Evidence based Practice (Health Sciences)

Background: Part of chiropractic education involves a requirement for clinical education. Traditionally the clinical education for chiropractors has been profession specific, with little inter professional engagement. There exists paucity in the literature on the amount of inter professional clinical engagements in chiropractic programs. Objective: To explore the perception of final year students from an American Chiropractic college regarding their level and understanding of inter professional engagement. Methods: A qualitative exploratory descriptive design was used for this research. Students were invited to participate. Semi structured focus group interviews were conducted with 15 students lasting 60 minutes. Thematic analysis of the transcribed interviews were undertaken. Results: Students expressed a strong desire for inter professional education as a component of their clinical education. Many described a low level of inter professional exposure within their clinical educatio...

Objective: This review article aims to analyze the existing relevant literature comparing the clinical outcomes and underlining the most common complications associated with immediate, early, and delayed dental implant placement in order to determine the most favorable timing for achieving optimal functional and esthetic results for the patient. Methods: A comprehensive review of the literature was conducted using PubMed-MEDLINE and Cochrane Library and a number of keywords, including "dental implant placement timing", "immediate implant", "early implant", "delayed implant", "clinical outcomes", "complications", and "implant success", focusing on studies comparing immediate, early, and delayed implant placement. The primary outcome variable was implant survival rate, while secondary outcome variables included implant success rate, complications, and patient-reported outcomes. Results: A total of 9774 articles were identified. The articles included a variety of studies, including randomized controlled trials, prospective cohort studies, and retrospective studies. Immediate implant placement was associated with a high survival rate (93.8-100%), but also with an increased risk of complications, such as gingival recession and implant exposure. Early implant placement (4-8 weeks or 12-16 weeks after extraction) showed similar survival rates (95-100%) and fewer complications compared with immediate placement. Delayed implant placement (more than 4 months after extraction) was the most commonly used protocol and demonstrated high survival rates (92-100%) with predictable outcomes. Implant success rates varied depending on the criteria used, but all types of placements showed acceptable success rates (83.3-100%). The choice of loading protocol (immediate, early, or conventional) also influences treatment outcomes. Conclusions: The timing of dental implant placement and loading should be individualized based on patient-specific factors, such as bone and soft tissue conditions, medical history, esthetic considerations, and patient preferences. Immediate placement can be successful in ideal conditions but requires careful patient selection and surgical expertise. Early and delayed placement offer more predictable outcomes and are suitable for a wider range of patients.

The early years of formal education are some of the most crucial in a child’s life. During this stage, students begin to build the skills, knowledge, and habits that will guide them through later academic success. In Dubai, institutions catering to young learners have become hubs of excellence, combining global educational practices with local cultural values to create a nurturing and stimulating environment.
Building Strong Academic Foundations
In the initial years of education, children are introduced to core subjects such as literacy, numeracy, science, and social studies. Lessons are designed to be engaging and interactive, encouraging curiosity and active participation. Many primary school programs focus on creative exploration and hands-on activities, ensuring children develop both knowledge and a love for learning.
Educators in these institutions employ a variety of teaching strategies, including storytelling, experiential learning, and collaborative activities, to cater to diverse learning styles and abilities. By emphasizing critical thinking, problem-solving, and communication skills, primary school programs lay the groundwork for students to thrive academically and socially in the years ahead.
Fostering Social and Emotional Growth
Academic learning is only part of the developmental journey. During these formative years, children also learn to navigate social dynamics, understand their emotions, and develop empathy. Collaborative activities, role-playing, and group projects encourage students to interact positively with their peers and cultivate strong interpersonal skills.
Teachers act as mentors, guiding students through challenges and helping them develop resilience and self-confidence. By fostering a supportive and inclusive environment, schools ensure that emotional and social growth progresses alongside academic achievement.
Encouraging Creativity and Innovation
Creative expression is a key component of early education in Dubai. Children are provided with opportunities to explore art, music, drama, and design, which help to develop imagination, fine motor skills, and self-expression. Creativity is also integrated into problem-solving exercises and classroom activities, allowing students to approach challenges in innovative ways.
This focus on creativity complements academic learning, enabling students to think critically and independently. Inquiry-based learning, brainstorming sessions, and hands-on experiments encourage children to explore ideas, make decisions, and learn from mistakes, fostering both intellectual and personal growth.
Incorporating Technology in Learning
Modern educational institutions in Dubai seamlessly integrate technology into their teaching methods. Digital tools such as interactive whiteboards, educational apps, and online resources enhance learning experiences and make concepts more accessible. Technology is used to promote collaboration, research, and creative problem-solving, equipping students with essential 21st-century skills from an early age.
Teachers leverage these tools to personalize learning, track progress, and address individual needs. By combining traditional instruction with innovative technology, schools create a dynamic environment that keeps students engaged and motivated.
Physical Development and Well-being
Physical activity is a vital aspect of early education. Structured exercises, sports, and outdoor play help children develop coordination, strength, and stamina. In addition, physical activities teach important life skills such as teamwork, discipline, and perseverance.
Play-based learning encourages exploration, experimentation, and active engagement with the environment. Outdoor play, sensory activities, and movement-based exercises not only promote physical development but also support cognitive and social growth, ensuring a well-rounded educational experience.
Global Awareness and Cultural Education
Dubai’s schools emphasize exposure to diverse cultures and global perspectives from an early age. Children participate in multicultural activities, language learning, and cultural celebrations that foster open-mindedness, respect, and adaptability.
By blending local traditions with international best practices, educators create a rich learning environment that encourages students to develop empathy and understanding. These experiences help young learners appreciate diversity and prepare them to thrive in a globalized society.
Engaging Families and Communities
Parental involvement is a cornerstone of early education in Dubai. Schools actively collaborate with families through workshops, regular updates, and participatory activities to support children’s growth. Engaging families ensures that learning continues beyond the classroom and reinforces positive habits, academic skills, and social development.
Community programs and cultural initiatives provide students with real-world experiences, helping them understand the value of civic responsibility and social participation. By connecting education to the broader community, institutions nurture a sense of belonging and social awareness in young learners.
Preparing for Future Academic Success
The early years of education serve as a foundation for future learning. Strong skills in literacy, numeracy, and critical thinking equip students for more advanced studies. At the same time, social-emotional development, creativity, and problem-solving abilities ensure that children are ready to navigate challenges both in and out of the classroom.
Guidance programs and mentorship opportunities help students transition smoothly to higher academic stages, fostering independence, confidence, and a lifelong love of learning. By the end of this formative stage, students are well-prepared to continue their educational journey with enthusiasm and resilience.
Conclusion
Education during the early years plays a pivotal role in shaping young learners into confident, knowledgeable, and socially responsible individuals. Institutions in primary school in dubai provide a comprehensive foundation that balances academic rigor, creative exploration, emotional growth, and global awareness.
Programs designed for young learners in primary school in dubai ensure that students develop the skills, curiosity, and confidence necessary to thrive in future academic stages. With careful attention to holistic development, primary school becomes a critical step in preparing children for lifelong learning and success.

El efecto de las medidas tomadas para el control de la pandemia de COVID-19 se han reflejado en una disminución de los ingresos por otras enfermedades infecciosas, por lo que resultó necesario describir con datos concretos este fenómeno. Objetivo: Describir aspectos de la morbilidad e indicadores de servicio en 2020 en relación con los dos años anteriores. Métodos: estudio descriptivo, de corte transversal. Se revisaron los registros de datos de los departamentos de estadística, economía y cuidados intensivos, del Hospital Pediátrico Paquito González, en Cienfuegos, para extraer las variables a estudiar, correspondientes a los años 2018, 2019 y 2020 y poder compararlas. Para el estudio de las variables se precisó el número de ingresos por neumonía, bronquiolitis, laringitis, enfermedad diarreica aguda, meningoencefalitis viral, meningoencefalitis bacteriana y sepsis, así como el número de ingresos totales, índice ocupacional, días-paciente, gastos en material y medicamentos, abordaje venoso central, pleurotomia y ventilación mecánica. Resultados: se observó una disminución en la incidencia de infecciones respiratorias agudas y enfermedad diarreica aguda en el año 2020 en comparación a los dos años precedentes, no así de la sepsis y del síndrome neurológico infeccioso. Igualmente disminuyeron, el número procedimientos médicos invasivos y los gastos en materiales y medicamentos. Conclusiones: las medidas sanitarias puestas en práctica para controlar la pandemia de COVID-19, consistentes en fomentar el distanciamiento físico y la protección personal a través del uso de mascarillas y el lavado de manos, ha tenido un impacto positivo en la incidencia de enfermedades que tienen las mismas características epidemiológicas de transmisión.

How do people with diagnosed autoimmune diseases feel, and what they do and think when they unexpectedly encounter an unregistered drug that may help them to heal, instead of palliatively controlling symptoms of autoimmune reactions through conventional immunosuppressants? What then if they are health professionals who became patients? How does such an encounter aA ect their lives, their perceptions and attitudes towards their respective medico-legal environments? In this article, I analyse letters exchanged between a physician in Brazil and eight of his patients, who are also health professionals, mainly between BCCD and EFFF, concerning their experiencing of using an unregistered medicine, the "anti-brucellic vaccine" (VAB), to treat diA erent immunopathologies such as rheumatoid arthritis. Considering VAB users as capable of systematically evaluating and communicating their experiences of illness and recovery, I seek to understand and discuss the tensions surrounding the repositionings and attitudes of aA ected health professionals within the co-production of medical evidence in the context of disruptive biotechnological innovation in Brazil. Apparently, their own experience with VAB seemed to have enabled them to re-ground their medical knowledge, experience, and skills in relation to their own and someone else's health in anticipation of the mediation regularly played out by conventional medical knowledge, technologies and procedures. Furthermore, when VAB-using physicians self-analyse and dialogue with others, writing and exchanging evaluative reports about their own and others' health and therapeutic experiences of using VAB, they seemed to implicitly co-produce medical evidence that can be taken into consideration by potential users.

Nursing education has undergone a transformation from being Diploma-based to Degree-based in the past few decades. This change has led to a shift from training to education in the preparation of the nurse accompanied by paradigm shift from school education to university education in nursing. This study assessed graduate nurses' perception of the undergraduate nursing education in Nigeria: Case study of Rivers State. Descriptive survey design was adopted in carrying out this research. The study was steered using four objectives of the study and four research questions. The population of the study was 200 graduate nurses in University of Port Harcourt Teaching hospital, (UPTH), with a sample size of 126 which was randomly selected. The instrument for data collection was a self-structured questionnaire with a reliability of 0.72. Mean and standard deviation were used to answer research questions. The results of the study revealed among others that 106 (84.1%) of respondents perceived that their institutions adequately prepared them to practice nursing in work areas. They have adequate level of selfconfidence in caring for patients without supervision, M=3.8, SD= 0.33. Study concludes that respondents had good perception of the undergraduate nursing education. Recommendations includes that nurses should practice to the full potential of their education to benchmark the global standard.

Key points • An assessment of the methodological quality of the systematic reviews can be carried out using the AMSTAR tool. • Less than 1% of recently published systematic reviews in dentistry were classified with high methodological quality by AMSTAR 2. • It is necessary to improve the methodological quality of systematic reviews in dentistry.

Hybrid working, mental health concerns, intergenerational dynamics, and increased diversity have changed how organisations function, challenging both traditional and contemporary leadership models. Meanwhile, healthcare systems have witnessed failures linked to a lack of empathy that have resulted in avoidable harm. Drawing on evidence that enhanced empathy in healthcare benefits both practitioners and patients, we propose a model of empathic leadership that involves understanding and cooperative action. We explore how implementing this model could benefit contemporary healthcare leaders, healthcare systems, and ultimately, patients. Future research can explore and evaluate the impact of this new model. While our focus is on healthcare leadership, we anticipate that the proposed model has relevance extending beyond the healthcare setting.

This study was conducted in the rural community of Alor, Anambra State, Nigeria, to determine the prevalence of malaria among children and to evaluate the ownership and use of long-lasting insecticide-treated nets (LLINs), as well as caregivers' knowledge, attitudes, and practices concerning malaria. A cross-sectional survey was carried out to assess malaria prevalence, employing a structured questionnaire to examine caregivers' understanding, perceptions, and preventive measures related to malaria. Blood samples were collected from children aged 0 to 15 years who visited the community health centre during the study period. The prevalence of malaria among the 94 children studied was 62.8%. Children aged 0 to 3 years had the highest prevalence (75%), while those aged 8 to 9 years had the lowest (50%). 93.1% of caregivers identified fever as a major symptom of malaria. More than half (51.1%) of caregivers reported that their children do not sleep under insecticide-treated nets. Additionally, 52.1% of caregivers did not perceive malaria as a serious health threat to children. Malaria remains a public health concern in the study area. The low usage of LLINs among children poses a challenge, as malaria eradication efforts will struggle if caregivers do not adopt net use. Health education on malaria and its prevention was provided to caregivers; however, a broader community enlightenment campaign is necessary to eliminate malaria.

This academic paper explores evidence-based practices in the administration and monitoring of enteral nutrition in hospitalized adult patients. Structured as an analytical literature review, the work addresses key topics such as nutritional assessment tools, feeding routes (nasogastric tube and PEG), administration methods (bolus vs continuous), gastric residual volume monitoring, glycemic control, and drug administration through enteral access. The role of the nurse is emphasized throughout as essential to ensuring safe, effective, and individualized nutritional support in clinical settings. This work was developed independently as part of a nursing academic internship and was presented at Hospital de Santa Maria, Porto.

Background and context: The Royal College of Midwives is engaged in a long-term twinning partnership with the Uganda Private Midwives Association. Uganda is one of the poorest countries in the world and only 27% of women and newborns have their needs met (UNFPA, 2014). A well-skilled, competent midwifery workforce is required to meet these needs yet Ugandan student midwives often receive poor-quality clinical education. The Ugandan Nurses and Midwives Council approached the Royal College of Midwives for assistance in designing a system of mentorship for Ugandan midwifery to address this gap. The project was funded by UK-Aid through the Tropical Health and Education Trust. Aims of the project: MOMENTUM was a 20-month action research project that aimed to develop and pilot a model of mentorship for student midwives in Uganda. This article focuses on one workstream relating to practice development, a twinning project that used workbased learning and appreciative inquiry, embedded in an action research approach, to facilitate practice development. Conclusions: This project added to the body of knowledge about midwifery twinning for building capacity in mentorship, research, and cross-cultural competence. MOMENTUM created a powerful community of practice that was enabling, fulfilling and transformative. Replication of this would require funding, management capacity and sufficient lead time for participatory planning and piloting. MOMENTUM's audit tool was a bespoke design for this pilot project and so may not be transferable to other settings without further development, testing and validation. Implications for practice: • Twinning, action research, appreciative enquiry and workbased learning can be effective in enabling practice development • The impact of midwifery twinning on leadership development requires further investigation, together with greater evidence on the reciprocal impact of twinning on the sending country.

This study investigated duration of breastfeeding as predictor of anthropometric indices of weight, height, and body mass of 0-24 months children in Delta State. The study adopted the descriptive research design. The population for this study consisted of 687,571 breastfed children within their 24 months of age whose mothers registered in the 473 Primary HealthCare Centres (Urban and Rural) in Delta State. It included mothers and their children within their two years of life attending the Primary Health Care Centres in Urban and Rural areas of Delta State. The sample size for this study was 631 using A systematic sampling technique. The instrument for the study was a questionnaire which contains items on selected demographics data, items on duration of breastfeeding, and items on anthropometric indices. Stadiometer either standardized or improvised was used to measure the children's height, while weighing scale that are functional and calibrated to the zero pointer was employed in the estimation of the babies' weight and the weighing was done on the same time of the day with minimal or no clothing. Obtained data were analysed using descriptive statistics of frequency, percentages, mean and standard deviation. Inferential Statistic of multiple regression was used to test the hypotheses at 0.05 level of significance.

Feminist philosophers have discussed the prospects for assessing values empirically, particularly given the ongoing threat of sexism and other oppressive values influencing science and society. Some advocates of such tests now champion a “values as evidence” approach, and they criticize Helen Longino’s contextual empiricism for not holding values to the same level of empirical scrutiny as other claims. In this paper, we defend contextual empiricism by arguing that many of these criticisms are based on mischaracterizations of Longino’s position, overstatements of certain claims, and false dichotomies. Her contextual empiricism not only allows for the empirical support and disconfirmation of values, but Longino explicitly discusses when values can be empirically adjudicated and emphasizes the crucial role of the community for standards of evidence. We support contextual empiricism and elaborate a less direct account of “values as heuristics” by reviewing Longino’s theory of evidence a...

Online learning challenges persist, and there are gaps in research on the impact of teaching online and transnational learning in different countries. Teachers’ engagement is often overlooked. This study aims to deepen understanding and research in graduate nursing education, covering all aspects of teaching and learning engagement, perceived obstacles, reinforcers and distinctiveness in distance education program.

The research utilized a quantitative descriptive correlation design employing PLS-SEM and a qualitative contextual analysis integrated in a sequential explanatory mix method.  An online engagement model was established, taking into account the multidimensional continuous process of teaching and learning in a new age of advanced digitalization.

It was revealed in the findings that female postgraduate teachers and those with over two years of experience are the most engaged in online teaching, with master degree students and nursing administrators being the most engaged. Teacher respondents and student participants’ engagement levels were high, with a mean score of 4.32 and 3.84 respectively. The major key factors influencing teaching domains of engagement were sex, years of teaching, faculty/institutional support, with convenience being distinct characteristics; while student positions, duration of study, and collaborative activities are major key factors for learning engagement, with flexibility being distinct characteristics. The primary problem for both was digital competency.

Online learning requires efficient interactions, promotes positive educational practices, and encourages flexibility, digital literacy, and prepared educators and nurses de-spite job obligations and personal expectations.

Este livro apresenta brevemente a história da TCC e destaca sua natureza integrativa. Este conhecimento permite que profissionais que atuam a partir desta perspectiva possam refletir criticamente sobre o conhecimento teórico e sobre suas próprias práticas de modo a lidar com as demandas clínicas que se apresentam na atualidade, considerando as necessidades únicas de seus clientes. Buscou-se apresentar discussões sobre responsabilidade ética, criatividade e sensibilidade do(a) terapeuta.

This paper includes the importance of Evidence-Informed Practices (EIP) in Early childhood education and how it improves learning and development through research, professional competence, and contextual understanding. EIP emphasises adaptive decision-making, where educators combine scientific findings with their pedagogical expertise and the unique needs of children, families, and communities. EIP emphasises play-based learning, responsive connections, and inclusive, culturally sustaining environments based on Vygotsky, Piaget, and Bronfenbrenner theories. It includes a wide range of academic research, observational evaluations, practitioner reflections, and family input inform effective EIP. Scaffolding, continuous shared thinking, and trauma-informed care show how research informs classroom strategy. It emphasizes that access to high-quality training, balanced resource distribution, and matching standardised research with local reality are issues.It pays a great emphasize on the global models like Reggio Emilia and High Scope demonstrate EIP's transformative power when tailored to individual circumstances. Leveraging neuroscientific advances, improving educator professional development, and lobbying for flexible, evidence-based policy are future directions. By encouraging collaboration between scholars, practitioners, and communities, EIP keeps early childhood education dynamic, equitable, and effective.

Radiation therapy is a basic tool in cancer treatment and so maximising safety during these procedures is essential. Here we present the evolution and development of these safety protocols in Spain by leveraging the so-called risk matrix tool. We also tested its application to 3D radiotherapy treatments. A working group comprising members of the Spanish Society of Medical Physics (SEFM), Spanish Society of Radiation Oncology (SEOR), Spanish Association of Radiotherapy Technicians (AETR), and Spanish Society for Radiation Protection (SEPR) was created with the collaboration of the Nuclear Safety Council, all under the auspices of the Spanish Health Authority, to adapt risk matrix methodology to radiotherapy applications in Spain (the Risk Matrices in Radiotherapy, or MARR project). The application we developed was a very effective tool to integrate the entire methodology as well as previous user experiences into risk analysis. Among its main qualities was the ease with which it could be modified to allow each hospital to generate analysis elements and parameters specific to its own practice and to accommodate process changes as part of their continuous improvement plans. As a continuation of this work, the MARRTA project, which includes the latest application techniques in external radiotherapy (IMRT and IGRT, among others) is currently in its latter research stages.

Postoperative pain management is a vital component of patient care that significantly influences the speed and quality of recovery, functional
outcomes, and overall patient satisfaction. Effective pain control not only reduces physiological stress but also minimizes the risk of complications
such as delayed healing, chronic pain, and prolonged hospital stays. Evidence-Based Practice (EBP) plays a central role in improving pain
management by combining the best available research evidence with clinical expertise and individual patient preferences. This study investigates
various pharmacological methods such as opioids, NSAIDs, and local anesthetics, along with non-pharmacological approaches like guided
imagery, breathing exercises, and physical therapy. It emphasizes the crucial role of nurses in the assessment, documentation, and management of
postoperative pain. Standardized pain assessment tools-such as the Visual Analog Scale (VAS), Numeric Rating Scale (NRS), and FLACC-are
highlighted for their role in guiding treatment decisions. Additionally, the study explores existing barriers such as lack of training, resource
limitations, and institutional challenges, and underscores the need for ongoing education, policy revision, and interprofessional collaboration to
enhance pain management outcomes.

La mayoría de los casos de influenza se manifiestan por una enfermedad respiratoria aguda que usualmente se resuelve dentro de una semana. Sin embargo, algunas complicaciones, especialmente neumonía, pueden observarse durante una epidemia. Hasta la epidemia de 1957-1958 hubo escaso reconocimiento de que el virus de influenza podía producir neumonía. Recién por estudios publicados por Louria y col. en 1959, se confirmó esta posibilidad por análisis clínico-patológicos 1 . La emergencia de la infección por virus de influenza A H1N1-2009 entre humanos representa la mayor pandemia desde la aparición de influenza A H3N2 en 1968. La pandemia por este nuevo virus en nuestro país tuvo distintos elementos para resaltar en lo que respecta a las formas graves de la enfermedad y, en consecuencia, en lo referente al ámbito de cuidados críticos:

 Avances tecnológicos en el desarrollo de test de diagnóstico: detección de virus y anticuerpos.  Polímeros y oligómeros para inactivar SARS-CoV-2 en superficies.  Superficies nanoestructuradas.  Nuevas autorizaciones FDA de tests de diagnóstico.  Mascarillas: todavía muy necesarias.  Gobernanza de la pandemia: diferencias y efectos.  Repaso del 2020-la ciencia en pandemia.

Clinical placements allow students the opportunity to apply theoretical knowledge and become workforce ready. Demand for clinical placements from education providers already exceeds supply. As healthcare workforce shortages continue, the need for increasing numbers of graduates will generate additional strain, and policymakers targeting health workforce shortages must be cognisant of their impact on the education and health sectors. At the same time, clinical placements must be fit for purpose and meet the learning needs of students. The diverse array of placement models has been compounded by rapid developments during the COVID-19 pandemic. Challenges and considerations include labour intensity, need for capacity building, importance of engagement at institutional and local supervisor levels, cost (including that to students), planetary impact, availability and equity. The future of high-quality clinical placements needs to be secured and built on a sustainable framework to support future clinical placement capacity.

Sentence completion norms are a valuable resource for researchers interested in the study of the effects of context in word recognition processes and language comprehension. This study presents completion norms for 278 sentences-final words in Spanish for Mexican children. These norms were obtained through the cloze method in a sample of 420 students (226 boys and 194 girls) 9 to 12 years old, from fourth to sixth grades of elementary public schools located in Estado de México. Children's task was to read each one of the sentences and completed them with one closing word. According to children's responses, cloze probability of each closing word was calculated for each sentence context. Although the set of sentences included different contextual constraints, subject's responses showed a greater number of sentences with high cloze probability. This corpus can be used in research on language comprehension (both oral and written) in children.

To investigate the time and factors related to the diagnostic interval of oral cancer in Brazilian health services from 2000 to 2022. Cross-sectional and hospital-based study, including 12,989 cases retrieved from the Hospital Cancer Registries of Brazil. Descriptive analyses were performed, and the negative binomial Poisson regression model was applied. Most Brazilians with oral cancer were diagnosed at an advanced stage (70%), referred by the Unified Health System (SUS) (82%), and needed to travel from their municipality of residence to undergo treatment (63%). The median number of days between screening and the start of treatment was 63 days, with a range between 32 and 104 days. The data show that the referral source (P < .001) and the hospital region (P < .001) are important factors influencing the diagnostic interval, with individuals referred by SUS and treated in hospitals in the Midwest region (IRR 1.45) experiencing a longer interval than others. The healthcare interval in Brazil exceeds 60 days, which may impact treatment, prognosis, and quality of life of Brazilians. Funding Source: CNPq.

Governments and social benefit organizations are expected to consider evidence in decisionmaking. In development and sustainability, evidence spans disciplines and methodological traditions and is often inconclusive. Graphical models are widely promoted to organize interdisciplinary evidence and improve decision-making by considering mediating variables. However, the reproducibility, objectivity and benefits for decision-making of graphical models have not been studied. We evaluate these considerations in the setting of energy services in the developing world, a contemporary development and sustainability imperative. We develop a database of relevant causal relations (331 concepts, 1,355 relationships) asserted in the literature (561 peer-reviewed articles). We demonstrate that high-level relationships of interest to practitioners feature less consistent evidence than the causal relationships that underpin them, supporting increased use of problem decomposition through graphical modelling approaches. However, adding such detail increases complexity exponentially, introducing a hazard of overparameterization if evidence is not available to match the level of mechanistic detail.

Overview

Vincenzo Di Nicola, WASP President, presents a world perspective on treating children, adolescents, and youth mental illnesses with family interventions in a call for clinical social psychiatry as a bridge between the Social Determinants of Health & Mental Health (SDH/MH) and clinical treatment.

This is a proposal for a model of clinical social psychiatry by offering as an instructive example the synthesis of the Social Determinants of Health & Mental Health (SDH/MH) and Family Therapy as one of the major practices of relational therapy.

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V Di Nicola (Invited Symposium Panelist), “When Therapy Fails: The Fog of Incoherence and the Illusion of Mastery in Theory and Practice,” DV Jeste (Symposium Chair), CA Alfonso, V Di Nicola, AL Jiminez (Symposium Panelists), “Psychotherapies: Addressing Social Determinants, Cultural Adaptations, and Mastery of Theory and Techniques” (A Session Sponsored by the World Federation for Psychotherapy, WFP), American Psychiatric Association Annual Meeting, Los Angeles, CA, May 21, 2025.

DOI: 10.13140/RG.2.2.28475.73767

The objective of this review is to identify the extent and nature of the existing literature on co-design with residents residing in aged care facilities. Introduction: Involving older people in their own care is a key challenge facing the aged care sector. Co-design is an approach that focuses on involving end users in the design of services. Mapping the evidence on co-design in residential aged care will identify the nature and extent of how older people living in residential care have been engaged in the design and delivery of their care. Inclusion criteria: This scoping review will include peer-reviewed primary studies; systematic and scoping reviews; and gray literature, including abstracts and reports of governments and non-governmental organizations. Older people residing in aged care homes, including those from culturally and linguistically diverse backgrounds and/or living with dementia, who are involved in the co-design, co-creation, participation, involvement, and engagement in their care will be considered for inclusion. Methods: This review will be conducted in accordance with the JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).

Objective
The present study aimed to evaluate the feasibility of an educational program disseminated via social media to improve the scientific and technical knowledge of physiotherapists.

Results
In this single-group interventional feasibility study, practicing physiotherapists participated in a 10-week Instagram-based program, which included 20 infographics posted twice weekly. Feasibility was evaluated using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance). After the intervention, semi-structured interviews were conducted to gather feedback on participant experiences. Of the 30 physiotherapists recruited, 15 initiated the program, and 8 (53%) completed it. No significant differences were observed between pre- and post-program scores on effectiveness outcomes related to perceptions, utilization, and understanding of scientific information for clinical practice. While 63% of participants reported that the program helped them overcome barriers to EBP, overall perceptions and behaviors showed minimal change. Nonetheless, all participants recognized a positive impact on their clinical practice, with 50% reporting that they applied program content to their work. Although 63% indicated they would maintain their approach to studying technical content, all participants affirmed their intention to use resources that facilitate knowledge acquisition. Feedback from interviews indicated positive attitudes towards social media-based educational programs.

Given the growing scale and complexity of responses to humanitarian crises, it is important to develop a stronger evidence base for health interventions in such contexts. Humanitarian crises present unique challenges to rigorous and effective research, but there are substantial opportunities for scientific advance. Studies need to focus where the translation of evidence from noncrisis scenarios is not viable and on ethical ways of determining what happens in the absence of an intervention. Robust methodologies suited to crisis settings have to be developed and used to assess interventions with potential for delivery at scale. Strengthening research capacity in the low- to middle-income countries that are vulnerable to crises is also crucial.

Este estudio tuvo como objetivo determinar la influencia del estrés académico y depresión en la agresividad en estudiantes universitarios de Lima, 2021. El tipo de investigación fue básica, de diseño no experimental, corte transversal, correlacional causal y de enfoque cuantitativo. La muestra la conformaron 124 estudiantes universitarios de ambos sexos de universidades nacionales como particulares. El estadístico utilizado fue la regresión logística multinomial. Los resultados evidenciaron que los altos niveles de agresividad, depresión y estrés académico recayeron más en las mujeres que en los varones; lo mismo sucedió respecto a la procedencia de la universidad siendo las casas de estudio particulares las que tuvieron puntajes más altos. El ajuste del modelo predijo la probabilidad de ocurrencia de las categorías de la variable dependiente en función de las independientes y la explica en un 36.7%. Se concluyó que el estrés académico y la depresión influyen en la agresividad en es...

Medical education requires students to master vast amounts of complex knowledge within a limited timeframe, yet many learners rely on suboptimal study methods such as re-reading and note-taking. In recent years, research from the field of psychology has identified six evidence-based learning strategies-spaced practice, interleaved practice, retrieval practice, elaboration, dual coding, and concrete examples-that can significantly enhance learning outcomes. Despite their proven efficacy, these strategies remain underutilized or inconsistently applied in medical education. This article explores each strategy, provides illustrative examples of their application, and discusses barriers to their integration within medical curricula. The importance of transdisciplinary collaboration between medical educators and psychologists is emphasized to optimize strategy implementation and address challenges such as resource constraints and student resistance. By adopting these strategies, medical education can transition toward a more effective and sustainable model, better preparing students for the demands of modern healthcare.

Autism Spectrum Disorder (ASD) presents a significant challenge in child development, and finding effective strategies to improve quality of life is a priority. This article presents the analysis of 183 children who followed the Katia Dolle Method, examining changes in severity levels (severe, moderate-severe, moderate, moderate-mild, mild) based on pre-and post-intervention ATEC scores. The results show an average reduction of 2 severity levels, from moderate-severe to moderate-mild, over a mean intervention period of 14 months. This significant improvement confirms the effectiveness of the Katia Dolle Method in reducing ASD-related severity and improving overall symptomatology. Introduction: Autism Spectrum Disorder affects millions of children worldwide, impacting communication, social interaction, and behavior. While numerous therapeutic strategies exist, effectiveness varies according to each child's profile and environment. The Katia Dolle Method is a naturopathic approach based on psychoneuroimmunoendocrinology (PNIE), designed to address neurodevelopmental disorders with complex biological imbalances, such as ASD. It integrates immune-nutrition optimization, systemic regulation, and targeted supplementation to support neuroregeneration and biochemical balance. Over 1,000 children have followed the Katia Dolle Method, with promising results. This article analyzes 183 cases from a retrospective cross-sectional study to quantify severity reduction through ATEC scores and assess the impact of the intervention. Methodology: From 281 initial participants, 183 children met the inclusion criteria: completion of ATEC at baseline and post-intervention, adherence to the method for at least 3 months, and consistent data. Exclusions were due to poor adherence, missing data, or inconsistent reporting. ATEC severity levels and scores were compared using a paired t-test. A multivariable regression model included intervention time, initial severity, and age at start. A subscale analysis was conducted to identify specific areas of improvement.

This retrospective cross-sectional study analyzes the effectiveness of the Katia Dolle Method® applied to 183 children with ASD (Autism Spectrum Disorder). Data from the ATEC (Autism Treatment Evaluation Checklist) questionnaires administered before and after the intervention were used, from an online pilot program carried out between 2020 and 2022, as well as from additional cases of interventions carried out between 2017 and 2019, and between 2022 and 2024. This extension allows for a more robust analysis of the method's effects across different periods.

Clinical placements allow students the opportunity to apply theoretical knowledge and become workforce ready. Demand for clinical placements from education providers already exceeds supply. As healthcare workforce shortages continue, the need for increasing numbers of graduates will generate additional strain, and policymakers targeting health workforce shortages must be cognisant of their impact on the education and health sectors. At the same time, clinical placements must be fit for purpose and meet the learning needs of students. The diverse array of placement models has been compounded by rapid developments during the COVID-19 pandemic. Challenges and considerations include labour intensity, need for capacity building, importance of engagement at institutional and local supervisor levels, cost (including that to students), planetary impact, availability and equity. The future of high-quality clinical placements needs to be secured and built on a sustainable framework to support future clinical placement capacity.

Writing a research paper in nursing is a structured process that involves selecting a relevant topic, designing a study, analyzing data, and interpreting statistical results. This guide provides an in-depth explanation of each stage of the research process, focusing on statistical analysis techniques and the importance of evidence-based practices in nursing. The paper emphasizes the essential role of nurses in conducting research that improves patient care and healthcare outcomes. Through the careful application of research methods and statistical tools, nursing researchers can make valuable contributions to their field. This guide is designed to assist both novice and experienced researchers in understanding the fundamental aspects of nursing research.

La identificación de niveles de estrés en pacientes diabéticos tiene implicancias clínicas y prácticas. En Chile no hay escalas válidas y confiables que midan estrés en pacientes diabéticos. Con el objetivo de estimar las propiedades psicométricas de la Escala de estrés para diabéticos de Polonsky et al. ( ) en una muestra de pacientes diabéticos chilenos, se realizó análisis de confiabilidad, análisis factorial exploratorio y correlaciones con la escala de síntomas depresivos (CES-D) y con el marcador fisiológico hemoglobina glicosilada (HbA1c), en una muestra de 76 pacientes diabéticos tipo 2 de la ciudad de Temuco, Chile. Tras los análisis, se estimó una consistencia interna de 0.74, una estructura de 4 subfactores y evidencia de validez convergente con la escala CES-D y HbA1c. La escala de estrés para diabéticos posee propiedades psicométricas adecuadas, permite la identificación de 4 subfactores y es de fácil aplicación en el campo clínico e investigativo.

In this paper we reviewed the literature to determine what "culturally sensitive" interventions (whereby "culturally sensitive" was defined as any study that included a specific focus on the cultural group of interest) can be considered well-established, beneficial treatments for use with Hispanic populations. Despite several hundred publications on Hispanics and cultural sensitivity over the past several decades, only 12 peer-reviewed articles that evaluated empirically supported treatments for the mental health disorders most commonly diagnosed among Hispanics were identified. These studies had significant methodological limitations and few employed the "gold standard" designs associated with randomized clinical trials. From this review we concluded that 1) the ratio of non-empirical to experimental publications is quite high; 2) there is evidence that Hispanics may be effectively treated using conventional cognitive behavioral therapy; 3) there is little evidence that cultural adaptations result in consistently improved effect sizes; and 4) cultural adaptations do not show expected homogeneity regarding cultural tailoring, suggesting that the construct of Hispanic culture is poorly understood.

РЕЗЮМЕ: Настоящая работа -- ответ на статью А.Б. Шмуклера «Доказательные
исследования в психиатрии: анализ практической значимости» (Психиатрия и
психофармакотерапия. Том 14 № 5.). Показана несостоятельность аргументов, с помощью
которых критикуется применение доказательной медицины и клинической эпидемиологии
в психиатрии и ошибочность сделанных в статье выводов.
Ключевые слова: Клиническая эпидемиология, Доказательная медицина, психиатрия
An analysis of practical importance or an attempt at a defamation of character of clinical
epidemiology and еvidenсe-based medicine?
Nikita A. Zorin M.D., Ph.D. Society for EBM.
This article is an answer to the article by A.B. Shmukler «Evidence-based investigations in
psychiatry: analysis of their practical value». It shows the inadequacy of the arguments used to
critique the use of evidence-based medicine and clinical epidemiology, as well as the
erroneousness of the conclusions drawn by the article.
Keywords: Clinical epidemiology; Evidenсe-based medicine; Psychiatry

Chen et al. [1], compared two modified polyurethane-based wound
dressings (PUE and PUESi), both intended for use in chronic wounds, with
a negative control (gauze) and a positive control (PolyMem) via a series of
preliminary in vitro and rodent model tests. Future studies may find that
one or both of these two new dressings are beneficial. However, the results
of this first study cannot be relied upon. Although they exhibited in-depth
knowledge of manufacturing techniques, the study designers seem far less
familiar with the science of wound healing and with PolyMem wound
dressings. This helps explain the flaws in the methods that led to many
of their tests not being translatable to real-world settings. In addition, the
interpretation of some of the test results is questionable.

Bu çalışmanın amacı kanıta dayalı hemşireliğe yönelik mezuniyet öncesinde ve sonrasında katılımcıların tutumlarını, etkileyen faktörleri belirlemek ve karşılaştırmaktır. Gereç ve Yöntem: Çalışmanın birinci aşamasında veriler, dördüncü sınıfta öğrenim gören (n=171) öğrencilere Birey Tanıtım Formu ve Öğrencilerin Kanıta Dayalı Hemşirelik Konusundaki Bilgi, Tutum ve Davranışları Ölçeği kullanılarak toplanmıştır. Araştırmanın ikinci aşaması mezunlar (n=103) ile yürütülmüştür. İkinci aşamada veriler Kanıta Dayalı Hemşireliğe Yönelik Tutum Ölçeği kullanılarak toplanmıştır. Bulgular: Katılımcıların mezuniyet öncesi ve sonrası kanıta dayalı hemşirelik konusundaki tutumları arasında pozitif yönde zayıf bir ilişki bulunmuştur. (r=0,236; p=0,016). Ayrıca mezuniyet öncesinde katılımcıların kanıta dayalı hemşireliğe yönelik tutumu olumlu oldukça, kanıta dayalı hemşireliğin klinik uygulamada sağladığı yararlar konusundaki duyguları da olumlu olmaktadır (r=0,214; p=0,030). Hemşirelik bakımını planlarken kanıta dayalı uygulamalardan yararlanmak, mesleki dergileri okumak ve bilimsel toplantılara katılmak hem mezuniyet öncesi hem de mezuniyet sonrası bireyin kanıta dayalı hemşireliğe yönelik tutumunu etkileyen faktörler arasındadır. Sonuç: Öğrencilerin lisans eğitimi boyunca öğrencilerin kanıta dayalı hemşireliğe yönelik bilgileri, tutum ve davranışları ne kadar geliştirilir ise, çalışma hayatlarında kanıta dayalı hemşireliği uygulama eğilimi o kadar artacaktır.

Polymyositis, a type of idiopathic inflammatory myopathy is an autoimmune condition that causes painful mobility resulting in significant morbidity. It is often diagnosed by elevated serum creatine phosphokinase (CPK), Electromyography (EMG), and radiologic tests like Magnetic Resonance Imaging (MRI). Intensive immunosuppressive therapy with steroids and steroid-sparing agents help in managing the disease and in attaining quick disease remission.

This is the second in a two-part series of articles about the Icelandic Model for Primary Prevention of Substance Use (IPM) in this volume of Health Promotion Practice. IPM is a community collaborative approach that has demonstrated remarkable effectiveness in reducing substance use initiation among youth in Iceland over the past 20 years. While the first article focused attention on the background context, theoretical orientation, evaluation and evidence of effectiveness, and the five guiding principles of the model, this second article describes the 10 core steps to practical implementation. Steps 1 to 3 focus on building and maintaining community capacity for model implementation. Steps 4 to 6 focus on implementing a rigorous system of data collection, processing, dissemination, and translation of findings. Steps 7 to 9 are designed to focus community attention and to maximize community engagement in creating and sustaining a social environment in which young people become progre...

Jean-Dadet Diasoluka est une figure polyvalente dans le monde académique et médical, avec des contributions qui s'étendent de la médecine ophtalmologique à la physique quantique, en passant par des réflexions sur la santé publique et la technologie. Ses publications reflètent un intérêt pour la vulgarisation scientifique et l'innovation dans divers champs de la science et de la médecine.

Objective: The study assessed the impact on clinicians' 'perception of skills' in postdisaster evidence-informed care (EIC) following participation in an online training programme implemented following the Queensland floods and cyclones of 2010-11, clinician confidence to provide EIC, the frequency clinicians used EIC and barriers to providing postdisaster specialist mental health care. Design: Clinician perception of pre and posttraining skills, confidence in providing therapies such as trauma-focused cognitive behaviour therapy (TF-CBT), frequency of therapies provided and clinician perception of barriers to the programme were assessed quantitatively and qualitatively. Participants and Setting: Clinical staff (n = 60) employed by the 2010-11 postdisaster mental health programme participated in an online survey conducted over the last 12 weeks of 2012. After the programme concluded an independent audit of the clinical record of mental health clients treated by clinicians employed in the specialist mental health programme was undertaken. Main Outcome Measure(s): Perception of clinical skills in various EIC modalities was completed pre and posttraining. Confidence to provide a treatment was rated on a five-point scale. The clinical record audit identified the treatments provided to clients. Barriers to programme delivery were rated on a five-point scale, with qualitative feedback highlighting programme concerns. Results: Posttraining clinicians perceived skills in TF-CBT (p < 0.0001), cognitive behaviour therapy (CBT) (p < 0.001) and exposure therapy (p < 0.001) had improved. Following training, clinicians described themselves as moderately to extremely confident in implementing TF-CBT (87%), exposure therapy (80%) and skills for psychological recovery (SPR) (88%). Clinical records analysis indicates that 25% of cases received no TF-CBT, while 43% received one to five sessions. Barriers to care included a lack of cross-service relationships. Recommendations focused on training and early commencement of intervention programmes. Conclusion: The study echoes the findings of the 2020 Australian Bushfire Royal Commission recommendations that highlighted a need for clinician training in postdisaster EIC and the availability of clinicians with specialised postdisaster mental health skills. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Bu çalışmada, yenidoğan yoğun bakım ünitesinde çalışan hemşirelerin bireyselleştirilmiş destekleyici gelişimsel bakıma yönelik bilgi, tutum ve davranış düzeyleri ile etkileyebilecek faktörlerin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Tanımlayıcı kesitsel tipteki bu araştırma, Şubat-Temmuz 2019 tarihleri arasında, yenidoğan yoğun bakım ünitesinde en az 1 ay çalışmış 100 hemşire ile yapılmıştır. Verilerin toplanması için sosyodemografik veri formu ile bireyselleştirilmiş destekleyici gelişimsel bakım konusundaki bilgi, tutum ve davranış düzeylerini belirlemeye yönelik hazırlanan soru formu kullanılmıştır. Bulgular: Hemşirelerin yaş ortalamaları 26,57±6,75 yıl, %68'i lisans ve üzeri eğitime sahip ve %52'si 0-1 yıl arasında yenidoğan yoğun bakım ünitesinde çalışmıştır. Bireyselleştirilmiş gelişimsel bakımı ile ilgili eğitim alanların oranı %18'dir. Hemşirelerin yaşı arttıkça bilgi, tutum ve davranış puanı azalmakta, eğitim durumu ve yenidoğan yoğun bakım ünitesinde çalışma süresi arttıkça bilgi, tutum ve davranış puanları artmaktadır. Erkek hemşirelerin kadın hemşirelere göre bilgi tutum ve davranış puanları daha düşüktür. Hemşirelerin bilgi, tutum ve davranış puanları (r=0,34, p<0,01; r=0,43, p<0,0001) ile tutum ve davranış puanları arasında (r=0,65, p<0,0001) anlamlı, pozitif yönde bir ilişki vardır. Sonuç: Yenidoğan yoğun bakım ünitesinde çalışan hemşirelerin bilgi tutum ve davranış puanını yaş, cinsiyet, çalışılan kurum, eğitim durumu ve yenidoğan yoğun bakım ünitesinde çalışma süresi etkilemektedir. Hemşirelerin bilgi puanı arttıkça tutum ve davranış puanlarının arttığı belirlenmiştir. Bu sonuçlar hemşirelerin bireyselleştirilmiş destekleyici gelişimsel bakıma ilişkin bilgi, tutum ve davranış düzeylerini geliştirmeye yönelik bir dizi girişim için yol gösterici olabilir. Anah tar Ke li me ler: Yenidoğan yoğun bakım ünitesi; yenidoğan; hemşirelik bakımı; bireyselleştirilmiş gelişimsel bakım ABS TRACT Objective: This study examines the knowledge, attitude and behavior levels of nurses working in the newborn intensive care unit (NICU) towards individualized supportive developmental care and the effecting factors. Material and Methods: A descriptive, cross-sectional study included 100 pediatric nurses who worked in the NICU at least 1 month between February and July 2019. "Sociodemographic data form" and "question form determining the knowledge, attitude and behavioral levels on individualized supportive developmental care" were used to collect the data. Results: The mean age of the nurses were between 26.57 and 6.75 years, 68% had undergraduate or higher education, 52% worked in the NICU up to 1 year, and 18% received training on individualized developmental care. As the age of the nurses increased, their knowledge, attitude and behavioral scores decreased, but these scores increased as their education level and working time in the NICU increased. Male nurses had lower scores than female nurses. There is a significant and positive relationship between the knowledge, attitude and behavioral scores (r=0.34, p<0.01; r=0.43, p<0.0001) and the attitude and behavioral scores of nurses (r=0.65, p<0.0001). The knowledge, attitude and behavioral scores of the nurses working in the NICU are affected by age, gender, institution, educational status and working time. It was determined that as the knowledge score of the nurses increased, their attitude and behavioral scores increased. These results can be a guide to improve the knowledge, attitudes and behavior levels of nurses regarding individualized supportive developmental care.