Relevant Terms Research Articles

Anti-discriminatory language in public health research and practice in Germany

Abstract Anti-discriminatory language has long been an important topic in the education and media sector, and has also been discussed in international public health research since the 1980s. However, the topic has so far had little presence in public health in Germany. Therefore, a guideline on discrimination-sensitive language around migration and health was developed at the Robert Koch Institute within the Improving Health Monitoring in Migrant Populations project. The 5 basic principles together with an overview of relevant terms and concepts are an orientation for responsible communication in public health research and invites people to critically examine and reflect on their own use of language. Expertise from the education and media sector, as well as from our anti-racist network played a crucial role the creation of the guideline. We will present and discuss the guideline with the international public health community to continue the learning process initiated during the creation process.

Guidelines for alcohol consumption in the era of ‘no safe levels’ - where do we stand?

Abstract Background Despite claims that moderation consumption could improve health outcomes, namely cardiovascular health, the latest scientific evidence shows there is no safe amount of alcohol consumption. This study sought to determine the current definitions of standard drink and alcohol consumption guidelines across different nations. Methods Based on information from the WHO and the authors’ own judgment, a pool of countries with available data was created. In order to gather the required information, structured internet searches of relevant terms for each country were conducted. Results In 2015, a similar study was conducted but no actualizations were made afterwards. Currently, there has yet to be a standard drink definition agreed upon by every national government, and there are differences between what constitutes this standard drink. Countries have different guidelines for how much alcohol is safe to consume, and low-risk consumption guidelines vary considerably. There are also double standards for men and women. There are few governments that explicitly state that alcohol consumption should be zero. Conclusions National drinking recommendations and guidelines and standard drinking units differ considerably from country to country. It should be evaluated how this impacts public health since this is information available to the general public and can influence how citizens view what they should consume. Public dissemination of messages about so-called safe alcohol consumption levels, moderate alcohol consumption, or protective effects of alcohol consumption is against WHO recommendations, so state governments and national health institutes should consider this matter. Key messages • Countries do not have standardized public health definitions and messages concerning alcohol consumption. • Public health practitioners should update the content of alcohol guidelines accessible to the public to accommodate the latest scientific evidence.

Waste-pathogen combinations from land-spreading for a farm-to-fork QMRA of public health in Ireland

Abstract Recent reports highlight the importance of assessing public health and food safety risks via land-spreading of organic wastes (i.e., biofertilisers) in Ireland. Accordingly, this study established a modular framework for farm-to-fork quantitative microbial risk assessment (QMRA) of targeted waste-pathogen combinations (W-PCs) due to land-spreading. Assessments will also consider resultant cross-contamination of soil, livestock, water, and crops (i.e., One Health approach). A scoping review of the scientific literature was undertaken, employing search strings of relevant terms relating to enteric pathogens in land-spread animal manures and biosolids. The primary eligibility criterion was “spatial relevance” (i.e., Ireland and western Europe). Directed graphical model chains were developed, incorporating both stochastic model parameters and inherent uncertainty and variability associated with model inputs. Mixed effects meta-analyses, likelihood ratio testing, and stepwise multivariate regression were used to pool estimates from extracted farm-level datasets (i.e., harmonisation, weighting, and density function fitting for target pathogen prevalence and concentration). Identified priority W-PCs based on Irish environmental prevalence and epidemiological data were: bovine slurry (BS)-STEC O157/O26, BS-Cryptosporidium parvum, biosolids-noroviruses GI and GII, and broiler litter-Campylobacter jejuni. All distributed baseline prevalence meta-models included: pooled estimates ranging 0.13-0.43, SE ranging 0.04-0.06 (for p ranging <0.0001-0.009, respectively), and bioclimatic indicators, temperature and precipitation seasonality (for p ranging <0.0001-0.01, respectively), explaining 34.91%-54.75% of heterogeneity (system variance). The directed graphical model chains, pooled analyses, and fitted distributions for identified W-PCs provide the first modular framework for spatially explicit QMRA of land-spreading in the Republic of Ireland. Acknowledgements DAFM R2021453 Key messages • The modular framework provides the tools to assess the public health and food safety risks of land-spread biofertilisers in Ireland. • This is the first modular framework for spatially explicit QMRA of land-spreading in the Republic of Ireland.

Assessing the Content Validity of Preference-Based Measures in Cancer

ObjectivesThis study assessed the content validity of generic and condition-specific preference-based measures (PBMs) with patients treated for cancer, evaluated against 10 Consensus-Based Standards for the Selection of Health Measurement Instruments criteria for good content validity, to best inform measurement strategies regarding the use of PBMs in oncology development programs and real-world applications. MethodsIndividual, semistructured interviews were conducted with patients who received drug treatment for cancer in the United Kingdom (n = 47) and the United States (n = 49). During the interview, patients completed 3 generic PBMs (EQ-5D-5L, EuroQol Health and Wellbeing measure–Short Form, Château Santé Base) and 2 condition-specific PBMs (Quality of Life Utility-Core 10 Dimension, Functional Assessment of Cancer Therapy Eight Dimension [FACT-8D]). Interviews were conducted via teleconference, audio recorded, and transcribed verbatim. Transcripts were coded using thematic and content analysis methods. ResultsCondition-specific measures were evaluated as having better relevancy than generic PBMs. Overall, the FACT-8D was evaluated as holding the best content validity in terms of relevancy, and the EuroQol Health and Wellbeing measure–Short Form received the most favorable evaluation of relevancy for generic PBMs. All measures demonstrated comparable comprehensiveness, with all suggested by patients to be missing concepts. The EQ-5D-5L was evaluated best in terms of comprehensibility. This was followed by the Quality of Life Utility-Core 10 Dimension and FACT-8D; both received similar evaluations. ConclusionsAll measures were generally seen by patients as adequate in capturing appropriate aspects of health-related quality of life for measuring cancer outcomes, although together condition-specific measures were evaluated as having better relevancy than generic PBMs. Further health-related quality of life instrument development is encouraged, particularly with regard to the longer-term detrimental impacts of cancer and treatment side effects. Other developments could include new cancer-specific tools inclusive of conventional health items, treatment impacts, and psychological items.

Musculoskeletal Injuries in Table Tennis during Competition: A Systematic Review.

The study aimed to investigate the incidence of musculoskeletal injuries among table tennis players and identify their associated risk factors. We conducted a literature search in online databases using relevant search terms related to "table tennis" and "injury". To compare the rate of injuries according to player-related variables, we extracted information on sex, level of games, circumstances of injury, and duration of sport absence after injury. Furthermore, we calculated the odds ratios based on the number of injuries according to variables. Eight articles included 873 professional table tennis players, revealing an overall musculoskeletal injury rate of 3.6% (31 musculoskeletal injuries). The incidence was 10.0 injuries per 1,000 playing hours (range, 0-27.0). The rate of musculoskeletal injuries for female and male players were 3.2% and 3.8%, respectively, and those for Summer Olympic Games, Asian Games, and domestic national games was 4.8%, 15.4%, and 0%, respectively. More than half (52%) of injuries occurred during training, and most injuries (64%) were of a nature that did not cause time loss. This review provides valuable information about the incidence of musculoskeletal injuries in table tennis competitions. However, owing to the limitations of this study in identifying injury-related risk factors, future studies analyzing comprehensive variables are required.

Considerations of Low Carbohydrate Availability (LCA) to Relative Energy Deficiency in Sport (RED-S) in Female Endurance Athletes: A Narrative Review.

The purpose of this narrative review is to identify health and performance consequences associated with LCA in female endurance athletes. The intake of carbohydrates (CHO) before, during, and after exercise has been demonstrated to support sport performance, especially endurance activities which rely extensively on CHO as a fuel source. However, low energy availability (LEA) and low carbohydrate availability (LCA) are common in female athletes. LEA occurs when energy intake is insufficient compared to exercise energy expenditure, and LEA-related conditions (e.g., Female Athlete Triad (Triad) and Relative Energy Deficiency in Sport (RED-S)) are associated with a myriad of health and performance consequences. The RED-S model highlights 10 health consequences and 10 performance consequences related to LEA. The independent effect of LCA on health and performance has been under-researched, despite current CHO intake being commonly insufficient in athletes. It is proposed that LCA may not only contribute to LEA but also have independent health and performance consequences in athletes. Furthermore, this review highlights current recommendations for CHO intake, as well as recent data on LCA prevalence and menstrual cycle considerations. A literature review was conducted on PubMed, Science Direct, and ResearchGate using relevant search terms (i.e., "low carbohydrate/energy availability", "female distance runners"). Twenty-one articles were identified and twelve met the inclusion criteria. The total number of articles included in this review is 12, with 7 studies illustrating that LCA was associated with direct negative health and/or performance implications for endurance-based athletes. Several studies included assessed male athletes only, and no studies included a female-only study design. Overall, the cumulative data show that female athletes remain underrepresented in sports science research and that current CHO intake recommendations and strategies may fail to consider female-specific adaptations and hormone responses, such as monthly fluctuations in estrogen and progesterone throughout the menstrual cycle. Current CHO guidelines for female athletes and exercising women need to be audited and explored further in the literature to support female athlete health and performance.

Management and Challenges of Senior High School

The purpose of the study was to explore the management and challenges of senior high schools in the fourth zone of Zambales. It looked into the level of management of senior high schools in terms of its roles and services and the level challenges of senior high school in terms of relevance of the program, responsiveness and quality. The null hypotheses were tested at .05 level of relationship between the career preference of junior high school student respondents and their profile variables. The descriptive method of research was employed and the questionnaire – checklist was used in gathering data. Frequency counts, percentages, numerical rankings, weighted means and Chi square were the statistical tools used in the analysis of data. The following recommendations are deemed essential and suitable. Utilized and proposed a career program guide focusing on how to help students decide on their future career. Review role responsibilities and levels of administrative support for principals to ensure that their priority is educational management and leadership and addressing to the challenges it encounters. Upgrading of school facilities that are suitable to the needs of the students. Emphasis on quality improvement. The particular challenge will be to maintain and extend quality at the primary level while expanding access at the SHS level. Continued push toward decentralization. The central issue will be how to attend to the needs of every school who are assigned to responsibilities for which they are not prepared.

Influenza Epidemic Trend Surveillance and Prediction Based on Search Engine Data: Deep Learning Model Study.

Influenza outbreaks pose a significant threat to global public health. Traditional surveillance systems and simple algorithms often struggle to predict influenza outbreaks in an accurate and timely manner. Big data and modern technology have offered new modalities for disease surveillance and prediction. Influenza-like illness can serve as a valuable surveillance tool for emerging respiratory infectious diseases like influenza and COVID-19, especially when reported case data may not fully reflect the actual epidemic curve. This study aimed to develop a predictive model for influenza outbreaks by combining Baidu search query data with traditional virological surveillance data. The goal was to improve early detection and preparedness for influenza outbreaks in both northern and southern China, providing evidence for supplementing modern intelligence epidemic surveillance methods. We collected virological data from the National Influenza Surveillance Network and Baidu search query data from January 2011 to July 2018, totaling 3,691,865 and 1,563,361 respective samples. Relevant search terms related to influenza were identified and analyzed for their correlation with influenza-positive rates using Pearson correlation analysis. A distributed lag nonlinear model was used to assess the lag correlation of the search terms with influenza activity. Subsequently, a predictive model based on the gated recurrent unit and multiple attention mechanisms was developed to forecast the influenza-positive trend. This study revealed a high correlation between specific Baidu search terms and influenza-positive rates in both northern and southern China, except for 1 term. The search terms were categorized into 4 groups: essential facts on influenza, influenza symptoms, influenza treatment and medicine, and influenza prevention, all of which showed correlation with the influenza-positive rate. The influenza prevention and influenza symptom groups had a lag correlation of 1.4-3.2 and 5.0-8.0 days, respectively. The Baidu search terms could help predict the influenza-positive rate 14-22 days in advance in southern China but interfered with influenza surveillance in northern China. Complementing traditional disease surveillance systems with information from web-based data sources can aid in detecting warning signs of influenza outbreaks earlier. However, supplementation of modern surveillance with search engine information should be approached cautiously. This approach provides valuable insights for digital epidemiology and has the potential for broader application in respiratory infectious disease surveillance. Further research should explore the optimization and customization of search terms for different regions and languages to improve the accuracy of influenza prediction models.

Education for Sustainability—Some Bibliometric Insights

The opportunities and challenges related to sustainability impose not only a societal transformation but also a personal one. Higher Education Institutions (HEIs) have great potential to promote sustainability and shape future generations’ skills, knowledge, thinking, and actions. Addressing environmental, social, and economic pillars, education for sustainable development (ESD), or education for sustainability (EfS), is a catalyst for quality education towards a sustainable future. This paper aims to analyze the state of the art and prevailing trends in the scientific literature pertaining to ESD/EfS. In this regard, specific objectives were established to identify the following: (1) authors’ productivity over time; (2) countries’ contribution and collaboration; (3) the most relevant keywords; and (4) the most prominent themes—in terms of relevance and degree of development. To fulfill the research objectives, quantitative research employing bibliometric analysis was carried out in April 2023. The research data sample was collected from the Web of Science (WoS) database. By conducting the search using a combined topic (“education for sustainable development” OR “education for sustainability”), a total of 2827 documents in English were identified within a timeframe of 33 years (1989–2023). These documents served as the foundation for subsequent data processing, visualization, and analysis using Biblioshiny/Bibliometrix (version R-4.2.0), as well as Excel (version 2309) software. The visualization and analysis focused on examining the most prolific authors and countries, in addition to generating word clouds based on keywords. Moreover, the thematic map that was delineated into four quadrants—Basic, Motor, Niche, and Emerging or Declining themes—provides an overview of the researched subject. ESD—embracing environmental, social, and economic pillars—implies transformative learning, action-oriented pedagogies, and professional development. As a holistic framework, it requires interdisciplinarity, system thinking, critical and experiential thinking, problem-based learning, and the use of 4IR technologies to enhance the teaching-learning process.

Dual antiplatelet management in the perioperative period: updated and expanded systematic review

BackgroundAntiplatelet agents are central in the management of vascular disease. The use of dual antiplatelet therapy (DAPT) for the management of thromboembolic complications must be weighed against bleeding risk in the perioperative setting. This balance is critical in patients undergoing cardiac or non-cardiac surgery. The management of patients on DAPT for any indication (including stents) is not clear and there is limited evidence to guide decision-making. This review summarizes current evidence since 2015 regarding the occurrence of major adverse events associated with continuing, suspending, or varying DAPT in the perioperative period.MethodsA research librarian searched PubMed and Cochrane from November 30, 2015 to May 17, 2022, for relevant terms regarding adult patients on DAPT for any reason undergoing surgery, with a perioperative variation in DAPT strategy. Outcomes of interest included the occurrence of major adverse cardiac events, major adverse limb events, all-cause death, major bleeding, and reoperation. We considered withdrawal or discontinuation of DAPT as stopping either aspirin or a P2Y12 inhibitor or both agents; continuation of DAPT indicates that both drugs were given in the specified timeframe.ResultsEighteen observational studies met the inclusion criteria. No RCTs were identified, and no studies were judged to be at low risk of bias. Twelve studies reported on CABG. Withholding DAPT therapy for more than 2 days was associated with less blood loss and a slight trend favoring less transfusion and surgical re-exploration. Among five observational CABG studies, there were no statistically significant differences in patient death across DAPT management strategies. Few studies reported cardiac outcomes. The remaining studies, which were about procedures other than exclusively CABG, demonstrated mixed findings with respect to DAPT strategy, bleeding, and ischemic outcomes.ConclusionThe evidence base on the benefits and risks of different perioperative DAPT strategies for patients with stents is extremely limited. The strongest signal, which was still judged as low certainty evidence, is that suspension of DAPT for greater than 2 days prior to CABG surgery is associated with less bleeding, transfusions, and re-explorations. Different DAPT strategies’ association with other outcomes of interest, such as MACE, remains uncertain. Systematic review registrationA preregistered protocol for this review can be found on the PROSPERO International Prospective Register of systematic reviews (http://www.crd.york.ac.uk/PROSPERO/; registration number: CRD42022371032).

New terminology of medication adherence enabling and supporting activities: ENABLE terminology.

Introduction: Medication non-adherence negatively affects the effectiveness of evidence-based therapies and sustainability of healthcare systems. Lack of agreed terminology of medication adherence enabling and supporting activities leads to underuse of the available tools. The ENABLE COST Action was aimed at proposing a new terminology for these activities in order to help both scientific research and its clinical application. Methods: Initial discussions within the ENABLE Working Groups allowed for the conceptualization of four interlinked terms related to adherence, i.e., "medication adherence technology", "medication adherence enhancing intervention", "best practice" and "reimbursement". The iterative process of internal discussion was structured around two dedicated international workshops. Moreover, extensive stakeholder consultations have been organised, including an interactive online survey used to assess the level of agreement with, and the clarity of relevant terms and definitions proposed. Results: Detailed analysis of the results of this process allowed for fine-tuning of the items, and finally, for proposing the final set of definitions. Across all the three phases of this process, the definitions were substantially modified to better reflect the concepts, simplify the language, and assure completeness and cohesiveness of terminology. Feedback obtained from the stakeholders helped this process and confirmed that the final terms and definitions were well received by the experts active in the field of medication adherence. Discussion: Covering the gap in the existing terminology, this work proposes a cohesive set of terms and definitions applicable to medication adherence enabling and supporting activities. Promoting evidence-based approach to this field, this terminology may help research, clinical practice and policy.

Eclipse Open SmartCLIDE: An end-to-end framework for facilitating service reuse in cloud development

Service-Oriented Architectures (SOA) have become a standard for developing software applications, including but not limited to cloud-based ones and enterprise systems. When using SOA, software engineers organize the desired functionality into self-contained and independent services that are invoked through end-points (with API calls). The use of this emerging technology has changed drastically the way that software reuse is performed, in the sense that a “service” is a “code chunk” that is reusable (preferably in a black-box manner), but in many (especially “in-house”) cases, white-box reuse is also meaningful. To confront the reuse challenges opened-up by the rise of SOA, in the SmartCLIDE project11An EU-funded Research and Innovation project with a duration of 40 months, supported by a consortium of 11 research, innovation, and industrial partners. we have developed a framework (a methodology and a platform) to aid software engineers in systematic and more efficient (in terms of time, quality, defects, and process) reuse of services, when developing SOA-based cloud applications. In this work, we: (a) present the SmartCLIDE methodology and the Eclipse Open SmartCLIDE platform; and (b) evaluate the usefulness of the framework, in terms of relevance, usability, and obtained benefits. The results of the study have confirmed the relevance and rigor of the framework, unveiled some limitations, and pointed to interesting future work directions, but also provided some actionable implications for researchers and practitioners.

Psychometric analysis of the revised CompLEC test to measure reading speed and reading comprehension in university students

BackgroundAt university level, reading comprehension is one of the most important linguistic competences in the professional training of students because it is an instrument that enables the acquisition and production of scientific knowledge. Likewise, at this level of education, speed reading becomes a technique that allows to make the most of the time devoted to reading and to develop the ability to concentrate. However, there are not many instruments in the scientific literature that measure these two variables; therefore, the objective of this study was: To determine the psychometric properties of the revised compLEC test to measure reading comprehension and speed in university students.MethodThe study was conducted under the quantitative approach, applied type, with non-experimental design. The type of sampling used was non-probabilistic and the sample consisted of 441 university students of both genders. The instrument prepared and applied was the Reading Speed and Reading Comprehension Test for Higher Education, which is an adaptation of the CompLEC test.ResultsIn the study, all the items had values above 0.80, which shows that the items were rated positively in terms of pertinence, relevance, and clarity. It was also evidenced that the model of three related factors presents adequate fit indices (CFI = 0.91; TLI = 0.90; RMSEA = 0.034 [IC90% 0.021 ‒ 0.046]; SRMR = 0.072). On the other hand, only the Recovery dimension (ordinal α = 0.62) presented acceptable reliability indices.ConclusionThe results show that the Reading Speed and Reading Comprehension Test for Higher Education has adequate psychometric characteristics in terms of content validity and internal structure of the scale. However, further studies are required to confirm the reliability of the scale.

Validation of the Cantonese version of the Traditional Chinese Medicine (TCM) Body constitution Questionnaire in elderly people

BackgroundThe Traditional Chinese Medicine (TCM) Body Constitution Questionnaire (For Elderly People) (TCMECQ) is a patient-reported outcome questionnaire developed in Mandarin in 2013 to differentiate the body constitutions of the elderly aged 65 and above. Considering the cultural and linguistic differences between Mainland China and Hong Kong (HK) Special Administrative Region, the TCMECQ was translated into Cantonese following “back translation” policy and validated in proper process.MethodsTen Chinese Medicine Practitioners (CMPs) and 30 senior citizens aged 65 or above were recruited to evaluate the first version of the Traditional Chinese Medicine Body Constitution Questionnaire (For Elderly People) (Cantonese version) (TCMECQ-C). Based on their comments, the second version was developed and discussed in the panel meeting to form the third version, validated the third version on 270 recruited seniors. Based on the validation results, a panel of 5 experts finalized the Questionnaire as the final version. The TCMECQ-C developers finalized the Questionnaire as the validated endorsed third version (i.e. final version).ResultsThe item-level content validity index of most items of the TCMECQ-C (First Version) were ranging from 0.80 to 1.00 in terms of clarity, relevance and appropriateness. Factor loadings of Qi-deficiency Constitution ranging from 0.37 to 0.71, Yang-deficiency Constitution ranging from 0.36 to 0.65, Yin-deficiency Constitution ranging from 0.36 to 0.65, and Stagnant Qi Constitution ranging from 0.68 to 0.82. The chi-squared degree-of-freedom ratio was 2.13 (928.63/436), Goodness-of-Fit Index (0.83), Adjusted Goodness-of-Fit Index (0.79), Normed Fit Index (0.66), Comparative Fit Index (0.78), Incremental Fit Index (0.78), Relative Fit Index (0.61) and Tucker–Lewis Index (0.75), and Root Mean Square Error of Approximation (0.07) and Standardized Root Mean Square Residual (0.07), implied acceptable Confirmatory Factor Analysis model fit of the overall scale. A Pearson correlation coefficient (r) showed the sufficient convergent validity for excessive subscales (Phlegm-dampness Constitution and Dampness-heat Constitution with r = 0.35, p < 0.01). Cronbach’s alpha coefficient ranged from 0.56 to 0.89, including Qi-deficiency Constitution (0.67), Yang-deficiency Constitution (0.84), Yin-deficiency Constitution (0.59), Stagnant Blood Constitution (0.56), Stagnant Qi Constitution (0.89), Inherited Special Constitution (0.76) and Balanced Constitution (0.73), indicating acceptable internal consistency for subscales. The intra-class correlation coefficients of the TCMECQ-C ranged from 0.70 to 0.87 (p < 0.001), indicating moderate to good test–retest reliability.ConclusionTCMECQ-C is a valid and reliable questionnaire for assessing the body constitution in Cantonese elderly.

Designing the structural model of temporary medical centers in biological emergencies

ABSTRACT Considering the importance of getting prepared for biological accidents and emergencies caused by the spread of biological agents, it seems necessary to design and codify a specific structural model for the establishment of temporary medical centers and hospitals. The present study was designed to provide a structural model of temporary medical centers in biological emergencies. This is a mixed-method study devised to present a model for the establishment of temporary medical centers. Multi-criteria decision-making methods were implemented in the quantitative section. Multi-criteria decision-making (MCDM) techniques, including Shannon entropy and TOPSIS, were used in this study to prioritize the components. The forms related to multi-criteria decision-making were designed by researchers according to the initial model, which were then completed by 15 experts. Also, 23 structural components of the model were prioritized and classified into four main categories (effective management, resources, infrastructure, and ideas). The categories were prioritized in terms of conceptual relevance as effective management, resources, infrastructure, and ideas, respectively. The results of this study can help to design temporary medical centers and manage biological emergencies more effectively in the future.

Patients with geriatric syndromes and anti-amyloid therapies: lack of consideration? An exploratory analysis of the literature.

Patients who should benefit from anti-amyloid therapies (AAT) are found across all geriatric settings. Yet, it remains unclear how the use of AAT in patients with geriatric syndromes, such as frailty and polypharmacy, has so far been discussed in the literature. Articles on aducanumab, gantenerumab, lecanemab, donanemab, crenezumab, solanezumab were retrieved in MEDLINE from inception to July 2023. For each article, identified geriatric relevant terms were assigned to five discussion contexts (eligibility of AAT study population, safety, prescription, patient clinical profile, alternative outcomes measurement). Article type and the involvement of geriatric healthcare professionals as an author were further extracted. Out of 538 articles, 23 (4.27%) were published in journals from the geriatric category, 44 (8.18%) included an author affiliated with a geriatric institution. One hundred and sixteen (21.56%) articles included at least one geriatric relevant term, which were mostly discussed in the context of safety and eligibility. Articles mentioning geriatric syndromes were more frequently authored by a geriatric healthcare professional (p = 0.044). The use of AAT in patients with geriatric syndromes has so far received poor attention in the literature raising concerns on their use in this patient group. The involvement of geriatric healthcare professionals in future studies may increase the relevance of AAT research in patients with geriatric syndromes.

A Narrative Review of Autism Spectrum Disorder in the Indian Context

Autism is called “spectrum” disorder because there is a wide variation in the type and the severity of symptoms that people experience. India has a vast population, diverse cultures, and multiple languages, making it crucial to under- stand the unique challenges faced by individuals with autism spectrum disorder in the Indian context. This narrative review explores the current state of knowledge about autism spectrum disorder in the Indian context. Databases such as PubMed, Google Scholar, Sage journals, and other sources were searched with relevant terms for preparing this review. All published literature till January 2023 was studied and those which met the inclusion criteria were included. The resources included were original research articles, review articles, web pages, and book chapters addressing the purpose of the paper. Forty-eight such studies which met the inclusion criteria were included in the study. Results showed that the prevalence of autism varied across different studies in India. The study found advanced paternal age, fetal distress, gestational respiratory infections, labor complications, preterm birth, neonatal jaundice, delayed birth cry, birth asphyxia, late initiation of breastfeeding, neonatal seizures, use of maternal hormonal intervention, and consanguinity as some of the identified risk factors of autism spectrum disorder. Parents and families of children with autism have to go through a complex negative experience, both in the family and the community. This negative experience is further compounded by the lack of awareness and access to appropriate professional help and resources. It can be concluded that there is an urgent need for services that help parents cope with the stress of parenting a child with autism.

Bibliometric Analysis of Research Interest in Rural Tourism

Rural tourism is a form of tourism that takes place in non-urban areas and is characterized by traditional lifestyle, rural culture, and nature-based activities. Over time, its features drew attention not only to more and more visitors, but also to researchers, transforming it into one of the most active fields of scientific study. The main objective of this paper is to investigate the evolution of academic work in rural tourism and the main trends in this domain. Using VOS Viewer, we processed a number of 6,656 studies published between 1964 and 2022 and indexed by Scopus, the world’s largest database for academic journals. Results showed a growing interest in rural tourism, with almost 800 articles published each year over the last couple of years. Different European organizations (e.g. British universities) and scientific journals (e.g. Tourism Management) proved to be highly influential, and through most cited authors and documents have shaped the perspective of academic communities on rural tourism. Finally, the cluster analysis of documents, countries, and word frequency in abstracts, titles, and keywords, based on relevance scores and term frequencies, allowed the mapping of bibliometric networks. Consequently, links and interrelations between all these elements were highlighted, as well as specific timelines showing the exact year when researchers, from different parts of the world, decided to focus on certain issues related to rural tourism and thus, managed to convert them into popular subject areas of study.

The use of honey in button battery ingestions: a systematic review.

Button battery (BB) ingestions may cause severe and possibly fatal complications, especially if the battery is located in the esophagus. The application of oral honey has recently been proposed by the National Capital Poison Center in the USA and in an ESPGHAN position paper in Europe, but clinical trials and experimental studies are limited. The goal of this systematic review was to analyze the evidence for this approach. A systematic review of clinical trials and experimental studies on the oral application of honey after BB ingestion in children was performed. Inclusion criteria according to the PICO format were patient age 0-18 years, ingestion of BB, oral administration of honey or other substances, all in vivo and in vitro studies, as well as reported complication rate, esophageal injury, and mortality. A manual search in the databases MEDLINE, Web of Science and Cochrane was performed to identify relevant search terms to form the following queries and to construct the extensive search. Furthermore, the search was extended by using snowballing on the reports reference lists. The review is registered at Research Registry. The identifying number is reviewregistry1581. We found four publications that investigated the effects of honey after button battery ingestion. Three of these presented experimental in vitro and in vivo results and one reported a clinical retrospective study of 8 patients. Follow up studies are required to further elucidate the effectiveness of the treatment with honey. The time intervals in which the use of honey is effective is not clear. Furthermore, a physiological model is needed for in vitro testing, preferably mimicking peristalsis and dynamic flow of the applied substances. However, since it is easy to apply and of minimal risk in patients over one year of age, honey should be considered a possible treatment option during the interval between presentation and endoscopic removal of the retained BB. https://www.researchregistry.com/browse-the-registry#registryofsystematicreviewsmeta-analyses/registryofsystematicreviewsmeta-analysesdetails/643e9df96750410027ee11b0/, identifier: reviewregistry1581.

Relationship between climate change and tourism: an integrative review

ABSTRACT The relationship between tourism and climate change has been explored and studied for a considerable amount of time. In the past quarter-century, more specialised research has emerged, and most recently, the subject of adaptation has been highlighted as an essential study requirement in tourism and climate change studies. This study offers a comprehensive literature assessment on climate change and tourism to date. We did a Boolean-based search on Scopus and got 703 records, which were then analysed bibliometrically using the bibliometrix package of R. It covers adaptation issues, the characteristics of vulnerability in a tourism setting, and the ramifications of such research for local communities. This study illustrates the difficulties associated with the interdependence of climate change and tourism by presenting the most relevant authors, countries, key terms, and research fields. In addition to descriptive insights into the field, we provide the conceptual framework (keyword analysis and thematic map). In addition to bibliometrically evaluating the publications, we closely reviewed the sample studies to gain a more comprehensive picture of the literature on climate change and tourism. Our evaluation reveals significant knowledge gaps and offers future research and policy objectives. Our study has suggested multiple research avenues for this topic.