Audit-based corrective and preventive actions to reduce wastage of blood components at a single blood center: A quality improvement study.

INTRODUCTION: The rate of discarded blood components or "wastage rate" reflects on the whole process, preparation, and production of blood and its quality control. It is the ratio of blood and blood components discarded to the total number of collections. The discard or unusability of blood products are many, and the ones that can be monitored and regarded as indicators to be improvised on are QC failure rate, transfusion-transmitted infection (TTI) positivity, and component discards (other than TTI), including those that caused transfusion reactions. These were studied over four intervention cycles to see if they could be improved. MATERIALS AND METHODS: This was a clinical audit and quality improvement study. The clinical audit was conducted over four cycles over 16 months. Each cycle included three stages wherein the data required for calculating those key performance indicators (KPIs) of the blood center were studied and analyzed, and causes for the poorly performing ones were identified; a corrective plan was drawn and implemented, followed by data collection and interpretation of the same in the next cycle for improvement. The data were compiled using a Microsoft Excel spreadsheet and analyzed using SPSS version 19 (IBM Corporation, New York, USA). RESULTS: The overall discard rates due to all cumulative causes mentioned were at about 5% at the start of the first cycle. The various factors comprising preparatory, preparation, and the management of inventory and issue were analyzed, and corrective interventions were performed in every cycle. The discard rates were reduced to about 3% by the end of the four cycles. The difference was statistically significant, with a P < 0.05. CONCLUSION: The implementation of Corrective and preventive action measures can rectify the deviations in KPIs. The blood center director, staff, and doctors should be responsible for maintaining and continuously improving the quality indicators.

Evaluating the academic scientific laboratories' safety by applying failure mode and effect analysis (FMEA) at the public university in Lebanon.

Workers at scientific academic laboratories are at risk of potential exposure to different types of hazards. The study's purpose was to assess the potential failure modes (FMs) of hazards facing them through the application of the Failure Mode and Effect Analysis (FMEA) method to propose corrective actions preventive actions (CAPA) to mitigate them and to improve the safety outcomes in these workplaces (WP) at the Lebanese public University (PbU). The potential FMs leading to accident occurrence in biological and chemical labs were identified and prioritized, their causes and effects were determined by applying two surveys, and the risk priority number (RPN) for each failure was calculated. A total of 24 FMs were identified. The most alarming FM having the highest RPN scores (80) was found in the workplace 'category requiring an emergency for corrective actions (CA), it is related to the unavailability of a hazard pictogram plot and the lack of labeling of chemicals and waste containers according to their categories. The FMs having RPN scores (75-60) requiring an urgent CA were assigned to other hazards of the WP, chemical, biological, and failure of the educational system. The need to program for the remaining FMs (RPN scores 20-48) is related to the safety, biological, physical, and radioactive categories 'hazards. It is recommended to apply continuously FMEA and implement the CA proposed for each detected FM in the scientific laboratories of the PbU in order to support the decision-makers to improve laboratory safety.

Toward food waste reduction at universities.

Food waste is a serious problem, which undermines the achievement of many sustainable development goals (SDGs), despite their consideration in the agendas of many countries and companies. Notoriously, food waste (FW) causes different kinds of pollution that affect public health and social justice, while contributing to economic losses. This waste phenomenon has causes, drivers, and impacts that require rigorous assessments and effective approaches to mitigate its noxious effects, which are a serious concern for universities. Within these institutions, reducing food waste becomes a circular economy strategy, which is being utilized to assist in promoting sustainable development. However, there is a need for urgent attention to the specific causes of food waste and for consistent actions to reduce it, while boosting awareness in the campus community and triggering a change in students' eating habits. The purpose of this study is to analyze what can be done to reduce the levels of food waste at universities. To achieve this, a review of the theme's state of the art, which is inclusive of an overview of food waste production at universities around the world, is presented. The study employed a qualitative methodology where a comprehensive review of the literature and case studies analyses from selected world regions were considered. The data indicate that a broad variance exists in producing food waste among universities, from 0.12 to 50 kg/capita/day. More factors influence the problem (e.g., gender, age, season, consumer behavior), as well as strategies to solve and prevent it (e.g., composting, recycling, new designs of packages, trayless meals, education), and benefits leading toward food waste reductions from 13 to 50%. Also, four priority actions were identified to reduce food waste at universities, and these consist of planning and awareness, food preparation and storage, services, and direct waste reuse. With appropriate adaptations, these recommended actions should be deployed as means for reducing food waste at universities around the world, while expanding learning and education in sustainability.

Exploring the impact of motivations on individual online and offline preventive actions against COVID-19.

Having accurate and sufficient information about the outbreak and actively adopting preventive actions are important to reduce the adverse effects of COVID-19 and control the spread of the epidemic. To this end, grounded in the situational theory of problem solving (STOPS) and self-concern and other-orientation theory, this study aims to examine motivations of individuals to adopt online and offline preventive actions during the COVID-19 pandemic. We explored the effects of three motivations, i.e., situational motivation, concern-for-self and concern-for-others motivation, and their antecedents on individual online and offline preventive actions. We used PLS-SEM to analyze the results of 628 questionnaires and found that: first, individual online preventive actions have a positive predictive effect on offline actions; secondly, individual online preventive actions are positively affected by situational motivation and concern-for-others motivation, and individual offline preventive actions are positively affected by concern-for-self and concern-for-others motivation; finally, three situational perceptual factors including problem, involvement and constraint recognition have significant effects on the three motivations. The findings of this study enriched the research results on individual behaviors in the context of COVID-19, and provided a basis for making decisions on the guidance and management of the individuals' COVID-19 preventive actions. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-023-04283-z.

ISO 15189 is a sufficient instrument to guarantee high-quality manufacture of laboratory developed tests for in-house-use conform requirements of the European In-Vitro-Diagnostics Regulation.

The EU In-Vitro Diagnostic Device Regulation (IVDR) aims for transparent risk-and purpose-based validation of diagnostic devices, traceability of results to uniquely identified devices, and post-market surveillance. The IVDR regulates design, manufacture and putting into use of devices, but not medical services using these devices. In the absence of suitable commercial devices, the laboratory can resort to laboratory-developed tests (LDT) for in-house use. Documentary obligations (IVDR Art 5.5), the performance and safety specifications of ANNEX I, and development and manufacture under an ISO 15189-equivalent quality system apply. LDTs serve specific clinical needs, often for low volume niche applications, or correspond to the translational phase of new tests and treatments, often extremely relevant for patient care. As some commercial tests may disappear with the IVDR roll-out, many will require urgent LDT replacement. The workload will also depend on which modifications to commercial tests turns them into an LDT, and on how national legislators and competent authorities (CA) will handle new competences and responsibilities. We discuss appropriate interpretation of ISO 15189 to cover IVDR requirements. Selected cases illustrate LDT implementation covering medical needs with commensurate management of risk emanating from intended use and/or design of devices. Unintended collateral damage of the IVDR comprises loss of non-profitable niche applications, increases of costs and wasted resources, and migration of innovative research to more cost-efficient environments. Taking into account local specifics, the legislative framework should reduce the burden on and associated opportunity costs for the health care system, by making diligent use of existing frameworks.

Analysis of the effect of high intensity intermittent training for young athletes / Análise do efeito do treinamento intermitente de alta intensidade para jovens atletas / Análisis del efecto del entrenamiento intermitente de alta intensidad en atletas jóvenes

ABSTRACT Introduction The CPC Central Committee and the State Council have pointed out that currently, the basic indicators of young students' physical health have completely declined. This circumstance has made adolescent physical health and improving the quality of young athletes a key issue in physical education targeting adolescents. Objective Investigate the effect of high-intensity intermittent training on young athletes. Methods 24 adolescents performed 10 intermittent high-intensity training for one month, and all athletes' pre and post-training indexes were collected and compared. Results The physical examination results of male and female athletes improved to some extent (athletes' blood pressure fluctuated during the 10 training sessions, increasing slightly, and heart rate variability increased considerably (P < 0.05). Conclusion High-intensity intermittent training has a good effect on health promotion in young athletes, and can effectively improve their physical function and competitive performance. Physical education teachers and student-athletes should conduct relevant training. In addition, this training method also fits the current learning life situation of high school students. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução O Comitê Central do CPC e o Conselho de Estado destacaram que, atualmente, os indicadores básicos da saúde física dos jovens estudantes têm diminuído de forma completa. Essa circunstância tornou a saúde física dos adolescentes e a melhoria da qualidade dos jovens atletas um ponto-chave na educação física direcionada aos adolescentes. Objetivo Investigar o efeito do treinamento intermitente de alta intensidade em jovens atletas. Métodos 24 adolescentes realizaram 10 treinos intermitentes de alta intensidade, com duração de um mês, todos os índices pré e pós-treino dos atletas foram coletados e comparados. Resultados Os resultados do exame físico de atletas do sexo masculino e feminino melhoraram em certa medida (a pressão arterial dos atletas flutuou durante as 10 sessões de treinamento, aumentando ligeiramente, e a variabilidade da frequência cardíaca aumentou consideravelmente (P < 0,05). Conclusão O treinamento intermitente de alta intensidade tem um bom efeito na promoção da saúde nos jovens atletas, podendo melhorar efetivamente sua função física e desempenho competitivo. Professores de educação física e atletas estudantes devem realizar treinamentos relevantes. Além disso, esse método de treinamento também se encaixa na situação atual da vida de aprendizagem dos alunos do ensino médio. Nível de evidência II; Estudos terapêuticos - investigação dos desfechos do tratamento.

RESUMEN Introducción El Comité Central del CPC y el Consejo de Estado han puesto de relieve que en la actualidad los indicadores básicos de salud física de los jóvenes estudiantes han disminuido completamente. Esta circunstancia hizo que la salud física de los adolescentes y la mejora de la calidad de los jóvenes deportistas fuera un punto clave en la educación física dirigida a los adolescentes. Objetivo Investigar el efecto del entrenamiento intermitente de alta intensidad en atletas jóvenes. Métodos 24 adolescentes realizaron 10 sesiones de entrenamiento intermitente de alta intensidad de un mes de duración, se recogieron y compararon los índices de todos los atletas antes y después del entrenamiento. Resultados Los resultados de la exploración física de los atletas masculinos y femeninos mejoraron en cierta medida (la presión arterial de los atletas fluctuó durante las 10 sesiones de entrenamiento, aumentando ligeramente, y la variabilidad de la frecuencia cardíaca aumentó considerablemente (P < 0,05). Conclusión El entrenamiento intermitente de alta intensidad tiene un buen efecto en la promoción de la salud en los atletas jóvenes, y puede mejorar eficazmente su función física y su rendimiento competitivo. Los profesores de educación física y los alumnos deportistas deben realizar la formación pertinente. Además, este método de formación también se ajusta a la situación actual de la vida de aprendizaje de los estudiantes de secundaria. Nivel de evidencia II; Estudios terapêuticos - investigación de los resultados del tratamiento.

The Protective Role of Mature Defense Mechanisms on Satisfaction with Life in the COVID-19 Era: A Moderated Mediation Analysis.

The COVID-19 pandemic significantly influenced people's lives, with non-negligible consequences for the perception of well-being. This study sought to examine the effect of anxiety, post-traumatic impairment, and mature defenses on life satisfaction during the COVID-19 pandemic. One thousand three hundred thirty-nine Italian individuals (30% male; 70% female; Mage = 34.70; SD = 11.83) completed an online survey enclosing the Satisfaction with Life Scale, State-Trait Anxiety Inventory-Form X3, Impact of event scale-revised, and the Forty Item Defense Style Questionnaire. To test the hypothesized relationship, data were analyzed by applying a moderated-mediation analysis, a regression-based approach. Results showed that the negative effect of anxiety on life satisfaction was partially mediated by post-traumatic impairment, with a significant moderation effect of mature defenses on the relationship between post-traumatic impairment and life satisfaction. Specifically, with higher levels of mature defenses, the effects of post-traumatic impairment on consequences of the COVID-19 emergency on well-being. Furthermore, the protective role of mature defenses in facing post-traumatic impairment was shown. Such data may have applicative implications in different contexts in a management perspective of the different pandemic phases, contributing to more effective positive strength-based preventive actions to also support positive healthy organizations.

Analysis of the renewed European Medical Device Regulations in the frame of the non - EU regulatory landscape during the COVID facilitated change.

The term "Medical devices" includes technology-based devices or articles, both basic and complex. Due to these types of variations, a strict, robust, transparent, and sustainable regulatory framework is required. In recent clinical practice, incidents including the breast implant and the hip replacement crisis have made it necessary to improve the regulatory and compliance approaches for the industry to ensure the manufacturing and distribution of safe and innovative MDs within the EU. In response to this, the EU revised the laws governing medical devices and in vitro diagnostics to align with the developments of the sector, address critical safety issues and support innovation. The new regulation (EU) 2017/745 on Medical Devices (MDR) is now applicable from May 26 2021 and the In Vitro Diagnostic Medical Devices Regulation (EU) 2017/746 will take effect from May 2022.In this review, we aim to provide an update on the new Medical Device Regulations in the context of the current medical needs of the world, and also to give a glimpse at the non-EU regulatory landscape. Finally, we take a look at the closed-system transfer devices (CSTD) and COVID facilitated changes promoting demand for continuous improvement and trends in the pharmaceutical and medical industry related areas.

The Impact of the COVID-19 Infodemic on Depression and Sleep Disorders: Focusing on Uncertainty Reduction Strategies and Level of Interpretation Theory.

BACKGROUND: During the COVID-19 pandemic, information diffusion about the COVID-19 has attracted public attention through social media. The World Health Organization declared an infodemic of COVID-19 on February 15, 2020. Misinformation and disinformation, including overwhelming amounts of information about COVID-19 on social media, could promote adverse psychological effects. OBJECTIVE: This study used the Psychological Distance and Level of Construal theory (CLT) to predict peoples' negative psychological symptoms from social media usage. In this study, the CLT intended to show peoples' psychological proximity to objects and events with respect to the COVID-19 pandemic. Furthermore, this study links the uncertainty reduction strategy (URS) and CLT for COVID-19-related preventive behaviors and affective reactions to assess their effects on mental health problems. METHODS: A path model was tested (N=297) with data from a web-based survey to examine how social media usage behaviors are associated with URS and psychological distance with COVID-19 (based on the CLT), leading to preventive behaviors and affective reactions. Finally, the path model was used to examine how preventive behaviors and affective reactions are associated with mental health problems including anxiety and sleep disorder. RESULTS: After measuring participants' social media usage behavior, we found that an increase in general social media usage led to higher use of the URS and lower construal level on COVID-19. The URS is associated with preventive behaviors, but the CLT did not show any association with preventive behaviors; however, it increases affective reactions. Moreover, increased preventive behavior showed negative associations with symptoms of mental health problems; that is, depression and sleep disorder. However, the affective reaction tends to be positively associated with depression and sleep disorder. Owing to the infodemic of COVID-19, the psychological perception of the pandemic negatively influenced users' mental health problems. CONCLUSIONS: Our results imply that the information from social media usage heightened concerns and had a lower construal level; this does not facilitate taking preventive actions but rather reinforces the negative emotional reaction and mental health problems. Thus, higher URS usage is desirable.

Sistema de acciones educativas: actividad física y salud bucodental en la adolescencia

Introducción: El control de la salud bucodental de los deportistas es uno de los aspectos menos atendidos en lo referente a su salud integral, lo que demuestra la necesidad de fortalecer los programas de promoción de salud y prevención de afecciones bucales en este ámbito. Objetivo: Proponer un sistema de acciones educativas sobre salud bucodental en los adolescentes que practican deportes de combate. Métodos: Se realizó un estudio descriptivo en el macrociclo 2019-2020 con una muestra no probabilística de 43 deportistas; utilizándose la observación y la encuesta. Se diseñó un sistema de acciones educativas, el cual fue valorado por criterio de especialistas. Resultados: El nivel de conocimientos sobre salud bucodental que predominó en los adolescentes que practican deportes de combate fue inadecuado con un 53,5 %. El sistema de acciones educativas propuesto consta de siete encuentros: uno introductorio, cinco de estudio y uno para las conclusiones. Los temas tratados son: la actividad física y su relación con la salud bucodental, la higiene bucal en la prevención de la caries dental y la enfermedad periodontal, los protectores bucales en el deporte, traumatismos dentales en el deporte, tabaquismo y alcoholismo, su efecto en la actividad física y la salud bucodental. Conclusiones: El diseño del sistema de acciones educativas actividad física y salud bucodental en la adolescencia resulta pertinente para su aplicación en el contexto deportivo, según la valoración de los especialistas.

Introduction: The control of the oral health of athletes is one of the least attended aspects in relation to their integral health, which shows the need to strengthen programs for the promotion of health and prevention of oral conditions in this area. Objective: To propose a system of educational actions on oral health in adolescents who practice combat sports, in the Lino Salabarría Pupo Provincial Initiation Sport School in Sancti Spíritus. Methods: A descriptive study was carried out in the 2019-2020 macrocycle with a non-probabilistic sample of 43 athletes; using observation and survey. A system of educational actions was designed which was evaluated by specialists' criteria. Results: The level of knowledge on oral health that prevailed in adolescents who practice combat sports was inadequate with 53.5%. The proposed system of educational actions consists of seven meetings: an introductory one, five for study and one for conclusions. The topics covered are: physical activity and its relationship with oral health, oral hygiene in the prevention of dental caries and periodontal disease, mouth guards in sports, dental trauma in sports, smoking and alcoholism, their effect in physical activity and oral health. Conclusions: The design of the educational actions system Physical activity and oral health in adolescence is relevant for its application in the sports context, according to the assessment of specialists.

Dos males o menor: representações de universitários sobre o uso das máscaras para prevenção da Covid-19 / The lesser evil: university students representations on the use of masks for Covid-19 prevention / El mal menor: representaciones de universitarios sobre el uso de máscaras para la prevención del Covid-19

Objetivo: conhecer as representações sociais de universitários brasileiros sobre o uso de máscaras para o controle da COVID-19. Método: estudo qualitativo, tipo survey, ancorado na Teoria das Representações Sociais. Participaram 283 universitários brasileiros, selecionados por conveniência. Os dados foram coletados por meio de formulário digital. Para análise, utilizou-se a Análise Temática. Resultados: elaborou-se um tema nomeado "A máscara para prevenção: materialização do medo de contágio", e três subtemas, intitulados respectivamente "A construção de um novo hábito: o mal necessário das máscaras"; "O macrossocial na modificação do eu" e "O uso da máscara no dia-a-dia: a individualização do social". Conclusão: observou-se a compreensão do uso de máscaras como um recurso para prevenção de uma condição ameaçadora à vida. Atitudes favoráveis parecem se organizar em contraposição ao medo causado pelo vírus e suas consequências.

Objective: to know the social representations of brazilian university students about the use of masks to control COVID-19. Method: qualitative survey, based on the Theory of Social Representations. 283 brazilian university students were selected by convenience. Data were collected through digital form. For analysis, the Thematic Analysis was used. Results: a theme named "The mask for prevention: materialization of the fear of contagion" was elaborated, and three sub-themes, respectively titled "The construction of a new habit: the necessary evil of masks"; "The macrosocial in the modification of the self" and "The use of the mask in everyday life: the individualization of the social". Conclusion: the understanding of the use of masks as a resource for preventing a life-threatening condition was observed. These favorable attitudes seem to be organized in contrast to the fear caused by virus and their consequences.

Objetivo: conocer las representaciones sociales de estudiantes universitarios brasileños sobre el uso de máscaras para el control de COVID-19. Método: estudio cualitativo, basado en la Teoría de las Representaciones Sociales. Participaron 283 universitarios brasileños, seleccionados por conveniencia. Los datos fueron recolectados a través de un formulario digital. Para el análisis se utilizó el Análisis Temático. Resultados: se elaboró un tema denominado "La mascarilla para la prevención: materialización del miedo al contagio" y tres subtemas, respectivamente titulados "La construcción de un nuevo hábito: el mal necesario de las máscaras"; "Lo macrosocial en la modificación del yo" y "El uso de la mascarilla en la vida cotidiana: la individualización de lo social". Conclusión: se observó la comprensión del uso de máscaras como recurso para la prevención de una condición potencialmente mortal. Estas actitudes favorables parecen organizarse en contraste con el miedo provocado por el virus y sus consecuencias.

Oral Assessment and Preventive Actions within the Swedish Quality Register Senior Alert: Impact on Frail Older Adults' Oral Health in a Longitudinal Perspective.

Poor oral health is common among older people in nursing homes. To identify and prevent oral health problems among the residents, ROAG-J (Revised Oral Assessment Guide-Jönköping), a risk-assessment instrument, is used by nursing staff routinely, and the outcome is registered in the web-based Swedish quality register Senior Alert. This study aims to investigate the preventive actions registered when oral health problems are identified and the effect of these actions longitudinally. ROAG-J data registered at nursing homes in Sweden during 2011-2016 were obtained from the Senior Alert database. Out of 52,740 residents (≥65 years), 41% had oral health problems, of whom 62% had preventive actions registered. The most common action was "Assistance with cleaning teeth". Longitudinally, during the five-year observation period, a slight increase in oral health problems assessed with ROAG-J was found. Registered preventive actions, however, led to significant improvement in the subsequent assessment for the ROAG items lips, tongue, and dentures. Standardised risk assessments like ROAG-J provide an opportunity to detect problems early and establish preventive actions. The study, however, indicates a further need for structured education and a continuous follow-up in ROAG-J. Moreover, increased collaboration between nursing and dental care to improve oral health for older residents at nursing homes is needed.

Acciones preventivo-curativas en la atención a la población / de 0 a 19 años / Preventive and curative actions in the care of a population aged / 0 to 19 years

RESUMEN Introducción: la salud bucal es parte integrante de la salud general; su deficiencia tiene importantes repercusiones, con consecuencias perjudiciales, en el crecimiento y desarrollo de niños y adolescentes. Su evaluación constituye una herramienta importante para la toma de decisiones y para aspirar a un servicio de excelencia. Objetivo: evaluar el cumplimiento de las acciones preventivo-curativas programadas para la atención a la población de 0 a 19 años en la Escuela «René Fraga¼. Métodos: se realizó un estudio descriptivo y transversal en la Facultad de Estomatología de la Universidad de Ciencias Médicas de Villa Clara, en el período de octubre de 2018 a abril de 2019; se revisaron 473 historias clínicas de alumnos matriculados en la Escuela «René Fraga¼, los cuales constituyeron la población de estudio. Resultados: se cumplimentaron las acciones de planificación y de promoción de salud; las acciones de prevención y las curativas fueron las más desfavorables, lo que aportó un resultado final de medianamente cumplidas las acciones evaluadas. Conclusiones: las acciones de planificación inicial y promoción alcanzaron la máxima categoría y otorgaron la mayor cantidad de puntos a la evaluación; las acciones preventivo-curativas desarrolladas en el programa analizado resultaron insuficientes, lo que concedió a la evaluación general una calificación de medianamente cumplida.

ABSTRACT Introduction: oral health is an integral part of general health; its deficiency has important repercussions, with harmful consequences, on the growth and development of children and adolescents. Its evaluation constitutes an important decision-making tool in order to aspire to an excellent service. Objective: to evaluate the fulfillment of the preventive and curative actions programmed for the care of the population aged 0 to 19 years at "René Fraga" School. Methods: a descriptive and cross-sectional study was carried out in the Dentistry Faculty from the University of Medical Sciences of Villa Clara, between October 2018 and April 2019; 473 medical records of students enrolled at "René Fraga" School were reviewed, which constituted the study population. Results: health planning and promotion actions were completed; the preventive and curative actions were the most unfavorable, which provided a final result of moderately fulfilled the evaluated actions. Conclusions: the initial planning and promotion actions reached the highest category and awarded the highest number of points to the evaluation; the preventive and curative actions developed in the analyzed program were insufficient, which gave to the general evaluation a qualification of moderately complete.

Assessing COVID-19 preventive behaviours using the health belief model: A Sri Lankan study.

OBJECTIVE: The novel coronavirus (COVID-19) is turning out to be one of the most severe public health crises in recent history. Promoting preventive behaviour among the public is of paramount importance to effectively contain the disease. Hence, this research attempts to identify factors that affect preventive behaviour against COVID-19. METHODS: The Health Belief Model (HBM), which outlines how perceived susceptibility, severity, benefits, barriers, and health motivation affect individuals' health behaviour, served as the theoretical basis of the study. As the outcome measure of the study was cues to action against COVID-19, a regression analysis was conducted to explore how the aforementioned HBM constructs influence the cues to action. The data were collected using an online survey with a total of 307 respondents. RESULTS: The results revealed that perceived benefits (0.395, p < 0.001), self-efficacy (0.405, p < 0.001), and general health motivation (0.313, p < 0.001) had significant positive impacts on the cues to action taken to prevent COVID-19, whereas perceived barriers (-0.097, p < 0.05) had a significant negative impact. The statistical analysis further revealed that the cues to action taken to prevent COVID-19 were not significantly influenced by perceived susceptibility and perceived severity. CONCLUSION: The study reinstates the usability of the HBM in exploring health behaviour. Importantly, the study findings suggest that by informing the public of the benefits of prevention and general health motivation, and by encouraging self-efficacy and eliminating the barriers to prevention, preventive actions against COVID-19 can be effectively promoted.

Knowledge, Attitudes, Prevalence and Associated Factors of Cigarette Smoking Among University Students: A Cross Sectional Study.

This study aimed to assess the prevalence of smoking and associated sociodemographic and economic factors as well as students' knowledge about and attitudes towards smoking among university students in Oman. A proportionate random sampling technique recruited 401 students from three universities in a cross-sectional study. The prevalence of smoking was 9.0%. Significant differences in gender, place of residence, if participants had received medical advice, years spent at the university, student income/day, family members who smoked, knowledge and attitude scores were identified. Universities in collaboration with health care providers should be leading the development of strategies to reduce the prevalence of smoking and to sustain the current knowledge and attitude towards smoking. Gender-specific approaches to smoking interventions need to be developed.

COVID-19: urgency for distancing from domestic violence.

BACKGROUND: Although COVID-19 is a major worldwide health threat, there is another global public health emergency that is becoming a growing challenge. Domestic violence is a public health and human rights issue that primarily affects women and children worldwide. Several countries have reported a significant increase in domestic violence cases since the COVID-19-induced lockdowns and physical distancing measures were implemented. The COVID-19 health crisis is exacerbating another pre-existing public health problem by increasing the severity and frequency of domestic violence, thus demonstrating the need to adopt significant and long-term measures. OBJECTIVE: Therefore, it is urgently necessary to promote and increase actions and policies to guarantee the safety and dignity of all victims of domestic violence worldwide. METHODS: This paper describes preventive measures and action plans to combat violence against women and children during the COVID-19 pandemic. CONCLUSION: The prevention of domestic violence must indeed be every government's priority and every citizen's responsibility.

Antecedentes: Aunque el COVID-19 es una amenaza mayor de la salud a nivel mundial, existe otra emergencia de salud pública global la cual está llegando a ser un desafío creciente. La violencia doméstica es un problema de salud pública y de derechos humanos que afecta primordialmente a mujeres y niños en todo el mundo. Varios países han reportado un aumento significativo en los casos de violencia domestica desde que se implementaron los confinamientos inducidos por COVID-19 y las medidas de distanciamiento físico. La crisis de salud del COVID-19 está exacerbando otro problema de salud pública preexistente al aumentar la gravedad y frecuencia de la violencia doméstica, lo cual demuestra la necesidad de adoptar medidas significativas y a largo plazo.Objetivo: Por lo tanto, es urgentemente necesario promover y aumentar las acciones y políticas para garantizar la seguridad y la dignidad de todas las víctimas de violencia doméstica en todo el mundo.Método: Este artículo describe medidas preventivas y planes de acción para combatir la violencia en contra de mujeres y niños durante la pandemia de COVID-19.Conclusiones: La prevención de la violencia doméstica debe ser, de hecho, la prioridad de todos los gobiernos y la responsabilidad de todos los ciudadanos.

Heat Stress in Indoor Environments of Scandinavian Urban Areas: A Literature Review.

Climate change increases the risks of heat stress, especially in urban areas where urban heat islands can develop. This literature review aims to describe how severe heat can occur and be identified in urban indoor environments, and what actions can be taken on the local scale. There is a connection between the outdoor and the indoor climate in buildings without air conditioning, but the pathways leading to the development of severe heat levels indoors are complex. These depend, for example, on the type of building, window placement, the residential area's thermal outdoor conditions, and the residents' influence and behavior. This review shows that only few studies have focused on the thermal environment indoors during heat waves, despite the fact that people commonly spend most of their time indoors and are likely to experience increased heat stress indoors in the future. Among reviewed studies, it was found that the indoor temperature can reach levels 50% higher in °C than the outdoor temperature, which highlights the importance of assessment and remediation of heat indoors. Further, most Heat-Health Warning Systems (HHWS) are based on the outdoor climate only, which can lead to a misleading interpretation of the health effects and associated solutions. In order to identify severe heat, six factors need to be taken into account, including air temperature, heat radiation, humidity, and air movement as well as the physical activity and the clothes worn by the individual. Heat stress can be identified using a heat index that includes these six factors. This paper presents some examples of practical and easy to use heat indices that are relevant for indoor environments as well as models that can be applied in indoor environments at the city level. However, existing indexes are developed for healthy workers and do not account for vulnerable groups, different uses, and daily variations. As a result, this paper highlights the need for the development of a heat index or the adjustment of current thresholds to apply specifically to indoor environments, its different uses, and vulnerable groups. There are several actions that can be taken to reduce heat indoors and thus improve the health and well-being of the population in urban areas. Examples of effective measures to reduce heat stress indoors include the use of shading devices such as blinds and vegetation as well as personal cooling techniques such as the use of fans and cooling vests. Additionally, the integration of innovative Phase Change Materials (PCM) into facades, roofs, floors, and windows can be a promising alternative once no negative health and environmental effects of PCM can be ensured.

Early identification and intervention on language deficits and behavioral difficulties in early childhood education / Identificação Precoce e Intervenção em Déficits de Linguagem e Dificuldades Comportamentais na Educação Infantil

Abstract This project had the aim of detecting and intervening in difficulties of language and behavior in children at the age of three and four. A hundred seventy-eight children were assessed in behavior, expressive and receptive vocabulary and in central auditory processing. 84 children constituted the experimental group and were engaged in an intervention for the development and refinement of language and management of behavior problems through activities developed in software used in tablets, concrete games and orientation provided to their parents and teachers by a professional team composed by speech therapists, psychologists and psycho pedagogues. Posttest analysis indicated significant difference between the vocabulary and language scores, suggesting that this model of early assessment and intervention can be a successful strategy in school environments.

RESUMO Esta pesquisa objetivou detectar e intervir nas dificuldades de linguagem e comportamento em crianças de três e quatro anos de idade. Foram avaliadas 178 crianças nas áreas de comportamento, vocabulário expressivo e receptivo e processamento auditivo central. O grupo experimental, com 84 crianças, foi submetido à intervenção para o desenvolvimento e aprimoramento de linguagem e manejo de comportamentos-problema por meio de atividades desenvolvidas em aplicativos usados em tablets, jogos concretos e orientações fornecidas a seus pais e professores por uma equipe de fonoaudiólogos, psicólogos e psicopedagogos. As análises do pós-teste indicaram diferença significativa entre os resultados dos testes de vocabulário e comportamento, sugerindo que esse modelo de avaliação e intervenção precoce pode ser uma estratégia bem-sucedida em ambiente escolar.

Malaria knowledge, preventive actions, and treatment-seeking behavior among ethnic minorities in Ratanakiri Province, Cambodia: a community-based cross-sectional survey.

BACKGROUND: Malaria incidence has been steadily declining in Cambodia, where the government is aiming to eliminate malaria by 2025. Successful malaria elimination requires active engagement and participation of communities to recognize malaria symptoms and the development of prompt treatment-seeking behavior for early diagnosis and appropriate treatment. This study examined malaria knowledge, preventive actions, and treatment-seeking behavior among different groups of ethnic minorities and Khmer in Ratanakiri Province, Cambodia. METHODS: Face-to-face interviews were conducted in December 2015, targeting 388 mothers with children under 2 years old, who belonged to ten ethnic minority groups or the Khmer group living in 62 rural villages in Ratanakiri. In addition to describing mothers' knowledge and actions for malaria prevention, logistic regression analysis was performed to identify determinants of fever during the most recent pregnancy and among children under two. RESULTS: Overall 388 mothers were identified for enrollment into the study of which 377 (97.2%) were included in analyses. The majority of mothers slept under bed nets at home (95.8%) and wore long-sleeved clothes (83.8%) for malaria prevention. However, knowledge of malaria was limited: 44.6% were aware of malaria symptoms, 40.6% knew the malaria transmission route precisely, and 29.2% knew of mosquito breeding places. Staying overnight at a farm hut was significantly associated with having fever during the most recent pregnancy (adjusted odds ratio [AOR] 2.008, 95% confidence interval [CI]: 1.215-3.321) and a child having fever (AOR 3.681, 95% CI 1.943-6.972). Mothers' partaking in a variety of malaria preventive actions was protective against fever in children (AOR 0.292, 95% CI: 0.136-0.650). Among those who had fever during pregnancy, 39.4% did not seek treatment. CONCLUSION: Although the majority of mothers took malaria preventive actions, knowledge of malaria epidemiology and vector ecology and treatment-seeking behavior for fever were limited. Staying overnight at farm huts, regardless of the differences in socio-demographic and socio-cultural characteristics, was strongly associated with fever episodes during pregnancy and childhood. This study indicates the necessity of spreading accurate malaria knowledge, raising awareness of health risks related to agricultural practices, and promoting treatment-seeking behavior among ethnic minorities to strengthen their engagement in malaria elimination.

Medico-legal aspects of deaths related to neglect and abandonment in the elderly.

As life expectancy increases, the phenomenon of the neglect of elderly persons is becoming increasingly relevant in the fields of both medicine and social care. This work analyses the cases of two subjects whose deaths initially seemed to have been attributable to natural causes. The autopsy findings and the analysis of clinical data, however, were able to establish that neglect had played a determining role in their deaths. These cases highlight the need for healthcare workers to be more alert to the clinical signs of neglect. Finally, in cases of death, the forensic pathologist must conduct a meticulous post-mortem examination to detect the physical signs of neglect and to establish if abuse has been responsible for the death.