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BACKGROUND: During the time a diarrhea patient presents at a health facility, the household members of the patient are at higher risk of developing diarrheal diseases (> 100 times for cholera) than the general population. The Cholera-Hospital-based-Intervention-for-7-Days (CHoBI7) is a health facility-initiated water treatment and handwashing with soap intervention designed to reduce transmission of diarrheal diseases between patients and their household members. The present research aimed to (1) develop a scalable approach to integrate the CHoBI7 intervention program into services provided at government and private health facilities in Bangladesh; and (2) tailor the intervention program for the household members of all diarrhea patients, irrespective of the etiology of disease. METHODS: We conducted 8 months of formative research, including 60 semi-structured interviews, 2 group discussions, and a pilot study. Thirty-two interviews were conducted with diarrhea patients and their family caregivers, government stakeholders, and health care providers both to explore existing WASH and diarrhea patient care practices in health facilities and to identify considerations for scaling the CHoBI7 program. Fifty-two diarrhea patient households participated in a pilot study of a modified version of the CHoBI7 intervention program for tailoring. Twenty-eight interviews and 2 group discussions were conducted with pilot households to explore experiences with and recommendations for intervention delivery. RESULTS: The intervention program was modified based on formative research findings. Pilot study participants recognized the benefits of the CHoBI7 intervention program and made suggestions to improve the acceptability and feasibility of the intervention. Modifications included 1) providing additional pictorial modules, cues to action, enabling technologies, and supplies for safe drinking water and handwashing with soap behaviors in the health facility; 2) switching out technology prone to breaks and leaks as well as ...

An international survey to explore current and future trends in Nursing Informatics (NI) was done in 2015. This article explores responses to questions about: what should be done to further develop NI as an independent discipline; existing policies and standards influencing NI; perceived support towards NI as a discipline; and advice from NI specialists to students and emerging professionals.
Nurse and allied health professionals in academia and practice were reached with snowball sampling. Open-ended questions were analysed with thematic content analysis and the mean and standard deviation is reported for the perceived support towards NI (scale ranging from 1 (not at all supportive) to 10 (very supportive)).
A total of 507 respondents from 46 countries responded to the survey. Respondents reported mediocre support towards NI from the environment (M 5.79, SD 2.60). Results showed that NI education needs development to better meet practice demands, that current NI resources seem insufficient, that NI expertise is not used to its full potential in health institutions and the community, and that NI needs to show its value through research and increase visibility to be recognised among stakeholders worldwide.
In conclusion, there is a need to clarify NI as a discipline and a need for strong leadership to impact policy making. An increase in NI teaching at undergraduate level in nursing as well as an increase in postgraduate NI programmes worldwide would better support practice demands. National policies and international white papers in NI are needed to guide resource distribution to better support practice.

Teacher leaders play an important role in advancing learning in schools. However, this theme is under-researched, particularly in the Indonesian school context. This study investigated how Indonesian teachers rate themselves as being teacher leaders using the Teacher Leadership Self-Assessment (TLSA) instrument with a quantitative approach. The data was collected from 3,564 teachers from Lampung Province, Indonesia, with a cross-sectional method using an online platform. The collected data was analysed using the Rasch Analysis approach and showed good reliability and validity for the TLSA instrument as well as the Indonesian data. The findings showed that Indonesian teachers perceived themselves as having high levels of teacher leadership, but at the same time, the behaviours under the construct of communication were rarely engaged in and was thus identified as an area for improvement. Meanwhile, in terms of perceiving themselves as teacher leaders, the senior teachers, and those with more working experience were more significantly different in many constructs compared to the other demographic variables. The implications of this study suggest that there is still room to enhance teacher leadership by identifying the constructs and considering the teachers' demographic variables.

AbstractSentinel lymph node (SLN) sampling is important for evaluating the nodal stage of breast cancer when the axillary nodes are clinically free of metastasis. The intraoperative frozen section (IFS) of SLN is used for lymph node assessment. This meta-analysis aims to provide evidence about the diagnostic accuracy and the applicability of IFS of SLN in breast cancer patients. Data were collected by searching PubMed, Cochrane, Scopus, and Web of Science electronic databases for trials matching our eligibility criteria. The statistical analysis included the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and pooled studies' diagnostic odds ratio outcomes. The analyses were conducted using the Open Meta-analyst software. This meta-analysis pooled the results of 110 studies. The overall sensitivity of IFS for SLN metastasis was 74.7%; 95% CI [72.0, 77.2], P < 0.001. It was 31.4% 95% CI [25.2, 38.3], P < 0.001 for the micro-metastasis, and 90.2%; 95% CI [86.5, 93.0], P < 0.001 for the macro-metastasis. The overall specificity was 99.4%; 95% CI [99.2, 99.6], P < 0.001. The overall positive likelihood ratio was 121.4; 95% CI [87.9, 167.6], P < 0.001, and the overall negative likelihood ratio was 0.226; 95% CI [0.186, 0.274], P < 0.001. The overall diagnostic odds ratio of IFS for diagnosing SLN metastasis was 569.5; 95% CI [404.2, 802.4], P < 0.001. The intraoperative frozen section of SLN has good sensitivity for diagnosing breast cancer macro-metastasis. However, the sensitivity is low for micro-metastasis. The specificity is very satisfactory.

This edited volume by CSS' Myriam Dunn Cavelty and CSS director Andreas Wenger, examines new and challenging political aspects of cyber security and presents it as an issue defined by socio-technological uncertainty and political fragmentation. The first part looks at the current use of cyber space in conflictual settings, while the second focuses on political responses by state and non-state actors in an environment defined by uncertainties. Within this, it highlights four key debates that encapsulate the complexities and paradoxes of cyber security politics from a Western perspective. This book will be of much interest to students of cyber security, global governance, technology studies, and international relations. ; Dieser Sammelband, herausgegeben von CSS Forscherin Myriam Dunn Cavelty und CSS Direktor Andreas Wenger, untersucht neue und herausfordernde politische Aspekte der Cybersicherheit und präsentiert sie als eine Problematik, welche durch sozio-technologische Unsicherheit und politische Fragmentierung definiert ist. Der erste Teil befasst sich mit der aktuellen Nutzung des Cyberraums in Konfliktsituationen, während sich der zweite Teil auf politische Reaktionen staatlicher und nichtstaatlicher Akteure in einem von Unsicherheiten geprägten Umfeld konzentriert. Darin werden vier Schlüsseldebatten hervorgehoben, welche die Komplexität und Paradoxa der Cybersicherheitspolitik aus westlicher Perspektive zusammenfassen. Dieses Buch wird von grossem Interesse für Studierende der Cybersicherheit, Global Governance, Technologiestudien und internationalen Beziehungen sein.

Background: Countries across Africa and Asia have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE). However, there has been considerable controversy surrounding some treatments including hydroxychloroquine where the initial hype and misinformation led to shortages, price rises and suicides. Price rises and shortages were also seen for PPE. Such activities can have catastrophic consequences especially in countries with high co-payment levels. Consequently, there is a need to investigate this further. Objective: Assess changes in utilisation, prices, and shortages of pertinent medicines and PPE among African and Asian countries since the start of pandemic. Our approach: Data gathering among community pharmacists to assess changes in patterns from the beginning of March until principally the end of May 2020. In addition, suggestions on ways to reduce misinformation. Results: One hundred and thirty one pharmacists took part building on the earlier studies across Asia. There were increases in the utilisation of principally antimalarials (hydroxychloroquine) and antibiotics (azithromycin) especially in Nigeria and Ghana. There were limited changes in Namibia and Vietnam reflecting current initiatives to reduce inappropriate prescribing and dispensing of antimicrobials. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries where documented. In addition, generally limited change in the utilisation of herbal medicines. However, shortages have resulted in appreciable price increases in some countries although moderated in others through government initiatives. Suggestions in Namibia going forward included better planning and educating patients. Conclusion: Encouraging to see increases in the utilisation of vitamins/immune boosters and PPE. However, concerns with increased utilisation of antimicrobials needs addressing alongside misinformation, unintended consequences from the pandemic and any appreciable price ...

Following the success of our first therapeutic discovery conference in 2017 and the selection of King Abdullah International Medical Research Centre (KAIMRC) as the first Phase 1 clinical site in the Kingdom of Saudi Arabia, we organized our second conference in partnership with leading institutions in academic drug discovery, which included the Structural Genomic Constorium (Oxford, UK), Fraunhofer (Germany) and Institute Material Medica (China) ; the participation of members of the American Drug Discovery Consterium ; European Biotech companies ; and local pharma companies, SIPMACO and SudairPharma. In addition, we had European and Northern American venture capital experts attending and presenting at the conference. The purpose of the conference was to bridge the gap between biotech, pharma and academia regarding drug discovery and development. Its aim primarily was to: (a) bring together world experts on academic drug discovery to discuss and propose new approaches to discover and develop new therapies ; (b) establish a permanent platform for scientific exchange between academia and the biotech and pharmaceutical industries ; (c) entice national and international investors to consider funding drugs discovered in academia ; (d) educate the population about the causes of diseases, approaches to prevent them from happening and their cure ; (e) attract talent to consider the drug discovery track for their studies and career. During the conference, we discussed the unique academic drug discovery disrupting business models, which can make their discoveries easily accessible in an open source mode. This unique model accelerates the dissemination of knowledge to all world scientists to guide them in their research. This model is aimed at bringing effective and affordable medicine to all mankind in a very short time. Moreover, the program discussed rare disease targets, orphan drug discovery, immunotherapy discovery and process, the role of bioinformatics in drug discovery, anti-infective drug discovery in the era of bad bugs, natural products as a source of novel drugs and innovative drug formulation and delivery. Additionally, as the conference was organized during the surge of the epidemic, we dedicated the first day (25 February) to coronavirus science, detection and therapy. The day was co-organized with the King Saud bin Abdulaziz University for Health Sciences, Kingdom of Saudi Arabia(KSA) Ministry of Education to announce the grant winner for infectious diseases. Simultaneously, intensive courses were delivered to junior scientists on the principle of drug discovery, immunology and clinical trials, as well as rare diseases. The second therapeutics discovery forum provided a platform for interactive knowledge sharing and the convergence of researchers, governments, pharmaceuticals, biopharmaceuticals, hospitals and non-profit organizations on the topic of academic drug discovery. The event presented showcases on global drug discovery initiatives and demonstrated how collaborations are leading to successful new therapies. In line with the KSA 2030 vision on becoming world leaders with an innovative economy and healthy population, therapeutic discovery is becoming an area of interest to science leaders in the kingdom, and our conference gave us the opportunity to identity key areas of interest as well as potential future collaborations.

Following the success of our first therapeutic discovery conference in 2017 and the selection of King Abdullah International Medical Research Centre (KAIMRC) as the first Phase 1 clinical site in the Kingdom of Saudi Arabia, we organized our second conference in partnership with leading institutions in academic drug discovery, which included the Structural Genomic Constorium (Oxford, UK), Fraunhofer (Germany) and Institute Material Medica (China); the participation of members of the American Drug Discovery Consterium; European Biotech companies; and local pharma companies, SIPMACO and SudairPharma. In addition, we had European and Northern American venture capital experts attending and presenting at the conference. The purpose of the conference was to bridge the gap between biotech, pharma and academia regarding drug discovery and development. Its aim primarily was to: (a) bring together world experts on academic drug discovery to discuss and propose new approaches to discover and develop new therapies; (b) establish a permanent platform for scientific exchange between academia and the biotech and pharmaceutical industries; (c) entice national and international investors to consider funding drugs discovered in academia; (d) educate the population about the causes of diseases, approaches to prevent them from happening and their cure; (e) attract talent to consider the drug discovery track for their studies and career. During the conference, we discussed the unique academic drug discovery disrupting business models, which can make their discoveries easily accessible in an open source mode. This unique model accelerates the dissemination of knowledge to all world scientists to guide them in their research. This model is aimed at bringing effective and affordable medicine to all mankind in a very short time. Moreover, the program discussed rare disease targets, orphan drug discovery, immunotherapy discovery and process, the role of bioinformatics in drug discovery, anti-infective drug discovery in the era of bad bugs, natural products as a source of novel drugs and innovative drug formulation and delivery. Additionally, as the conference was organized during the surge of the epidemic, we dedicated the first day (25 February) to coronavirus science, detection and therapy. The day was co-organized with the King Saud bin Abdulaziz University for Health Sciences, Kingdom of Saudi Arabia(KSA) Ministry of Education to announce the grant winner for infectious diseases. Simultaneously, intensive courses were delivered to junior scientists on the principle of drug discovery, immunology and clinical trials, as well as rare diseases. The second therapeutics discovery forum provided a platform for interactive knowledge sharing and the convergence of researchers, governments, pharmaceuticals, biopharmaceuticals, hospitals and non-profit organizations on the topic of academic drug discovery. The event presented showcases on global drug discovery initiatives and demonstrated how collaborations are leading to successful new therapies. In line with the KSA 2030 vision on becoming world leaders with an innovative economy and healthy population, therapeutic discovery is becoming an area of interest to science leaders in the kingdom, and our conference gave us the opportunity to identity key areas of interest as well as potential future collaborations. ; This research was funded by the King Abdullah International Medical Research Centre (KAIMRC), grant number RC15/163.

Presents a pioneering collection studying religion as a wider determinant of health in BritainHighlights the role of religion in exacerbating health inequalities, along with ethnicity, racism, social class and deprivationInvestigates contemporary health inequalities among second and third generation British Muslims, with a particular focus on disadvantaged childrenCaptures a wide range of health issues that British Muslims live with, such as: structural discrimination; COVID-19; mental health; consanguinity; genetic predispositions; dementia; domestic violence; end of life care; absentee fathers; and migrationCritically appraises current health practices and methods and offers practical guidelines on how to involve British Muslims in health promotion initiativesIncludes a foreword by Professor Aziz Sheikh, OBE, Chair of Primary Care Research and Development, University of EdinburghThis landmark volume presents the lived experience of British Muslims in regards to health inequalities, access to health services and involvement in health promotion initiatives. Exploring religion, ethnicity, racism, social class and deprivation, the book examines how British Muslims interact with the UK healthcare system and the subsequent marginalisation in accessing benefits from those systems. Authors expose the unequal distribution of health benefits among British Muslims and explore how this has come to the fore during the COVID-19 pandemic. Using reflexive, interpretive, critical and evidence-based data-driven scenarios from across the UK; this book identifies loopholes in the healthcare system affecting high-risk groups. In doing so, it analyses why and how British Muslims live with the worst health outcomes when compared with all deprived social groups and ethnicities in the country

Background: Countries across Africa and Asia have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE). However, there has been considerable controversy surrounding some treatments including hydroxychloroquine where the initial hype and misinformation led to shortages, price rises and suicides. Price rises and shortages were also seen for PPE. Such activities can have catastrophic consequences especially in countries with high co-payment levels. Consequently, there is a need to investigate this further. Objective: Assess changes in utilisation, prices, and shortages of pertinent medicines and PPE among African and Asian countries since the start of pandemic. Our approach: Data gathering among community pharmacists to assess changes in patterns from the beginning of March until principally the end of May 2020. In addition, suggestions on ways to reduce misinformation. Results: One hundred and thirty one pharmacists took part building on the earlier studies across Asia. There were increases in the utilisation of principally antimalarials (hydroxychloroquine) and antibiotics (azithromycin) especially in Nigeria and Ghana. There were limited changes in Namibia and Vietnam reflecting current initiatives to reduce inappropriate prescribing and dispensing of antimicrobials. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries where documented. In addition, generally limited change in the utilisation of herbal medicines. However, shortages have resulted in appreciable price increases in some countries although moderated in others through government initiatives. Suggestions in Namibia going forward included better planning and educating patients. Conclusion: Encouraging to see increases in the utilisation of vitamins/immune boosters and PPE. However, concerns with increased utilisation of antimicrobials needs addressing alongside misinformation, unintended consequences from the pandemic and any appreciable price ...