Standard Tools Research Articles

Substance use disorders in hospice palliative care: A narrative review of challenges and a case for physician intervention.

Substance use disorders (SUDs) are frequently encountered in hospice palliative care (HPC) and pose substantial quality-of-life issues for patients. However, most HPC physicians do not directly treat their patients' SUDs due to several institutional and personal barriers. This review will expand upon arguments for the integration of SUD treatment into HPC, will elucidate challenges for HPC providers, and will provide recommendations that address these challenges. A thorough review of the literature was conducted. Arguments for the treatment of SUDs and recommendations for physicians have been synthesized and expanded upon. Treating SUD in HPC has the potential to improve adherence to care, access to social support, and outcomes for pain, mental health, and physical health. Barriers to SUD treatment in HPC include difficulties with accurate assessment, insufficient training, attitudes and stigma, and compromised pain management regimens. Recommendations for physicians and training environments to address these challenges include developing familiarity with standardized SUD assessment tools and pain management practice guidelines, creating and disseminating visual campaigns to combat stigma, including SUD assessment and intervention as fellowship competencies, and obtaining additional training in psychosocial interventions. By following these recommendations, HPC physicians can improve their competence and confidence in working with individuals with SUDs, which will help meet the pressing needs of this population.

Measuring continuing medical education conference impact and attendee experience: a scoping review.

The aim was to comprehensively identify published research evaluating continuing medical education conferences, to search for validated tools and perform a content analysis to identify the relevant domains for conference evaluation. We used scoping review methodology and searched MEDLINE® for relevant English or French literature published between 2008 and 2022 (last search June 3, 2022). Original research (including randomized controlled trials, non-randomized studies, cohort, mixed-methods, qualitative studies, and editorial pieces) where investigators described impact, experience, or motivations related to conference attendance were eligible. Citations were assessed in triplicate, and data extracted in duplicate. Eighty-three studies were included, 69 (83%) of which were surveys or interview based, with the majority conducted at the end of or following conference conclusion. Of the 74 tools identified, only one was validated and was narrowly focused on a specific conference component. A total of 620 items were extracted and categorized into 4 a priori suggested domains (engagement-networking, education-learning, impact, scholarship), and an additional 4 identified through content analysis (value-satisfaction, logistics, equity-diversity-inclusivity, career influences). Time trends were evident, including the absence of items related to equity-diversity-inclusivity prior to 2019, and a focus on logistics, particularly technology and virtual conferences, since 2020. This study identified 8 major domains relevant for continuing medical education conference evaluation. This work is of immediate value to individuals and organizations seeking to either design or evaluate a conference and represents a critical step in the development of a standardized tool for conference evaluation.

Two New Estimators for the Autocorrelation Function Through Singular Spectrum Analysis

It is around a century that sample autocorrelation function has been introduced and used as a standard tool in time series analysis. A vast literature can be found on the statistical properties of the sample autocorrelation function. However, it has been highlighted recently that the sum of the sample autocorrelation function over the lags 1 to [Formula: see text] is −0.5 for all time series of length T. This property produces a big concern for the cases in which all available sample autocorrelations are used in the inference. This paper provides two new alternative for estimating the autocorrelation function. These estimators come from the idea of singular spectrum analysis which is a non-parametric technique for time series analysis. The paper utilizes a simulation study to illustrate the performance of the new approach. The results suggest that further improvement to the sample autocorrelation is possible and the new methods provide an attractive alternative to the classical approach.

Comparing outcomes of single-use vs reusable ureteroscopes: a systematic review and meta analysis.

Flexible ureterolithotripsy is a frequent urological procedure, usually used to remove stones from the kidney and upper ureter. Reusable uretero-scopes were the standard tool for that procedure, but recent concerns related to sterility and maintenance and repair costs created the opportunity to develop new technologies. In 2016, the first single-use digital flexible ureteroscope was introduced. Since then, other single-use ureteroscopes were developed, and studies compared them with the reusable ureteroscopes with conflicting results. The purpose of this study is to describe the literature that compares the performance of single-use and reusable flexible ureteroscopes in retrograde intrarenal surgery for urinary stones. A Systematic Review was performed in October 2022 in accordance with the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA). A search in MEDLINE, EMBASE, Web of Science, Google Scholar and LILACS retrieved 10,039 articles. After screening, 12 articles were selected for the Meta-Analysis. No differences were found in stone-free rate (OR 1.31, CI 95% [0.88, 1.97]), operative time (MD 0.12, CI 95% [-5.52, 5.76]), incidence of post-operative fever (OR 0.64, CI 95% [0.22, 1.89]), or incidence of post-operative urinary tract infection (OR 0.63 CI 95% [0.30, 1.32]). No differences were observed in the studied variables. Hence, the device choice should rely on the availability, cost analysis and surgeons' preference.

Genetic Diversity of Brucella melitensis Isolated from Domestic Ruminants in Iraq.

The control and eradication of brucellosis represents a critical objective for Veterinary and Health Authorities across several countries globally. Efficient surveillance programs play a pivotal role in detecting and managing outbreaks. Epidemiological investigations significantly benefit from standardized and efficient molecular typing techniques and analytical tools, enabling public health laboratories to identify the origin of outbreaks. This study aimed to sequence Brucella spp. strains isolated in Iraq from different ruminant species to verify their molecular epidemiological correlations and, above all, to shed a light on how these Iraqi isolates are positioned in the phylogenetic context of Brucella spp. The 35 isolates under study were from abortion, milk, placenta, and the fetal membranes of sheep, cattle, and buffalo. Genotyping involved various techniques: MLVA-16, Whole Genome Sequencing, MLST, and cgMLST. All the Iraqi isolates from our study clustered in MLVA-16 within the East Mediterranean clade, and all but one grouped together in the same branch of the MST tree. MST analysis showed the minimum distance of one allele between the studied isolates, except for one strain from buffalo, which was positioned farther away from the rest of the isolates. In cgMLST, the majority of strains grouped within a large cluster predominantly comprising genotypes from the Middle East. The application of different control measures in different territories based on molecular epidemiological studies would increase the chances of maximizing public health benefits and minimizing the spread of infection to disease-free or lower prevalence areas.

DETERMINANTS OF FEMALE ENTREPRENEURSHIP IN POLAND

Aim: Female entrepreneurship is a still-untapped economic potential. To trigger it, it is necessary to better recognize barriers to its development. Thus, the aim of the research was to identify the motives that make women start their own businesses, the reasons why they postpone or decline such decisions, the barriers that they encounter when running a business, and their priorities concerning professional careers and family. Methods: Applied methods include an e-mail survey and direct interviews, both using a questionnaire. The gathered data was processed using standard qualitative data analysis tools and descriptive analysis. Results: Women decide on their own business mainly because of negative experiences of being an employee and, to a lesser degree, because of a lack of satisfactory job offers or a lack of job offers at all. However, they often postpone starting their own business because of subjective reasons: the feeling that they lack experience, the lack of self-confidence, the fear of failure, and objective ones: lack of capital. The identified barriers in women running businesses are mainly universal, not gender-related, i.e., high taxes, problems with findingemployees, and frequent changes in legal and administrative regulations. Limited time devoted to family is the only gender-related barrier. However, a considerable share of respondents claims that there are no bottle-necks to female entrepreneurship in Poland. Conclusions: To trigger the potential of female entrepreneurship, we recommend two types of actions: training, mentoring and promoting success stories aimed at decreasing the subjective barriers to women starting businesses and actions aimed at diminishing the universal, not gender-related obstacles in running businesses in Poland.

Psychometric evaluation of the Chinese version of the attitudes, subjective norms, perceived behavioural control and intention to pursue a career in mental health nursing scale

AimTo adapt culturally and assess the reliability and validity of the Attitudes, Subjective Norms, Perceived Behavioural Control and Intention to Pursue a Career in Mental Health Nursing (ASPIRE) scale among Chinese nursing students. BackgroundMental health nurses make up a substantial proportion of the mental health workforce and are pivotal for improving access to professional mental health care. However, a shortage of mental health nurses persists across various countries. Although new nursing graduates have the potential to alleviate the labor shortages, there is currently no standardized tool specifically designed to measure nursing students' intentions to pursue a career in mental health nursing in China. DesignA quantitative and cross-sectional design. MethodsFollowing email authorization from the author, the Chinese version of the ASPIRE scale was translated following the cross-cultural adaptation process guidelines established by the American Association of Orthopedic Surgeons (AAOS). A questionnaire survey was conducted among 540 nursing students from three universities in Hunan Province from April 2023 to October 2023. Nine experts were invited to evaluate the content equivalence of each item. Item analysis, exploratory factor analysis, confirmatory factor analysis, internal consistency reliability and test-retest reliability were used to test reliability and validity. ResultsThe Chinese version of the ASPIRE scale retained 14 items and it has high content validity. Pearson correlation analysis revealed a statistically significant difference in the correlation between the total scores of the items (P < 0.001). Exploratory factor analysis indicated that the one-factor solution explained 65.82% of the total variance and confirmatory factor analysis results indicated a good fit (CMIN/DF = 2.64, RMSEA = 0.079, GFI = 0.908, IFI = 0.964, SRMR = 0.0326). The Cronbach's alpha coefficient for the scale was 0.958 and the test-retest coefficient was 0.783. ConclusionThe Chinese version of the ASPIRE scale has great reliability and validity and can be used for assessing Chinese nursing students' intention to pursue a career in mental health nursing.

Radiation Data Analysis Tool (RaDAT)

Radiation Data Analysis Tool (RaDAT), developed under a specific task order of ITER project, was designed using Matlab and it is a GUI (Graphical User Interface)-based compact application intended to support expert and non-expert users in: (1) visualization analysis of 2D radiation maps, (2) radiation qualifications of electronic equipment and (3) Occupational Radiation Exposure (ORE) analysis.It was certified for Protection Important Activities (PIA) and authorized to be used for equipment radiation qualification activities. Its main functionalities allow: (1) to visualize quickly 2D radiation maps (.VTR/.VTK files) on different planes and positions, investigating radiation conditions in different spots of the Tokamak Complex Building (TCB); (2) to analyse automatically radiation conditions of lists of millions of equipment volumes (.STL files), providing the best and the worst radiation conditions on Excel tables; (3) to calculate the total biological dose cumulated by a worker along a specific route, passing from a workstation to another, in the TCB. Another feature implemented in RaDAT is the Flexibility Radius (FR) option, which could be applied to the volumes, extending them by this FR, in order to take into account any possible relocation in proximity of the nominal installation spot.RaDAT allows reducing the analysis time considerably. It is capable to analyse one radiation map, finding the best and the worst radiation conditions within a single volume (e.g.: an electrical enclosure) in ∼ 50 ms, using a standard office laptop, reducing the analysis time by a factor ∼1000, compared to a manual analysis approach on standard visualization tools.

Exploring statistical approaches for accessing the reliability of Y2O3-based memristive devices

Memristive devices have emerged as promising alternatives to traditional complementary metal-oxide semiconductor (CMOS)-based circuits in the field of neuromorphic systems. These two-terminal electronic devices, known for their non-volatile memory properties, can emulate synaptic behavior within artificial neural networks, offering remarkable advantages, including scalability, energy efficiency, rapid operation, compact size, and ease of fabrication. They hold the potential to serve as fundamental components for artificial neurons, revolutionizing neuromorphic computing systems by closely mimicking biological neurons. However, the integration of resistive random-access memory (RRAM) into commercial production faces challenges due to substantial variations in resistive switching (RS) parameters, which include cycle-to-cycle (C2C) and device-to-device (D2D) fluctuations. These variations are rooted in the stochastic nature of RS, linked to physical mechanisms like diffusion and redox reactions. Nonetheless, limitations exist in the current analytical approaches, emphasizing the need for more standardized tools to assess memristive device reliability consistently. Weibull distribution is widely used to analyze RRAM variability and many further studies are based on it. However, this distribution may not work well for some memristive devices. In such cases, one can use other statistical distributions available in the literature. In the present work, statistical distributions, namely Weibull, Exponential, Log-Normal, Gamma, and Logistic distributions, are employed to scrutinize memristive devices device parameters, shedding light on their performance and reliability. Also, analytical methods namely maximum likelihood estimates for parameter estimation and Kolmogorov-Smirnov test for assessing goodness of fit of the distributions are used. This study aims to provide an approach with a deeper understanding of memristive device parameters and analysis techniques.

Understanding Occupational Therapists' Knowledge and Confidence When Assessing for Spatial Neglect: A Special Issue Review.

Spatial neglect (SN)-failure to respond to stimuli on the side of the body contralateral to a poststroke lesion-is one of the most disabling impairments for stroke survivors, and 80% of stroke survivors may have undetected SN. Occupational therapists' evaluations should include determining the impact of poststroke SN. To investigate occupational therapists' confidence, knowledge, current practices, barriers, and facilitators when assessing for SN in adult stroke survivors. A 30-item survey was created with guidance from stroke rehabilitation occupational therapists who reviewed the survey for face and content validity. Online survey. Occupational therapist survey responders (N = 76). Self-report assessments were used to measure occupational therapists' confidence in identifying SN, SN assessment practices, and barriers to and facilitators of SN assessment. Knowledge of SN signs and symptoms, neuroanatomy, and clinical presentation were measured with a three-question quiz. Eighty-one percent of the respondents reported a high level of confidence in identifying SN, and 70% reported routinely assessing for SN, with 81% using clinical observation rather than standardized tools as the primary assessment method. Barriers to SN assessment included time and resources. Most respondents, despite reporting high levels of confidence with routine SN assessments, did not use standardized SN measures and demonstrated suboptimal knowledge of SN. These results emphasize the need to increase clinical education about SN and its assessments. Plain-Language Summary: This study gathered baseline information on an underinvestigated topic-occupational therapists' education, confidence, current practices, barriers, and facilitators when assessing for spatial neglect in adult stroke survivors. The study results also contribute to future research on occupational therapists' current confidence and knowledge when assessing for spatial neglect.

Extending the code in the open-source saemix package to fit joint models of longitudinal and time-to-event data

Background and ObjectiveJoint modeling of longitudinal and time-to-event data has gained attention over recent years with extensive developments including nonlinear models for longitudinal outcomes and flexible time-to-event models for survival outcomes, possibly involving competing risks. However, in popular software such as R, the function used to describe the biomarker dynamic is mainly linear in the parameters, and the survival submodel relies on pre-implemented functions (exponential, Weibull, ...). The objective of this work is to extend the code from the saemix package (version 3.1 on CRAN) to fit parametric joint models where longitudinal submodels are not necessary linear in their parameters, with full user control over the model function. MethodsWe used the saemix package, designed to fit nonlinear mixed-effects models (NLMEM) through the Stochastic Approximation Expectation Maximization (SAEM) algorithm, and extended the main functions to joint model estimation. To compute standard errors (SE) of parameter estimates, we implemented a recently developed stochastic algorithm. A simulation study was proposed to assess (i) the performances of parameter estimation, (ii) the SE computation and (iii) the type I error when testing independence between the two submodels. Four joint models were considered in the simulation study, combining a linear or nonlinear mixed-effects model for the longitudinal submodel, with a single terminal event or a competing risk model. ResultsFor all simulation scenarios, parameters were precisely and accurately estimated with low bias and uncertainty. For complex joint models (with NLMEM), increasing the number of chains of the algorithm was necessary to reduce bias, but earlier censoring in the competing risk scenario still challenged the estimation. The empirical SE of parameters obtained over all simulations were very close to those computed with the stochastic algorithm. For more complex joint models (involving NLMEM), some estimates of random effects variances had higher uncertainty and their SE were moderately under-estimated. Finally, type I error was controlled for each joint model. Conclusionssaemix is a flexible open-source package and we adapted it to fit complex parametric joint models that may not be estimated using standard tools. Code and examples to help users get started are freely available on Github.

Density of smooth functions in Musielak–Orlicz–Sobolev spaces Wk,Φ(Ω)$W^{k,\Phi }(\Omega)$

AbstractWe consider here Musielak–Orlicz–Sobolev (MOS) spaces , where is an open subset of , and is a Musielak–Orlicz function. The main outcomes consist of the results on density of the space of compactly supported smooth functions in . One section is devoted to compare the various conditions on appearing in the literature in the context of maximal operator and density theorems in MOS spaces. The assumptions on we apply here are substantially weaker than in the earlier papers on the topics of approximation by smooth functions. One of the reasons is that in the process of proving density theorems, we do not use the fact that the Hardy–Littlewood maximal operator on Musielak–Orlicz space is bounded, a standard tool employed in density results for different types of Sobolev spaces. We show in particular that under some regularity assumptions on , (A1) and that are not sufficient for the maximal operator to be bounded, the space of is dense in . In the case of variable exponent Sobolev space , we obtain the similar density result under the assumption that , , , , satisfies the log‐Hölder condition and the exponent function is essentially bounded.

Quantification of stimulus-evoked tactile allodynia in free moving mice by the chainmail sensitivity test.

Chronic pain occurs at epidemic levels throughout the population. Hypersensitivity to touch, is a cardinal symptom of chronic pain. Despite dedicated research for over a century, quantifying this hypersensitivity has remained impossible at scale. To address these issues, we developed the Chainmail Sensitivity Test (CST). Our results show that control mice spend significantly more time on the chainmail portion of the device than mice subject to neuropathy. Treatment with gabapentin abolishes this difference. CST-derived data correlate well with von Frey measurements and quantify hypersensitivity due to inflammation. Our study demonstrates the potential of the CST as a standardized tool for assessing mechanical hypersensitivity in mice with minimal operator input.

Development and Validation of Micro-Lecture Videos as Learning Support Material for Grade 7 Science Competencies

As students opted for modular distance learning during the pandemic, they were forced to self-regulated learning with little assistance from teachers. Video lectures are materials commonly designed for active learning methods in distance learning. However, studies found that the length of videos has a strong influence on students’ control over their learning. Longer videos have issues sustaining students’ focused attention to content. This study aimed to develop, validate and evaluate the quality and effectiveness of micro-lecture videos in Physics. Using the developmental research design anchored on the ADDIE model, 7 videos were developed. Videos were quality assured and administered to grade 7 students for evaluation, and feedbacking. Using a developed instrument, an LRMDS standard evaluation tool from the Department of Education, and thematic analysis, quality assurance results, test scores, and interview transcripts were gathered and analyzed statistically and thematically. Results show that despite limited engagement, video lectures are vital so students are guided to self–regulate their learning at their own pace. They also brought positive outcomes, particularly on ownership of learning where students manage and control the pace of their video view, allowing them to replay anytime. On the quality of materials, micro-lecture videos have relevant, logically arranged information, with appropriate content and language that are free of bias. They also have a well-defined purpose, are content-friendly, and can engage viewers for a better understanding of concepts. Moreover, end-users responded that the material was easy to use, can be viewed in messenger, and can be downloaded anytime since it has a smaller file size.

Assessing urban social sustainability with the Place Standard Tool: Measurement, findings, and guidance

This study introduces the Place Standard Tool as an instrument for assessing urban social sustainability. The Place Standard Tool was developed in Scotland as a simple framework to evaluate physical (e.g., buildings, public spaces, transport system), social (e.g., social interaction, identity and belonging, safety), and procedural (e.g., public participation, sense of control) aspects concerning places, neighborhoods, and districts. The tool was tested in three cities in Norway – Kristiansand, Stavanger, and Fredrikstad – through a transdisciplinary collaboration between researchers, municipalities, and local stakeholders. We first present the methodology we applied for testing the tool and then report some indicative findings. Next, municipal advisors present their qualitative assessment of the tool discussing its usefulness for urban planning and local governance. Finally, researchers offer theoretical and methodological guidance: they theoretically discuss the relevance of the tool for urban social sustainability, present its strengths and weaknesses, and provide methodological recommendations for future applications.

Tracheal Tumours

Malignant primary tracheal tumours are rare. The most common histological subtypes are squamous cell carcinoma and adenoid cystic carcinoma. These two entities have different prognoses and growth patterns. Tracheobronchoscopy and thoracic sectional imaging are standard diagnostic tools for tumour staging and local evaluation. Complete surgical resection of the affected tracheal segment is the treatment of choice for limited disease without distant metastases. Incomplete gross tumour resection with additional irradiation is an acceptable therapeutic option for adenoid cystic carcinoma. Interventional endoscopy with tumour debulking or tracheal stenting and/or definitive mediastinal radiotherapy are treatment alternatives in either a locally advanced or palliative setting.

Evaluation of the quality and safety of commercial complementary foods: Implications for nutrient adequacy and conformance with national and international standards.

Optimal nutrition in early childhood increases growth and development while preventing morbidity and mortality in later life. This study focused on the quality and safety of 32 commercially produced complementary foods collected from supermarkets in Addis Ababa, Ethiopia. The proximate composition (moisture, protein, fat, crude fibre, and ash); and the mineral profile (calcium, iron, zinc, manganese, and magnesium) were determined using the AOAC method. The determination of antinutritional factors (Condensed tannin and oxalate) was done using a UV spectrophotometer. A rapid visco analyzer was used to measure the rheological property. The microbial load of commercially produced complimentary foods was identified using aerobic colony counts for mold and yeast. Labeling practice was evaluated using the WHO and Ethiopian standard tools. The results of proximate compositions were: protein (0.92-18.16 g/100g), fat (0.63-6.44 g/100g), crude fiber (1.04-13.2 g/100g), energy (410-337 kcal/100g), moisture (0.03-17 g/100g), and ash (0.60-4.67 g/100g). The protein and fat content of all the products is below international standards. Only three products met the standards for energy. Moisture and ash contents partially met the requirement, while all of the carbohydrate contents of the products fell under the specified standard. The lowest and highest mineral contents of the products were: Fe (1.38 to 15.10 mg/100g), Zn (0.64 to 6.78 mg/100g), Ca (30.55 to 364.45 mg/100g), Mg (1.2 to 34.2 mg/100g), and Mn (0.80 to 32 mg/100g). Based on these, 21.5% of the foods met the Fe standard, and 31.5% didn't meet the Zn standard. The Ca and Mg of all the products met the requirement. Except for one product, all met standards. The highest and lowest results for the tannin and oxalate content of the products were 49.20 to 90.09 mg/100g and 0.47 to 30.10 mg/100g, respectively and this shows that the products are below the permissible range for tannin and oxalate. The counts of yeast and mold were 0.00-2.95 log10 cfu/g and 0.00-2.91 log10 cfu/g, respectively. Only one product fell below the standard for yeast count, and none of the products showed a mold count that exceeded the standard. The final viscosity was 63.5-3476 RVU, and only 31.25% of the samples fell under the permissible peak viscosity range, of 83-250 RVU. Thus, regular monitoring of the raw material and processing trends and the inclusion of animal sources in the raw material are suggested for having well-enriched complementary foods. Regulatory bodies should also conduct frequent market surveillance to safeguard the health of the consumer.

ANALYSIS OF IMPLEMENTATION OF ACUTE APPENDICITIS CLINICAL PATHWAY WITH ICPAT (INTEGRATED CLINICAL PATHWAY APPRAISAL TOOL) AT FAISAL ISLAMIC HOSPITAL MAKASSAR YEAR 2022

Background: Clinical Pathways are crucial for implementing Good Clinical Governance in hospitals to reduce variations, ultimately decreasing the risk of medical errors. A Clinical Pathway must create a diagnosis with high volume, risk, cost, and problem-proneness standards. Appendicitis is an essential public health problem; the prevalence and incidence have increased globally. The clinical pathway implementation at our institution has yet to be evaluated. Objective: This study aims to analyze the implementation of the Acute Appendicitis Clinical Pathway using ICPAT. Methods: This study is a mixed methods study with a case study approach. Quantitative samples were collected from medical records of patients with acute appendicitis through proportional random sampling based on the inclusion and exclusion criteria. Qualitative participants were chosen according to appropriateness and adequacy principles. The validation method used was data triangulation. Result: The outcomes demonstrated a 0% compliance rate in implementing the clinical pathway for acute appendicitis. ICPAT results (content and quality); D1 (90%, 100%), D2 (39.13%, 25%), D3 (30.77%, 35.29%), D4 (60%, 100%), D5 (50%, 30.77%), D6 (66.67%, 75%). Conclusion: There was never a comprehensive review, especially using standard tools. This study helps Faisal Islamic Hospital conclude points to improve, especially the bad categories, namely the documentation, development, and maintenance dimensions.

Transportation Management in Urban Functional Areas

Abstract Urban and suburban transport within Functional Urban Areas (FUAs) is now considered an integrated system. In these regions, many residents commute from the suburbs to the city daily for work, education, and social purposes. Transport planning must consider these dynamics to ensure consistent and convenient connections between the city and its suburbs. This article stresses the need for a standardized tool to collect data on transport management models in FUAs across 38 OECD-affiliated countries. The proposed tool, a survey questionnaire, aims to gather information on how transport management models are organized and operate in these regions. The article discusses research conducted in the Olsztyn FUA, revealing significant variations in transport management methods among municipalities. The questionnaire is categorized into four themes: public transport, transport infrastructure, FUA transport strategy and innovation, and risks and monitoring, offering a comprehensive view of the transport management model. The study also highlights varying development priorities among FUA municipalities; some focus on public transport, while others invest in road infrastructure. This study underscores the importance of a cohesive approach to transport management in FUAs, considering their diverse needs and requirements.

Effect of digital based nursing intervention on knowledge of self-care behaviors and self-efficacy of adult clients with diabetes

BackgroundIn recent years, there has been growing interest in the use of Digital Based Nursing Intervention to support diabetes management. This study aimed to evaluate the effect of digital based nursing intervention on knowledge of self-care behaviors and self-efficacy of clients with diabetes.MethodsEmploying a quasi-experimental design, a sample of 120 adult participants diagnosed with type 2 diabetes, aged more than 18 years with focus on older adults was drawn from outpatient clinics at Cairo University Hospital. The intervention was approved and registered by the ethical committee of the faculty of nursing with IRB number: RHDIRB2019041701. The intervention group (n = 60) received a digital-based nursing intervention, while the control group (n = 60) received standard care. Data were collected using adopted standardized tools including the Diabetes Knowledge Test, the Diabetes Self-Efficacy Scale, and the Summary of Diabetes Self-Care Activities. Demographic characteristics were analyzed, and pre- and post-intervention scores were compared using paired t-tests were statistical methods.ResultsThe digital-based nursing intervention resulted in significant enhancements in participants with diabetes knowledge and self-efficacy levels. Moreover, the intervention group demonstrated marked improvements in various self-care behaviors encompassing diet, exercise, medication adherence, blood glucose testing, and foot care. While the control group also exhibited some progress, the effects were less pronounced. Regression analyses highlighted age as a consistent factor associated with knowledge, self-efficacy, and specific self-care behaviors.ConclusionThis study underscores the potential of tailored digital nursing interventions to complement traditional care approaches, empowering patients with type 2 diabetes to actively engage in self-management. The findings suggest that digital-based nursing interventions hold promise for enhancing patient knowledge, confidence, and proactive health behaviors. Nevertheless, limitations, including the relatively short intervention duration and a sample from a single clinic, warrant consideration. Future research should address these limitations to bolster the validity and applicability of the study’s conclusions.