Suchergebnisse

Globally, the COVID-19 pandemic is triggering a public health emergency and crisis on a large scale, with far-reaching effects and severe damage to all aspects of politics, economy, cultural and social life, and health. Consecutive outbreaks over the past nearly 2 years of "living with COVID-19" have forced most schools to physically close, resulting in the largest educational disruption in human history. In turbulent times of the COVID-19 crisis, school leaders are facing numerous major challenges germane to school governance and leadership. The key objective of the study is to fully explore the prospective challenges principals are encountering in public schools in times of COVID-19. To fulfill the research purpose, a systematic literature review (SLR) was carried out to investigate the leadership challenges. As a result, a total of 24 challenges were explored through SLR approach. Frequency analysis approach was initially applied to figure out the most significant challenges. Accordingly, seven challenges were found statistically significant as showing frequency ≥ 50 each. Irrevocably, the study works as a contribution to K-12 school leadership by providing guidance for current and future leaders in crisis based on practical investigation, experiences, and recommendations. Policy makers can leverage these findings to make necessary adjustments to school policy to better prepare school leaders for crisis. Additionally, the findings of the current study are believed to have profound implications for future research. These findings expand our current understanding on school leadership in time of crisis that needs further investigation. Subsequent studies can quantitatively and/or qualitatively validate these leadership challenges findings regarding a particular school context.

Objective: to assess nurses' knowledge and practice toward computed tomography scan safety guidelines. Methods: a cross-sectional study was conducted using a convenience sample of 131 nurses from two government hospitals. Self-designed questionnaire was used to assess nurses' sociodemographic characteristics, knowledge, and practice. Descriptive analysis was performed to evaluate characteristics, correlations were evaluated using Spearman's rank correlation coefficient, and the Mann-Whitney U and the Kruskal-Wallis H tests were used to compare the mean ranks of knowledge and practice scores. Results: most respondents were female (91.6%), were aged 20–29 years (57.3%), and had bachelor's degrees (74%). Knowledge and practice levels were 58% and 78.9% respectively. A positive correlation between knowledge and practice was observed among nurses (r=0.684, p<0.001). No statistically significant differences were observed between sociodemographic characteristics and knowledge and practice scores. Conclusion: nurses showed adequate level of practice toward computed tomography scan safety preparations while their knowledge level was deficient. Contributions to practice: this study informs the importance of knowledge in guiding nursing practice toward appropriate computed tomography scan safety measures. ; Objetivo: avaliar o conhecimento e as práticas de enfermeiros quanto às recomendações de segurança para realização de tomografias computadorizadas. Métodos: estudo transversal utilizando amostra de conveniência de dois hospitais públicos. Foi elaborado um questionário para avaliar as características sociodemográficas, conhecimento e práticas dos enfermeiros. Realizou-se análise descritiva para avaliar as características, e as correlações foram avaliadas através da correlação de Spearman. Os testes U de Mann-Whitney e H de Kruskal-Wallis foram usados para comparar as médias das pontuações de conhecimento e práticas. Resultados: a maioria dos participantes era do sexo feminino (91,6%), de 20 a 29 anos (57,3%), e tinha a graduação como seu nível de formação (74%). Níveis de conhecimento e prática foram de 58% e 78,9%, respectivamente. Houve correlação positiva entre o conhecimento e a prática nos enfermeiros (r=0,684, p<0,001), mas, sem diferenças estatisticamente significativas entre características sociodemográficas e a pontuação de conhecimento ou práticas. Conclusão: enfermeiros mostraram um nível adequado em sua prática do preparo seguro para tomografias computadorizadas, embora seu nível de conhecimento tenha se mostrado deficiente. Contribuições para a prática: esse estudo demonstra a importância do conhecimento enquanto guia da prática de enfermagem rumo a um uso melhor das medidas de segurança para tomografias computadorizadas.

Many scholars claimed that due to maintenance, high reconstruction and construction costs in Malaysia, LCC shows an important role in estimating the cost of rigid pavement. Because of the government's expenditure and high budget allocation on pavement rehabilitation and maintenance work in Malaysia, choosing the most cost-effective pavement maintenance, maximizing the budget allocation and rehabilitation alternatives is essential for transportation agencies. A useful technique LCC of economic analysis that measures the different solutions of cost-effectiveness to rehabilitation and maintenance within the same category of roads. To generate a broad and accurate LCC output, however, it is necessary to ensure that the value information inputs are ready and of sufficient quality to use in the estimation of the LCC. This article shows the findings of Malaysia's systematic literature review inputs for LCC cost information study of dynamic pavement rehabilitation and maintenance. The literature study results showed that the greater part of key players in the construction industry are aware of the need for LCC analysis in the rigid rehabilitation and maintenance of the pavement. In Malaysia the LCC current state system of rigid pavement rehabilitation and maintenance, however, is still in its not only infancy stage but also is not ready for the difficulties to be implemented in achieving quality cost data to generate a reliable and comprehensive analysis of life cycle cost. The present findings of the paper which provide information on cost data current state inputs in the construction industry from the LCC analysis of rigid pavement rehabilitation and maintenance.

Abstract Introduction Breast cancer is the most commonly diagnosed cancer and the 2nd leading cause of cancer-related deaths among women in the U.S. Although routine screening via mammogram has been shown to increase survival through early detection and treatment of breast cancer, only 3 out of 5 women age ?40 are compliant with annual mammogram within the U.S. and the state of Florida. A breadth of literature exists on racial/ethnic disparities in compliance with mammogram; however, few such studies include data on individual Black subgroups, such as Haitians. This study assessed the association between race/ethnicity and annual mammogram compliance among randomly selected households residing in the largely Haitian community of Little Haiti, Miami-Dade County (MDC), Florida. Methods This study used cross-sectional, health data from a random-sample, population-based survey conducted within households residing in Little Haiti between November 2011 and December 2012 (n = 951). Mammogram compliance was defined as completion of mammogram by all female household members within the 12 months prior to the survey. The association between mammogram compliance and race/ethnicity was assessed using binary logistic regression models. Potential confounders were identified as factors that were conservatively associated with both compliance and race/ethnicity (P???0.20). Analyses were restricted to households containing at least 1 female member age ?40 (n = 697). Results Overall compliance with annual mammogram was 62%. Race/ethnicity was significantly associated with mammogram compliance (P = 0.030). Compliance was highest among non-Hispanic Black (NHB) households (75%), followed by Hispanic (62%), Haitian (59%), and non-Hispanic White (NHW) households (51%). After controlling for educational level, marital status, employment status, the presence of young children within the household, health insurance status, and regular doctor visits, a borderline significant disparity in mammogram compliance was observed between Haitian and NHB households (adjusted odds ratio = 1.63, P = 0.11). No other racial/ethnic disparities were observed. Discussion Compliance with annual mammogram was low among the surveyed households in Little Haiti. Haitian households underutilized screening by means of annual mammogram compared with NHB households, although this disparity was not significant. Compliance rates could be enhanced by conducting individualized, mammogram screening-based studies to identify the reasons behind low rate of compliance among households in this underserved, minority population.

Hoarseness in school-aged children may affect their educational achievement and interfere with their communication and social skills development. The global prevalence of hoarseness in school-aged children ranges between 6% and 23%. To the best of our knowledge, there is a scarcity of studies describing the prevalence or determinates of hoarseness in Saudi school-aged children. Our aim was to measure the prevalence of hoarseness among school-aged children and to identify its determinants. A cross-sectional questionnaire-based survey was used that included randomly selected primary and early childhood schools from private and governmental sectors in Saudi Arabia. The data were collected using a questionnaire which was self-completed by the children's parents and covered the following aspects: sociodemographic features, health and its related comorbidities about children and their families, attendance and performance in school, child's voice tone, past history of frequent crying during infancy, history of letter pronunciation problems and stuttering, the Reflux Symptom Index (RSI) and the Children's Voice Handicap Index-10 for parents (CVHI-10-P). Determinants of hoarseness were investigated using the SPSS software (version 20). The mean age of the study children (n = 428) was 9.05 years (SD = 2.15), and 69.40% of them were male. The rate of hoarseness in the participants was 7.5%. Hoarseness was significantly common in children with a history of excessive infancy crying (p = 0.006), letter pronunciation issues (especially 'R' and 'S'; p = 0.003), and stuttering (p = 0.004) and in those with a previous history of hoarseness (p = 0.023). In addition, having the symptoms of gastrointestinal reflux increased the risk of hoarseness by four times (OR = 4.77, 95% CI = 2.171, 10.51). In summary, hoarseness in children may be dangerously underestimated, as it may reflect the presence of speech problems, in addition to the presence of laryngopharyngeal reflux (LPR). Hoarseness was assumed on the basis of parental complaints. Therefore, further research with diagnoses based on a clinical assessment is needed to understand the magnitude of the hoarseness problem and its consequences in children.

Governments across the world are starting to make a dynamic shift to cloud computing so as to increase efficiency. Although, the cloud technology brings various benefits for government organisations, including flexibility and low cost, adopting it with the existing system is not an easy task. In this regard, the most significant challenge to any government agency is security concern. Our previous study focused to identify security factors that influence decision of government organisations to adopt cloud. This research enhances the previous work by investigating on the impact of various independent security related factors on the adopted security taxonomy based on critical ratio, standard error and significance levels. Data was collected from IT and security experts in the government organisations of Saudi Arabia. The Analysis of Moment Structures (AMOS) tool was used in this research for data analysis. Critical ratio reveals the importance of Security Benefits, Risks and Awareness Taxonomies on cloud adoption. Also, most of the exogenous variables had strong and positive relationships with their fellow exogenous variables. In future, this taxonomy model can also be applied for studying the adoption of new IT innovations whose IT architecture is similar to that of the cloud. ; N/A

INTRODUCTION: As of 2015, as part of the implementation of the Welsh Government primary care plan and primary care clusters, the Welsh Government has encouraged non-medical healthcare professionals working in primary care to train as independent prescribers (IPs). OBJECTIVES: This research aimed to identify the number of NMIPs in primary care in Wales and describe their prescribing trend of items between 2011 and 2018, in order to compare their prescribing pattern before and after the implementation of primary care clusters for Wales. DESIGN: Retrospective secondary data analysis and interrupted time series analysis in order to compare prescribing by non-medical independent prescribers (NMIPs) preimplementation and postimplementation of primary care clusters across Wales. RESULTS: Over the study period, 600 NMIPs (nurses n=474 and pharmacists n=104) had prescribed at least one item. The number of nurse IPs increased by 108% and pharmacists by 325% (pharmacists had the largest increase between July 2015 and March 2018). The number of items prescribed by NMIPs increased over time by an average of 1380 per month (95% CI 904 to 1855, p<0.001) after the implementation of primary care clusters compared with 496 (95% CI 445 to 548, p<0.001) prior its implementation. Approximately one-third of the items prescribed by NMIPs was within Betsi Cadwaladr University Health Board (HB) with only 4% in Powys Teaching HB. CONCLUSION: The number of NMIPs and their volume of prescribing in primary care in Wales has increased following the implementation of primary care clusters in 2015. This suggests that the Government's recommendations of using NMIPs in primary care have been implemented. Future studies should focus on efficiency and quality of prescribing by NMIPs in primary care.

Background: Many chromosomal abnormalities are associated with Central Nervous System (CNS) malformations and other neurological alterations, among which seizures and epilepsy. Certain chromosomal syndromes are specifically associated with epilepsy and show a particular clinical and EEG pattern. This retrospective research proposal will study the prevalence of epilepsy in cytogenetic abnormalities, its classification and the prognostic factors regarding the response to Anti-epileptic medications (AED). Objective: The present study aims at exploring prevalence of epilepsy in cytogenetic abnormalities, its classification and Prognostic factors of responsiveness to anti-epileptic medication. Design and Setting: a retrospective study that was carried out in Prince Sultan Military Medical City, Riyadh, Saudi Arabia, that included a review of all chromosomal abnormalities (2010-2018). The chromosomal abnormalities were detected by chromosomal study, FISH, or array CGH . All patients with chromosomal abnormalities who develop epilepsy were included. Detailed clinical assessment was done through recording seizures, EEG, and MRI brain finding. Statistical analysis: Data were represented in terms of frequencies and valid percentages for categorical variables. The analysis was done using SPSS version 26. Results: 550 patients were included in this study. The prevalence of seizures in the whole cohort was 14.7%, with 45.7% of females and 54.3% of males having seizures. Additionally, 44.4% of the whole cohort had a chromosomal micro-deletion abnormality, followed by 23.5% with chromosomal micro-duplication. As for the age of onset, 48% of patients with seizures had their first seizure at the age of less than one-year-old. 52.5% of the patients had generalized seizures followed by focal epilepsy in 29.4% of patients. 41.1% of patients with seizures showed unremarkable findings on Brain MRI, and congenital brain malformations in different chromosomal aberrations 27.6 % and 11.1% had a Lennox-Gastaut syndrome (LGS) after ...

We explored the relationship between religious orientation and spiritual intelligence. Specifically, we examined differences in spiritual intelligence by grade, type of school, and student achievement level. Participants were 142 students in the 7th and 10th grades, who were randomly
selected from Al-Taif schools in the Kingdom of Saudi Arabia. For data collection, we used Al-Ruwaitea's Religious Orientation Scale with its 4 dimensions of religiousness: personal extrinsic, social extrinsic, intrinsic, and quest, and we also developed a scale of spiritual intelligence (SI)
for use in this study. Data analysis revealed statistically significant differences in SI by type of school, in favor of religious schools. There was no difference in SI by grade. Multiple regression analysis results showed that extrinsic socially oriented religiousness was the only religious
orientation that was a significant predictor of SI.