Search Results (30)

Background: Antimicrobial resistance (AMR) is a critical global health issue. Like other low- and middle-income countries, the misuse of antimicrobial medicine, including widespread self-medication, exacerbates AMR in Bangladesh. Making future generations aware of AMR through educational interventions is an effective tool in combating AMR. This research focuses on understanding the effects of AMR awareness interventions on the knowledge, attitudes, and behaviors of the schoolchildren in the selected district of Bangladesh. Methods: In this study, 241 students of the 12- to 16-year-old age group participated in a two-day program. The programs include four hours of activities, including reading comics and coloring books, presentations, quizzes, and watching an animation about AMR on the first day, followed by an art competition on the second day. To assess changes in knowledge earlier and after the intervention, pre- and post-tests were conducted. Results: This pilot study demonstrates that using age-appropriate interactive educational tools can significantly improve students’ knowledge about AMR, showing a mean difference of 1.28 (p < 0.001). The regulatory step of the Directorate General of Drug Administration, incorporating red identification marks on antibiotic packaging, makes it easier and shows that 93.36% of students could identify antibiotics, which helps them to be aware of these types of medicines. Interventions were equally effective for boys and girls and science and commerce students, and these helped participants recognize the inappropriate practices of antibiotic use in their daily lives. Conclusions: This study identified the importance of incorporating AMR issues into the educational curriculum to address AMR for future generations. Full article

Background/Objectives: Healthcare accounts for approximately 4.4% of global carbon emissions. Gastroenterology is a particularly heavy producer, with professional organisations outlining targets to move towards carbon neutrality. Missed hospital appointments, associated with poor medical outcomes, also represent physical and economic waste to the sector. COVID-19 expedited the shift toward virtual clinics, but tele-diagnostics have not expanded similarly. We aimed to assess the feasibility of a virtual C13 urea breath test clinic for H. pylori in Ireland. Methods: C13 urea breath test kits were provided to patients in the community, who were subsequently invited to book an online video appointment with a GI lab technician to assist them in performing the test at home. Completed tests were returned to the hospital via local GP, by post, or a specified hospital drop-off point, and analysed using our standard protocol. Results: 423 virtual appointments were reviewed. 135 (32%) were male, and the mean age was 42 years. The test positivity rate was 22%, similar to a matched in-person testing cohort (21%). In all, there were no non-attenders, and two cancellations. Virtual patients were more likely to attend their appointments (OR = 153.9, p = 0.0004) than in-person patients. Virtual UBT appointments saved 9943.5 Km of road journeys, equivalent to 254 person-hours of travel time and 1.24 metric tonnes of CO₂. Additionally, 300 (71%) patients returned a feedback questionnaire, of which 276 (92%) rated the overall home breath test experience as ‘good’ or ‘excellent’. Conclusions: Home testing for H. pylori is effective, acceptable, and reduces both reliance on invasive procedures such as endoscopy and carbon emissions. Full article

Under a 2021 amendment to German law, the KelRide project became the first public on-demand service operating electric autonomous vehicles (AVs) without fixed routes on public roads. This paper addresses two notable gaps in the literature by (1) conducting an ex post evaluation of demand predictions for a non-infrastructure (Mobility-on-Demand (MoD)) project and (2) using real-world data to analyze how demand responds to key Autonomous Mobility-on-Demand (AMoD) system parameters in a rural context. Earlier simulation-based demand forecasts are compared to observed booking data, and the recalibrated model is used to investigate the sensitivity of passenger numbers to vehicle speed, fleet size, service area, operating hours, and idle vehicle positioning. Results show that increasing vehicle speed leads to a superlinear rise in passenger numbers—especially at small fleet sizes—while demand saturates at large fleet sizes. A linear increase in demand is observed with expanding service areas, provided fleet size is sufficient. Extending operating hours from 9 a.m.–4 p.m. to full-day service increases demand by a factor of two to four. Passengers numbers also vary notably depending on the positioning of idle vehicles. Consistent with empirical findings, the analysis underscores that raising AV speed is essential for ensuring the long-term viability of autonomous mobility services. Full article

Ride-pooling (RP) services, in which passengers with similar destinations share a ride, offer considerable potential for enhancing urban mobility by bridging gaps in public transportation (PT) networks and providing a convenient alternative to private car use. For the effective design and operation of such services, a detailed understanding of user preferences and usage patterns is essential. This study investigates differences in RP preferences and usage between day and night (with nighttime defined as 10:00 p.m. to 5:00 a.m.), drawing on both a stated choice experiment (SCE) and revealed preference data collected in Mannheim, Germany. The focus lies on the local RP service fips, which is integrated into the PT system. The SCE, conducted in 2024 with 566 participants, was analyzed using a nested logit model. The analysis of the SCE reveals that nighttime preferences for RP are characterized by reduced sensitivity to travel time and cost, creating an opportunity for RP operators to optimize stop network designs during nighttime hours by increasing pooling rates. In addition, it indicates a greater likelihood of private car usage at night, especially among women, likely due to safety concerns and limited PT availability. The analysis of revealed preference data provides a complementary perspective. It shows that the RP nighttime service primarily attracts younger users, while many respondents report not being active on weekend nights. However, the combination of low public awareness and limited service availability, evidenced by rejected booking requests, suggests that existing demand is not being fully captured. This implies that low usage is not merely the result of low demand, but also of structural barriers on both the supply and information side. Overcoming these barriers through targeted information campaigns and expansion of nighttime service capacity could substantially enhance sustainable urban travel options during nighttime. Full article

Typically developing peers are the key factor for children with disabilities to participate in inclusive settings. Good peer relationships can improve the social communication and language expression of children with disabilities, and typically developing children play a role as “gatekeepers” in the social activities of children with disabilities in the schools. In this study, 36 primary school students from grades 1 to 3 received online picture book teaching for 3 weeks, 6 units, 12 class hours, and 40 min per class hour with six volumes of disability picture books (including physical disability, deaf and hard of hearing, visual impairment, intellectual disability, learning disability and autism spectrum disorder) selected by experts in summer vocation. The attitudes of typically developing children toward peers with disabilities of participants were tested before and after attending the online picture book course. The teaching of disability-themed picture books online has significantly improved the attitudes of typically developing children in lower grades toward peers with disabilities. Specifically, there are significant differences in the sub-dimensions of emotion and positive behavior and negative behavior before and after the intervention. The results showed that online picture book teaching activities with disability themes can effectively improve the attitudes of typically developing children in primary schools toward children with disabilities in terms of cognition, emotion, and behavior, and they can be used in schools to create an inclusive climate for students with disabilities. Full article

With the recent increase in retail investor participation led by commission-less fintech trading applications and new features like fractional trading, we now have higher volatility and significantly quicker price changes. This makes it hard to make informed trading decisions. Moreover, these effects are exacerbated even further around earnings announcements days. In this paper, we use Nasdaq data feed at a minute frequency and show that there is a significant increase in the slope of the price–volume structure during extended hours (after-hours, or pre-market hours) as compared with the ones observed during regular market times. Our analysis shows that the liquidity is much less during the extended market hours. As such, earnings announcements of stocks during these times have a significantly larger price impact than those stocks that have their earnings announced during regular trading hours. This significant difference can be explained by observing the limit order book structures during these different trading periods. We suggest that the earnings announcements should not be made during extended hours given the significantly lower liquidity and thus, the significantly larger price impact that not only determines the prices for the next trading session but also sets the new “fundamental” price signals for the stocks. Full article

Warhammer 40,000 (40k) is the world’s most popular miniature wargame. The game is played with miniatures (small-scale figures made of hard plastic or other materials), which have usually been painted by each individual player. These player–painters typically spend hours in deep concentration painting the models. Drawing on interviews and journal entries from a six-month participant study of 14 painters, this paper explores whether miniature painters achieve a flow state, whether this creates a greater feeling of mindfulness, and how painting impacts their overall mental health. Results from this study indicate that miniature painting is meditative, meaningful, and positive for the participants’ mental health. Using the definition of flow outlined in Mihaly Csikszentmihalyi’s book Optimal Experience: Psychological Studies of Flow in Consciousness (1988), flow is a state of pleasure had when an individual concentrates on a specific task. Csikszentmihalyi, from his research on flow, notes that this state of mind involves both immersion and a sense of transcendence, where the individual temporarily loses a sense of self. This sense of loss of self was explored with an increased attention to the feeling of the body, and situated cognition has been further explored to understand how this connects to painting. While flow is regularly applied to videogame studies, less work has been carried out on this flow state during activities like miniature painting. Full article

Background: Approximately two to three children die from pneumonia every hour, and pneumonia is the leading cause of hospitalization for children under five in Bangladesh. Bangladesh has adopted the Pocket Book guidelines by the World Health Organization (WHO) for hospital management of childhood pneumonia. These guidelines recommend the proper use of injectable antibiotic administration. Objectives: We assessed and compared the prescription drugs for treating childhood pneumonia following WHO guidelines in a secondary and tertiary hospital in Bangladesh. Methods: We conducted a cross-sectional comparative study among children under five years who were admitted to a tertiary hospital, Dhaka Medical College Hospital (DMCH), and a secondary-level hospital, Kushtia District Hospital (KDH), with pneumonia between May 2021 and May 2022. A structured questionnaire was administered to the eligible participants. Additionally, we reviewed the hospital records related to the patient’s treatment. SPSS (Version 28) was used to conduct statistical analysis. Results: 316 children were enrolled during the study period, of whom 66.4% were collected from DMCH. There were 65.8% and 24.6% of patients who were classified with severe pneumonia and very severe pneumonia, respectively. In DMCH, the severity of pneumonia percentage was 57.6%, while in KDH, the percentage was 82%. A significant difference was found between the two facilities in diagnosing complicated pneumonia, prescribing the appropriate antibiotics, and ensuring oxygen availability. Amoxicillin was prescribed to 83.5% of the participants, and ceftriaxone was used at a high rate (64.5–70.9%). Combining injections of ceftriaxone with oral amoxicillin or other combinations of antibiotics, both facilities used high frequencies of non-antibiotic corticosteroids. Conclusions: Antibiotics were overprescribed, and injections were prescribed at higher levels than WHO recommended. This could pose a threat to antibiotic resistance. There is a need to enforce standard prescribing policies and treatment guidelines to reduce morbidity and mortality among hospitalized children with pneumonia. Full article

Background/Objectives: Despite the availability of screening services, the rate of diabetic retinopathy (DR) screening continues to be suboptimal in Australia, necessitating improvement. However, improving DR screening rates requires a more comprehensive understanding of the factors influencing adherence to the screening recommendations. This study aimed to explore the factors that influence adherence to DR screening among people with diabetes attending a community screening clinic in Australia. Methods: This qualitative study included purposively patients with diabetes recruited from a nurse-led community screening clinic in Australia. Semi-structured interviews were conducted to explore barriers and enablers impacting patient adherence to DR screening recommendations. The interview data were analyzed thematically using NVivo based on the socio-ecological model, with salience identified by the frequency of the theme. Results: A total of 22 participants completed the interview, including 10 females with a mean age of 60 ± 16.2 years. The interviews identified several factors that improved adherence to DR screening guidelines, including (a) knowledge of the connection between DR and diabetes and the importance of the screening, (b) the care provider’s recommendations, and (c) pre-booked appointments and automatic invitations. Beyond these factors, clinic staff interactions, family support, fear of vision loss, flexible clinic hours, and transportation accessibility also facilitate DR screening adherence. Conclusions: The present study identified key multi-level factors influencing adherence to DR screening. While these findings from a single clinic provide valuable insights to inform screening strategies, larger multi-center studies are needed to validate their broader applicability across diverse healthcare settings and populations. Full article

This article is the latest in a series examining the offices in the Horologion of Sinai Arabic 232 (13th century). This Book of Hours has its origin in Melkite Alexandria and has never been studied before, nor indeed have the Arabic Books of Hours, in general. The article presents an English translation of the Office of Compline from this manuscript (apart from the psalms, which are simply indicated), with comments and identification of the individual texts. Features of particular interest are the extra saints in the intercessions, different psalms and prayers from the modern rite, and the series of common troparia at the end. The additional saints in the intercessions pose a conundrum: whereas the analysis of Matins, the Hours, and Vespers has suggested that this is an Arabic Melkite Horologion from Alexandria that must have been received from Jerusalem c. the 7th century and then underwent both Alexandrian (Coptic) influences and later Byzantinisation which did not entirely eliminate more archaic elements from Jerusalem such as the tri-ode system at Matins, the choice of additional saints suggests a double provenance from both Alexandria and Sinai. We therefore suggest that the Horologion was brought from Alexandria and underwent some degree of adaptation on Sinai without eliminating all the specifically Alexandrian features. Full article

The intensive development of road transport has resulted in a significant increase in air pollution. This phenomenon is particularly noticeable in urban areas. This creates the need for analyses and forecasts of the scale and extent of future emissions of harmful substances into the environment. The aim of this study was to estimate the costs of the emission of toxic components of exhaust gases generated by all users of conventionally propelled vehicles travelling on a section of urban road in the next 25 years. The traffic study was carried out on an urban traffic route, playing a key role for road transport in the dimension of a given urban agglomeration. The traffic forecast for the analysed road section was based on the results of our own measurements carried out in April 2023 and external data from the General Directorate for Roads and Motorways. The results of the observations concerned six categories of vehicles for the morning and afternoon rush hours. Based on the data obtained, the generic structure of the vehicle population on the analysed section and the average daily traffic were determined. Using the methodology contained in the Blue Book of Road Infrastructure, parameters were calculated in the form of annual indicators of traffic growth on the analysed section, travel speed, and annual air pollution costs for selected vehicle categories, remembering at the same time that the Blue Book-based methodology does not distinguish between unit costs in relation to the type of emissions. The results of the study confirmed that there was an increase in the cost of toxic emissions for each vehicle category over the projected 25-year period. The largest increases were seen for trucks with trailers and passenger cars. In total, for all vehicle categories, emission costs nearly doubled from 2024 to 2046, from EUR 3,745,229 to EUR 7,443,384, due to the doubling of the number of vehicles resulting from the traffic forecast. The analyses presented here provide an answer to the question of what pollution costs may be faced by cities in which road transport will continue to be based on conventional types of propulsion. In addition, the research presented can be used to develop urban mobility transformation plans for the coming years, within the scope of the widely promoted smart city concept and the idea of electromobility, by pointing out to local authorities the direct economic benefits of these changes. Full article

This article examines the unique depiction of the Visitation in the Book of Hours of Juana Enriquez, housed in the Biblioteca del Palacio Real de Madrid and also known as the Book of Hours of Isabella the Catholic. While the Visitation is a common theme in other Books of Hours, this manuscript’s rendition stands out for its inclusion of visual elements not found in other works by the same illuminator. Through a detailed iconographic analysis, the article emphasizes the significance of the Visitation scene, exploring its visual components and their implications for understanding the spiritual and cultural context of the era. The study aims to highlight the Visitation miniature as a prime example of imagery crafted to serve the inner devotion of its first owner, Juana Enriquez. Ultimately, this research offers a deeper appreciation of the Book of Hours of Juana Enriquez as a product of its time, designed for meditation and contemplation. Full article

Background/Objectives: this longitudinal study aimed to investigate the refractive errors, the amplitude of accommodation, and myopia progression in Kazakhstani medical students as they progressed from the first to the fifth course of their studies. Methods: A total of 696 students from Semey Medical University underwent non-cycloplegic and cycloplegic autorefraction in the first course, and 655 were available for examination in the fifth year of study. The amplitude of accommodation was measured before the instillation of cycloplegics using the push-up and push-down methods. A self-administered questionnaire was applied to evaluate the risk factors associated with myopia progression. Results: In the first course, the median spherical equivalent was −0.75 Diopters before cycloplegia and −0.25 Diopters after cycloplegia. In the fifth course, it constituted −1.125 Diopters before cycloplegia and −0.5 Diopters after cycloplegia. The proportion of students with myopia following cycloplegic refraction increased from 44.7% in the first course to 47.5% in the fifth course. The proportion of emmetropic students declined from 31.5% to 30.3%, and hyperopia decreased from 23.8% to 16.8%. The dioptric power of accommodative excess increased from 0.375 in the first year to 0.50 in the fifth year. The hours spent on near-work activities, such as reading books, writing, working at a computer, and using a mobile device, were significantly associated with a myopia progression of ≥0.5 Diopters. Conclusions: the findings of this study suggest implications for public health policy and educational practice. Full article

Medieval colors used in illuminated manuscripts from the 12th to 15th centuries can be at risk. Knowing the binding media used, the medieval tempera, is fundamental to developing new and greener methodologies to increase sustainability in Cultural Heritage. A closer look at the tempera used in medieval illuminated manuscripts kept in Portuguese collections, namely, the Ajuda Songbook (13th c.), the winter breviary (14th to 15th c.), the books of hours (15th c.), and a Renaissance Charter (1512), shows that most of the paints analyzed used a tempera similar to gum mesquite. Infrared spectra were the basis for the differentiation between the gums used in medieval times originating from Prosopis spp. and Senegalia spp., gum mesquite and gum arabic, respectively. The ethnobotanical uses of gum mesquite further engage the reader. This micro review represents a significant step forward in Heritage Conservation, offering new perspectives for innovative and greener treatments. Our research, focusing on the differentiation of gums used in medieval times and the identification of the binding media, has the potential to revolutionize our understanding and the preservation of illuminated manuscripts in Cultural Heritage. Full article

This article examines the representation and significance of the Holy House of Mary as a metaphor for the domus Dei in the initial letters of a 13th-century Book of Hours (Brailes Hours BL MS Add. 49999) using hermeneutics, visual studies, and anthropology of art methodologies. The manuscript delves into the theological implications of the doctrine of the Incarnation and the virginal divine motherhood of Mary depicted in these images. Additionally, it explores the connection between these representations and the devotion to the Holy House of Nazareth and its replica in the sanctuary of Our Lady of Walsingham, recognized as a sacred pilgrimage site. To conduct this analysis, the article considers the figures of the Holy House depicted on pilgrim badges and religious jewels. Specifically, it focuses on the Hylle jewel, whose effectiveness, attributed to its form and materiality, symbolized the aurea palatium Dei. Full article