Planning Support Research Articles

Risk and protective factors for health behaviour in adolescence in Europe

The purpose of the analysis was to identify the risk and protective factors for health behaviour in European adolescents from population health status and expenditure, mental health status, sexual life, social life and education indices and the existence of national strategies, programmes. National and international databases providing information on the presumed health behaviour predictors were used in the analysis. The existence of national health strategies, the level of health expenditure, the socioeconomic conditions, the level of education and literacy had significant influence on the health-risk behaviour of adolescents in the European societies. Six clusters of European countries were extracted by considering the health behaviour risks and health protection strategies. National health strategies combined with governmental support for health prevention and action plans have the most effective impact on the health-risk behaviour of adolescents.

Conceptual Foundations of Information Modeling Technology in Urban Planning

Introduction. For the management of complex urban planning systems, the problems of choosing alternatives and finding effective solutions under conditions of risk and uncertainty in the interaction of many exogenous and endogenous factors are of great theoretical and practical importance. A special place in decision-making is occupied by an integrated approach that allows, based on artificial intelligence models, expert assessment, analytical and computational models, modeling methods and a number of other models and methods, to successfully apply various approaches to decision support, to provide a deeper and more comprehensive account of various factors. , their relationship, act in conditions of semistructured or unstructured information about the control object. In this regard, the problem of creating integrated intelligent decision support systems based on the theory and principles of hybrid artificial intelligence systems, mathematical modeling methods, system analysis, synthesis of control actions, etc. is relevant.The purpose of this article is to clarify the conceptual foundations of information modeling technology in urban planning.Materials and methods. To achieve this goal, the article used methods of problem analysis, synthsis, scientific approaches to solving the stated problem, classification of hybrid models used in information modeling in urban planning. The materials of the article are the works of scientists on the stated issues.Research results. The article points out that the possibilities of modeling in urban planning are associated with the development of hybrid models, which are models that are built using various methods. The author determined that a hybrid intelligent system is a combination of: analytical models, expert systems, artificial neural networks, fuzzy systems, genetic algorithms, simulation statistical models. The main task in the development of hybrid systems is to best combine different forms of representation and methods of knowledge processing in the decision-making process in the field of urban planning.Discussion and conclusion. The article substantiates the importance of introducing hybrid models for studying the functioning and forecasting the development of urban infrastructure. Approaches to the creation of intelligent information systems for decision support in urban planning based on a combination of analytical methods and models, such as simulation modeling, computational calculations, optimization calculations with soft computing models, such as fuzzy systems, neural networks, genetic solutions of complex weakly structured or unstructured tasks. The creation of such systems will increase the level of managerial decision-making in urban planning, better assess the quality of the housing policy being pursued.

Developing and Implementing a Culturally Consonant Treatment Fidelity Support Plan with the Apsáalooke Nation.

Treatment fidelity remains underreported in health intervention research, particularly among Indigenous communities. One explanation for this gap is the lack of culturally consonant strategies listed in the National Institutes of Health (NIH) Behavior Change Consortium (BCC) treatment fidelity framework, the gold standard for understanding and measuring fidelity. This paper focuses on the development and implementation of a culturally consonant treatment fidelity support plan across two of the five BCC fidelity areas, provider training and treatment delivery, within a chronic illness self-management program for the Apsáalooke (Crow) Nation. Our team selected and adapted strategies from, and added strategies to, the BCC framework, that centered on relational accountability and the Apsáalooke culture. To be culturally consonant, we approached treatment fidelity as supporting Aakbaabaaniilea (Apsáalooke program facilitators) rather than monitoring them. This resulted in the development of a fifth treatment fidelity area: building and fostering relationships. We propose that fidelity to relational accountability is the foundation of successful programs in Indigenous communities. This suggests an important shift from tracking what was conducted in an intervention to prioritizing how things were conducted. We encourage others to view the BCC framework as a starting point in developing fidelity strategies that are consonant with local cultures.

Association between an anesthesia department development program for junior faculty and long-term production of publications: A longitudinal cohort study

BackgroundAn important mission of academic medical departments is to further the scholarship and education of its junior faculty. In 2013, Hindman et al. described the design and initial outcomes of a faculty development program for junior faculty at the University of Iowa Department of Anesthesia. In the current study, we reassessed whether the program increased the production of publications long-term. We included all department faculty, years before joining the department, and years after leaving the department, to control for the effects of simply being current faculty in the department, benefiting from its resources, and having had progressively more experience working. MethodsThe population studied was the faculty for any period between January 2006 and December 2022. The dependent variable was the count of publications in Scopus each year with the faculty member's Scopus identifier, 1996 through 2022. The two-year faculty development program included non-clinical time, two mentors, defined mentorship plan, didactic program, and financial support for clinical and/or laboratory studies. Statistical analyses were with logistic and Poisson random effect models for panel data, with standard errors estimated using jackknife resampling. ResultsAmong the 128 distinct faculty in the department from 2006 through 2022, the 10% with the most publications per year accounted for 54% of the total annual publications. The two-year program was completed by 41% (53/128). Completion of the faculty development program was associated with a 17% absolute increase in the predicted marginal probability of one or more publications per year, from 25% to 41%. The 95% confidence interval for the 17% absolute increase was 9% to 24% (P < .0001). The predictive marginal effect of completing the program was 1.7 more publications per year per faculty (95% confidence interval 1.1 to 2.4, P < .0001). The estimate was also 1.7 more publications per year while limiting consideration to the 108 faculty who joined the department after 1996 and including as an independent variable the count of publications the year before joining the department. ConclusionsA faculty development program for junior faculty can reliably increase the production of publications in an anesthesiology department by at least one per year. However, there is considerable heterogeneity in publication production among faculty.

Commercial weight-loss diets, greenhouse gas emissions and freshwater consumption.

Weight-loss attempts are widespread in the United States, with many using commercial weight-loss diet plans for guidance and support. Accordingly, dietary suggestions within these plans influence the nation's food-related environmental footprint. We modelled United States (US) per capita greenhouse gas emissions (GHGe) and water footprints associated with seven commercial weight-loss diets, the US baseline, and selected other dietary patterns. We characterised consumption in commercial weight-loss diets both via modelling from provided guidelines and based on specific foods in 1-week meal plans. Cradle-to-farmgate GHGe and water footprints were assessed using a previously developed model. GHGe results were compared to the EAT-Lancet 2050 target. Water footprints were compared to the US baseline. Weight-loss diets had GHGe footprints on average 4.4 times the EAT-Lancet target recommended for planetary health (range: 2.4-8.5 times). Bovine meat was by far the largest contributor of GHGe in most diets that included it. Three commercial diets had water footprints above the US baseline. Low caloric intake in some diets compensated for the relative increases in GHGe- and water-intensive foods. Dietary patterns suggested by marketing materials and guidelines from commercial weight-loss diets can have high GHGe and water footprints, particularly if caloric limits are exceeded. Commercial diet plan guidance can be altered to support planetary and individual health, including describing what dietary patterns can jointly support environmental sustainability and weight loss.

An evaluation of nasogastric (NG) tube removal practices and nutritional intake parameters in an acute neurosurgical population: The development of an NG Transition Feeding Protocol.

As a result of the complex nature of neurosurgical patients, nasogastric (NG) tube feeding is often implemented for patients who are unable to consume adequate oral intake. During recovery, patients on enteral nutrition (EN) are progressed to oral nutrition, which can result in NGT removal and discontinuation of supportive feeding plans. This is often before patients become established on sufficient oral intake to meet their nutritional requirements. We conducted an exploration of current NG removal practices in patients (n = 23) across five neurosurgical wards over a 3-month period to assess practitioner review response times, NG feeding duration, decision making on NG removal, and the influence of dietary recommendations and differing EN protocols on patients' ability to meet their nutritional requirements. Our aim was to use this data to design and implement a protocol to improve consistency of these practices. After oral intake was commenced, only those receiving supplementary EN achieved nutritional targets immediately. Conversely, no patient who had their NGT removed at this stage achieved these targets. Following NG removal, the likelihood of a patient meeting nutritional targets was influenced by the decision maker, supporting the practice of registered dietitian led cessation of NG feeding. These findings led us to develop an "NG Transition Feeding Protocol" to serve as a simple, clear pathway which treating teams can utilise to guide NG feeding decisions. NG feeding supports neurosurgical patients to meet nutritional requirements in the early stages following commencement of oral intake. The development of an "NG Transition Feeding Protocol" may help to improve consistency of transition feeding on neurosurgical wards, allowing time for nutrition assessment to support informed decisions around NG removal. The aim of this protocol is to improve the efficiency of transition feeding, improve dietetic workload efficiency, nursing staff confidence and avoid compromising nutritional status of patients as a result of the early cessation of EN.

How do gravity alterations affect animal and human systems at a cellular/tissue level?

The present white paper concerns the indications and recommendations of the SciSpacE Science Community to make progress in filling the gaps of knowledge that prevent us from answering the question: “How Do Gravity Alterations Affect Animal and Human Systems at a Cellular/Tissue Level?” This is one of the five major scientific issues of the ESA roadmap “Biology in Space and Analogue Environments”. Despite the many studies conducted so far on spaceflight adaptation mechanisms and related pathophysiological alterations observed in astronauts, we are not yet able to elaborate a synthetic integrated model of the many changes occurring at different system and functional levels. Consequently, it is difficult to develop credible models for predicting long-term consequences of human adaptation to the space environment, as well as to implement medical support plans for long-term missions and a strategy for preventing the possible health risks due to prolonged exposure to spaceflight beyond the low Earth orbit (LEO). The research activities suggested by the scientific community have the aim to overcome these problems by striving to connect biological and physiological aspects in a more holistic view of space adaptation effects.

Case Report: A rare case of Fanconi anaemia

Fanconi anaemia (FA) is autosomal recessive but can also be an autosomal dominant or X-linked recessive disease. In India, Fanconi anaemia is a very rarely seen disorder. Clinical findings in FA include pancytopenia, hyperpigmentation or hypopigmentation, skeletal anomalies, small stature or growth retardation, endocrine abnormalities, anal atresia, deafness, malignancy of head and neck, and it has a tendency to run in families. Diagnosis of FA can be made on clinical findings and laboratory examination. Recommended prenatal testing like chorionic villus sampling and amniocentesis. Androgen therapy and hematopoietic stem cell transplantation (HSCT) are treatment modalities recommended for FA. Follow-up of all diagnosed FA patients is essential throughout their lifetime. Having a healthcare team with diverse expertise is vital in preventing anemia and malignancy. A meticulous plan and unwavering support are also crucial. Outcomes of FA patients is desolate due to complications associated with it. Our aim of the study is to increase awareness among physicians about the presence of such rare diseases. Well-timed diagnosis with appropriate treatment is needed to prevent complication.

Artificial intelligence systems in surgery: A review of opportunities, limitations, and prospects

Artificial intelligence technologies are increasingly being applied in a variety of medical disciplines. After reviewing 278 publications from 1985 to 2023, 99 articles were selected from the databases elibrary, PubMed, Medline, WoS, Nature, Springer, and Wiley J Database to present the main approaches and a modern picture of the application of artificial intelligence methods and technologies in pediatric surgery and intensive care. The article examines many facets of artificial intelligence systems for medical uses, namely, computer decision support systems or supporting the surgeon throughout the surgical intervention procedure. Computer analysis of 3D visualization and 3D anatomical modeling of images obtained from computed tomography and magnetic resonance imaging investigations can be used to plan operations. Because of the possibilities of sufficiently accurate 3D models and methods for organs and pathological processes, various methodologies and software tools for preoperative planning and intraoperative support of surgical intervention have been developed. Computer (technical) vision analyzes high-quality medical images and interprets them in multimodal three-dimensional images for computer diagnoses and operations under visual control, including augmented reality methods. Robotic surgery involves manipulators, including remotely controlled ones, and intellectualized complexes that independently perform specific actions of the second assistant surgeon. In intensive care, artificial intelligence technologies are being investigated to merge data from bedside monitors and other information about patients conditions to identify critical situations and control mechanical ventilation. Simultaneously, several obstacles impede the adoption of artificial intelligence in surgery. The nature and standardization of the initial data required for their integration, taking into consideration atypical cases, the possibility of bias in the sample used, and the transparency of the decision-making process in machine learning models are examples. The explanation of solutions presented in machine learning models and the transition to full-fledged validation of the systems being built define the prospects for developing and using artificial intelligence systems.

Implementing and evaluating care and support planning: a qualitative study of health professionals’ experiences in public polyclinics in Singapore

BackgroundTwo polyclinics in Singapore modified systems and trained health professionals to provide person-centred Care and Support Planning (CSP) for people with diabetes within a clinical trial. We aimed to investigate health professionals’ perspectives on CSP to inform future developments.MethodsQualitative research including 23 semi-structured interviews with 13 health professionals and 3 co-ordinators. Interpretive analysis, including considerations of how different understandings, enactments, experiences and evaluative judgements of CSP clustered across health professionals, and potential causal links between them.ResultsBoth polyclinic teams introduced CSP and sustained it through COVID-19 disruptions. The first examples health professionals gave of CSP ‘going well’ all involved patients who came prepared, motivated and able to modify behaviours to improve their biomedical markers, but health professionals also said that they only occasionally saw such patients in practice. Health professionals’ accounts of how they conducted CSP conversations varied: some interpretations and reported enactments were less clearly aligned with the developers’ person-centred aspirations than others. Health professionals brought different communication skill repertoires to their encounters and responded variably to challenges to CSP that arose from: the linguistic and educational diversity of patients in this polyclinic context; the cultural shift that CSP involved; workload pressures; organisational factors that limited relational and informational continuity of care; and policies promoting biomedical measures as key indicators of healthcare quality. While all participants saw potential in CSP, they differed in the extent to which they recognised relational and experiential benefits of CSP (beyond biomedical benefits), and their recommendations for continuing its use beyond the clinical trial were contingent on several considerations. Our analysis shows how narrower and broader interpretive emphases and initial skill repertoires can interact with situational challenges and respectively constrain or extend health professionals’ ability to refine their skills with experiential learning, reduce or enhance the potential benefits of CSP, and erode or strengthen motivation to use CSP.ConclusionHealth professionals’ interpretations of CSP, along with their communication skills, interact in complex ways with other features of healthcare systems and diverse patient-circumstance scenarios. They warrant careful attention in efforts to implement and evaluate person-centred support for people with long-term conditions.

Exploring the historical and future spatial interaction relationship between urbanization and ecosystem services in the Yangtze River Basin, China

Diagnosing the spatial interaction between urbanization and ecosystem services (ES) is of guiding significance for regional sustainable development. The complex spatial interactions mechanism between different types of urbanization and ES during historical and future periods were rarely explored at the whole watershed scale. To fill this gap, we systematically evaluated, predicted and compared the complex spatial interaction relationship between different types of urbanization and ES in the Yangtze River Basin (YRB) during 1990–2019 and in 2050 under different Shared Socioeconomic Pathways (SSPs) and Representative Concentration Pathways (RCPs) scenarios. Results showed that economic and land urbanization in the YRB will increase sharply during 1990–2050, while the population urbanization will drop slightly during 2019–2050. More than 59% of the YRB will experience an increase in total ecosystem services (TES) in SSP1-2.6 and SSP2-4.5 scenarios during 2019–2050. The average coupling coordination degree (CCD) between urbanization and TES in the YRB ranged 0.16–0.61 during 1990–2050, with a gradual increase from severe uncoordinated to basic coordination, and experienced a transition from lagging urbanization to lagging TES. More than 64% and 38% of the YRB will achieve strong decoupling between economic and population urbanization and TES during 1990–2050, respectively, which largely occur in the upper reaches, while over 34% of the YRB belong to weak decoupling between land urbanization and TES except for SSP1-2.6, which cluster in the middle and lower reaches. Moreover, we found that SSP1-2.6 will be the most promising scenario to achieve a win-win situation between different types of urbanization and TES, while prominent conflict between them will likely emerge in SSP5-8.5 scenario. The findings can contribute to further understanding the spatial interaction relationship between urbanization and ES, and provide support for ecosystem protection and sustainable urban planning.

Resilience, posttraumatic growth and psychological wellbeing of paramedicine clinicians: An integrative review

Clinicians in paramedicine are exposed to stressful events at work that have potential to cause negative psychological outcomes. Posttraumatic growth (PTG), resilience and psychological wellbeing, however, are adaptive psychological states that can also occur following trauma and adversity. Synthesis of knowledge on these positive outcomes can provide insight into resources needed to support paramedicine clinicians. To examine and synthesise what is known of PTG, resilience and psychological wellbeing of paramedicine clinicians, including the experience of these phenomena and relationship between them. An integrative review of peer-reviewed empirical literature published in English from 2013 to 2022 was conducted, following Whittemore and Knafl’s method. CINAHL Complete, MEDLINE Complete, PsycINFO, Scopus and Embase databases were searched. Included articles were quality appraised, with data analysed using the constant comparison method. Thirteen articles were included, with results synthesised into four categories. Mean PTG scores were reportedly moderate, and resilience ranged from average to above average. PTG and resilience had positive and negative relationships with specific coping strategies including dysfunctional coping, active coping, planning, venting emotions, social and emotional support and mental and behavioural disengagement. PTG scores were significantly lower for clinicians with longer shift duration and paramedics compared to emergency medical technicians. Resilience scores were higher for clinicians working part-time. Wellbeing was reportedly moderate and associated with the psychosocial climate established by managers. Qualitative findings indicated that workplace culture was perceived as stoic and masculine, which served to undermine staff resilience and willingness to disclose emotions. To support PTG and resilience, organisations should work to reduce stressors in workplace culture, including management and clinical supervision style, and offer employment flexibility. Organisations can upskill clinicians’ capacity for positive adaptation to adversity with professional development targeting identified coping strategies. Future research could examine clinicians’ experiences of PTG, resilience and wellbeing, and the relationship between them.

Going soft on soft skills

Much has been documented about the impacts of the COVID-19 pandemic on hard skill development (i.e., skills and knowledge) during clinical placements. Little is known, especially from a student supervisor perspective, on the impacts of the pandemic on soft skills (e.g., communication, teamwork) during student clinical placements. A mixed methods online survey was administered to healthcare workers in 2021. The survey collected textual data from 216 respondents through 22 questions. Using a hybrid content analysis approach, data were analysed deductively using the Canadian Interprofessional Competency Framework domains, and inductively. Three categories were developed namely reduced access impairing soft skill development, adjusted learning experiences strengthening soft skills, and telehealth being a barrier to soft skills. Student supervisors, healthcare organisations, and policy makers can use this information to guide new graduate support plans, additional learning strategies, appropriate telehealth infrastructure, and staff training to promote soft skills. Collectively, these measures can be useful in ensuring future pandemic preparedness.

CHALLENGES OF POST- COVID VIETNAM TOURIST BRAND RECOVERY

This article analyzes the resurrection of the Vietnam's tourism industry after COVID-19 pandemic, which had a significant impact on the tourism industry, particularly in terms of reducing travel demand and disrupting supply chains. However, the government has implemented several measures to support the industry and promote tourism, including financial assistance, tax incentives, and marketing campaigns. The article highlights the need for continued government support and strategic planning to ensure the long-term recovery and growth of Vietnam's tourism industry. In addition, this paper elaborates on the factors that have impacted the slow return of Vietnam's tourism industry post-COVID-19 pandemic and the government's role in promoting the country's tourism brand. Opportunities and recommendations for Vietnam are discussed to enhance its tourism industry and effectively promote its image in the post-pandemic era.

Identification of Critical Links in Urban Road Network Based on GIS

A GIS-based method is proposed to identify critical links in urban road networks. This study utilizes a geographic information system (GIS) to evaluate the distribution of road infrastructure, road density, and network accessibility at the micro, meso, and macro levels. At the micro level, GIS is used to assess the distribution of public facilities along the roads. At the meso level, a city’s road density distribution is evaluated. At the macro level, a spatial barrier model and a transportation network model are constructed to assess the network accessibility. An inverse distance weighting method is employed to interpolate the accessibility. Furthermore, a network topology is established, and the entropy method is utilized to evaluate the sections comprehensively. The sections are ranked based on the evaluation results to identify the critical links in the urban road network. The road-network data and points of interest (POI) data from the Anning District in Lanzhou are selected for a case study, and the results indicate that the top five critical links have scores of 0.641, 0.571, 0.570, 0.519, and 0.508, respectively. Considering the three indicators enhances the accuracy of critical section identification, demonstrating the effectiveness of the proposed method. Visualizing each indicator using GIS 10.7 provides a new approach to identifying critical links in urban road networks and offers essential theoretical support for urban planning.

Research on resilience model of UAV swarm based on complex network dynamics

The resilience of UAV swarms mainly revolves around ensuring stable and uninterrupted operations. Malicious attacks can implement the adverse impacts of potential threats through swarm communication links. In this context, the SIS (Susceptible → Infected → Susceptible) method is suitable for describing the information transmission within UAV swarms. An enhanced resilience model of the UAV swarm is proposed in this study, which incorporates the factors of self-dynamics, dynamics of topology, dynamics of information transmission, and SIS into the complex network model. The model proposed in this paper has the capability to effectively capture changes in the network topology as well as the dynamics of the system. The average number of susceptible drones is utilized as the metric to evaluate the resilience of the swarm. Furthermore, an experiment is conducted where a UAV swarm successfully carries out a surveillance mission. The proposed model not only enables the support of mission planning but also facilitates the design enhancements of UAV swarms.

“I get higher marks via BYOD”: A descriptive qualitative study on student experiences using BYOD e-assessments to enhance the dimensions of administration and support for learning excellence.

Background: A Bring Your Own Device (BYOD) e-assessment strategy empowers students to use personal devices for digital exams, reducing the need for specialised facilities and enhancing learning excellence by simplifying by streamlining the administrative and support dimensions of the student experience. Despite its benefits, it remains underused. This study investigates student perceptions of BYOD for e-assessments within a Faculty of Medicine and Health Science. Methods: A descriptive qualitative approach was adopted, employing a survey with open-ended and Likert-scale questions to delve into student experiences. Results: The findings revealed that 82.7% of students had a positive experience due to the method's efficiency and convenience. However, 20.7% still preferred traditional pen-and-paper assessments. Various factors, such as technical difficulties, device quality and familiarity, and confidence in using technology, shaped these experiences. Students with older devices expressed worries about compatibility and performance. There were also issues related to connectivity and the specific device used. Interestingly, most students felt a sense of safety and were less stressed using a familiar device. However, those with outdated devices harboured performance concerns, and some lacked confidence in their technological skills. Conclusion: While BYOD for e-assessment offers a valuable means to enhance student experience and decrease administrative load, it is not a one-size-fits-all solution. Successful execution requires a mix of interventions, including faculty support, student training, and thoughtful planning. When implementing a BYOD e-assessment system, it is essential to consider student experiences and address their needs. Additionally, implementing BYOD for assessment requires multiple strategic actions to ensure effective integration. Furthermore, the study underlines the need for a comprehensive learning excellence approach that factors in student support and administration, affirming that technology can elevate the student experience. Therefore, conducting research on how technology can contribute to learning excellence warrants more research.

Land Use/Cover Change Prediction Based on a New Hybrid Logistic-Multicriteria Evaluation-Cellular Automata-Markov Model Taking Hefei, China as an Example

Land use/cover change (LUCC) detection and modeling play an important role in global environmental change research, in particular, policy-making to mitigate climate change, support land spatial planning, and achieve sustainable development. For the time being, a couple of hybrid models, such as cellular automata–Markov (CM), logistic–cellular automata-Markov (LCM), multicriteria evaluation (MCE), and multicriteria evaluation–cellular automata–Markov (MCM), are available. However, their disadvantages lie in either dependence on expert knowledge, ignoring the constraining factors, or without consideration of driving factors. For this purpose, we proposed in this paper a new hybrid model, the logistic–multicriteria evaluation–cellular automata–Markov (LMCM) model, that uses the fully standardized logistic regression coefficients as impact weights of the driving factors to represent their importance on each land use type in order to avoid these defects but is able to better predict the future land use pattern with higher accuracy taking Hefei, China as a study area. Based on field investigation, Landsat images dated 2010, 2015, and 2020, together with digital elevation model (DEM) data, were harnessed for land use/cover (LUC) mapping using a supervised classification approach, which was achieved with high overall accuracy (AC) and reliability (AC &gt; 95%). LUC changes in the periods 2010–2015 and 2015–2020 were hence detected using a post-classification differencing approach. Based on the LUC patterns of the study area in 2010 and 2015, the one of 2020 was simulated by the LMCM, CM, LCM, and MCM models under the same conditions and then compared with the classified LUC map of 2020. The results show that the LMCM model performs better than the other three models with a higher simulation accuracy, i.e., 1.72–5.4%, 2.14–6.63%, and 2.78–9.33% higher than the CM, LCM, and MCM models, respectively. For this reason, we used the LMCM model to simulate and predict the LUC pattern of the study area in 2025. It is expected that the results of the simulation may provide scientific support for spatial planning of territory in Hefei, and the LMCM model can be applied to other areas in China and the world for similar purposes.

A - 119 A Case Study: the Cognitive Functioning of an Adult Patient with Recurrent Craniopharyngiomas.

Craniopharyngiomas are extremely rare (incidence rate of 1.34 per million). Due to its proximity to the sellar/suprasellar prefrontal regions region, cognitive impairment, behavioral changes, and adverse endocrinological outcomes are common. Further, surgery and radiotherapy can further impact functioning. Currently, there is no parsimonious cognitive profile of adult patients following interventions. This case highlights the role of neuropsychological evaluations in monitoring global psychological functioning and frontal behavioral syndrome in an adult with recurrent craniopharyngioma. The patient is a 39-year-old Black female first evaluated as an inpatient prior to resection surgery. She was evaluated on four additional times post-surgically. At the most recent evaluation, she and her family reported memory problems, apathy, and gait instability. Complicating factors included hypothyroidism, chronic kidney disease, diabetes, obstructive sleep apnea, pulmonary embolism, hypotension, COVID-19, and recurrent tachycardia, with inconsistent adherence to treatment recommendations. She displayed global cognitive deficits two years post-surgery, particularly in language and memory. Neurobehaviorally, she exhibited pervasive signs of severe frontal lobe syndrome, including, abulia, hypophonic and dysarthric speech, psychomotor retardation, bradyphrenia, and anosognosia. Neuropsychological evaluations remain critical in monitoring the patient's neurocognitive status and provide valuable insights into treatment planning and need for additional support and care to optimize patients' quality of life in the context of significant cognitive disability.

Local authority variation in primary school-recorded special educational needs provision among children with major congenital anomalies: A research protocol

Introduction: Special educational needs (SEN) provision has been called a “postcode lottery” in England, but the extent to which this represents underlying inequities has not been sufficiently investigated. This study will focus on children with similar underlying health characteristics to explore sources of systematic variation in SEN provision by local authority (LA) in England. Methods and analysis: We will use linked individual-level state-funded hospital and school records from the Education and Health Insights from Linked Data (ECHILD) database, alongside open-source school-level data. Our cohort will be defined as singleton children with major congenital anomalies born in England between 1 September 2003 and 31 August 2012. We will identify major congenital anomalies from diagnoses in hospital records in the first year of life using European Surveillance of Congenital Anomalies (EUROCAT) guidelines. LA (152 in total) will be defined by child’s residential address reported in education records at entry into year one of school (aged five years old). SEN provision will be defined by a recording of an educational health and care plan or SEN support in any census in Reception, year one or two of primary school (ages four/five to six/seven). To quantify variation in SEN provision we will fit multilevel logistic regression models to the individual records, with a-priori selected individual-, school- and LA-level characteristics. We will report the estimated intraclass correlation coefficient at each stage of the model, signifying the percentage of remaining variation in the odds of recorded SEN provision that is due to differences between LAs. Ethics and dissemination: We have existing research ethics approval for analyses of the ECHILD database described in this protocol. We will disseminate our findings to diverse audiences (academics, relevant government departments, service users and providers) through seminars, peer-reviewed publications, short briefing reports and infographics for non-academics (published on the study website).