Recent Intervention Research Articles

Cristiano of Arabia: Did Ronaldo increase Saudi Pro League attendances?

AbstractIn December 2022, Cristiano Ronaldo, five‐time Ballon d’Or winner and the most‐followed person on Instagram, signed for Al‐Nassr in the Kingdom of Saudi Arabia. This marked one of several expensive, recent interventions by the kingdom in global sports markets. We exploit the timing of this event to estimate superstar effects. Ronaldo alone increased stadium attendance demand, even before the influx of further stars in the summer of 2023. On average, Ronaldo filled an additional 20% of the seats in his home team's stadium when he played, 15% in the stadiums he visited, and 3% where he did not even play.

African Accounts of Religious Conversations and Interventions in Mental Healthcare

The importance of healthcare has attracted conversations from healthcare professionals, as well as other groups like the United Nations, academic institutions, governments, the private sector, and religious organisations, all contributing to healthcare conversations because healthcare is foundational to human survival. However, there are questions on the quality and gaps of conversations and interventions regarding mental health among religious groups. This is because the quality of healthcare delivery may be rooted in the quality of conversations and interventions. This study explores the quality of mental healthcare (MHC) conversations and interventions in Traditional Religions, Christianity, and Islam in Africa. It interrogates past and recent conversations and interventions within the frameworks of spiritual care (SC) as a form of compassion science, interreligious collaborations, spiritual healings, and allopathic collaborations. Lastly, it places a searchlight on the loopholes of spiritual care in MHC and recommends closure where possible in the pursuit of improved healthcare and well-being in Africa.

Voting behaviour in AMNOG benefit assessments

The study examines the voting behaviour in the G-BA in AMNOG benefit assessments since 2011, showing on the one hand that most decisions (93%) are passed unanimously. On the other hand, it is particularly striking that the National Association of Statutory Health Insurance Funds (GKV-SV) voted in favour of a lower classification of added benefit in 100% of the dissenting resolutions compared to the other benches. The result empirically illustrates a procedural conflict of interest at the GKV-SV and underpins the structural criticism regarding the governance deficits of the G-BA. Even in the unanimously adopted procedures, these deficits can lead to a systematic negative distortion of the benefit assessment. This cannot be verified due to a lack of documentation at the G-BA. Overall, the unity of the GKV-SV as regulator, referee and player in the AMNOG procedure should be scrutinised more closely. This also applies in particular to the evaluation of the more recent statutory interventions (guard rails and combination discounts), which are highly susceptible to conflicts of interest.

On the Limits of Islamic Cinema: The Politics of Halal Cinema Discourse in Kerala, India

Some of the most crucial debates surrounding Islamic legitimacy and cinema rotate around the question of the permissible ( ḥalāl) and prohibited ( ḥarām) in Islamic law and how these function for Muslim theology and politics. Emerging from these debates, halal cinema has been one of the recent critical interventions in the field of Indian and Islamic cinema. Rather than making cinema Islamic from an ideological position, the new halal experiments with the visual language of cinema without compromising the popular dimensions of its viewership. This article looks at the politics of halal cinema within the context of the state of Kerala in South India and argues that the space of halal cinema shows the aspirations and negotiations of the Muslim community in Kerala. Halal cinema thus becomes an immanent critique of Islamic cinema by destabilizing the dominant practice that connects the relationship between Islam and cinema.

Harnessing the potential of microbial keratinases for bioconversion of keratin waste.

The increasing global consumption of poultry meat has led to the generation of a vast quantity of feather keratin waste daily, posing significant environmental challenges due to improper disposal methods. A growing focus is on utilizing keratinous polymeric waste, amounting to millions of tons annually. Keratins are biochemically rigid, fibrous, recalcitrant, physiologically insoluble, and resistant to most common proteolytic enzymes. Microbial biodegradation of feather keratin provides a viable solution for augmenting feather waste's nutritional value while mitigating environmental contamination. This approach offers an alternative to traditional physical and chemical treatments. This review focuses on the recent findings and work trends in the field of keratin degradation by microorganisms (bacteria, actinomycetes, and fungi) via keratinolytic and proteolytic enzymes, as well as the limitations and challenges encountered due to the low thermal stability of keratinase, and degradation in the complex environmental conditions. Therefore, recent biotechnological interventions such as designing novel keratinase with high keratinolytic activity, thermostability, and binding affinity have been elaborated here. Enhancing protein structural rigidity through critical engineering approaches, such as rational design, has shown promise in improving the thermal stability of proteins. Concurrently, metagenomic annotation offers insights into the genetic foundations of keratin breakdown, primarily predicting metabolic potential and identifying probable keratinases. This may extend the understanding of microbial keratinolytic mechanisms in a complex community, recognizing the significance of synergistic interactions, which could be further utilized in optimizing industrial keratin degradation processes.

Arboreal Assemblages and Ecologies of Feeling: The Bodhi Tree in the Buddhist Reform Movement in Colonial South Asia

This article centres on the Bodhi tree, aśvattha/pippala or Ficus religiosa, in Bodh Gaya, India. It analyses the tree as an assemblage by combining concepts from the ancient Buddhist Pali literature with recent interventions in new materialism and posthumanism. The text foregrounds the role of emotions in the relational cosmologies of both early South Asian Buddhist texts and contemporary general ecology, tracing how they connect the tree-as-assemblage with other human and nonhuman actors. This allows the article to recover an emergent agency in the assemblage, informing a re-examination of the tree’s role in the Buddhist reform movement in colonial India, specifically in its connections to the Anagarika Dharmapala and the Maha Bodhi Society. Besides its contribution to the history of Buddhism in colonial modernity, the article thus develops theoretical reflections on writing history beyond anthropocentrism by mobilising the potential of South Asian vernacular philosophies to speak to contemporary issues in philosophy and the Anthropocene at large.

Mapping Knowledge Landscapes and Emerging Trends of Sarcopenic Obesity in Older Adults: A Bibliometric Analysis From 2004 to 2023.

Background The prevalence of obesity in combination with sarcopenia, the age-related loss of muscle mass and strength or physical function, is on the rise among adults aged 65 years and older. A significant portion of this demographic now falls under the classification of sarcopenic obesity, a high-risk geriatric syndrome predominantly seen in an aging population vulnerable to compounded complications from both sarcopenia and obesity. It is essential to promptly evaluate the impact of academic research in this field, taking into account factors such as geographical regions, authors, journals, and institutions. Furthermore, exploring current topics and identifying potential areas that could inspire future researchers to conduct additional studies is crucial for advancing overall health in this population. Methodology A search was conducted in the Web of Science Core Collection database to identify English language articles and reviews focusing on sarcopenic obesity in older adults, published between January 1, 2004, and December 31, 2023. Bibliometric analysis was performed using VOSviewer (v.1.6.18) and CiteSpace (v.6.1.R2). Results A total of 985 original English-language articles were collected, consisting of 783 articles and 202 reviews. The volume of research publications in this field has shown significant growth since 2012. The United States leads in contributions, with 239 articles (24.3% of the total) and the highest number of citations at 18,403, along with the highest total link strength. The University of Melbourne in Australia stands out with 25 published articles (2.5% of the total). University of Verona in Italy has the most citations at 9,405, and Monash University in Australia has the highest total link strength at 53. Among prolific authors, John A. Batsis from Duke University is the most productive with 24 articles (2.4% of the total). The journal "Nutrients" has the most articles on sarcopenic obesity in older adults, publishing 54 articles (5.5% of the total). Key topics in this area include sarcopenia, obesity, sarcopenic obesity, and elderly. Recent interventions focus on "nutrition" and "exercise" for sarcopenic obesity in older adults. Conclusions Research on sarcopenic obesity in older adults has seen significant growth on a global scale from 2004 to 2023, indicating a promising area for further study with potential benefits from current advancements. Although academic inquiries have shed light on various aspects of sarcopenic obesityin older adults, there remains a noticeable dearth of clinical research and evidence-based medicine on the effective management of this condition in elderly individuals. Future studies could focus on developing tailored interventions for older adults with sarcopenic obesity.

Mechanoimmunology in the solid tumor microenvironment.

The tumor microenvironment (TME) is a complex and dynamic ecosystem that adjoins the cancer cells within solid tumors and comprises distinct components such as extracellular matrix, stromal and immune cells, blood vessels, and an abundance of signaling molecules. In recent years, the mechanical properties of the TME have emerged as critical determinants of tumor progression and therapeutic response. Aberrant mechanical cues, including altered tissue architecture and stiffness, contribute to tumor progression, metastasis, and resistance to treatment. Moreover, burgeoning immunotherapies hold great promise for harnessing the immune system to target and eliminate solid malignancies; however, their success is hindered by the hostile mechanical landscape of the TME, which can impede immune cell infiltration, function, and persistence. Consequently, understanding TME mechanoimmunology - the interplay between mechanical forces and immune cell behavior - is essential for developing effective solid cancer therapies. Here, we review the role of TME mechanics in tumor immunology, focusing on recent therapeutic interventions aimed at modulating the mechanical properties of the TME to potentiate T cell immunotherapies, and innovative assays tailored to evaluate their clinical efficacy.

Spatiotemporal Assessment of Water Pollution for Beira Lake, Sri Lanka

Beira Lake, located in Colombo, Sri Lanka, has suffered severe anthropogenic impacts, with previous restoration attempts failing due to a limited understanding of pollutant dynamics. Aiming to fill this gap, a comprehensive study was conducted during dry and wet seasons to assess the spatiotemporal water pollution of Beira Lake, employing key physicochemical parameters, numerical indices, and remote sensing analysis. The water pollution index (WPI) results categorize Beira Lake as highly polluted, with WPI values ranging from 2.38 ± 0.92 in the wet season to 2.53 ± 1.32 in the dry season. Comparatively higher COD levels recorded in the Beira Lake network, especially for Gangarama Lake show significant pollution levels during both the dry and wet seasons, e.g., the highest COD levels, at 306.40 mg/L, were observed during the wet season. The Trophic State Index (TSI) results indicate eutrophic and hypereutrophic conditions in Beira Lake, which are particularly pronounced during the wet season. The heavy metal pollution index (HPI) results suggest elevated heavy metal concentrations in Beira Lake, especially in the wet season. Combined with field investigation results, a remote sensing data analysis between 2016 and 2023 reveals significant improvements in water transparency, suggesting positive effects of recent management interventions. Parameters demanding attention include COD, nitrate, and total phosphate levels due to their consistent exceedance of permissible limits. The PCA results of indices correlations between wet and dry seasons offer valuable insights into the complex dynamics of Beira Lake’s water quality. The study makes recommendations for restoring Beira Lake, including stringent pollution controls, regular dredging, green infrastructure implementation, implementing new rules and regulations, and community engagement.

Can Feminism Think Black Incapacity? On Resistance, Ambivalence, and the Ungendered Reading of Blackness and Sexuality: Revisiting Judith Butler and Hortense Spillers

Abstract: The article explores claims of resistance and ambivalence in discourses of feminisms. By contemplating these two terms as they are positioned in different feminist articulations (as well as in black critical theory, psychoanalysis, and literary studies), it argues that Blackness's negativity of the real gives rise to representations of race, gender, sexuality, and the body. Closely examining central works by Judith Butler and Hortense Spillers, the article further ruminates on how the incapacity of Blackness might yield an ungendered reading of these differences. In doing so, it pursues questions such as what might be the implications of such readings concomitant with the effects of trans - and Blackness's (non-)appearance in language and writing. The article visits meditations by Frantz Fanon and recent interventions in Afro-pessimism to consider an aporia that underlines the triangulation of Blackness, sexuality, and ungendering.

Development of an Interdisciplinary Approach to the Radiocarbon Dating of Earth Mortars from Alula Old Town (Saudi Arabia). Integration of Building Archaeology, Mortar Analysis and Radiocarbon Dating

AbstractThis paper discusses the approach used to identify the most relevant chronological information on the historic development of the abandoned site of AlUla Old Town, in the northwest of the Kingdom of Saudi Arabia (Western Asia). The approach is based on the use of the radiocarbon method to date earth mortars samples and soil layers used to create the constructive sequence of some buildings and, in turn, the chronological evolution of the site. Eleven samples of organic material (i.e., charcoal and vegetable fibers) were carefully removed from mortar samples and soil levels from six buildings and structures in the northern and southern areas of the town. Buildings and soil layers were chosen for their stratigraphic relevance and conservation conditions, based on an initial archaeological analysis of both, buildings and underground structures. Laboratory-based mortar analysis led to the characterization of the mortar’s inorganic fraction, and to the isolation of the organic material for the radiocarbon dating. Results from the accelerator mass spectrometry (AMS) laboratory provides evidence of a Late Mamluk/Early Ottoman constructive phase (i.e., 15th–17th c. AD) of the Old Town that was only partially known until very recently. Furthermore, the results allowed the identification of an Ottoman phase (i.e., 17th–19th c. AD) during which most of the buildings and structures were rebuilt, and of a Late Ottoman phase (i.e., 19th–20th c. AD) representing the most recent interventions before the end of the Ottoman occupation of the area.

Is badger culling associated with risk compensation behaviour among cattle farmers?

Risk compensation theory suggests that behaviours are modified in response to interventions that remove risks by substituting them with other risky behaviours to maintain a 'risk equilibrium'. Alternatively, risk reduction interventions may result in spill-over behaviours that seek to minimise risks further. This paper assessed evidence for these behavioural risk responses among farmers in response to badger culling that seeks to remove the risk of bovine tuberculosis in cattle. Data from the UK's randomised badger culling trial were re-analysed, comparing farmers' cattle movement practices in proactive and reactive culling areasand control areas. Analysis compared cattle movementsduring and after the trial using zero-inflated negative binomial regression. The analysis found no strong evidence of risk compensation behaviours among farmers who experienced proactive culling. However, strong evidence for a reduction in cattle movements in reactive culling areas was found. The results indicate high levels of inertia within farming systems in relation to cattle purchasing. Data do not account for the risk of cattle purchases and reflect previous policy regimens. Evidence from recent badger culling interventions should be analysed. Proactive badger culling was not associated with risk compensation behaviours, while reactive badger culling was associated with decreased risk taking among farmers.

Who counts? Anti-antisemitism and the racial politics of emotion

This article focuses on the rise of anti-antisemitic discourse in Britain over the past fifteen years. It explores the relationship between the increasingly emotional tone of public discourse in Britain and other western countries and the miring of anti-antisemitism in dynamics of competitive victimhood and ethnic antagonism. The development of this dynamic is traced from the bitter arguments over the representation and reporting of the Palestine/Israel conflict at the time of the Israeli ground assault in the Gaza Strip in early 2009 – with special attention to Caryl Churchill’s short play Seven Jewish Children – through to recent anti-antisemitic interventions such as David Baddiel’s bestselling polemic Jews Don’t Count (2021) and Jonathan Freedland’s verbatim play recently staged at London’s Royal Court Theatre (2022). These interventions, the article shows, call for the ‘normal’ treatment of anti-Jewish prejudice while simultaneously appealing on exceptionalist grounds for public sympathy with Jewish perceptions of antisemitism. The exceptional moral authority widely accorded to anti-antisemitism has made the cause an attractive one for those who resent what they believe to be the unwarranted priority accorded to non-white victimhood. Various forms of anti-antisemitism, such as Baddiel’s, have thus become front-line arguments in shrill culture-war tussles suffused with intellectual confusion and racially tinged rhetorical combat. This racialization, politicization and emotionalization of anti-antisemitism has reached new heights, the article concludes, following the outbreak of war between Israel and Hamas in October 2023.

Validity of a common measure of intimate partner violence perpetration: Impact on study inference in trials in low- and middle-income countries

BackgroundIn lower-and middle-income countries (LMICs), studies of interventions to reduce intimate partner violence (IPV) perpetration are expanding yet measurement equivalence of the construct has not been established. We assessed the measurement equivalence of physical and sexual IPV perpetration used in recent trials in LMICs and tested the impact of non-invariance on trial inference. MethodsWith data from three recent intervention trials among men (sample size 505–1537 across studies), we calculated tetrachoric correlations among items and used multiple-group confirmatory factor analysis to assess invariance across arms and over time. We also assessed treatment effects adjusting for covariate imbalance and using inverse probability to treatment weights to assess concordance of invariant measures with published results, where warranted. Findings.The average correlation among items was high and increased over time with several items in two studies showing correlations ≥0.85 at endline. Increases in correlation for physical IPV were concentrated in the treatment arm in two of the studies. The increase in correlation in sexual IPV differed by arm across studies. Across all studies, a correlated two-factor solution was the best fitting model according to the EFAs and CFAs. One study demonstrated measurement invariance across arms and over time. In two of the studies, longitudinal measurement non-invariance was detected in the intervention arms. In post hoc testing, one study attained invariance with a one-factor model and study inference was concordant with published findings. The other study did not attain even partial invariance. ConclusionCommon measures of physical and sexual IPV perpetration cannot be used for valid effect estimation without further refinement. The study highlights the need for an expanded item set, content validity assessments, further measurement invariance testing, and then consistent use of the item sets in future intervention trials to support accurate inference on the effectiveness of IPV perpetration prevention interventions.

A Systematic Narrative Review of Recent Obesity Interventions with Black Women in the United States.

This study is to comprehensively review recent obesity interventions for Black women in the United States. We searched PubMed and EBSCOhost for articles published between 2013 and 2022 using a comprehensive search strategy. Two reviewers screened titles, abstracts, and full texts. Data from the included articles were extracted.Qualitative themes related to the intervention designs were identified across studies. Fifty-two studies were included in the review. Interventions typically aimed to reduce weight by targeting diet and/or physical activity. Intervention activities were delivered virtually and in-person via several formats including didactic content and interactive sessions. Outcomes were assessed through a variety of research designs. Across papers, we identified six key themes of intervention design: integration of technology, centering community and culture, personalization of content, use of social support, skill-building through intervention activities, and addressing comorbid health conditions. To address the obesity epidemic, future research can build upon key lessons learned from recent interventions tailored to Black women.

Cybersecurity of Internet of Things in the health sector: Understanding the applicable legal framework

Although the digitalisation of healthcare is an ongoing process that dates back to more than two decades ago, it has gained more momentum with the COVID-19 pandemic. Recent developments in this sector include the adoption of wearable devices based on Internet of Things technology. The possibility of connecting devices that can work outside the physical boundaries of a hospital and follow patients at home, i.e. during their day-to-day life, has several obvious advantages. However, the digitalisation of the health sector through increased adoption of connected devices does not exclude vulnerabilities, particularly risks concerning the protection of patients’ data and the security of networks and information systems. Connected devices can gather, process, and store personal patient health data. Failure to safeguard the integrity and security of these data may affect the patients’ identity and finances and put their lives at risk. The presence of an IoT device in a healthcare setting may affect and reduce the level of network security of the overall system as it may provide an access point for an unlawful hacking attack. Although IoT technologies in the health sector are becoming increasingly pervasive, the European legal framework applicable to them is not clearly defined. This is extremely relevant in the case of cybersecurity, where the legal point of reference is the General Data Protection Regulation, addressing the measures and requirements applicable in case of data breaches, and the Medical Device Regulation, providing provisions focused on the security of data relevant to IoT defined as medical devices. The most recent interventions that address health data processing and cybersecurity are the proposed Cyber Resilience Act and the Health Data Space Regulation. The two acts provide measures and requirements applicable to IoT from two perspectives. Yet, they add complexities and some inconsistencies that may hamper the effectiveness of the overall cybersecurity framework.

Single-Center In-Hospital and Outpatient Opioid Use for Lower Extremity Arterial Disease.

The pain associated with lower extremity arterial disease is difficult to treat, even with lower extremity revascularization. We sought to evaluate in-hospital and post-operative opioid usage in patients with different disease severities and treatments for lower extremity vascular disease. A retrospective review was performed for all hospital encounters for patients with an International Classification of Diseases (ICD) code consistent with lower extremity arterial disease admitted to a single center between January 2018 and March 2023. Cases included patients admitted to the hospital with a primary diagnosis of lower extremity arterial disease. These patients were subdivided based on disease severity, treatment type, and comorbid diagnosis of diabetes mellitus. The analysis focused on in-hospital opioid use frequency and dosage among these patients. The control group (CON) included encounters for patients admitted with a secondary diagnosis of lower extremity atherosclerotic disease. A total of 438 patients represented by all the analyzed encounters were then reviewed for the number and type of vascular procedures performed as well as opioid use in the outpatient setting for one year. Critical limb ischemia (CLI) encounters were more likely to use opioids as compared to the CON and peripheral arterial disease (PAD) without rest pain, ulcer or gangrene groups (CLI 67.9% (95% CI: 63.6%-71.6%) versus CON 52.1% (95% CI: 48.5%-55.7%), p < 0.001 and CLI 67.9% (95% CI: 63.6%-71.6%) versus PAD 50.2% (95% CI: 42.6%-57.4%), p < 0.001). Opioid use was also more common in encounters for gangrene and groups treated with revascularization (REVASC) and amputation (AMP) as compared to CON (gangrene 74.5% (95% CI: 68.5%-82.1%) versus CON 52.1% (95% CI: 48.5%-55.7%), p < 0.01; REVASC 58.3% (95% CI: 57.3%-66.4%) versus CON 52.1% (95% CI: 48.5%-55.7%), p =0.01; and AMP 72.3% (95% CI: 62.1%-74.0%) versus CON 52.1% (95% CI: 48.5%-55.7%), p < 0.01). Significantly increased oral opioid doses per day (MME/day) were not noted for any of the investigated groups as compared to the CON. In the outpatient setting, 186 (42.5% (95% CI: 37.2%-46.4%)) patients were using opioids one month after the most recent vascular intervention. By one year, 31 (7.1% (95% CI: 1.30%-7.70%)) patients were still using opioids. No differences in opioid usage were noted for patients undergoing single versus multiple vascular interventions at one year. Patients undergoing certain vascular surgery procedures were more likely to be using opioids at one year. Patients with CLI and gangrene as well as those undergoing vascular treatment have a greater frequency of opioid use during hospital encounters as compared to those patients with less severe disease and undergoing conservative management, respectively. However, these findings do not equate to higher doses of opioids used during hospitalization. Patients undergoing multiple vascular procedures are not more likely to be using opioids long-term (at one year) as compared to those patients treated with single vascular procedures.

Vegetation Analysis in the Archaeological Area of Pasargadae WHS (Iran) Enhancing the Naturalistic Value of the Site within the Occurring Environmental Changes

This study provides pioneering research on the vegetation of archaeological areas in Iran to enhance its naturalistic and bioindication values by selecting the Pasargadae World Heritage Site (WHS). Vegetation surveys were carried out in different homogeneous habitats, analyzing the plant communities through statistical elaboration, syntaxonomic role, mapping, and enhancement of plants with conservation interest. In an ecological approach, the study included an analysis of the recent climate changes and human interventions influencing the water resources. Results revealed seven main vegetation types reflecting ecological gradients shaped by environmental, edaphic, and anthropogenic factors. The syntaxonomic analysis showed a primary subdivision in semi-natural grasslands and synanthropic vegetation. Several key species were identified as bioindicators of multiple factors, such as: Launaea acanthodes, Stipa barbata, Alhagi maurorum, Bellevalia saviczii, Glycyrrhiza glabra, Convolvulus arvensis, and Hordeum murinum. The vegetation map showed how the hilly grassland communities hosted the highest number of species with conservation interest and their need to be better protected. Bio-climatic data, such as the construction of dams and the exploitation for irrigation purposes, pointed to the increasing xeric conditions, which make urging conservation efforts for the site’s historical and naturalistic values. The study underscores the importance of preserving places with high plant diversity for effective site management, and enhances the intricate relationship between vegetation and natural features in the occurring environmental changes.

A prospective re-audit on insulin prescribing and administration practices in a university teaching hospital

Abstract Introduction Insulin is a high-alert medication which can cause significant patient harm if used inappropriately and has been identified as a significant medication safety concern in Galway University Hospitals. The first hospital-wide insulin review[1] was conducted in 2022 to evaluate insulin prescribing/administration practices and identify/develop quality improvements inclusive of: -The appointment of a senior pharmacist with a special interest in diabetes (June 2022), -An updated insulin record (November 2022; previous edition June 2019), -Development/implementation of a bespoke local eLearning module for the safe use of high-alert medications including insulin (March 2023), and -Continuous education on appropriate use for healthcare staff and patients/carers. Aim The aim was to conduct a similar insulin study to assess performance since the previous review, and develop further quality improvements as needed. Methods This study was conducted over one day in June 2023 on 24 wards by 26 interprofessional data collectors. Inclusion criteria comprised inpatients prescribed and/or administered insulin for the previous 72 hours. Exclusion criteria comprised non-admitted patients, short stay wards, critical care, maternity, and psychiatry. The protocol and tool were approved by the local Clinical Audit Committee, piloted with four inpatients, and communicated to all data collectors prior to commencement. Generated data were anonymous and securely stored. Data analysis was carried out using Excel by three independent researchers to confirm reliability of results. Results In total 557 inpatients were reviewed, of which 21% (116/557) had diabetes and 10% (56/557) were prescribed insulin. Nearly three-quarters (73%; 41/56) were prescribed a meal-time supplement, whilst 68% (38/56) were prescribed regular insulin – of which 63% (24/38) comprised prescribing errors, an improvement from 78% (32/41) in 2022. Administration errors comprised 84% (32/38) of records, similar to the 88% (36/41) error rate observed in 2022. Approximately one-fifth (21%; 8/38) of insulin orders were not signed by a prescriber, compared to 12% (5/41) the previous year. More than nine out of ten prescribers clearly documented the correct insulin name, dose, and administration times, and 71% (27/38) documented a medical council registration number, bleep, or name for contact purposes, compared to 59% (24/41) the previous year. Failure to document administration times was noted in 42% (16/38) of instances compared to 46% (19; n=41) the previous year. Insulin was not double-checked by a second independent individual in 21% (8/38) of cases, compared to 29% (12; n=41) in 2022. Conclusion Results have identified an overall practice improvement. Building on recent interventions implemented and incorporating newer strategies will aid in enhanced insulin use. An updated version of the insulin record has been implemented due to the recent discontinuation of the referenced perioperative fluid and the introduction of non-referenced blood ketone monitors. High leverage strategies such as ePrescribing is a current consideration to standardise practices. Conducting a study over a longer period may identify further trends. Strengths include study robustness, interprofessional collaboration, and transferability to other hospitals. Disseminating results and promoting benefits should encourage Irish hospitals to participate in a standardised national annual review to optimise patient care.

Use and Occupation of the Hydrographic Micro-Basin of Igarapé do Mariano in the Municipality of Manaus-Amazonas

Objective: To analyze the dynamics of the use and occupation of land based on the planning and sustainability of natural resources at the micro-basin of Igarapé do Mariano. Method: This study is characterized by a quali-quantitative approach based on field-collected primary data, followed by data treatment in a laboratory and data analysis in an office. It presents an exploratory nature, with research and information regarding a micro-basin. Results and conclusion: The urban expansion of Manaus advances towards the Mariano micro-basin, likely leading to an intensified use and occupation of land. The recent interventions on the routes and areas of leisure at the riverbed have been provoking negative environmental impacts that are typical of the urban micro-basins of Manaus, which have been and continue being destroyed as the city expands. Implications of the research: Based on the realizations from the analyses of the use and occupation of land, the research is expected to contribute to a planning policy for the territory, be it the Mariano micro-basin or other geographical areas. Originality/value: The study’s value lies on the peculiar location of the studied area, which is situated in the transition vector of urban expansion; on the lack of studies and of deeper information on the subject; on the use of a Remotely Piloted Aircraft in the field work for the photographic and aerophotogrammetric survey, which has proven to be an effective support for the study of the geographical area. All these aspects are of high relevance to the acquired knowledge and could potentially contribute to socioenvironmental actions.