Urban Settings Research Articles

Pilot study on neonicotinoids in Finnish waterbirds: no detectable concentrations in common goldeneye (Bucephala clangula) plasma.

Neonicotinoids have been detected in farmland-associated birds and exposure to these insecticides has been linked to adverse effects. Even though neonicotinoids are mobile and persistent and have been detected in surface waters and aquatic invertebrates, there is a considerable lack of knowledge on their occurrence in waterbirds. Here we investigated the occurrence of seven neonicotinoids and some of their transformation products (imidacloprid, thiacloprid, thiamethoxam, acetamiprid, clothianidin, dinotefuran, nitenpyram, 6-chloronicotinic acid, hydroxy-imidacloprid, imidacloprid-urea, imidacloprid-olefin, thiamethoxam-urea, thiacloprid-amide, acetamiprid-acetate, and acetamiprid-desmethyl) in blood plasma of 51 incubating female common goldeneyes (Bucephala clangula). We collected samples from five different regions from southern to northern Finland encompassing rural and urban settings in coastal and inland areas. Surprisingly, none of the targeted neonicotinoids was found above the limit of detection in any of the samples. As neonicotinoid concentrations in wild birds can be very low, a likely reason for the nil results is that the LODs were too high; this and other possible reasons for the lack of detection of neonicotinoids in the goldeneyes are discussed. Our results suggest that neonicotinoid exposure in their breeding areas is currently not of major concern to female goldeneyes in Finland. Even though this study did not find any immediate danger of neonicotinoids to goldeneyes, further studies including surface water, aquatic invertebrates, and other bird species could elucidate potential indirect food chain effects.

Urban residential clustering and mobility of ethnic groups: impact of fertility

We studied residential clustering and mobility of ethnic minorities using a theoretical framework based on null models of spatial distributions and movements of populations. Using microdata from population registers we compared the patterns of clustering amongst various socioethnic groups living in and around the capital region of Finland. The models enabled us to connect the factors influencing intraurban migration to the spatial patterns that have developed over time. The observed clustering seems to be a combined effect of fertility and the tendency to migrate locally. The models also highlight the importance of factors like proximity to the city centre, neighbourhood income levels, and similarity of socioeconomic profiles. While the demonstrated relationship between clustering, mobility, and fertility is based on a limited number of observations, it could serve as a motivation for future research in different urban settings. Overall, these insights are expected to contribute to our understanding of demographic dynamics in culturally diverse environments.

Green infrastructure and well-being nexus within slums: a Lagos case

ABSTRACT Green infrastructure includes network of natural systems and environmental features that deliver ecosystem services which improves human well-being. This article reports a study dealing with health-related impacts of green infrastructure within a low-income informal urban setting. The study utilized a quantitative approach through survey data collection from residents in Ajegunle-Ikorodu community in Lagos, Nigeria. The residents’ survey (sample size = 455) was conducted to understand socio-economic and housing characteristics of the residents; green features available; pattern of Park Use. It elicited self-reported health information on physiological well-being and mental health. The Warwick-Edinburgh Mental Well-being Scale was used for mental health assessment. Inferential and descriptive statistical analysis was conducted on the data collected. This study shows a generally low presence of Green Infrastructure. Regression analysis (p = 0.033) affirms the positive link between green spaces and mental health. Contrary to popular opinion, the study revealed no correlation between some aspects of self-reported health and green features. The findings highlight the need to develop and maintain green spaces to optimize health benefits. By exploring the connections between greening and well-being in slums, the study contributes to knowledge on human health-nature linkages among low-income urban residents in context of developing countries.

The Impact of Street Trees on Temperature Reduction in a Nature-Based Climate Adaptation Program in George Town, Malaysia

Nature-based solutions have been promoted as an effective strategy to address climate impacts, including urban temperature reduction. In this paper, we analyze the impacts of the introduction of street trees on temperature (Universal Thermal Climate Index, UTCI) for three different dates, 2000, 2023, and 2050. A 3D model was developed in Rhinoceros software for a part of George Town, on Penang Island. Four different sections of streets were simulated after integration of the model with the Grasshopper plug-in, where a parametric system was built for temperature measurements based on simulations in the Ladybug and Honeybee plug-ins. The tree species used were selected from a pool of tree species commonly planted in urban settings in Malaysia that have low and medium sensitivity to climate impacts. The results show a maximum reduction of 7 °C between 2000 and 2050, achieved on a street with an NW–SE orientation that was planted with three rows of trees. The minimum UTCI reduction achieved was 3 °C, between 2023 and 2050, in a street with NW–SE orientation that was planted with one tree row. The two streets with a SW–NE orientation showed a 5 °C temperature reduction between 2023 and 2050. Both streets have only one row of trees but different species and sizes, with the bigger trees reducing the temperature in a slightly larger area. The results show the importance of introducing and safeguarding street trees to reduce urban temperatures in the country, potentially keeping temperatures below life-threatening levels, thereby safeguarding urban health, while also reducing costs of energy consumption. Solar orientation, the number of tree rows, and their distribution impact the outcomes. The findings provide useful guidance for climate-conscious urban planning practices in Malaysia.

Effects of Litter Removal and Biochar Application on Soil Properties in Urban Forests of Southern China

Urban forests are crucial components of cities, serving as vital ‘green lungs’ that embody urban civilization and sustainability. Despite their significance in maintaining the urban environment and ecological functions, management practices for urban forests can be unreasonable at times. This study investigated the impact of two common practices, litter removal and biochar application, on soil properties in an urban forest in Changsha city, China. The aim was to understand how these practices affect soil carbon, nutrients, and microbial activity in urban settings. The results showed that soil water content (SWC), pH, available phosphorus (AP), and soil microbial biomass carbon (SMBC) were significantly reduced in areas where litter was removed compared to areas where litter was retained. Conversely, biochar application led to a significant increase in SWC, pH, AP, and SMBC. The treatment alone had no significant effects on total nitrogen (TN), soil organic carbon (SOC), and soluble soil organic carbon (SSOC) in the examined urban forests. However, the SOC and SSOC contents significantly increased over time with biochar application. Our results demonstrated that the influences of litter removal and biochar application on soil property were attributed to the regulation of AP and SMBC in the studied urban forests. This study provides a scientific basis and reference for understanding the sustainable management of urban environments and guiding future conservation efforts in urban greening spaces.

Fluorimetric Detection of Vapor Pollutants with Diketopyrrolopyrrole Polymer Microcavities.

The increasing prevalence and detrimental effects of volatile organic compounds are driving the need for selective on-site sensors that do not require complex sampling or instrumentation. Broadband selective sensors exhibiting selectivity based on their distinct response mechanism is becoming of increasing technological relevance in both industrial and urban settings. In this context, we propose a label-free sensor based on a polymeric planar microcavity embedded with a fluorescent organic dye, designed to detect various pollutants in the vapor phase. The sensor consists of alternating layers of cellulose acetate and poly(N-vinylcarbazole) and contains a polystyrene defect layer doped with a quadrupolar diketopyrrolopyrrole. Both the structural properties of the polymer microcavity and the dye in the defect layer contribute to the sensor's response to analytes, creating a dual-probe system where a single photonic element translates chemical signals into optical signals, namely, transmission and fluorescence spectral variations. The discrimination capability of the photonic structure arises from the physicochemical interactions between the analytes and the polymer components. To validate our approach, we evaluate the sensor's response to four distinct volatile molecules and investigate the mechanisms influencing the optical response.

Experimental and theoretical study on building integrated radiative cooling with a limited sky-view factor

Building integrated radiative cooling (BIRC) technology leverages the coldness of outer space through the 8–13 μm atmospheric window for cooling. While BIRC's thermal performance has been widely studied across various climates, urban areas with obstructed sky views pose unique challenges often overlooked. To address this gap, the sky-view factor (SVF) was introduced as a metric to gauge BIRC effectiveness in urban settings. The novelty of this study lies in the experimental validation of SVF's impact on radiative cooling. A novel theoretical model was developed and validated, which was then applied to calculate BIRC's hourly, monthly, and year-round cooling power under Shenzhen's varying SVF conditions. The results revealed significant temperature drops in the RC module, ranging from 4.57 °C to 0.11 °C as SVF decreased from 0.7 to 0.1. Additionally, a numerical model was created based on experimental data, further validating the findings. This comprehensive analysis of SVF's effects on BIRC in Shenzhen's climate demonstrated that RC capacity averaged 57.27 W/m2 for SVF 0.9 but dropped below 22.55 W/m2 when SVF decreased to 0.3 or lower throughout the year. These insights enhance our understanding of BIRC's potential and limitations in densely populated urban environments.

Validation of Noise Barrier Insertion Loss Simulation in Reducing Road Traffic Noise by Site Measurement Data

A noise barrier serves as a method to control noise pollution resulting from road traffic, particularly prevalent in rural areas near heavy traffic routes such as highways. This study focuses on simulating the sound Insertion Loss (IL) of existing noise barriers designed to mitigate road traffic noise around school areas. The primary goal is to assess the precision of the Finite Element Modeling (FEM) program. Utilizing the finite element analysis software, COMSOL, the study models the noise barrier and its surroundings in two-dimensional acoustic radiation problem based on on-site dimensions and parameters. By examining the often-neglected aspect of noise leakage and its impact on noise reduction, the research aims to provide specific guidance for urban planners and architects to optimize noise mitigation in various urban settings. The study reveals a strong agreement between the simulated IL and on-site measurements, with a minimal difference ranging from 0.4 dB to 1.1 dBA on average. Additionally, the research suggests potential improvements to simulation accuracy through adjustments in aperture sizes. The findings demonstrate that finite element simulation can be a valuable tool for designers to assess the effectiveness of noise barriers before construction begins.

Contemporary Art in Public Spaces: Forms of Expression, Social Significance, and Revitalization

Introduction: This study examines the significance of contemporary art in public spaces, with a specific emphasis on its various manifestations, societal functions, and capacity to revitalize urban environments. It emphasizes the ways in which art enhances aesthetic enjoyment, enhances the overall quality of life, and contributes to economic growth. Methodology: A qualitative study examines the use of sculptures, installations, murals, performances, and digital artworks in urban settings. Illustrative instances of effective art initiatives demonstrate the positive impact of these interventions on public spaces. When considering a project, we carefully evaluate factors such as accessibility, interactivity, the differentiation between temporary and permanent installations, and the influence on community relations. Results: The study finds that contemporary art in public spaces expands cultural access, strengthens social bonds, and raises societal awareness. Interactive and temporary artworks particularly influence the use and perception of these spaces, promoting community identification with the environment. Discussions: Art projects like New York City's High Line and Copenhagen's Superkilen show how aesthetic improvements and cultural activities attract residents and tourists, driving economic benefits. Temporary installations and pop-up art actions offer dynamic experiences that continually draw visitors, aiding economic revitalization. Conclusions: Integrating contemporary art into urban development improves public spaces by fostering cultural experiences and contributing to social and economic growth. Cities should actively support such projects to enhance community sense and urban quality of life.

Prevalence of Computer Vision Syndrome and Ergonomic Practices among Adults in an Urban Setting

Prevalence of Computer Vision Syndrome and Ergonomic Practices among Adults in an Urban Setting

Bullying in Banyuwangi's Schools: A Social Studies-Based Comparison between Urban and Suburban Educational Settings

Bullying in Banyuwangi's Schools: A Social Studies-Based Comparison between Urban and Suburban Educational Settings

Geochemical fractionation of trace elements in ostreid and gastropod shells: A potential proxy for heavy metal pollution in Ghana’s coastal environment

The content of trace elements from Crassostrea tulipa (Ostreidae, Bivalvia) from four localities (Pra Estuary, Densu Estuary, Kpone Beach, and Anyanui Creek) along the coast of Ghana has been used as a bioindicator of environmental pollution. The lowest values of heavy metals correspond to the Crassostrea shells from Densu Estuary and Anyanui Creek, whereas the highest contents are recorded in the shells from Pra Estuary and Kpone Beach. Densu Estuary and Anyanui Creek are located in areas not affected by major industries, and only Densu is located in a densely urbanized setting. Crassostrea shells from Densu Estuary are only enriched in Ni. However, the Total Organic Carbon content of the sediments of the Densu Estuary indicates anthropogenic organic pollution not evidenced by the composition of Crassostrea shells. The Crassostrea shells from the Pra Estuary show enrichment in most of the analysed trace elements (Li, Be, V, Cu, Cr, Zn, Ga, Y, Sn, Pb, U, Th, ∑REE, and As) compared with other studied sites. This enrichment is related to heavy metals influx to the Pra River by the mining activities, extensive forest clearance, and loss of soil minerals. The Crassostrea shells from Kpone Beach present comparatively high content of some trace elements (Be, Ba, Cu, Zn, Nb, Pb, and REE). The metal pollutants are related to the input of the Heavy Industrial Area of Tema (located around 3.5 km west of Kpone Beach) and urban effluences from the Greater Accra Region. The high content of Ba, Cu, Zn, and Pb in Crassostrea is directly related to high phytoplankton productivity (mainly for diatoms) linked to the input of trace metals transferred into the marine food webs. In addition, some analyses of gastropod shells from Kpone Beach indicate that Cerithium and Nerita are more sensitive to accumulating Ni and As than Crassostrea. The values of trace metals from the Crassostrea shells of the Densu Estuary and Anyanui Creek are comparatively low. Considering the role of Crassostrea shells as bioindicators for heavy metals pollution, the less polluted localities are Anyanui Creek and Densu Estuary, whereas Pra Estuary and Kpone Beach are affected by anthropic activities such as mining, urban effluents, and industry.

A-287 Mycoplasma pneumoniae outbreak in 2023: Post pandemic resurgence of an atypical bacterial pathogen

Abstract Background Mycoplasma pnuemoniae is an atypical fastidious bacteria known to cause respiratory infections of both upper and lower tract, with a wide range of clinical presentations. M. pnuemoniae is one of the major causes of community acquired pneumonias worldwide. Almost all of the M pnuemoniae outbreak incidences have been reported in closed- community or congregate settings, such as schools, universities and colleges, and hospitals and long-term care facilities. Since the clinical symptoms of M pneumoniae overlap with other pneumonia causing pathogens, detection via multiplex PCR remains paramount for accurate and timely diagnosis to curb the infection spread. In the present study we demonstrate an unexpected increase in the detection of M. pneumoniae in the outpatient population, during 2023, as compared to the previous two years. In addition, a detailed analysis of the ICD10 diagnostic codes associated with the outbreak is also presented. Methods Respiratory samples (oropharyngeal, nasopharyngeal, sputum and EBL) summited to the HealthTrackRX laboratories were tested for the presence of M. pneumoniae and other respiratory bacterial and viral pathogens using the nanofluidic OpenArray qPCR platform (ThermoFisher, California, USA). Patient data was analyzed on the basis of age, gender and geographical location. Data was also classified in the basis of ICD10 diagnostic codes associated with the patient samples. All statistical analysis was performed using R version 3.6.0 (R Foundation for Statistical Computing). Results A total of 541,267 samples were submitted for testing at the HealthTrackRX facilities between January 1, 2021 and December 31, 2023. Only 13 samples tested positive for M. pneumoniae between 2021 (0.004%, n =3/61,498) and 2022 (0.006%, n = 10/165,423). The positivity rate of M. pneumoniae in 2023 increased to 0.19% (n = 621/314,346). The highest proportion of M. pneumoniae cases were detected from Georgia (26.8%), followed by Ohio (21.7%), Texas (8.5%) and California (6.4%). Most of the outbreak appears to be concentrated in large urban settings. Median age of the patients testing positive for M. pneumoniae was 10 (interquartile range [IQR] 8-18) years. Gender classification of the positive samples showed an almost equal distribution between females (49.8%) and males (50.1%). Co-infecting pathogens detected in samples positive for M. pneumoniae were similar in proportion to the M. pneumoniae negative population. The co-detected pathogens at a statistically significant difference were lower than the negative population. Survey of the ICD-10 codes submitted in conjunction with the samples suggest that the current outbreak is mostly associated with upper respiratory tract infections. Conclusions The present study shows an unprecedented increase in the detection of M. pneumoniae in the outpatient population in the United States during 2023. Our analysis suggests that this outbreak was not associated with any other bacterial or viral respiratory pathogen but appears to be case of “immunity debt” caused by the COVID19 pandemic. The outbreak of this atypical pathogen was concentrated in the pediatric population in large urban areas. Our study highlights the importance of performing continuous surveillance of respiratory pathogens, especially in the altered epidemiological landscape of the post COVID world.

Disparities in mental health screening for veteran women with a new diagnosis of breast cancer.

222 Background: Compared to the general population, mental health disorders, including depression, are higher for Veteran women. Breast cancer (BC) is the most commonly diagnosed cancer in this population and up to 50% of women will experience depressive symptoms after diagnosis, associated with poor prognosis and survival. An increasing number of Veteran women live in rural areas, where access to behavioral health care may be limited. This study sought to evaluate rural disparities in mental health screening and follow-up evaluation after a new BC diagnosis. Methods: Women Veterans with a new BC diagnosis were identified between 2017 and 2021. Data for mental health screenings [Patient Health Questionnaire (PHQ)-2, PHQ-9, General Anxiety Disorder-7] were collected subsequent to the first BC diagnosis. Rurality was defined per the USDA Rural-Urban Commuting Area (RUCA) codes framework to determine rurality based on population density and commuting patterns. Data were abstracted from several large VA and non-VA datasets, including the Corporate Data Warehouse (CDW) Outpatient files, non-VA Care Medical and Pharmacy System files, Program Integrity Tool, and VA Informatics and Computing Infrastructure for Oncology. Rurality data was specified using CDW designations combined with ZIP-code-level USDA RUCA information. All categorical variables were analyzed using chi-square tests. Means were tested using t-tests. Results: 14,225 Veteran women with a new BC diagnosis were identified. The mean age was 63.4 (SD 11.7). The most common documented race was White (30.6%), followed by Black (15.7%). 59.6% lived in an urban setting as opposed to rural setting (40.4%). In the entire population, only 14% had a mental health screening within 3 months of a cancer diagnosis. Veteran women living in an urban setting were more likely to be screened compared to those living in a rural setting (17.4% vs 9.2%, p < 0.001). For women screened within 3 months, most screened negative, regardless of rurality (76.1% rural, 75.7% urban). Of women who had a positive mental health screen within 3 months, only approximately one-third (31.8% rural, 34.2% urban) had additional screening regardless of rurality. However, for those with a negative initial screen, urban Veterans were more likely to have any additional screening (17% vs 10.2%, p = 0.001). PHQ-2 was the most common mental health screening tool used (73.8%) followed by a combination of PHQ-9 and GAD-7 (9.6%). Conclusions: Mental health screening within 3 months of breast cancer diagnosis is low for Veteran women. There is a significant difference in screening between rural and urban populations. It is critical to both improve mental health screening overall in this population and bridge the disparity gap between screening in rural and urban Veteran women. This may impact not only mental health but also breast cancer outcomes during the period encompassing treatment and survivorship.

Development of Vertical Farming Systems from Waste Polymers Using Additive Manufacturing Techniques

Driven by population growth, rising living costs, and the urgent need to address climate change, sustainable food production and circular economy principles are becoming increasingly important. Conventional agriculture faces significant challenges, including land scarcity, water shortages, and disrupted supply chains. As a solution, cities are adopting vertical farming to enhance urban food security and promote circularity. This research introduces FLOAT (Farming Lab on a Trough), an innovative vertical farming system made from bio-polymers and recycled polyethylene terephthalate glyco (rPETG) pellets from plastic bottles. FLOAT’s design emphasizes sustainability and closed-loop material usage. The study showcases the versatility of additive manufacturing (AM) in creating complex geometries with fully functional 1:1 prototypes. These prototypes highlight FLOAT’s potential as a scalable and adaptable solution for sustainable food production in urban settings, contributing to improved food security and environmental sustainability. By integrating FLOAT with conventional practices, we aim to exceed Singapore’s 2030 food security targets and achieve lasting urban food resilience. FLOAT aims to scale sustainable food production, fostering community ties with food, and nurturing future responsibility.

Exploring Bark‐Water Interaction Effects on Stemflow Nutrient Concentrations in Urban Trees

ABSTRACTThis study investigates the influence of bark properties on nutrient fluxes in urban environments, focusing on the relationship between bark wettability, chemical composition, and the concentrations of nutrients in stemflow and adjacent soil across eight urban tree species. Through a comprehensive analysis involving chemical assays and ecohydrological measurements, we explored how variations in bark characteristics affect water interaction and subsequent chemical dynamics within urban landscapes. Contrary to the initial hypothesis that bark properties would significantly influence nutrient flux, results revealed a complex scenario where environmental and anthropogenic factors in urban settings seemingly overshadow the direct impact of bark characteristics on nutrient dynamics. Our findings indicate that while bark properties such as wettability and chemical composition do vary among tree species, these variations do not directly correlate with significant differences in stemflow or soil nutrient concentrations. This suggests a homogenising effect of urban environments on ecohydrological processes, highlighting the need for a broader understanding of urban forest ecology that incorporates both biological traits and urban‐specific environmental influences. This research contributes to the field of urban ecohydrology by underscoring the complexity of nutrient fluxes in urban forests and suggesting that effective urban tree management requires an integrated approach that considers the interplay between tree physiological traits and urban environmental conditions. Our study calls for further research to unravel the intricate dynamics of urban ecosystems, aiming to enhance the sustainability and ecological benefits of urban forests.

Prevalence of knowledge and awareness about Helicobacter pylori infection among urban population of Kingdom of Saudi Arabia

IntroductionThis cross-sectional study investigates the prevalence of knowledge and awareness of Helicobacter pylori (H. pylori) infection among the urban population of the Kingdom of Saudi Arabia (KSA). The study is motivated by the need to understand the specific demographic segments within the urban setting and their awareness levels of this prevalent bacterial infection affecting the digestive system. MethodologyThe cross-sectional study, employing a purposive sampling method and involving 840 participants from major cities in the KSA, utilized a structured survey questionnaire to gather data on demographic factors, awareness levels, attitudes, and experiences related to H. pylori infection, with subsequent statistical analysis and adherence to ethical guidelines for participant confidentiality and privacy protection. ResultThe study involved 840 participants from major cities, revealing that 59.16% were aware of H. pylori. Demographic variations included higher participation from Jeddah and Riyadh, with the majority being females aged 18-25, Saudi nationals, and individuals with undergraduate education. About 57.02% reported experiencing suspected H. pylori symptoms, and 49.16% had prior infections, with varying severity. Hesitancy toward screening (42.61%), but 72.97% believed in preventability. Limited awareness of treatments (15.35%) and identification of factors like water and food were noted. Participants perceived the seriousness of H. pylori in the mid-range (5 to 7). ConclusionThe findings shed light on variations in awareness, knowledge gaps, and attitudes, emphasizing the need for targeted public health interventions, educational campaigns, and policy measures to address the challenges associated with H. pylori infections in urban areas.

For resilient rural shorelines: reviewing Nature-based Solutions for flood risk reduction in small coastal communities

Coastal flood risk poses a serious, existential threat to shoreline populations around the world both now and in the future. Unsurprisingly, global decision makers are considering their options – one of these being Nature-based Solutions – for effective disaster risk reduction which specifically targets coastal flooding. While strides have been made in the field of Nature-based Solutions for coastal flooding, much of this attention has been directed towards the urban setting, with a wealth of scholastic documentation to support this notion. The sizeable rural populations scattered throughout the world's small coastal communities, meanwhile, have been largely neglected in academic literature. Without this information, it is impossible to properly capture the full potential of Nature-based Solutions in (global) flood risk modelling endeavours or understand their role in the future of equitable disaster risk reduction. In light of this gap, we have reviewed the limited amount of existing literature from around the world involving the implementation and effectiveness of Nature-based Solutions in small coastal communities. We analysed 28 peer-reviewed studies to gather common themes and insights about the barriers and opportunities unique to these rural shorelines. Takeaways we have identified include a near consistent scarcity of resources (e.g., technical, financial, institutional) to implement disaster risk reduction measures; an abundance of space and opportune land use regimes which make Nature-based Solutions a highly plausible option; amplified nature contributions to people leading to larger benefits reaped from investments into Nature-based Solutions; and the presence of local knowledge regarding societal norms, climate patterns, and ecosystem capabilities. We argue that these four common themes point to the fact that more attention must be given to coastal flooding-focused Nature-based Solutions in the rural setting. As such, we present this collation as a starting point for future projects of similar setting and scope. We also recommend improving benefit-cost analysis methods as well as including local knowledge and other perspectives in future global assessments of coastal flood risk.

A Study to Determine Consensus for Nursing Documentation Reduction in Times of Crisis.

Nurses faced numerous challenges during the pandemic, particularly with the increased burden of electronic documentation. Surges in patient volume and visits led to rapid changes in nursing documentation, prompting diverse responses from regulatory and healthcare organizations. Nurses expressed safety concerns and struggled with changes, calling for national standards and regulatory support. Policy relaxations, such as the 1135 Waiver, sparked debate on the future of nursing care plan documentation. Using mixed-methods exploratory design, the study identified modifications of nursing documentation during crises, commonalities in documentation burden reduction for applicability beyond pandemics, and consensus on the definition of "surge." Documentation patterns were assessed from February to November 2022, involving 175 North American nurse leaders and informaticists. Data analysis included descriptive statistics, thematic analysis, and Pearson correlation coefficient. Significant differences were found between rural and urban settings (P = .02), with urban areas showing higher odds of changes to care plans (odds ratio, 4.889; 95% confidence interval, 1.27-18.78). Key findings highlighted the persistence of postcrisis documentation changes and varied definitions of surge criteria based on organizational leadership, policy, and mandates. The study yielded insights for modifying documentation, offering policy recommendations, and emphasizing ongoing collaboration and evidence-based approaches for future nursing practices.

Defining pediatric neurosurgery in low-income countries: a cross-sectional study in Ethiopia.

Pediatric neurosurgical practice is prevalent in most low- and lower-middle-income countries but lacks comprehensive documentation of practice patterns, demographics, and case variety. This study aimed to present the current state of pediatric neurosurgery in Ethiopia, including workforce characterization, case variety, and relevant procedures. A survey was developed and distributed to all Ethiopian fully trained neurosurgeons (n = 50). Survey questions assessed sociodemographic variables, level of training, case variety, and neurosurgical practice. Statistical analysis was conducted to describe the current practice of pediatric neurosurgery. A total of 45 neurosurgeons responded (90%). Three respondents (7%) were women. There was only 1 fellowship-trained pediatric neurosurgeon, while most neurosurgeons were general neurosurgeons who served a pediatric patient population. Most neurosurgeons (56%) worked in the capital city, Addis Ababa, while another 13% worked in other urban settings. The top three indications for a pediatric neurosurgical procedure were neural tube defects (NTDs) (96%), hydrocephalus (93%), and trauma (60%). NTD-associated hydrocephalus was the most common hydrocephalus type seen (71%). The most common procedure for hydrocephalus was shunt insertion (96%). A prenatal diagnosis of NTD was made in < 10% of cases, as reported by 84% of respondents. The study highlights Ethiopia's need for more pediatric neurosurgeons. Suggested strategies to facilitate subspecialty training include the establishment of a fellowship program facilitated by the implementation of a nationwide pediatric neurosurgery registry. Promoting efforts for early diagnosis and treatment of pediatric conditions coupled with NTD prevention initiatives could improve pediatric neurosurgical care in Ethiopia.