Background: Type 2 Diabetes Mellitus (T2DM) and Alzheimer’s Disease (AD) are increasingly linked through shared pathophysiological mechanisms, giving rise to the concept of Type 3 Diabetes Mellitus (T3DM). Brain insulin resistance, oxidative stress, and neuroinflammation are central to both conditions, contributing to cognitive decline and AD progression. Aim: This review aims to explore this emerging relationship and its implications for prevention and management. Methods: Using an integrative review, 21 studies were systematically analyzed. The review focused on identifying demographic, genetic, and lifestyle factors contributing to T2DM and AD and examined shared molecular pathways such as insulin dysregulation and amyloid-beta accumulation. Results: The findings reveal that T3DM shares key features with T2DM and AD, including insulin resistance and chronic inflammation. Lifestyle interventions, such as diet and exercise, alongside routine cognitive and metabolic screenings, are critical in mitigating progression. Conclusions: Further research into diagnostic biomarkers and targeted therapies is essential to manage T3DM and its impact on AD. The role of nursing professionals in early detection, education, and holistic management is emphasized as vital in addressing this dual disease burden. This review offers actionable insights into integrated strategies for addressing these interconnected conditions.

Background: Diabetes is a chronic global health issue that requires effective management to improve patient outcomes and quality of life. Nursing education plays a critical role in empowering diabetic patients with self-management skills. Aim This systematic review evaluates the impact of diabetes-focused nursing education on patient outcomes and quality of life. Methods: This study uses PRISMA guidelines and a systematic approach to identify and evaluate relevant literature. Results and Discussion: Among the 14 studies reviewed, eight emphasized self-management education, while four incorporated multidisciplinary approaches. Findings consistently demonstrated that structured nursing education programs significantly improved self-management behaviors, glycemic control, and patient knowledge. For instance, nurse-led self-management programs resulted in substantial enhancements in self-care skills and diabetes-related knowledge. Moreover, interventions that combined health education with psychological support were particularly effective, leading to better blood glucose control and increased adherence to treatment. Studies that examined quality of life reported reductions in anxiety, improved lifestyle habits, and better overall self-management. These findings highlight the multifaceted benefits of nursing education, suggesting that structured, supportive programs positively impact both clinical and psychological aspects of diabetes care. Conclusion: The review emphasizes the value of comprehensive nursing education that integrates both clinical guidance and psychological support for holistic diabetes management. Implications: Ongoing professional development and culturally sensitive education programs are recommended to address the diverse needs of diabetic patients. Future research should investigate the long-term effects of nursing education and explore innovative strategies to enhance diabetes management outcomes.

This paper examines the impact of primary level classroom environments on the acquisition of English as a second language (L2) in Bangladesh, comparing English-medium and Bangla-medium schools. The study investigates how different instructional approaches and early exposure to English influence language proficiency among students. Through a mixed-methods approach, including surveys, interviews, and proficiency tests, the research reveals significant differences in language acquisition outcomes between the two educational settings. Findings indicate that students in English-medium schools, who are exposed to Natural approach methods of language learning and immersive English-speaking environments, demonstrate higher proficiency in speaking and listening skills compared to their Bangla-medium counterparts, who primarily receive grammar-focused instruction. The study highlights the critical role of early exposure to English, with students who begin learning the language at a younger age showing better phonological and syntactic development. Additionally, the integration of technology in language teaching emerges as a valuable tool for enhancing language learning, particularly in contexts with limited classroom exposure. The research suggests that Bangla-medium schools could benefit from adopting more interactive, student-centered teaching methods and integrating digital tools to support practical language use. The study's findings have significant implications for educational policy, advocating for a shift towards more immersive and communicative teaching practices to improve English language acquisition in Bangladesh. This research contributes to the broader understanding of SLA and offers practical recommendations for enhancing language education in similar contexts.

The Gambia uses the Primary Health Care model with no trauma response system. Trauma patients are transferred through multiple levels of health care facilities before definitive care hospitals. This study was conducted to identify predictors of injury factors associated with transfer. In this study, we examined characteristics of transferred patients compared to those directly admitted in definitive care hospitals. The study was conducted in two major trauma hospitals in The Gambia. 251 road traffic injury (RTI) patients were either transferred (84%) from lower-level health centers or directly admitted (16%) to one of the study hospitals. Transferred patients were more likely to have been pedestrian/bicyclists (aOR = 1.81; 95% CI = 0.86 – 3.80). Administration of antibiotics was significantly associated with direct admit than transferred patients (aOR = 6.84; 95% CI = 2.38 – 19.68). Transferred patients were more likely to receive intravenous fluid compared to direct admits (aOR = 0.03; 95% CI = 0.01 – 0.08). The study results have implications for policies and planning in the healthcare setting in The Gambia and other LMICs with similar settings. Based on the findings of this study, it is essential that hospital management teams adapt to increasing reliance of RTI patients on lower-level healthcare facilities. The study results suggest increased burden on lower-level health care facilities. Efforts and resources should focus more on supporting lower-level facilities.

Background: The COVID-19 pandemic disrupted routine osteoporosis care due to clinic closures and limited in-person consultations. Telehealth emerged as an alternative model enabling remote care delivery and monitoring. However, previous reviews on telehealth either did not include the pandemic period or had a limited focus in scope. Evidence synthesized specifically for osteoporosis care during the pandemic is needed but lacking. Methods: We systematically searched PubMed, MEDLINE, EMBASE, PsycINFO, Web of Science, and CINAHL for studies on telehealth for osteoporosis published between January 2021 and March 2023. Five studies met the inclusion criteria of: osteoporosis population, telehealth intervention, and COVID-19 pandemic timeframe. Data was extracted on study characteristics, COVID-19 outcomes, osteoporosis status, telehealth purpose, patient satisfaction, and clinical outcomes. Result: The five studies showed telehealth was used for monitoring data, delivering test results, adjusting medications, and assessments. Osteoporosis prevalence among telehealth users ranged 30-100%. High patient satisfaction was reported with telehealth versus in-person care. No major differences occurred in medication delays or fractures between telehealth and in-person groups. Conclusion: This review found telehealth enables effective osteoporosis care and monitoring during the pandemic, with high patient and provider satisfaction. However, more robust randomized controlled trials are needed to establish stronger evidence around telehealth's impacts on clinical osteoporosis outcomes. Implications: Though promising, further high-quality studies will help clarify telehealth's role in improving osteoporosis care and outcomes. Findings inform guidelines on integrating telehealth into routine management. Evidence on user perspectives optimizes telehealth implementation policies.

Occupational lead (Pb) exposure continues to be an important public health problem globally, yet data is lacking on the associated risks and resources available for the prevention of Pb related diseases in low middle income countries (LMICs) like The Gambia. In this study, we used a case-control design to compare blood lead levels (BLLs) between the exposed (auto repair workers) and unexposed (healthcare workers) populations in The Greater Banjul Area. The data was analyzed using Chi square test of independence to determine the characteristic factors associated with BLL. Multivariate logistic regression was used to test the relationship between BLLs for auto repair and healthcare workers and their experiences. The results of this study indicated 82.1% of cases had higher BLLs compared to 52.9% of controls. Also, the proportion of workers with elevated BLLs was higher for certain factors including more than 80% of those with greater than 10 of years job experience, more than 70% of those who worked greater than 5 days a week, worked more than 8 hours per day, did not use personal protective equipment (PPE), were illiterate or had no formal education, and smoked or ate at work. The study results have implications for policies and practice in the auto repair industry and related workplaces in The Gambia and other LMICs with similar settings. Based on the findings of this study, it is essential to initiate discussions to establish national occupational health policies in The Gambia aimed at protecting workers and the general population.

Background: Oncology nurse navigators (ONNs) are becoming even more vital as healthcare continues to develop into a more complicated, confusing maze for patients. When many specialists on the treatment team have divergent points of view due to the nature of their respective professions or other factors, the patient may experience feelings of confusion. In the end, this can cause delays in treatment, pose a threat to the established standard of care, and lead to a decrease in patient satisfaction. Aim: To enumerate various ways in which ONNs may help improve the quality of life of cancer patients. Design: An integrative review. Results: A total of 19 studies related to the topic are evaluated. Four main themes namely: provider of psychological support, facilitator of timely care, oncology nurse navigators perception of their role and patient’s perception of oncology nurse navigators and 3 sub themes which are: information giver, source of emotional support and coordinator, were identified to be the roles of the ONNs. The findings showed that oncology nurse navigators help reduce patients anxiety and distress, increase patient satisfaction, shorten the time from diagnosis to treatment, provide necessary information, support them emotionally and coordinate their care with the different members of the healthcare team and resources. Conclusion: The main function of the ONNs is to address any barrier that may hinder the patient’s cancer treatment, survivorship and even palliative care. ONNs make sure that each patient has individualized nursing care according to the patients and their families' needs. Implications for Practice: ONNs have the potential to significantly contribute not only to the quality of life of cancer patients but also to the process of achieving better service integration. The result of this integrative review contributes to the growth of the healthcare system by improving accessibility, fairness, efficiency, effectiveness, and the ability to maintain health services throughout time brought about by ONNs.

Background: By rediscovering the medical field spiritual foundation, clinicians sought to balance their care and realize that spirituality is frequently associated with healthcare, thus one’s spiritual beliefs influence patients' decisions between aggressive care and complementary therapies in oncology care. Aim: This study investigates clinicians’ experiences and perceptions of spirituality in oncology care that clinicians can utilize to improve cancer and spiritual care provision. Methods: A thematic, qualitative synthesis. Results: Four main themes emerged from the synthesis of the 11 included studies that can steer future framework and policies to make clinicians more inept in providing care to address spiritual well-being of the patients and their family from a clinician's point of view of spirituality: “Maintaining Hope and Spiritual Wellness, Clinician’s Sensitivity to Cancer Patients, Provision of Culturally Respectful Spiritual Care, and Education in Providing Spiritual Care”. Conclusion: Cancer patients, cancer survivors, and clinicians’ quality of life is correlated with measures of spirituality and spiritual well-being. Spirituality also fulfill these oncologic patients has been linked to improved emotional and spiritual adjustment. Implications: Clinicians with different proficiencies, novice or expert, develop a strong spiritual belief can also be a strength when it comes to caring for those terminally ill patients, to be able to aid them in their sufferings. Amidst the challenges of spiritual care, these clinicians provide a patient strategy approach that is holistic to the care.

Avian influenza (bird flu) occurs sporadically in American poultry flocks, decimating these flocks and causing substantial economic losses. Avian influenza also impacts the beliefs of food handlers and preparers in the home (home cooks). Although those who properly handle and prepare processed poultry products cannot succumb to avian influenza, there is a widespread belief that one can contract the bird flu from these foods. Beliefs about getting avian influenza from poultry products and intentions to avoid consuming poultry products are the focus of this study of 285 home cooks. False beliefs about getting avian influenza from handling, preparing, and consuming poultry products are apparent in this sample. Correlational analysis also shows that those holding the false beliefs intend to act upon those beliefs by planning not to consume poultry products. Moreover, the false beliefs about contracting avian influenza from poultry products are correlated with a bias to see oneself as less likely to produce food that contains foodborne diseases. These findings are consistent with, and contribute to, the research literatures on belief formation and change, behavioral intentions, and with research showing how guilt by association thought processes underlie false beliefs related to food safety. This research has important implications for poultry and other food processing industries, and for campaigns to persuade the public about real and imaginary risks associated with particular food products.

The c-equivalence principle, commonly accepted as true by most physicists, is the unstated assumption that equals the kinematic speed of light. Should someone prove the principle false, it would render the composition of two Lorentz transformations meaningless. The second hypothesis of the Special Theory of Relativity in its strong form would also be invalidated. This paper examined some of the consequences for physics, should this principle be proven false and outline some experiments to determine light speed, which could falsify the principle and provide evidence for the ether.

Studies have highlighted the benefits of frequent quizzing in class. Frequent quizzing can promote more student attendance, engagement, practice and review, and achievement. Conversely, the opponents of frequent quizzing suggest that too frequent testing might hinder learning by frustrating anxious students and inhibiting larger units of instructional material. Notably, most studies have used degree examinations to evaluate the impact of quizzes on student learning and performance, yet little is known about whether quizzes can reinforce student performance in the in-course assessments (ICAs) despite ICA importance in student learning. The present study aimed to test the hypothesis that administration of weekly MCQ quizzes can enhance the leaning outcomes and performance of biomedical science students in assessment methods such as essay and oral presentation that can directly measure and provide information about student learning. It was therefore limited to in-course assessments. We found that the performance of the weekly quiz student group is remarkably better than that of the control student group in both the essay and oral presentation ICAs, which are two measures and indicators of student learning, suggesting improved student learning outcomes and performance after administrating weekly MCQ quizzes that also promoted student attendance in classrooms. The findings of this research study have implications for students, teachers, and curriculum designers in higher education.

Background: Sleep deprivation is increasingly prevalent among young adults due to academic, occupational, and social demands, making them susceptible to circadian disruption. Executive functioning—encompassing working memory, inhibitory control, and cognitive flexibility is essential for academic and professional success. This meta-analysis quantifies the effect of sleep deprivation on executive functioning in healthy young adults. Practical Implications: These findings highlight the need for evidence-based interventions such as university-level sleep education programs, flexible academic scheduling, and workplace policies promoting adequate sleep to optimize cognitive performance and productivity among young adults. Methods: Following PRISMA 2020 guidelines, PubMed, Scopus, PsycINFO, and Web of Science were searched (January 2000–March 2024) for studies assessing acute (<6 hours sleep or ≥24 hours total deprivation) or chronic (<6 hours/night over multiple days) sleep deprivation in young adults. Outcomes included validated executive function tests (e.g., Stroop, N-Back). Random-effects meta-analysis (Hedges’ g) was conducted using R (version 4.3.2) with metafor/meta packages. Heterogeneity (I², Q-test), sensitivity (leave-one-out), and publication bias (funnel plot, Egger’s test) were evaluated. Results: Out of 2,478 screened studies, 39 met inclusion criteria (n=4,578). Sleep deprivation had a moderate-to-large detrimental effect on executive functioning (Hedges’ g = -0.62, 95% CI [-0.78, -0.45], p<0.001). Subdomain analysis revealed greatest impairment in working memory (g = -0.71), followed by inhibitory control (g = -0.59) and cognitive flexibility (g = -0.49) (all p<0.001). Moderate heterogeneity was present (I² = 58%), with results robust to sensitivity analysis. Egger’s test indicated no significant publication bias (p=0.22). Interpretation: Sleep deprivation significantly impairs executive functioning in young adults, especially working memory. Interventions improve sleep may enhance cognitive performance and should be integrated into public health strategies and educational policies. Future research should assess chronic restriction and individual vulnerability factors.

Nodal marginal zone lymphomas are indolent and rare non-Hodgkin lymphomas, most often diagnosed at an advanced stage. Their clinical presentations are typically insidious, which can lead to delayed diagnosis. The concomitant secretion of IgM and IgG immunoglobulins with kappa light chains constitutes an exceptional feature in this type of lymphoma, as illustrated by our case. We report the case of a 62-year-old man with a history of treated syphilis and inferior vena cava thrombosis managed with rivaroxaban, who presented with a left inguinal mass evolving over three months, accompanied by fever, night sweats, and weight loss. Clinical examination revealed non-inflammatory left inguinal lymphadenopathy without other abnormalities. Laboratory tests showed non-regenerative anemia, leukopenia, and elevated LDH levels. Protein electrophoresis revealed a monoclonal peak in the gamma region, confirmed by serum immunofixation showing two monoclonal bands of IgG kappa and IgM kappa types. Biopsy of the inguinal lymph node revealed histological and immunohistochemical features consistent with a small B-cell marginal zone lymphoma, staged as IV based on the extension workup. A chemotherapy regimen consisting of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) was initiated, resulting in a partial response after four cycles. The coexpression of IgM and IgG kappa light chains in nodal marginal zone lymphomas, which are already rare, is an unusual finding. This particularity warrants multicenter studies to better assess its diagnostic, prognostic, and therapeutic implications.

This review article provides a comprehensive anatomical analysis of soccer footwear, delving into the intricate structure and functional roles of its constituent components, including the upper, heel counter, tongue, toe box, outsole/sole plate, studs, and insole. Manufacturing processes influencing these structural elements are also discussed. Current market offerings and patented innovations in soccer cleat technology are examined through a biomechanical lens, highlighting their intended functions and limitations. A critical synthesis of existing knowledge underscores the anatomical and biomechanical distinctions between male and female athletes' feet, arguing for the necessity of sex-specific footwear design. This review culminates in emphasizing the imperative for specifically engineered soccer footwear for female athletes to optimize performance, enhance comfort, and mitigate the elevated risk of lower extremity injuries prevalent in the female game, thereby identifying crucial directions for future research in sports biomechanics and footwear engineering.

This systematic review aimed to evaluate the biomechanical properties, functional performance, and clinical outcomes of different hip prosthesis materials and designs used in total hip arthroplasty (THA). A comprehensive search strategy identified 34 peer-reviewed studies published between 2015 and 2024. The materials investigated included cobalt-chromium-molybdenum (CoCrMo), titanium alloys, PEEK, ceramics, and advanced surface coatings such as polycrystalline diamond (PCD). In addition, dual mobility systems, lattice structures, and additively manufactured and patient-specific implants were assessed. The studies utilized clinical trials, finite element analysis, and biomechanical testing to compare outcomes such as wear resistance, stress distribution, osseointegration, and range of motion. The findings demonstrated that titanium alloys and porous lattice structures reduce stress shielding, while ceramics and CoCrMo provide superior wear resistance. Dual mobility implants improved joint stability and range of motion, particularly in high-risk patients. PEEK and PCD showed promising properties but lacked robust long-term data. The integration of advanced manufacturing technologies and material innovations has led to more personalized and biomechanically efficient solutions for THA. Further longitudinal studies are needed to validate these developments. This review provides a critical synthesis of the biomechanical, functional, and clinical implications of contemporary hip prosthetic systems.

Smartphone use among adolescents has surged globally, reshaping communication and learning patterns, especially in developing countries. However, the implications of such digital habits on students in rural or under-resourced areas remain underexplored. This study aims to examine the patterns of smartphone usage and its effects on learning among high school students in Tarutung, a developing region of North Sumatra, Indonesia. Utilizing a quantitative descriptive approach, data were collected from 358 students using structured questionnaires. The results show that 96.05% of students own personal smartphones regardless of socioeconomic background, with an average daily usage of 4 hours and 45 minutes. While 91.81% believe smartphones support their learning, 25.99% report declining academic performance. Alarmingly, 20.62% of students admitted involvement in cyberbullying activities, highlighting a critical digital risk impacting the school environment and student well-being. The study concludes that although smartphones offer educational benefits, their misuse can lead to negative academic, social, and psychological outcomes. This study recommends digital literacy curricula and structured cooperation between parents and educators to prevent risks while optimizing educational opportunities in smartphone use.

This study investigated the pedagogical implications of out-of-field teaching in Social Studies. The Out-of-field Social Studies teachers could encounter several challenges in their preparation and the implementation of the integrated Social Studies curriculum. This study sought the lived experiences of the out-of-field teachers concerning the causes of out-of-field teaching in social studies, problems encountered by the out-of-field teachers and the mechanisms they employ to cope with the teaching of Social Studies. The study chose the qualitative phenomenological research design. Data were collected from all the 17 out-of-field Social Studies teachers through in-depth structured interview. Data were transcribed and analysed, through the inductive thematic analysis approach, unveiling of themes and concepts from the narratives of the research participants. The study revealed that out-of-field teaching in Social Studies occurs as a result of teacher shortage in integrated social studies programme. It is also caused by the perception that any teacher could teach Social Studies irrespective of the teachers’ qualification. Out-of-field teacher encounter problems such as inadequate content and pedagogical knowledge, lack of classroom managerial techniques and inability to deliver lessons through the integrated approach. Engaging in professional development courses, peer coaching, in-service training and workshops were some of the mechanisms employed by out-of-field teachers to cope with the teaching of Social Studies. The pedagogical implications of this phenomenon are that when teaching the Social Studies, the out-of-field teachers place more emphasis on aspects of the Social Studies curriculum where they have much knowledge and skip or put less emphasis on other aspects they lack in-depth knowledge, thus, the integrated approach to teaching Social Studies is not adopted effectively by out-of-field teachers. This waters down the content of Social Studies at the Senior High School level. Addressing the problem of out-of-field teaching in Social Studies requires training and recruiting more teachers who have background training and experience in the integrated approach to the teaching of Social Studies.

Background: Maternal nutrition plays a crucial role in fetal brain development, with vitamin B12 being essential for neuronal myelination and cognitive function. The paper by Hrezova et al. entitled “Vitamin B12 Intake During Pregnancy Linked to Child Speech Development and Intelligence Quotient”, examines the association between maternal B12 intake and early childhood neurodevelopment. Methods: Using data from 5,151 mother-child pairs in the ELSPAC-CZ cohort, maternal B12 intake was assessed through dietary questionnaires, and child cognitive outcomes were evaluated at 18 months, 3 years, and 8 years. Multivariate adjustments were applied to control for potential confounders. Results: The research reports that higher maternal B12 intake was positively associated with improved language comprehension at 18 months (B=0.20,95% CI 0.06,0.34) and increased verbal IQ at 8 years (B=1.08,95% CI 0.09,2.08). However, no significant relationship was observed between maternal B12 intake and speech intelligibility at age 3 (OR=1.03,95% CI 0.99,1.07). Findings suggest B12’s role in early cognitive development but highlight gaps in its long-term effects. Conclusions: Ensuring adequate maternal B12 intake is vital for optimizing early neurodevelopment. Public health initiatives should promote B12 supplementation, especially for pregnant women at risk of deficiency. Further research with objective biomarkers is needed to clarify long-term effects.

“To Be Twice as Good to Get Half” is a common mindset among high aspiration and ambition Black individuals in the U.S., capturing the lived reality of Minorities’ Diminished Returns (MDRs). This paper explains that MDRs reflect how, even with high levels of ambition, self-efficacy, education, and income, Black individuals and other marginalized groups do not experience the same protective benefits for health and well-being as White populations. Systemic obstacles embedded within U.S. society weaken the expected returns on socioeconomic achievements for racialized individuals, creating a reality where “being twice as good” still results in lesser outcomes. High-SES Black individuals, for instance, continue to face significant risks for adverse outcomes, such as depression and chronic disease, due to structural inequities across domains like labor market discrimination, segregation, and accumulated disadvantage from childhood. Our analysis identifies key mechanisms—including interpersonal discrimination, lower-quality education, and structural racism in sectors like banking, policing, and real estate—that erode the protective effects of SES across racial lines. Mediating factors, such as chronic stress, allostatic load, and epigenetic changes over the life course, further compound these diminished returns, weakening the expected physical and mental health benefits. Drawing on extensive evidence from U.S. national and local datasets and corroborated by international studies, this paper underscores the necessity of policies that dismantle structural barriers rather than relying solely on SES improvements. Recommendations include implementing multi-sectoral policies, recognizing the unique challenges of middle-class non-White populations, and approaching policy with humility, acknowledging that achieving equity is a long-term endeavor. By challenging the “bootstraps” narrative, this paper advocates for structural interventions aimed at genuine health and economic equity for all racial and socioeconomic groups. While we provide an in-depth analysis of MDRs’ phenomena, mechanisms, mediators, and policy implications, the experience is often distilled as, “I have to be twice as good to get half.”

Background: Epigenetic aging, measured through various DNA methylation-based clocks, may have implications for predicting disease risk. However, the sensitivity of different epigenetic clocks that have emerged as biomarkers for biological aging and in predicting physical and mental health outcomes remains uncertain. This study examines the age and sex-adjusted associations between multiple epigenetic age acceleration measures and three key health indicators, including self-rated health, depressive symptoms, and body mass index (BMI), in a nationally representative sample of U.S. middle-aged and older adults. Methods: We analyzed data from 4,018 adults in the 2016 wave of the Health and Retirement Study (HRS), which included several epigenetic age acceleration measures: HORVATH, HANNUM, LEVINE, HORVATHSKIN, LIN, WEIDNER, VIDALBRALO, YANG, ZHANG, BOCKLANDT, GARAGNANI, and GRIMAGE. Linear regression models were used to assess the associations between epigenetic age acceleration and self-rated health (poor health), depressive symptoms, and BMI, adjusting for age and sex. Results: We found significant positive associations between epigenetic age acceleration and worse self-rated health, higher depressive symptoms, and increased BMI. However, these associations varied across different epigenetic clocks, with some measures potentially having more consistent utility for specific health outcomes than others. Conclusion: Epigenetic age acceleration is linked to poorer self-rated health, greater depressive symptoms, and higher BMI, but choosing which epigenetic clock(s) to use is also important. These findings underscore the need to consider multiple epigenetic aging markers when assessing health risks and highlight the potential for particular clocks to serve as more sensitive indicators of physical and mental health outcomes.

Background: The sensory-motor network is essential for integrating sensory input with motor function and higher-order cognition. Resting-state functional connectivity (rsFC) within this network undergoes significant developmental changes, and disruptions in these connections have been linked to behavioral and psychiatric outcomes. However, the relationship between sensory-motor connectivity, early-life adversity, and later health behaviors remains understudied. Objective: This study examines the associations between rsFC within the sensory-motor network (mouth and hand regions) and key social, psychological, and behavioral factors, including baseline and past socioeconomic status (SES), trauma exposure, family conflict, impulsivity, major depressive disorder (MDD), and future substance use. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) Study, a national sample of U.S. children. Resting-state fMRI data were used to assess functional connectivity within the sensory-motor network. Bivariate analyses examined associations between rsFC in the sensory-motor mouth and hand regions and baseline SES, past SES, childhood trauma exposure, family conflict, impulsivity, and MDD. Longitudinal analyses assessed whether baseline rsFC predicted future substance use. Results: Greater rsFC between the sensory-motor mouth and hand regions was significantly associated with lower SES, higher trauma exposure, and greater family conflict. Increased connectivity was also correlated with older age and more advanced puberty status. Higher rsFC between the sensory-motor mouth and hand regions was linked to greater impulsivity, lower cognitive function, an increased likelihood of MDD, and future marijuana use. Conclusion: These findings suggest that sensory-motor connectivity is sensitive to socioeconomic and psychosocial stressors, with potential long-term implications for mental health and substance use risk. The results highlight the importance of early-life environmental factors in shaping neurodevelopmental trajectories and emphasize the need for targeted interventions to mitigate the effects of adversity on brain function and behavior. Future research should further explore the role of sensory-motor network alterations in behavioral health outcomes as a function of environmental stressors.

Background: Tobacco control policies are implemented globally to reduce tobacco-related morbidity and mortality. Emerging evidence suggests that individual tobacco use may influence the level of support for these policies. However, the extent to which personal use affects policy endorsement remains underexplored, particularly among young adults in academic settings. Aims: This study aimed to examine whether college students who use tobacco exhibit lower support for tobacco control policies compared to their non-user counterparts. Methods: We conducted a multi-center, cross-sectional study involving 2403 college students from various provinces in Iran. Tobacco use was ascertained based on self-reported consumption of cigarettes, electronic cigarettes, and hookah. Attitudes toward tobacco control policies were evaluated using a structured survey instrument, and comparative analyses were performed to assess differences in policy support between tobacco users and non-users. Results: The analysis revealed that tobacco users demonstrated significantly lower support for tobacco control policies compared to non-users. This association was consistently observed across users of cigarettes, electronic cigarettes, and hookah, suggesting a systematic pattern irrespective of the type of tobacco product used. Conclusion: These findings indicated a clear association between tobacco use and reduced endorsement of tobacco control policies among Iranian college students. These results have potential implications for public health policy, emphasizing the importance of addressing individual tobacco use behaviors in the development and implementation of tobacco control strategies. Further research is needed to elucidate the underlying mechanisms of this relationship.

Background: As a central component of the brain's reward system, nucleus accumbens (NAcc) plays a crucial role in reward salience and substance use behaviors. Changes in the NAcc are also relevant to higher rates of substance use of youth and adults from low-income backgrounds. Although resting-state functional connectivity (rsFC) of the NAcc provides valuable insights into the neural mechanisms underlying reward processing and the propensity for self-reported reward salience and substance use, research exploring the association between NAcc rsFC and brain networks beyond the default mode network (DMN) and prefrontal cortex (PFC) is limited. Objective: To investigate the role of the resting-state functional connectivity of the NAcc with the cingulo-opercular network, sensorimotor mouth network, and sensorimotor hand network in the association between socioeconomic status, self-reported reward salience, and future substance use. Methods: Data were obtained from the Adolescent Brain Cognitive Development (ABCD) study. NAcc rsFC with the cingulo-opercular network, sensorimotor mouth network, and sensorimotor hand network was assessed at baseline. Socioeconomic status was measured using family income. Self-reported reward salience was assessed using validated psychometric scales. Substance use outcomes were tracked longitudinally over the study period. Structural Equation Modeling was employed to examine the covariances between family income, NAcc rsFC, reward salience, and subsequent substance use. Results: Higher baseline family income was positively associated with baseline NAcc rsFC (B = 0.092, p < 0.001) and negatively associated with baseline reward salience (B = -0.040, p = 0.036) and future substance use (B = -0.081, p < 0.001). Baseline NAcc rsFC was strongly and positively associated with reward salience (B = 0.734, p < 0.001) and future substance use up to age 13 (B = 0.124, p < 0.001). Additionally, baseline reward salience was positively associated with future substance use (Covariance = 0.176, p < 0.001). Conclusion: The findings suggest that NAcc rsFC with brain networks beyond the DMN or PFC may contribute to the links between low parental socioeconomic status, reward salience, and substance use risk. Expanding the understanding of NAcc rsFC provides new insights into the neural mechanisms underlying these associations. These results have important implications for developing targeted interventions aimed at preventing substance use, particularly among low-income youth with heightened reward salience. Further research is needed to explore causal pathways and moderating factors influencing these relationships.

Background: The increasing frequency and intensity of extreme heat exposure is a significant consequence of climate change, with broad public health implications. While many health risks associated with heat exposure are well-documented, less research has focused on its impact on children’s cognitive function. Objectives: This study examines the relationship between extreme heat exposure and various domains of cognitive function in children. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study. Key variables included race/ethnicity, age, gender, family socioeconomic status (SES), heatwave exposure, and multiple cognitive domains: total composite score, fluid composite score, crystallized intelligence, reading ability, picture vocabulary, pattern recognition, card sorting, and list recall. Structural equation modeling (SEM) was used for data analysis. Results: A total of 11,878 children were included in the analysis. Findings revealed significant associations between extreme heat exposure and lower cognitive performance across multiple domains. The strongest adjusted effects were observed in pattern recognition (B = −0.064, p < 0.001) and reading ability (B = −0.050, p < 0.001), both within the learning domain, as well as total composite cognitive ability (B = −0.067, p < 0.001), fluid composite (B = −0.053, p < 0.001), and crystallized intelligence (B = −0.061, p < 0.001), all within general cognitive ability. Weaker but still significant associations were found for list recall (B = −0.025, p = 0.006) and card sorting (B = −0.043, p < 0.001) within the memory domain, as well as picture vocabulary (B = −0.025, p = 0.008) within general cognitive ability. These associations remained significant after controlling for demographic factors, race/ethnicity, family SES, and neighborhood SES. Conclusions: This study underscores the impact of climate change on cognitive function disparities, particularly in learning and general cognitive ability among children exposed to extreme heat. Findings highlight the need for targeted interventions to mitigate the cognitive risks associated with heat exposure in vulnerable populations.

Background: Extreme heat exposure is an increasing public health concern, particularly in the context of climate change. Limited research has explored its impact on children's cognitive outcomes. This study investigates the association between extreme heat exposure and cognitive function in 9–10-year-old children, using data from the Adolescent Brain Cognitive Development (ABCD) study. Additionally, we assess whether this effect is independent of socio-demographic factors such as race, family socioeconomic status (SES), and neighborhood SES. Methods: Data were drawn from the ABCD study, comprising over 10,000 children aged 9–10 years. Cognitive function was assessed through standardized cognitive tests, while extreme heat exposure was estimated using geographic and climate data. Structural equation modeling (SEM) was employed to examine the direct effects of heat exposure on cognitive outcomes and to account for potential confounding variables, including race, family SES, and neighborhood SES. Results: Black families, low SES households, and children from low SES neighborhoods were disproportionately exposed to extreme heat. Extreme heat exposure was significantly associated with lower cognitive function in children, and this association remained robust even after adjusting for socio-demographic factors. Conclusions: Extreme heat exposure is linked to diminished cognitive function in children, particularly among socio-economically disadvantaged and marginalized populations. Given the increasing frequency of extreme heat events due to climate change, future research should further explore these implications for children’s cognitive outcomes. Policy interventions that improve access to cooling infrastructure, expand green spaces, and prioritize at-risk populations are critical to mitigating the adverse cognitive effects of extreme heat in low SES communities.

Drug shortages represent a significant and growing challenge within the pharmaceutical supply chain, with profound implications for patient care, public health, and healthcare costs. This manuscript provides a comprehensive examination of the causes and impacts of drug shortages, highlighting the multifaceted nature of this issue. Key factors contributing to shortages include manufacturing complications, limited availability of active pharmaceutical ingredients (APIs), market dynamics that discourage the production of less profitable medications, and regulatory challenges that slow down the approval process for new manufacturing capacities. The consequences of these shortages are far-reaching. Patients often face treatment delays, which can lead to adverse health outcomes, increased hospitalization rates, and even mortality. Healthcare providers experience heightened operational costs as they seek alternative therapies and manage complications resulting from inadequate treatment. Furthermore, the frequent occurrence of drug shortages erodes public trust in both the healthcare system and the pharmaceutical industry, leading to decreased patient adherence to prescribed therapies. To mitigate the impacts of drug shortages, this manuscript proposes several strategic solutions, including enhanced communication among stakeholders, diversification of supply sources, increased regulatory flexibility, and collaborative approaches between public and private sectors. Additionally, raising awareness among healthcare providers and patients regarding the causes and potential alternatives can empower stakeholders to navigate shortages effectively. Ultimately, addressing drug shortages necessitates a proactive and coordinated effort from all participants in the pharmaceutical supply chain. By implementing these strategies, stakeholders can enhance the resilience of the supply chain, ensuring that essential medications remain accessible and that patient care is not compromised. The findings of this manuscript underscore the urgent need for ongoing vigilance and collaborative action to tackle the challenges posed by drug shortages, safeguarding public health and improving healthcare outcomes globally.

This study investigates the benefits of forgiveness among adolescents in Junior High Schools (JHS) in Bimbilla, Ghana, focusing on the influence of age on the effectiveness of forgiveness interventions. The study adopted a mixed-method experimental design, a purposive selection of eight JHSs within the Nanumba North Municipality, from which 60 adolescents were randomly chosen to participate. The study employed the Enright Forgiveness Inventory, Depression Mood Scale, and Anger Self-Report items to assess participants' emotional states before and after the intervention. The interventions were structured around the REACH model of forgiveness, which included sessions aimed at helping participants identify sources of hurt, understand the concept of forgiveness, and recognise the emotional costs of holding onto grievances. Qualitative data were analysed into themes using an interpretative lens. A two-way Analysis of Covariance (ANCOVA) was used to analyse the data. The findings revealed that exposure to forgiveness therapies significantly reshaped participants' negative emotions, leading to a marked decrease in feelings of anger and depression. Post-intervention assessments indicated that participants developed a more positive outlook towards their offenders, highlighting the transformative power of forgiveness in fostering emotional well-being. The study's results align with previous research, indicating that forgiveness interventions can effectively reduce negative emotional states and promote psychological resilience. The implications of these findings suggest that integrating forgiveness education into school curricula could be beneficial for enhancing the mental health of adolescents. By fostering an environment that encourages forgiveness, educators and mental health professionals can help mitigate the adverse effects of unresolved emotional conflicts, ultimately contributing to healthier interpersonal relationships and improved overall well-being among young individuals.

Background: Socioeconomic status (SES) is traditionally viewed as a protective factor against impulsivity and subsequent tobacco use in youth. The prevailing model suggests that higher SES is associated with lower impulsivity, which in turn reduces the likelihood of future tobacco use. However, this pathway may not hold uniformly across racial groups due to differences in impulsivity and the phenomenon of Minorities' Diminished Returns (MDRs), where the protective effects of SES, such as educational attainment, tend to be weaker or even reversed for Black youth compared to their White counterparts. Objectives: This study aims to examine the racial heterogeneity in the pathway from childhood SES to impulsivity and subsequent tobacco use initiation during adolescence, focusing on differences between Black and White youth. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) Study, which includes a diverse sample of youth aged 9 to 16 years. The analysis examined the relationship between baseline family SES (age 9), impulsivity (age 9), and subsequent tobacco use (ages 9 to 16). Impulsivity was measured using the Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking, and Positive Urgency Impulsive Behavior Scale (UPPS-P). Structural equation modeling (SEM) was employed, with analyses stratified by race to explore potential differences in these associations. Results: Overall, 6,161 non-Latino White and 1,775 non-Latino Black adolescents entered our analysis. In the full sample, higher family SES was linked to lower childhood impulsivity and, consequently, less tobacco uses in adolescence. However, racial differences emerged upon stratification. Among White youth, higher SES was associated with lower impulsivity, leading to reduced tobacco use, consistent with the expected model. In contrast, among Black youth, higher SES was not associated with lower impulsivity, thereby disrupting the protective effect of SES on tobacco use through this pathway. These findings suggest that racial heterogeneity exists in the SES-impulsivity-tobacco use pathway, aligning with the MDRs framework, which highlights how structural factors may weaken the protective effects of high SES among Black youth. Conclusions: These findings underscore the importance of considering racial heterogeneity in the relationships between SES, impulsivity, and tobacco use. The observed disparities suggest a need for targeted interventions that address the unique challenges faced by Black youth, who may not experience the same protective benefits of high SES as their White peers. These results carry significant implications for public health strategies aimed at reducing tobacco use in racially diverse populations.

Background: The initiation of substance use during adolescence is a significant public health concern with long-term implications. Structural and environmental factors, such as community-level crime statistics related to drug offenses, are often assumed to influence the likelihood of substance use among youth. However, the relationship between these environmental crime indicators and early substance use initiation in adolescents is not well understood. Objective: This study aims to examine the association between environmental drug-related crime statistics—derived from Uniform Crime Reports, including drug abuse violations, drug sales, marijuana sales, drug possession, and driving under the influence (DUI)—and the use of tobacco, marijuana, and alcohol among adolescents aged 9-16 in the United States. Methods: Data from the Adolescent Brain Cognitive Development (ABCD) study, which follows a cohort of adolescents from ages 9-10 to 16, were analyzed. 11,878 participants entered our analysis. The primary environmental measures included total drug abuse violations, drug sale offenses, marijuana sale offenses, drug possession offenses, and DUI reports. Substance use outcomes of interest were the frequency and prevalence of tobacco, marijuana, and alcohol use across the observed age range. Results: Contrary to expectations, higher levels of drug-related crime in a community were not associated with increased use of tobacco, marijuana, or alcohol among adolescents. In fact, the study found a significant inverse relationship between the total number of drug-related crimes and tobacco use, suggesting lower tobacco use in areas with higher reported drug abuse violations, drug sales, marijuana sales, drug possession, and DUI incidents. No significant associations were observed between these crime indicators and the use of marijuana or alcohol. Conclusions: These findings challenge the prevailing assumption that higher environmental drug-related crime statistics necessarily predict greater substance use among adolescents. The observed inverse relationship between drug-related crime and tobacco use warrants further investigation to understand the underlying mechanisms and to inform targeted intervention strategies. Future research should explore the complex interplay between structural environmental factors and youth substance use to better inform public health policies.

This study assessed the handling and processing practices of 30 small-scale folded vermicelli processors in Tanga, specifically in urban areas of Tanga City, Tanzania. However, the micro- and small-scale processors were producing in unhygienic way because they are lacking facilities and equipment to process and handle the product hygienically. Multistage sampling design was adopted for this study and face-to-face interviews were conducted to collect data from all processing units through nine streets using semi-structured questionnaires and observation checklists. Data were analyzed using Statistical Package for Social Sciences, where the statistics aspect was determined from the results obtained. The processors found across various streets (ranging from 3.3% in Kwaminchi Street to 23.3% in Mabawa Street), exhibited diverse demographics, with 53.3% being owner-operators and 40% and 6.7% in labourer and supervisor roles, respectively. A significant portion (53.3%) had 1-3 years of experience, and a small portion (10%) attended formal training in pasta processing. Despite 73.3% possessing food manufacturing licenses, many were unfamiliar with legal requirements, lacking documentation and standardized processes, raising concerns about food safety. Raw materials were sourced locally, but 56.7% lacked storage facilities. Hygienic practices varied, with 43.3% undergoing periodic medical check-ups, 70% using protective gear, and 60% had hand washing facilities. Sun drying was the sole method employed, with 86.7% placed drying trays on rooftops. Packaging practices raised concerns, as 93.3% reused woven polypropylene bags, potentially impacting product quality. Awareness of aflatoxin and its health implications was lacking in 90% of the processors. Overall, the study highlighted gaps in awareness, training, and adherence to standards among processors, posing potential risks to food safety and quality. Encourage them to adhere with Tanzania Bureau of Standards requirements and formalize their quality control practices.

This perspective article discusses the striking contrasts and inequalities observed during a walk from Manhattan to Harlem in New York City, highlighting the significant social and economic differences that have profound implications for public health and social policy. Through this journey, we explore various aspects including racial segregation, the composition of shops, smoking habits, street cleanliness, police presence, unemployment, real estate disparities, and the pervasive sense of insecurity. The transition from a predominantly White Manhattan to a predominantly Black and Hispanic Harlem underscores the historical and systemic inequalities that continue to shape the city's demographic and economic landscape. These disparities, rooted in discriminatory housing policies, economic disparities, and social exclusion, manifest in poorer health outcomes, higher rates of substance use, and limited economic opportunities for minority populations. By addressing these structural issues through targeted policies and sustained interventions, we can work towards reducing health disparities and promoting racial equity. This paper also highlights the concept of Minorities' Diminished Returns (MDRs), where the benefits of education and income are less pronounced for minority individuals compared to their White counterparts, further perpetuating cycles of disadvantage. Comprehensive efforts to dismantle systemic inequities are essential for fostering a more equitable and healthy society.

The intersection of race and place in shaping health disparities presents complex dynamics, as evidenced by studies in cities like Detroit, Baltimore, and Philadelphia, where predominantly Black and economically disadvantaged populations experience high overall rates of health problems. Surprisingly, these cities do not exhibit the most pronounced racial disparities. In contrast, areas with a higher percentage of White residents, indicative of greater income inequality, show stark differences in health outcomes between Black and White populations. This disparity underscores how conditions diverge more sharply between Black and White individuals in wealthier urban areas. This phenomenon suggests a complex and sometimes counterintuitive relationship among race, place, income, and income inequality in shaping racial health disparities. These dynamics have significant policy implications. Addressing health disparities requires nuanced strategies that recognize the multiplicative effects of race and income inequality on health outcomes. Policies focusing on areas with a high disease burden, such as Detroit, Philadelphia, and Baltimore can effectively mitigate disparities both locally and more broadly. Conversely, interventions targeting regions with lower disease prevalence, but higher racial disparities must be approached carefully to avoid exacerbating inequalities. In conclusion, understanding and addressing the complex drivers of health disparities demand comprehensive approaches that acknowledge the intertwined influences of race, income, and place. By prioritizing interventions that address economic disparities alongside health initiatives, policymakers can foster more equitable health outcomes across diverse communities.

Through an in-depth discussion of the International Design Conference in Aspen from 1951 to 1970, this paper explores how environmental discourse underwent a shift in its connotations in the field of design during the conference. Of particular importance in this process of discursive transformation was the 1970 conference. This year's conference erupted into a conflict over the connotations of environmental discourse as environmental discourse outside of design impacted on and transformed the environmental discourse within design. This article examines the different concepts of the term 'environment', as presented by speakers and participants at the International Design Conferences in Aspen from 1951 to 1970, and especially focuses on the debates surrounding 'environment' at the 1970 conference. The article concludes by exploring the implications of this event and summarises the role of the 1970 International Design Conference in Aspen at this crucial turning point in environmental discourse. The aim is to explain and strengthen the significance of discourse a design conferences in the history of design, and to explore a new direction of design history research.

Background: In the landscape of education, the decision-making process that leads students to pursue or reject nursing as a career is a multifaceted phenomenon shaped by a plethora of influences ranging from personal experiences to societal norms. Aim: To explore non-nursing students' insights on nursing education, seeking to shed light on the considerations and challenges that influence their views on nursing education. Materials & Methods: A qualitative approach using thematic analysis were utilized. Lincoln and Guba's framework for rigor and trustworthiness directed the validation process. Semi-structured interviews based on vetted questionnaires yielded the data. Results: Analysis of interviews with ten (10) non-nursing college students revealed three key themes: 1) initial insights, 2) factors influencing their insights, and 3) difficulty of nursing education. Non-nursing students view nursing education as multifaceted and rigorous, recognizing the profession's complexity but have reservations about the heavy workload, intense clinical demands, and health risks, particularly highlighted by the pandemic, which contributes to their reluctance to choose nursing as a career path. Implications: Addressing perceptions, enhancing curricula, offering mentorship, and providing emotional support, nursing education can be improved, steering more students towards a career in nursing. Conclusion: Non-nursing students respect the complexity of the nursing profession but are deterred by its demands and risks, indicating a need for educational reforms to better convey the role, value, and opportunities within nursing to encourage more students into the field.

Ghana's Free Senior High School (SHS) policy has been touted as one of the most significant educational reforms in recent years, fueling the nation's achievement of Goal 4 of the United Nations Sustainable Development Goals (SDGs). While many studies have been conducted on the policy’s impact on beneficiaries, little is known about its impact on tertiary institutions. The purpose of this study is to evaluate the socioeconomic effects of the Free SHS policy on tertiary institutions in Ghana's Western Region. We also provide suggestions on how to improve the policy's efficacy and lessen any obstacles to its incorporation into higher education. Methodologically, 103 employees of Takoradi Technical University and the University of Mines and Technology were sampled using a purposive sampling technique. According to the report, despite the lack of adequate facilities such as lecture halls, dorms, and residence halls on campus, the Free SHS policy has increased enrollment at the postsecondary level. This has resulted in a high student-to-lecturer ratio, increased utility bills, a high cost of living on campus, and a rise in the opening of businesses on campus. To address some of these socioeconomic impacts, respondents proposed that the government should improve infrastructure in the country's higher institutions, hire more lecturers, boost incentives for lecturers, and foster partnerships with private institutions to support infrastructure development.

This study examines the influence of socio-demographic factors on work-family conflict among management staff in star-rated hotels in the Accra Metropolis. The research aims to explore how variables such as gender, age, marital status, and educational background impact the experiences of work-family conflict among hotel managers. A quantitative research design was employed, and data were collected through structured questionnaires distributed to a purposive sample of hotel managers. The findings reveal significant associations between socio-demographic characteristics and work-family conflict, highlighting the complexities of balancing work responsibilities with family obligations in the hospitality industry. The implications of the study underscore the importance of tailored interventions to support the well-being of hotel managers, while the recommendations emphasise the implementation of work-life balance programs, support for family obligations, promotion of diversity and inclusion, and continuous training and development. It is recommended that hotel organisations create a supportive work environment that enhances the job satisfaction and productivity of their management staff. This study contributes valuable insights to the existing literature on work-family conflict in the hospitality sector and provides a foundation for future research endeavours in this area.

Background: Over the past decade, there has been a rapid advancement in technology and virtual reality applications, leading to the emergence of the metaverse - a virtual universe where users interact with each other and their surroundings through immersive experiences. In the nursing profession, the metaverse presents unique opportunities to enhance patient care, education, and collaboration. Aim: To analyze and identify the attributes of metaverse in nursing, exploring its dimensions, benefits, challenges, and implications. By examining relevant literature, this study will contribute to a better understanding of the metaverse in nursing. Method/Design: Concept analysis by Walker and Avant (2019). Results: Metaverse in nursing involves three defining attributes: use of advanced technologies, better access to education and healthcare, and collaboration and community building. Antecedents of metaverse in nursing require technological advancements, increased digital literacy, demand for innovative education, globalization of healthcare education Conclusion: Metaverse in Nursing suggests that it is a promising technology that has the potential to enhance nursing practice and improve patient outcomes, but further research is needed to fully explore the impact of its integration.

Calotropis procera, a medicinally important plant found in Asia, was explored for its anticancer and antibacterial properties in this study. The leaves of C. procera were extracted using methanol and FTIR and UV-VIS spectrophotometry were used to characterize them. Using the MTT assay and the disc diffusion test, the extract was examined for anticancer activity against the MCF7 breast cancer cell line and antibacterial activity against methicillin-resistant Staphylococcus aureus (MRSA). The methanolic fraction of C. procera was found to be efficient against the MCF7 cell line and dramatically suppressed MRSA growth. The metabolic fraction of C. procera leaves is important in suppressing the growth of the MCF7 cell line, and it has the potential to be an effective antibacterial agent, according to our findings. The implications of Calotropis procera for all healthcare professionals including oncologists, physicians, pharmacists, nurses, and nutritional therapists are significant. With the increasing incidence of cancer and antibiotic-resistant bacterial infections, there is a growing need for new, effective, and safer herbal treatments.

Oncology nurses are more likely to get compassion fatigue (CF) than nurses in other fields because of the emotional stress and poor outlook of cancer patients. Because of this, the care might not be very good, the job might not be very satisfying, and there is a good chance that the patient's pain won't be noticed. Aim. To synthesize empirical evidence on compassion fatigue in order to extract the common, central, and fundamental elements that may improve nursing care. Design. An integrative review Results. Fifteen (15) studies met the eligibility criteria wherein five themes emerged. These are the level of compassion fatigue among oncology nurses, the oncology nurses' perspectives on compassion fatigue, precipitating factors leading to CF with 2 subthemes (work environment and a feeling of lack of support), the influence of compassion fatigue on the personal lives and general well-being of cancer nurses, and the consequences on the quality of oncology nurses' professional lives at work. Conclusion. CF is a significant problem for nurses who work in specialized areas such as cancer units, demonstrated as a basic incapacity to nurture others. The integration of studies provides evidence of clinical practice application which can provide better outcomes and improve nursing care. Implications for Practice. The findings provide understanding into healthcare practice on how to avoid compassion fatigue. Clinical management approaches that can mitigate compassion fatigue and its negative repercussions are presented, as well as the formation of peer support groups that have the ability to ameliorate CF.

The main purpose of this study is to investigate students’ awareness, understanding and use of the information on care labels. Quantitatively, the study adopted a cross-sectional survey design. The population of the study comprised all the Family and Consumer Science students at the University for Development Studies, Nyankpala campus, Tamale. Morgan and Krejcie chart, was used to select 159 out 270 students. Data collected were analysed using IBM SPSS with descriptive statistics which included mean, standard deviation, frequencies and percentages. Findings of this study proved that students do not always use the information on care labels when purchasing and caring for clothes and cannot identify the symbols on care labels that do not directly link with their meaning. This study has practical implications for students by using the information on care labels when purchasing and caring for clothes. Students should likewise find ways of identifying the symbols even without their meanings. The Social Implication implications of this study also postulates that local clothes manufacturers should be encouraged to create their labelling schemes for care labels that will be peculiar to how Ghanaians care for their clothes as they exist in other countries. Organizations and bodies that formulate the symbols should make sure the shape of the symbols has a direct link with their meaning to aid in their understanding and usage.

The purpose of this study was to examine the ideological motivations behind the use of metaphor in some selected speeches of former president John Dramani Mahama. Qualitatively, the study adopted a textual analysis research design. The study focused on Ghana’s political discourse with an emphasis on some selected speeches of former president John Dramani Mahama which were published between 4th July, 2012 to 6th January, 2017. A purposive sampling technique was used to select twenty (20) speeches of former president Mahama which were predominantly couched by layers of metaphors. The data were coded and metaphorically analysed in themes with interpretations. The analysis of metaphor in this study has shown that Critical Discourse Analysis is the best methodology for the analysis of spoken text in order to find out metaphorical meanings in discourse structures. The study revealed that Mahama’s use of metaphors was motivated by discursive practices such as hope, self-glorification, superiority and dominance and establishing commonality. The study indicated that metaphors are key discourse elements that foster understanding between and among participants in a political context. The study found that Mahama employs intertextuality as a rhetorical device. It is recommended that future researchers should devote time to look at the ideological implications of the use of intertextuality by Mahama.

Background: Sexuality is considered to be one of the most significant markers of quality of life. This is due to the fact that sexuality is linked to ideas, feelings, behaviors, social integration, and therefore, a person's physical and mental health and well-being but with patients who have gynecologic cancers, there are significant challenges when it comes to matters of sexuality and intimacy. Aim: To find out how gynecological cancer affects women's sexual experiences and how they express sexuality in the context of their sickness Design: A qualitative synthesis, thematic approach Result: Nineteen (19) eligible studies centered with gynecologic cancers on sexual functioning were included with two (2) main themes emerged: (1) Issues with Sexual Experiences and (2) Physical and Emotional Burden. Many individuals were found to have one or more sexual dysfunctions, which commonly caused distress. Conclusion: Changes in the women’s quality of life in the sexual aspect due to their disease takes a toll not just on the physical but in other facets as well. Better knowledge and patient-centered approaches would improve gynecologic cancer patients' capacity to cope in terms of sexual functioning. Implications: Healthcare professionals such as oncology nurses and doctors should better understand ways to address the sexual problems of their patients following the myriad of events following their diagnosis and treatment of their gynecologic cancers.

There is an ongoing debate regarding how to feed Sub-Saharan Africa's fast rising population in the long run, as well as the implications for food security. To maintain food security, various strategies have been recommended, including a focus on the significance of diversifying and improving people's diets. Proposals have been tabled elsewhere with a primary focus on enhancing agricultural inputs and technology adoption in order to increase agricultural production and productivity, hence strengthening food security. The current opinion piece attempts to contribute to this debate by examining smallholder agriculture and its role to African food security. This discussion proposes a future paradigm shift toward a gendered climate-smart smallholder agriculture and food production and security conceptual framework based on the promotion and development of smallholder agriculture and food production and security. Therefore, it's predicated that the micro-livestock-centered approach can remodel smallholder agrarian households and communities toward a gender-inclusive global climate change adaptive smallholder agriculture to strengthen production, supply, and food security in Sub-Saharan Africa. For Africa, today’s predicament is to ensure food security for the anticipated rapid population expansion, while on the other hand handling an overall net adverse effect of worldwide global climate change, and increased socio-economic ills associated with gender inequality in smallholder agriculture and ensuring long-term agriculture sustainable development. The failure to address gender inequality in smallholder agriculture and food production and pontificate of global climate change effect has thrown Sub-Saharan Africa into a state of perpetual food scarcity and insecurity because of low agricultural productivity and food supply, and by force of circumstances exposing the agricultural communities and its people to extreme poverty and nutrition and food insecurity. Therefore, it's predicated that the micro-livestock-centered approach can remodel smallholder agrarian households and communities toward a gender-inclusive global climate change adaptive smallholder agriculture to strengthen production, supply, and food security in Sub-Saharan Africa. For this purpose, this discussion proposes a future paradigm shift towards a gendered climate-smart smallholder agriculture and food production and security conceptual framework hinged on the promotion and development of the micro-livestock and/or unconventional animal species sub-sector to strengthen food security on the continent. Overall, the discussion emphasizes the importance of taking immediate action to alleviate the negative effects of climate change and address gender inequality through promotion of micro livestock to assist in the development of long-term adaptation measures to maintain smallholder agricultural productivity.

Background: There are currently numerous risk instruments available to aid in predicting the present or future chance of getting a cancer diagnosis. It aids in determining a person's likelihood of developing certain cancers by looking at various risk factors, including environmental, behavioral, and genetic. Aim: To analyze the effectiveness of cancer risk assessment techniques utilized in primary care settings. Methods: An integrative review of literature Results: Five (5) studies were met the criteria based on the inclusion and exclusion criteria. These tools demonstrated effectiveness in improving patient outcomes and serving as useful therapeutic tools in the primary care setting. Conclusion: Advantages that may aid clinicians in the primary care setting in validating the diagnosis and assisting patients in determining the early signs and symptoms in the diagnosis of cancer. The role of assessment tools can enhance the reliability and caliber of clinical judgment, which can enhance patient outcomes. Implications: The role of healthcare professionals, such as oncologists, nurses, and the healthcare team, on cancer risk assessment in the primary care setting across the lifespan is crucial to ensure a care plan tailored to each patient’s needs.

One of the current issues facing humanity is ensuring sustained global food security in the face of devastating effects of climate change; this challenge is particularly pressing on the African continent. Here, I present an opinion piece identifying local animal genetic resources as "African leverage point" that provide the highest chances to cushion rural fork to climate change, enhance environmental sustainability and food security in Africa. When it comes to boosting food production, coping with climate change, or bolstering the delivery of a wide range of ecosystem services, I believe that African animal genetic resources are essential alternatives for the sustainable growth of the livestock industry and its contribution to food security. Africa needs to address the support and development of indigenous animal genetic resources in order to meet the basic food needs of more than 1 billion people, address numerous environmental issues with continental implications, and focus on more effective and resilient food systems with the greatest impact on food security. The indigenous animal resources diversity and support actions to this unique group could provide a boost in protein that is lacking to constitute healthy diets in Africa. The priorities of nonprofit organizations, foundations, governments, citizens' groups, and companies can be influenced by this leverage point in the African food system. Due to continuous food insecurity, which appears to be becoming worse with climate change and makes it even harder to accomplish the SDGs on the continent, Africa has paid a hefty price for being misled about the worth of its own animal genetic resources. To the contrary, it is highly improbable that a strategy to improve food security and rural livelihoods that undermines the utilization of indigenous animal genetic resources will be viable in long-term. If Africa makes an effort, is committed, and fully commits resources to putting indigenous animal genetic resources at the forefront of combating food insecurity and accelerating the achievement of SDGs, it can achieve more under the adverse prevailing climate change induce environmental conditions. Our personal opinion is that we would not have had the ongoing food problems, even in the face of climate change, if Africa had over the years implemented the necessary mechanisms to develop and promote local animal genetic resources. What lies ahead in terms of climate change effect on food security in Africa is anyone's guess – but whatever it is, promoting continental adapted indigenous animal genetic resources portfolio is ready to handle it. Development and promotion of African animal genetic resources should be part of a continental strategy to transform smallholder animal production by 2050, in line with the goals of achieving the SGDs, to improve rural household food security, and bringing rural economy prosperity, resilience, sustainability, and all other desired animal related food outcomes for rural healthy diets. African animal genetic resources are the most important but underutilized resource to address the issue of ongoing food insecurity. The responsible use of local animal genetic resources through climate smart animal husbandry practices also contributes to food security, rural development and increased employment opportunities. African genetic improvement programs involving indigenous animal genetic resources must be considered as regards to local agriculture and livestock development aspirations, appropriateness to local reality and livelihood security, as well as environmental friendliness. Animal agriculture will fill in the enormous gaps in the continent's food supply if this animal group receives adequate attention and is used integrated properly in crop and livestock systems which characterize smallholder farming sector in Africa. Because they have evolved over time to accommodate the various climatic conditions and environmental pressures on the continent, Africa's native animal genetic resources are particularly resilient. Indirectly, the impact of climate change offers a chance to use native animal genetics from Africa. The use of local animal genetic diversity has the potential to substantially improve Africa's food security landscape hence should be given special consideration for sociocultural, environmental, and economic aspects, and with regard for smallholder farmer-specific factors of interest. African animal genetic resources have contributed significantly to the food and nutrition security aspects of the millions of people in their communities of origin and custody in Africa. The purpose of the perception piece is to educate the reader about the fundamental mechanisms that control the use of continental animal genetic resources and how the outlook for these mechanisms can be manipulated in the future for the benefit of improving food security in Africa. The discussion provides in-depth insight into the pertinent literature in understanding the significance of local animal genetic resources in terms of their contribution to food security in Africa.

The study focused on the nature and characteristics of the chieftaincy succession conflict in the Akuapem Traditional Area of Ghana. This study was anchored on an interpretivist philosophical viewpoint. Methodologically, the study employed a qualitative approach with a descriptive phenomenology research design. Thirty-four (34) adults who have lived in the area for the past five years participated in the study. They included members of the traditional council, the Akuapem North Municipal Assembly, the royal gates to the paramountcy and others within the community. Participants were selected using extreme case, critical case and convenience sampling techniques. Data were collected with the use of interview guide, focus-group discussion and observation protocols. The data collected were analysed thematically in line with the research questions and emerged patterns from the dataset. The study found out that the dynamics of the conflict revolved around the nature and frames. The findings showed multiple causes that resulted in the exacerbation of the conflict. A major conclusion drawn from the study was that the chieftaincy institution in Akuapem is hurled with conflict which has complex dynamics and thus, has had multiple implications on the stability and development of the society. It is therefore recommended that all stakeholders to the installation are duly left to perform their duties without any intrusion from external parties or outsiders. Moreover, the grievances of these stakeholders should be addressed to ensure smooth running of the processes. This can be ensured by the traditional council of the area.

The purpose of this study was to assess the educational implications of children involved in small scale mining activities at Kyebi in the Abuakwa South District of Ghana. Qualitatively, case study research design was adopted for the study. The population for the study consisted of junior high school head teachers in the Abuakwa South District of Ghana. Purposive sampling technique was used to select all the thirty (30) junior high school head teachers who have taught in the district between 25 to 30 years. The main instrument for data collection was Semi-structured interview guide. Data collected by the researchers from participants was analysed through the use of the interpretive method based on the themes identified at in the data collection. The themes were related to the research question and interpreted based on the number of issues raised by participants. The study concluded that, students’ academic lives are being hampered as a result of their continuous engagement in small scale mining activities at the expense of their schooling. The study also revealed that students always score below pass grades during the Basic Education Certificate Examination (BECE) due to the menace caused by illegal mining activities, hence the poor academic performance. It is recommended that the Ghana Education Service, in collaboration with other stakeholders must institute strict measures to curb absenteeism in schools. This would go a long way to ensure that the pupils would attend school on a regular basis. It is also recommended that government intervention programmes such as School Feeding and Free School uniforms be made available to these children in order to keep them in school.

The supervisory role of kindergarten teachers is primarily concerned with supervising and managing the efforts of their learning environment to create safe, positive learning environments for all learners, as well as ensuring that no child is left alone or unsupervised by teachers or caregivers while under their supervision. The purpose of this study was to examine the effects of teachers’ supervision on the safety of kindergarten pupils in Komenda Edina Eguafo Abirem (K.E.E.A.) Municipality in the central region of Ghana. Qualitatively, the Instrumental Case Study Design was employed in this study to gather information on the participants. The population consisted of 227 Kindergarten teachers in the KEEA Municipality of Ghana. Convenience sampling technique was used to select sixteen (16) public kindergarten teachers for the study. The main instrument used for data collection was semi-structured interview guide. The data were analyzed thematically. The analysis of the data was done with the help of online qualitative software, Taguette version 1.3, Using the Taguette, the researchers highlighted quotes and phrases from the interviews that were significant to the study. The study supported that, establishing a well-conducive school environment enhance teachers’ supervision which goes a long way to ensures learners’ comfortability and safety; maximize learners’ academic performance; lessen fear in learners; promote teaching and learning; and support learners’ participation in play experiences. It is recommended that, key players in education such as Ministry of Education and Ghana Education Service should investigate the effect of teacher supervision on learners’ safety vis-a-vis with its educational implications. It is also recommended that, kindergarten teachers should be encouraged to supervise their learners to guarantee positive outcomes of promoting learners’ comfortability and safety; maximizing learners’ academic performance; promoting teaching and learning; and contributing to support learners’ participation in play experiences.

Purpose: The aim of this study is to the analysis of the South African history of the culture of teaching and learning. This study was driven by the desire for effective teaching and learning within the South African context. Design / Method / Approach: The information in this research came from outside sources (secondary sources). Journal articles (after peer review), dissertations (both published and unpublished), internet sources, and textbooks were used as informational resources. Findings: Teachers believe they have no say in the development of the educational system but are expected to execute its policies and procedures. Fear of change can lead to inappropriate behaviour. For a country to have globally competent citizens it needs to review its curriculum. South Africa has undergone a substantial educational change since the mid-1990s, but its efforts to implement new curricula have been problematic. After the dawn of democracy, concerns were raised about the decline of a positive culture of teaching and learning, especially in disadvantaged township schools. Theoretical implications: there is a lack of theory on an analysis of the South African history of the culture of teaching and learning. Thus, this study seeks to expand the theory. Practical implications: Findings from this research will advance the science behind the culture of teaching and learning in South Africa. Originality / Value: This research will shed light on the development of South Africa's teaching and learning culture, provide suggestions gleaned from its findings, and point the way toward other avenues of inquiry. Research Limitation & Implications: This research was constrained by the quantity and quality of published secondary sources at the time of writing.