality assessment guidelines. Of the 965 initial articles retrieved, 34 were considered suitable for qualitative synthesis after screening procedures and removing duplicates and irrelevant records. There appears to be an imbalance between the general public's low and dentists' high awareness. This draws attention to the shortage of professional and societal knowledge-sharing and education initiatives. Women were more than twice as likely as men to have oral piercings. Piercing usage had a low incidence among a cohort of students with a mean age of 16. Merely circumstantial evidence has indicated a plausible correlation between oral and perioral piercings and the emergence of secondary bacterial and fungal colonization, particularly periodontopathogenic bacteria and Candida albicans. Furthermore, several adverse consequences have been observed linked to various piercings-such as lip and tongue piercings. These include caries, gingivitis/periodontitis, dental fractures, enamel chipping/cracks, plaque buildup, bone loss, bleeding, inflammation, and swelling. Given the risks involved and the complications that might impair oral health, the prevalence of oral piercings is alarming. As a result, public health authorities need to firmly support initiatives to raise awareness of the risks associated with oral/perioral piercings. For piercers to enhance their expertise in this field, professional training is necessary because there is a shortage of knowledge on the possible adverse effects of piercings.

Appraising the performance of ChatGPT in psychiatry using 100 clinical case vignettes.

ChatGPT has emerged as the most advanced and rapidly developing large language chatbot system. With its immense potential ranging from answering a simple query to cracking highly competitive medical exams, ChatGPT continues to impress the scientists and researchers worldwide giving room for more discussions regarding its utility in various fields. One such field of attention is Psychiatry. With suboptimal diagnosis and treatment, assuring mental health and well-being is a challenge in many countries, particularly developing nations. To this regard, we conducted an evaluation to assess the performance of ChatGPT 3.5 in Psychiatry using clinical cases to provide evidence-based information regarding the implication of ChatGPT 3.5 in enhancing mental health and well-being. ChatGPT 3.5 was used in this experimental study to initiate the conversations and collect responses to clinical vignettes in Psychiatry. Using 100 clinical case vignettes, the replies were assessed by expert faculties from the Department of Psychiatry. There were 100 different psychiatric illnesses represented in the cases. We recorded and assessed the initial ChatGPT 3.5 responses. The evaluation was conducted using the objective of questions that were put forth at the conclusion of the case, and the aim of the questions was divided into 10 categories. The grading was completed by taking the mean value of the scores provided by the evaluators. Graphs and tables were used to represent the grades. The evaluation report suggests that ChatGPT 3.5 fared extremely well in Psychiatry by receiving "Grade A" ratings in 61 out of 100 cases, "Grade B" ratings in 31, and "Grade C" ratings in 8. Majority of the queries were concerned with the management strategies, which were followed by diagnosis, differential diagnosis, assessment, investigation, counselling, clinical reasoning, ethical reasoning, prognosis, and request acceptance. ChatGPT 3.5 performed extremely well, especially in generating management strategies followed by diagnoses for different psychiatric conditions. There were no responses which were graded "D" indicating that there were no errors in the diagnosis or response for clinical care. Only a few discrepancies and additional details were missed in a few responses that received a "Grade C" CONCLUSION: It is evident from our study that ChatGPT 3.5 has appreciable knowledge and interpretation skills in Psychiatry. Thus, ChatGPT 3.5 undoubtedly has the potential to transform the field of Medicine and we emphasize its utility in Psychiatry through the finding of our study. However, for any AI model to be successful, assuring the reliability, validation of information, proper guidelines and implementation framework are necessary.

Inclusion of Subjects who are Obese in Drug Development: Current Status and Opportunities.

The prevalence of obesity has grown tremendously in recent years and this population has an increased risk of disease comorbidities. The presence of disease comorbidities requires treatment interventions and proper dosing guidelines. However, drug development programs often do not have adequate representation of individuals who are obese in clinical trials, leaving gaps in the understanding of treatment response leading to a lack of adequate individualization options. Based on a recent survey of approved drug product package inserts, very few approved products included specific dosing based on obesity, in both adults and pediatrics. Reasons for the limited information on patients who are obese may include the under-reporting of information regarding such patients and a lack of clinical trial diversity in enrolling patient groups in whom obesity or obesity-related comorbidities are more prevalent. An inadvertent impact of the practice of exclusion of subsets of patients with some comorbidities in clinical trials may play a role in the reduced enrollment of individuals who are obese. Recently, regulatory authorities have taken specific initiatives to promote clinical trial diversity, including engaging with stakeholders and publishing regulatory guidance. These guidance documents highlight the need to enroll diverse clinical trial populations and provide recommendations on concepts related to drug development for obese populations. Such efforts will help to address the gap in information regarding drug response and dosing in patients who are obese.

Functional Outcomes in Surgically Treated Clavicle Fractures: A Longitudinal Observational Study.

Introduction The clavicle is the most unique long bone and has a significant incidence in terms of fractures. Operative fixation for clavicle fractures has seen a steep rise in terms of technique as well as type of implant. Although extensive studies have been carried out in relation to clavicle fractures and their treatment modalities, no proper guidelines or approach has been identified as ideal, and hence, this study was carried out to evaluate operative fixation as a viable strategy. Objective The objective of this article was to assess functional outcomes of plate fixation in clavicle fractures. Materials and methods This longitudinal prospective observational study included 30 patients treated for clavicle fractures with plate fixation in the Orthopedics Department of Himalayan Institute Hospital Trust (HIHT), Jollygrant, Dehradun, over a period of one year. Functional outcomes were assessed as Constant-Murley shoulder scores, and complications were recorded. Radiological assessment was done on thebasis of time to union through follow-up skiagrams. Statistical analysis was performed using the SPSS statistical package version 17.0 (IBM Inc., Armonk, New York).Continuous variables are presented as mean±SD, and categorical variables are presented as absolute numbers and percentages.Continuous variablesand constant score values over time within the groups were analyzed using repeated measures analysis of variance (ANOVA) followed by Bonferroni's post hoc testing. A p-value of <0.05 was considered statistically significant. Results The mean age of patients undergoing surgical fixation of clavicle fractures was 36 ± 12.53 years, ranging from 18-65 years. Of the entire study group, 83.3% were males and 16.7% were females. Road traffic accident (RTA) was the most common cause of clavicle fracture, constituting 76.7% of the entire study population, followed by fall on the floor (20.0%), and one patient sustained trauma by being hit by a bull (3.3%). Our study demonstrated a mean Constant score of 73.87 ± 2.64, 82.80 ± 2.20, and92.40 ± 2.37 at one-month, two-month, and four-monthfollow-up times, respectively, which was found to be statistically significant in terms of progression (p value<0.001). The mean union time of clavicle fractures in our study population was 12.1 weeks. Two patients in our study developed implant impingement. Conclusion Our study revealed that patients with clavicle fractures treated with plate fixation had statistically significant good functional outcome (Constant) scores at sequential follow-ups, consistent with available literature. Mean union time was also comparable to existing literature. Non-union was not noted in our study, and only two cases developed implant impingement. Hence, we conclude that early primary plate fixation for displaced clavicle fractures is a promising technique with good overall functional outcomes and patient satisfaction, especially in young, active patients.

Investigating the Impact of Teaching and Learning of Religious Institution [pondok] on the Society in Kelantan, Malaysia

The religious learning institution [pondok] is a common form of traditional Islamic educational institution in the archipelagic areas of Malaysia, Indonesia, and southern Thailand. It has been widely known and established, especially in Kelantan, Malaysia, for many years. It is regarded as a significant learning institution since it focuses on lifelong learning concepts. However, there are some crises faced by learners who study at a pondok. These need to be addressed as the learning institution receives negative perceptions from society in general. This study aimed to analyse the perception of the role of religious learning institutions and how this contributes to spreading knowledge so that society can get a better understanding of the concept of learning in a pondok. This study uses both quantitative and qualitative methods; questionnaires were distributed and focus group discussions were conducted among selected research participants. There were 121 research participants for the quantitative studies and five groups for the qualitative study. This study used a purposive sampling method and the participants were selected according to whether they were willing to support the development of the pondok and whether they had experience living near a religious institution. The study revealed that the pondok requires a lot of improvements, especially in spreading religious knowledge and having a good relationship with society. It is also suggested that a proper guideline be provided for every religious learning institution in Kelantan so that it becomes more systematic. It was revealed that the potential of the pondok is to ensure that society gains benefits from these religious institutions. The significance of the current study lies in its analysis of the quality of teaching and learning in religious institutions so that they meet international educational qualification standards.

Reflection On Service-Learning Among Universiti Teknologi Malaysia Students

The purpose of service learning is to connect theory and practice in a way that gives students a prospect to both take part in a service activity that meets community needs, as well as reflect on the experience in class to enhance their civic engagement and deepen their understanding of course content. A successful service-learning program requires reflective practice. The School of Education at Universiti Teknologi Malaysia (UTM), Malaysia has been conducting service-learning for many years. Although there is no proper guideline for the students to reflect on their service-learning experiences, students are still expected to do so. The objective in this study are describing service-learning experience. This research study applies case study research method among students’ reflective experiences in service-learning at School of Education in UTM. Data collection was done using qualitative research methodology involving semi structured interviews with UTM postgraduates. Triangulation method used to validate the data and continued with thematic analysis to identify the themes. The findings for every research question have been plotted in diagram. Based on the themes from the findings, a template was proposed for improving service-learning reflection for the students from UTM.

Dimension of Governance on Microfinance Institutions in South Asian Countries (A Cross Country Study of Nepal and Bangladesh)

This research aims to empower Nepalese and Bangladeshi microfinance institutions (MFIs) to strengthen their microfinance governance. By contrasting the governance structures of MFIs in Bangladesh and Nepal, the study focuses on the corporate governance aspect of MFIs for sustainability. This study adopted an interpretive methodology and a qualitative research design. Internal control, timely internal audit, proper rules and regulations, institutional culture, full compliance with rules and regulations, budget and annual plan review, financial transparency, and board literacy education are the main dimension of corporate governance, broadly influencing MFIs for sustainability. The study found sustainability of MFIs is affected by proper guidelines for operation, effective internal control mechanisms, professional management, board literacy education, financial transparency, the rule of law in operation, institutional culture, and review of budget and achievement. The findings of the study might be applicable to the BFIs, MFIs, regulatory authorities, economist, HR analyst, and planners.

Home Management Practices among Caregivers on Malaria Treatment in Primary Healthcare Centre Amansea, Anambra State, Nigeria

Malaria is a major cause of fever in children. When a child has fever, parents or caregivers commonly treat them as if they were affected by malaria, with available medicines at home, with or without proper information or guideline. This study was carried out to explore the effectiveness of the various home management practices on malaria treatment among caregivers in Primary Health Care Center Amansea, Awka North L.G.A, Anambra State between May and August 2021. Mothers and caregivers (N=200) visiting the facility and their children (N=200) were involved. Blood specimens were collected through venipuncture and analyzed by microscopy while data on management practices were collected using pretested, structured questionnaires. Data were analyzed with SPSS version 25.0. Mothers and caregivers had good knowledge of the correct cause (70.0%), symptoms (63.0%) and preventive measures (53.5%) of malaria. Sources of medical treatment ranged from doctors (43.0%) to herbalist (13.5%) and 80% of them seek medical treatment within 24 hours of onset of fever. Caregivers preference of home treatment of malaria to hospital is greatly influenced by a lot of reasons with high cost of hospital bills (53.5%) being the highest reason among many. Prevalence of malaria among the mothers and caregivers was 36(18.0%) which was dependent on their age (X2=44.629, df=3, P=0.000) and educational status but not with occupation. However, malaria prevalence among the children was 50(25%) even though it was not significant in relation to age and sex of the children (P&gt;0.05). The effectiveness of home management of malaria depends on the early diagnosis, prompt and appropriate use of health facilities for treatment of malaria symptom especially fever. Therefore, health programmes and special campaigns to enlighten mothers and caregivers on more of the dangers of delayed treatment for their children could help to improve their treatment seeking pattern.

Voluntary blood donation camp- A challenge during COVID-19 pandemic

Voluntary blood donors are the mainstay of any blood donation camp, whether in a hospital or in a blood bank. Selection of such donors becomes an important element in any blood donation program. However, the spread of COVID-19 worldwide had a crippling impact on blood donations/ blood safety and had posed a huge challenge. Hence, an insight into conduction of a blood donation camp during the pandemic and analysis of reasons for donor deferral becomes highly important.This is an observational study about a voluntary blood donation camp held for general public during the second wave of COVID-19 in a school at Kottur, Karnataka. Donor details were taken with the help of questionnaires. Procedures and safety protocols put in place during donation was noted and reasons for deferral obtained from donor questionnaires and by examination of donors was analyzed.The blood donation camp was conducted with proper COVID-19 guidelines. A total of 105 individuals came for donation of which 37 were deferred. 6 deferrals were due to COVID-related cause, 31 deferrals were non-COVID related and overall the most common cause of deferral was hypertension. With the help of proper safety measures, blood donation camps can be successfully conducted during pandemic like COVID-19. And the crisis for blood and its products can be met by adopting appropriate guidelines.

Neurotrophic keratitis: inflammatory pathogenesis and novel therapies.

Neurotrophic keratitis is a rare degenerative disease characterized by decrease or absence of corneal sensation. Neurotrophic keratitis varies from mild forms with mild epitheliopathy to severe manifestations such as corneal ulceration, melting and perforation that can lead to irreversible visual loss. The cause of neurotrophic keratitis comprises a long list of diseases, medications, congenital or genetic conditions as well as trauma. The mechanism of neurotrophic keratitis is complex and multifactorial and its understanding is crucial to better address the treatment strategies. We aimed to review neurotrophic keratitis pathology, mechanisms and management. Corneal nerves are critical for the homeostasis of a healthy ocular surface. The lack of nerve-derived neuromediators and corneal-released neuropeptides, neuro-trophins and neurotrophic factors in neurotrophic keratitis leads to a decrease in trophic supply to corneal cells in addition to a decrease in afferent signaling to the brain. This results in pathological tear secretion, decreased blinking rate, corneal healing along with ocular surface and corneal inflammation. Lately, nerve growth factor in special gained emphasis as a treatment strategy targeting the disease mechanism rather than its manifestations. Other therapies, including surgical interventions, are in the pipeline of neurotrophic keratitis management. However, there are still no proper therapeutic guidelines and neurotrophic keratitis treatment remains challenging. Neurotrophic keratitis may have a devastating outcome and treatment is still challenging. Understanding the disease pathology may assist in the development of new treatment strategies. Prompt disease recognition and immediate intervention are key factors to promote corneal healing and avoid further deterioration.

Are There Any Developments in the Attitudes and Practices of Oncologists Regarding Fertility Preservation in Saudi Arabia After 12 Years?

The current practice of offering fertility preservation (FP) counseling and treatment has become one of the focal points in patient care throughout cancer treatment. The turning point was the approval of the Council of Senior Religious Scholars four years ago to freeze tissues from the ovarian membrane, the entire ovary, and the eggs for later use in reproduction to preserve the offspring. Thus, we aimed to assess any development in oncologists' knowledge, attitude, and referral practices regarding FP in Saudi Arabia. This is a cross-sectional survey using a self-administered questionnaire. We assessed oncologists' opinions on the importance of FP, their perception of the patient's preferences, and factors to consider when discussing the subject. Then, we assessed the knowledge and referral practices, including the timing of referral before starting cancer treatment. Most oncologists showed good knowledge and positive attitudes toward FP; however, their referral practices could be better. Most were familiar with FP options. The most significant factors influencing the oncologist-patient FP discussion were the number of existing children, marital status, cost, and type of cancer (96.6%, 76.7%, 65.7%, and 58.9%, respectively). There is a significant improvement in the knowledge and attitude of oncologists toward FP. However, patients' counseling and referral to fertility services still need to be improved. There is a shortfall in the clinical practice guidelines for FP in cancer patients in Saudi Arabia. The implementation of clinical practice guidelines would enhance FP. However, patients' counseling and referral to fertility services still need to be improved. The lack of proper guidelines on FP is affecting oncologists' practice.

Entrepreneurial Practices and Employment Development in India: An Empirical Analysis of Post-COVID

Entrepreneurship in India is a catalyst for a nation’s growth and development. Other countries, like Japan, Russia, the USA, have remarkable growth in entrepreneurial practices, which also leads to their country’s growth and prosperity. Their economies are much more robust and self-dependent. It contributes considerably to production, and this sector creates nearly one-third of total export. The study explores the impact of entrepreneurial registrations on the country’s economic development, especially employment. Unemployment in the country is a major problem that needs to be tackled. A country’s growth and development have a robust positive relationship with the number of its population’s employment. A country with colossal work has excellent development chances as the economy’s demand and supply side is balanced. The study aims to find the statistical relationship between entrepreneurial rolls and employment generation. It has used the existing literature as a secondary source to fulfil this purpose. Some statistical tools are employed to check the trend and relationship between the variable and concludes that entrepreneurship has a vast potential to solve various economic problems. Still, it needs proper guidelines, assistance and support (financial, technical and legal) to boost economic condition.

Perancangan Buku Pedoman Pelaksanaan Didikan Subuh Di Desa Tanjung Pucuk Jambi Kabupaten Tebo

This research is motivated by several problems that the authors found in the activities of implementing dawn education in Tanjung Pucuk Village, Jambi, Tebo Regency, to be precise in the Al-Muhajirin Mosque. The dawn education activities have not been carried out perfectly, due to the absence of proper guidelines for carrying out the dawn education activities, the dawn education teachers are often confused in carrying out the dawn education activities. In each dawn education activity there is only the activity of reading short surahs after the dawn prayer alternately, so that the dawn education activities are not interesting for the dawn students. The purpose of this study was to produce a manual for the implementation of dawn education that can be used in general in Tanjung Pucuk Jambi Village, Tebo Regency, specifically in the Al-Muhajirin Mosque, which is valid, practical, and effective for application in dawn education activities. The type of research used is Research and Development or abbreviated as R&amp;D. The R&amp;D model used is the Four D (4-D) version from Thiagarajan (Define, Design, Develov, Disseminate). From the results of the research that has been done, it can be concluded that the produced Subuh Education Manual can be used and is suitable for use as a guide for teachers and students who carry out their special Subuh education activities in Jambi. The results of the validation trial by experts on the subuh education guidebook are categorized as valid with an average value of 0.81. The practicality test of the subuh education manual showed that the manual had a very high level of practicality with a value of 0.95. And the results of the manual effectiveness test have a moderate level of effectiveness with a value of 0.4.

Epidemiology of Migraines in Iraqi Females: Emphasis on Dietary Influence.

Introduction Migraine is a neurological condition that frequently results in a severe headache. The headache comes in episodes and is occasionally accompanied by nausea, vomiting, and sensitivity to light. Migraines can be caused by a variety of conditions and can last anywhere from three to four hours to several days, with females experiencing them three times more frequently than men. Studies have found some evidence that lifestyle variables, such as nutrition, may play an important role in the emergence of migraines. The purpose of this research is to determine the epidemiology of migraine among females with an emphasis on the relationship between headaches and the dietary habits of females who are enduring migraine attacks in Iraq. Methods This study is descriptive research employing a quantitative method, specifically a survey. The data collection process involved a three-section online survey disseminated to females through internet platforms, including WhatsApp, Viber, Facebook, and Instagram. In this research, 360 females from Sulaymaniyah, Iraq, aged 18 to 35, participated. The survey's primary questions centered on the characteristics of the female respondents, drawing from the International Headache Society (IHS) criteria for migraine diagnosis. Participants meeting the migraine diagnostic criteria were also asked a few questions about aura symptoms. The Migraine Disability Assessment (MIDAS) questionnaire was incorporated, accompanied by inquiries about headache treatment, headache-related signs and symptoms, headache triggers, factors that relieve headaches, sleep routines, dietary consumption, and the impact of each factor on migraines. Results Of the 360 females who participated in the study, 159 (44.2%) experienced migraines, while 201 (55.8%) did not. The dietary habits of females who experienced migraines showed a statistically significant relationship to the duration of their headaches, specifically those lasting from 4 to 72 hours. This relationship was particularly evident in relation to nuts (p-value= 0.000), hot/spicy foods (p-value= 0.000), tomatoes (p-value= 0.005), bananas (p-value=0.01), aspartame (p-value=0.012), beverages containing caffeine (p-value=0.000), and citrusy fruits (p-value=0.008). These findings are based on p-values less than the commonly accepted alpha of 0.05. To maintain good health, it's essential to adhere to healthy eating habits and proper nutritional guidelines. Further research is necessary to identify additional dietary triggers for migraines. Enhancing data collection methods, such as using face-to-face interviews, could improve the quality of future research. Conclusion This study determined the prevalence of migraines among a sample of females in Sulaymaniyah, Iraq, and identified various foods consumed in excess by females without considering their potential impact on migraines.

Hallucinogenic potential: a review of psychoplastogens for the treatment of opioid use disorder.

The United States is entering its fourth decade of the opioid epidemic with no clear end in sight. At the center of the epidemic is an increase in opioid use disorder (OUD), a complex condition encompassing physical addiction, psychological comorbidities, and socioeconomic and legal travails associated with the misuse and abuse of opioids. Existing behavioral and medication-assisted therapies show limited efficacy as they are hampered by lack of access, strict regimens, and failure to fully address the non-pharmacological aspects of the disease. A growing body of research has indicated the potential of hallucinogens to efficaciously and expeditiously treat addictions, including OUD, by a novel combination of pharmacology, neuroplasticity, and psychological mechanisms. Nonetheless, research into these compounds has been hindered due to legal, social, and safety concerns. This review will examine the preclinical and clinical evidence that psychoplastogens, such as ibogaine, ketamine, and classic psychedelics, may offer a unique, holistic alternative for the treatment of OUD while acknowledging that further research is needed to establish long-term efficacy along with proper safety and ethical guidelines.

Online Safety for Children and Youth under the 4Cs Framework-A Focus on Digital Policies in Australia, Canada, and the UK.

This study analyzes the previous literature on the online safety of children and youth under "the 4Cs risk framework" concerning contact, content, conduct, and contract risks. It then conducts a comparative study of Australia, Canada, and the UK, comparing their institutions, governance, and government-led programs. Relevant research in Childhood Education Studies is insufficient both in quantity and quality. To minimize the four major online risks for children and youth in cyberspace, it is necessary to maintain a regulatory approach to the online exposure of children under the age of 13. Moreover, the global society should respond together to these online risks with "multi-level" policymaking under a "multi-stakeholder approach". At the international level, multilateral discussion within the OECD and under UN subsidiaries should continue to lead international cooperation. At the domestic level, a special agency in charge of online safety for children and youth should be established in each country, encompassing all relevant stakeholders, including educators and digital firms. At the school and family levels, both parents and teachers need to work together in facilitating digital literacy education, providing proper guidelines for the online activities of children and youth, and helping them to become more satisfied and productive users in the digital era.