Search

AbstractBackground This study aimed to determine the factors that promote and facilitate rehabilitation as well as challenges and possible barriers perceived by people with spinal cord injury (SCI).Materials and Methods This study was part of a larger, mixed-method Finnish Spinal Cord Injury (FinSCI) study. We interviewed 45 persons with SCI representing participants from the FinSCI study and used a qualitative approach and a deductive-inductive content analysis to analyse the data.Results We identified 28 facilitators and 19 barriers in the rehabilitation process. The majority of the facilitators and barriers were related to the rehabilitation planning phase. There were more barriers than facilitators in applying for and accessing treatment or rehabilitation and during the implementation of rehabilitation. Facilitators consisted of successful, realized, or planned treatments or rehabilitation events; clear goals; multidisciplinary teamwork; support and monitoring in various changing situations; and the rehabilitees’ own capabilities and activities, among other things. The barriers included delays, challenges and deficiencies in the planning and implementation of treatment or rehabilitation; the lack of different skills; and resources of rehabilitation professionals; and different personal factors, which made the rehabilitation process cumbersome.Conclusions Good communication and interaction between stakeholders are crucial for the progress of rehabilitation.

ABSTRACT Glucocorticoids (GCs) are commonly used anti‐inflammatory medications with significant side effects, including glucocorticoid‐induced osteoporosis (GIO). We have previously demonstrated that chronic subcutaneous GC treatment in mice leads to gut barrier dysfunction and trabecular bone loss. We further showed that treating with probiotics or barrier enhancers improves gut barrier function and prevents GIO. The overall goal of this study was to test if probiotics could prevent GC‐induced gut barrier dysfunction and bone loss in a clinically relevant oral‐GC model of GIO. Eight‐week‐old male CD‐1 mice were treated with vehicle or corticosterone in the drinking water for 4 weeks and administered probiotics Lactobacillus reuteri ATCC 6475 (LR 6475) or VSL#3 thrice weekly via oral gavage. As expected, GC treatment led to significant gut barrier dysfunction (assessed by measuring serum endotoxin levels) and bone loss after 4 weeks. Serum endotoxin levels significantly and negatively correlated with bone volume. Importantly, LR 6475 treatment effectively prevented both GC‐induced increase in serum endotoxin and trabecular bone loss. VSL#3 had intermediate results, not differing from either control or GC‐treated animals. GC‐induced reductions in femur length, cortical thickness, and cortical area were not affected by probiotic treatment. Taken together, these results are the first to demonstrate that LR 6475 effectively prevents the detrimental effects of GC treatment on gut barrier, which correlates with enhanced trabecular bone health in an oral mouse model of GIO. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

AimThe goal of this study was to evaluate consistency among multiple connectivity models for jaguar and puma across Panama to evaluate the plausible current patterns of habitat connectivity for these and potentially other species in this critical biogeographic linkage zone.ApproachWe compared 72 different models of landscape connectivity for both large felids using both empirically based and expert opinion derived resistance layers. We conducted resistant kernel modeling with different dispersal abilities to reflect uncertainty in the movement potential of the two species. We applied three transformations to the resulting connectivity surfaces to account for uncertainty about the shape of the dispersal kernel function. We then evaluated the similarities and differences among these connectivity models, identifying several factors that drive their differences. We quantified the factors that drive differences in connectivity predictions using surface correlation, Mantel testing, and agglomerative hierarchical clustering.ResultsWe found that the main differences among predicted connectivity surfaces were related to species and resistance modeling approach, with relatively little consistent difference related to dispersal ability and nonlinear kernel transformation. Based on the ensemble connectivity prediction across the 72 models, we identified two major core areas, corresponding to the eastern and western portions of the central mountain range, significant attenuation of connectivity in lowland and developed areas of Panama, a major breakage in connectivity in the Canal Zone spanning the width of the country, and weak but potentially critical movement routes connecting the two core areas across the Canal Zone.ImplicationsThis paper contributes to both a theoretical and practical understanding of the functional connectivity of large felids, confirming the strong effect of differences in source points and resistance surfaces on connectivity predictions and identifying and mapping key core areas, barriers, and potential corridors for carnivore movement across the critical Pan-American linkage of the Isthmus of Panama.

The promotion of physical activity and well-being calls for sociological knowledge of the factors that constrain individual's activities, especially among disadvantaged populations. We investigated perceived barriers to physical activity and their associations with social background factors within the theoretical framework of social space. Survey data (n = 302) were collected from adult residents in two low socioeconomic status city suburbs in Finland and examined using binary logistic regression analysis, multiple correspondence analysis and variance analysis. The most prevalent barriers among adults were low mood, lack of time, health problems and lack of companions. A data-driven classification of the barriers showed that an accumulation of barriers was associated with nondomestic native language, single parenting, age 30–44 years and low household income. Perceiving personal barriers, as opposed to environmental barriers, was characterised by retirement, low household income, low physical activity level and domestic native language. The results support the following deduction: to reduce inequalities in access to physical activity, policies should focus on sports service delivery that aims at the removal of barriers to physical activity, especially social and personal barriers. Deepening this understanding requires not only further development of relevant theory and empirical research into the different social spaces of physical activity but also close dialog with welfare policy decision makers and sports service planners.

Introduction: The United Kingdom (UK) government's healthcare policy in the early 1990s paved the way adoption of the skills mix development and implementation of diagnostic radiographers' X-ray reporting service. Current clinical practice within the public UK healthcare system reflects the same pressures of increased demand in patient imaging and limited capacity of the reporting workforce (radiographers and radiologists) as in the 1990s. This study aimed to identify, define and assess the longitudinal macro, meso, and micro barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X-ray reporting service in the National Healthcare System (NHS) in England. Methods: Multiple independent databases were searched, including PubMed, Ovid MEDLINE; Embase; CINAHL, and Google Scholar, as well as journal databases (Scopus, Wiley), healthcare databases (NHS Evidence Database; Cochrane Library) and grey literature databases (OpenGrey, GreyNet International, and the British Library EthOS depository) and recorded in a PRISMA flow chart. A combination of keywords, Boolean logic, truncation, parentheses and wildcards with inclusion/exclusion criteria and a time frame of 1995–2022 was applied. The literature was assessed against Joanna Briggs Institute's critical appraisal checklists. With meta-aggregation to synthesize each paper, and coded using NVivo, with context grouped into macro, meso, and micro-level sources and categorised into subgroups of enablers and barriers. Results: The wide and diverse range of data (n = 241 papers) identified barriers and enablers of implementation, which were categorised into measures of macro, meso, and micro levels, and thematic categories of context, culture, environment, and leadership. Conclusion: The literature since 1995 has reframed the debates on implementation of the radiographer reporting role and has been instrumental in shaping clinical practice. There has been clear influence upon both meso (professional body) and macro-level (governmental/health service) policies and guidance, that have shaped change at micro-level NHS Trust organisations. There is evidence of a shift in culturally intrenched legacy perspectives within and between different meso-level professional bodies around skills mix acceptance and role boundaries. This has helped shape capacity building of the reporting workforce. All of which have contributed to conceptual understandings of the skills mix workforce within modern radiology services. [ABSTRACT FROM AUTHOR]

Physical activity (PA) has positive effects on the physical and cognitive functioning of people with dementia. Knowledge about what limits and stimulates people with dementia to participate in PA is essential to promote effective PA implementation and enhance PA levels. Previous reviews primarily included opinion-based studies, using data from interviews, focus groups or dyads. By including implementation studies, we aimed to elaborate on previous reviews by identifying new barriers to PA and new facilitators and motivators for PA. We conducted systematic searches in Pubmed, PsychInfo and Web of Science for studies published up to the 21st of September 2021. Search terms were related to the population of people with dementia, PA interventions and implementation outcomes. Studies were included if PA participation was investigated during actual PA implementation. No restrictions were made regarding study design, date of publication, PA type or outcome measures. Studies not implementing PA or not evaluating the implementation were excluded. Based on 13 empirical studies, we identified 35 barriers, 19 facilitators and 12 motivators. Of these, 21 barriers, 11 facilitators and 4 motivators were not identified by previous reviews. New factors are related to the support for people with dementia from informal and formal caregivers, e.g., revealing the importance of a trusting relationship. Furthermore, support for staff from the institution or an external party is needed to overcome doubts about PA, for example, related to safety and effects. New factors also suggested specific recommendations for the content and organization of the PA intervention, for instance, related to how to give instructions. Overall, factors affecting PA identified with opinion-based or implementation studies are complementary. Our extended overview shows the complexity of PA implementation and may help to personalize PA, develop implementation strategies, facilitate actual PA implementation and free up resources needed for effective implementation. [ABSTRACT FROM AUTHOR]

To better understand how normal stress heterogeneity affects earthquake rupture, we conducted laboratory experiments on a 760 mm poly (methyl‐mathacrylate) PMMA sample with a 25 mm "bump" of locally higher normal stress (∆σbt). We systematically varied the sample‐average normal stress (σn‾ $\overline{{\sigma }_{n}}$) and bump prominence (∆σbt/σn‾ ${{\increment}\sigma }_{\text{bt}}/\overline{{\sigma }_{n}}$). For bumps with lower prominence (∆σbt/σn‾<6 ${{\increment}\sigma }_{\text{bt}}/\overline{{\sigma }_{n}}< 6$) the rupture simply propagated through the bump and produced regular sequences of periodic stick‐slip events. Bumps with higher prominence (∆σbt/σn‾>6 ${{\increment}\sigma }_{\text{bt}}/\overline{{\sigma }_{n}} > 6$) produced complex rupture sequences with variable timing and ruptures sizes, and this complexity persisted for multiple stick‐slip supercycles. During some events, the bump remained locked and acted as a barrier that completely stopped rupture. In other events, a dynamic rupture front terminated at the locked bump, but rupture reinitiated on the other side of the bump after a brief pause of 0.3–1 ms. Only when stress on the bump was near critical did the bump slip and unload built up strain energy in one large event. Thus, a sufficiently prominent bump acted as a barrier (energy sink) when it was far from critically stressed and as an asperity (energy source) when it was near critically stressed. Similar to an earthquake gate, the bump never acted as a permanent barrier. In the experiments, we resolve the above rupture interactions with a bump as separate rupture phases; however, when observed through the lens of seismology, it may appear as one continuous rupture that speeds up and slows down. The complicated rupture‐bump interactions also produced enhanced high frequency seismic waves recorded with piezoelectric sensors. Plain Language Summary: Natural faults have complex geometries, but are idealized as planar surfaces in most models and laboratory setups. To study the effect of one isolated "bump" of high normal stress, we conducted laboratory experiments on a 760 mm poly (methyl‐mathacrylate) sample with a 25 mm long section of locally high normal stress. We varied both the average normal stress applied to the sample and the prominence of the bump to explore how more dramatic bumps could affect sequences of slip events. When the bump was small and stress was nearly uniform, the bump had little effect and the entire fault consistently slipped the same amount, at the same time. When the bump was large and the bump stress was much higher than stress elsewhere on the sample, different sections of the fault slipped independently resulting in complex sequences with large variations in event sizes. Smaller events slipped areas around the bump without slipping the bump. In some cases, the bump could be by‐passed and the entire fault slipped, except the bump. But the bump was never able to permanently stop these slip events. Eventually, the bump was stressed close to its limit and slipped which created larger events than otherwise expected. Key Points: A 25 mm‐long bump of high normal stress can cause persistently complex rupture sequences on a 760 mm‐long sampleA sufficiently prominent bump (∆σbt/σn‾>6 ${{\increment}\sigma }_{\text{bt}}/\overline{{\sigma }_{n}} > 6$) can stop rupture; but slip can sometimes re‐initiate on the other side of the bumpA prominent bump can act as an asperity or a barrier depending on strength excess, resulting in a variety of event sizes [ABSTRACT FROM AUTHOR]

[Display omitted] Atopic dermatitis (AD) is an inflammatory disorder characterized by dominant type 2 inflammation leading to chronic pruritic skin lesions, allergic comorbidities, and Staphylococcus aureus skin colonization and infections. S aureus is thought to play a role in AD severity. This study characterized the changes in the host-microbial interface in subjects with AD following type 2 blockade with dupilumab. Participants (n = 71) with moderate-severe AD were enrolled in a randomized (dupilumab vs placebo; 2:1), double-blind study at Atopic Dermatitis Research Network centers. Bioassays were performed at multiple time points: S aureus and virulence factor quantification, 16s ribosomal RNA microbiome, serum biomarkers, skin transcriptomic analyses, and peripheral blood T-cell phenotyping. At baseline, 100% of participants were S aureus colonized on the skin surface. Dupilumab treatment resulted in significant reductions in S aureus after only 3 days (compared to placebo), which was 11 days before clinical improvement. Participants with the greatest S aureus reductions had the best clinical outcomes, and these reductions correlated with reductions in serum CCL17 and disease severity. Reductions (10-fold) in S aureus cytotoxins (day 7), perturbations in T H 17-cell subsets (day 14), and increased expression of genes relevant for IL-17, neutrophil, and complement pathways (day 7) were also observed. Blockade of IL-4 and IL-13 signaling, very rapidly (day 3) reduces S aureus abundance in subjects with AD, and this reduction correlates with reductions in the type 2 biomarker, CCL17, and measures of AD severity (excluding itch). Immunoprofiling and/or transcriptomics suggest a role for T H 17 cells, neutrophils, and complement activation as potential mechanisms to explain these findings. [ABSTRACT FROM AUTHOR]

Copyright of China Surfactant Detergent & Cosmetics (2097-2806) is the property of China Surfactant Detergent & Cosmetics Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The updated World Health Organization (WHO) guideline recommends immediate kangaroo mother care (KMC) for all infants, particularly those born preterm. However, its uptake and sustainability have been unsatisfactory. Therefore, we aimed to gain deeper insight into factors influencing the uptake of KMC practice in our setting, and thereby identify possible solutions for the development of relevant interventions to improve its adoption and make KMC a routine practice for all infants. Methods: Using the Triandis model of social behaviour as our framework, we conducted key informant interviews with parents and healthcare providers. Trained interviewers conducted interviews with nine parents, recruited via purposive sampling. These parents were parents of preterm infants who had been introduced to KMC. Data was transcribed and analysed based on Triandis' Theory of Interpersonal Behaviour. This paper only reports the results of the parent interviews. Results: Major findings were how positive feelings like warmth and contentment, the sense of parenthood with KMC, the benefits of KMC for their infant and parents being enablers for KMC uptake. Conversely, the lack of KMC awareness, the initial negative feelings such as fear, uncertainty and embarrassment, the prioritization of time for milk expression, overcrowding in the ward, lack of space and privacy, limited visiting hours, lack of support and poor communication resulting in misapprehension about KMC were major barriers. Conclusion: A deeper understanding of the factors influencing the uptake of KMC using the Triandis behavioural model provided a way forward to help improve its uptake and sustainability in our settings. Trial registration: This study was registered with the National Medical Research Registry (NMRR-17-2984-39191). [ABSTRACT FROM AUTHOR]

Background: Expression of the urokinase plasminogen activator receptor (uPAR) is elevated in the airway epithelium in asthma; however, the contribution of uPAR to asthma pathogenesis and scope for therapeutic targeting remains unknown. Objectives: To determine (i) the expression profile of uPAR in cultured human bronchial epithelial cells (HBEC) from asthma patients, (ii) the relationship between uPAR and the epithelial barrier, including blocking uPAR functions and (iii) the function of different uPAR isoforms. Methods: uPAR levels in HBECs isolated from asthma patients and cells at air liquid interface (ALI) during differentiation were quantified. Transepithelial electrical resistance or electrical cell impedance sensing was used to relate uPAR levels to barrier properties, including effects of uPAR blocking antibodies. The functional effects of gain of function was determined using transcriptomics, in cells over‐expressing membrane (muPAR), soluble cleaved (scuPAR) or soluble spliced (ssuPAR) isoforms. Results: Elevated expression of uPAR was a feature of cultured HBECs from asthma patients, suggesting intrinsic alterations in asthma patient cells. Soluble uPAR levels inversely correlated with barrier properties of the HBEC layer in 2D and ALI. Blocking uPAR‐integrin interactions enhanced barrier formation. The gain of function cells showed limited transcriptomic changes. Conclusion: This study provides a significant advance in our understanding of the relationship between asthma, uPAR and the epithelial barrier, where elevated circulating uPAR results in a reduced cell barrier, a phenotype prevalent in asthma. [ABSTRACT FROM AUTHOR]

Aim: Early intervention in eating disorders (EDs) is hampered by a lack of validated measures of barriers to treatment seeking. The present study examined the factor structure of the Perceived Barriers to Psychological Treatment scale (PBPT) and a combination of PBPT and Barriers to Seeking Help for ED items (BATSH‐ED) with respect to treatment‐seeking for an ED. Method: Participants were 456 female university students aged 17–25 reporting a wide range of disordered eating severity. Confirmatory factor analyses were conducted with the whole sample followed by correlational and regression analyses with a high‐risk sample to assess validity of the selected questionnaire items. Results: Four models were tested. First, we replicated the original PBPT 8‐factor structure in our sample with comparable fit indices. Second, the addition of six ED items comprising a Denial and Ambivalence subscale improved model fit. Third and fourth, when only significant subscales predicting treatment seeking were retained, with removal of items with weak loadings, a 15‐item six‐factor solution provided a best fit. A range of psychosocial measures had relationships in the expected directions with the questionnaire subscales. In addition to disordered eating, the denial subscale was uniquely associated with treatment seeking. Conclusions: While the present study contributes to refining the assessment of barriers to help‐seeking, future studies should consider co‐design with lived experience to further improve the model fit of the questionnaire and improve predictiveness of help‐seeking. [ABSTRACT FROM AUTHOR]

This research delves into the impact of incorporating thermally treated oyster shell powder (TOS), a biowaste filler, into low-density polyethylene (LDPE) to develop a LDPE/TOS blend, aiming at enhancing food packaging materials. The LDPE/TOS blend portrays advantageous characteristics such as augmented mechanical strength, thermostability, crystallinity, water absorption, and improved hydrophobicity with TOS content up to 50%. Microstructure analysis reveals a transition from a sparse to a more interconnected structure, contributing to the amplified tensile strength. The blend demonstrates increased barrier properties against water vapor transmission, which is attributed to elongated diffusion paths induced by the TOS particles. Application of the blend material in vegetable preservation trials manifested a substantial reduction in water loss compared to pure LDPE or no packaging. This biowaste-based blend film extends the shelf-life of chicken significantly when compared to that of pure LDPE. Importantly, the LDPE/TOS blend exhibits excellent antibacterial properties against both Escherichia coli and Staphylococcus aureus. [ABSTRACT FROM AUTHOR]

BACKGROUND: Obstetric care has been at the center of both global and national agendas. More than 50% of pregnant mothers are still preferring to give birth at home with some even after having full antenatal care. However, a few literatures looked at contributing factors for this problem but they are not conclusive and do not consider different sociocultural context of Ethiopia and different health service related barriers. Hence, the aim of this study was to explore barriers to obstetric care service utilization in Ethiopia using the socio-ecological model. METHODS: Explorative qualitative study was employed involving key-informant interviews, in-depth interviews, and focus group discussions between October and December 2021; Individual, community, health system, and contextual barriers were explored. Atlas ti. Version 9 was used for analysis. RESULT: Lack of awareness, unfavorable perception, lack of partner involvement, cultural barrier, shortage of supplies, poor infrastructure, provider-related factors, poor monitoring, and evaluation system, challenging topography, and conflict were the major barriers that hinder mothers from receiving obstetrics service in Ethiopia. CONCLUSION: Lack of awareness, unfavorable perception, conflict, problems with health system structure and process, and cultural and geographical conditions were major barriers in Ethiopia. Therefore, packages of intervention is important to avail essential equipment, strengthening follow up system, create awareness, and increase access to health facilities is very important for service improvement by the government and non-governmental organizations. Additionally, implementing conflict resolution mechanism is important for addressing better obstetric service. [ABSTRACT FROM AUTHOR]

The aim of this scoping review was to identify factors that would enable or hinder the opportunity for laypersons to undertake resuscitation education. We searched PubMed, Ovid EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL) to identify studies published from January 1, 1966 to December 31, 2022 including factors that could influence laypersons to undertake resuscitation education. Data regarding participant characteristics, interventions, and design and outcomes of included studies were extracted. Of the initially identified 6627 studies, 23 studies (20 cross-sectional and 3 cohort studies) were finally included. Among them, a wide variety of enablers and barriers were identified. High heterogeneity among studies was observed. We categorized factors into three themes: personal factors (age, sex, race, family status, language, prior experience of resuscitation, and immigration status), socioeconomic and educational factors (income, societal status, occupation and legislation, and educational attainment), and geographic factors (birthplace and habitancy). Several barriers were identified that affect laypersons from participating in resuscitation training, such as personal factors like advanced age, lower socioeconomic and educational status, as well as being part of marginalized groups due to race or language barriers. On the other hand, several enablers identified in the study included prior experiences of witnessing someone collapsing, awareness of automated external defibrillators in public locations, certain occupations, or legal requirements for training. Various barriers and enablers were found to influence laypersons to participate in resuscitation training. To enhance layperson response to cardiac arrest, targeted initiatives that aim to eliminate barriers need to be initiated, and further research is required to explore factors relating to populations with special needs. [ABSTRACT FROM AUTHOR]

Working canines often deploy into environments with unknown chemical and biological contaminants. Disaster canines may be deployed for lengthy periods and thus may experience longer periods of environmental exposure with greater possibility for contaminant contact. The skin functions as a protective barrier to prevent potential contaminants and pathogens from entering the system. To mitigate the effects of contaminant exposure to canine and handler, daily decontamination efforts are often required. However, little data exist on the effect of repeated decontamination to the canine skin. The objective of this study was to identify changes to the skin associated with a 14-day serial decontamination program. Labrador retrievers (n = 8) were decontaminated daily using a dish detergent solution (1:8, detergent:water). Skin measurements were collected weekly for pH, trans-epidermal water loss (TEWL), sebum, and moisture. Additionally, visual assessments were recorded for skin health, coat condition, and dander scores (back and body). Statistical tests were conducted with SAS (version 9.4) with measured data analyzed using a PROC GLM two-way ANOVA and visual assessments analyzed using the PROC FREQ Chi-square test. Significance was set at 5% for all tests. Repeated decontamination significantly increased TEWL (P < 0.0001) through day 16 with values returning to baseline by day 49. Sebum was also affected by repeated, daily decontamination efforts (P = 0.0387). However, higher sebum values are seen later in the study, on day 42, and may be associated with recovery. In contrast, moisture content (P = 0.3842) and pH (P = 0.7462) were unaffected by repeated decontamination. Interestingly, dander scores assessed on the back were worsened by repeated decontamination (P = 0.0222), but dander scores assessed across the whole body were unaffected (P = 0.1804). Coat shine and softness were unaffected by decontamination (P = 0.1156 and P = 0.3418, respectively). Overall coat condition remained unchanged as a result of repeated decontamination efforts (P = 0.9466). These data demonstrate negative impacts to the skin barrier associated with daily decontamination, which may increase the risk of inflammation and skin damage (Ananthapadmanabhan et al., 2004 ; Vidémont et al., 2012). Future work should include investigations into safer methods of decontamination to mitigate these risks. • Trans-epidermal water loss measurements of canine skin changed significantly across study day. • Trans-epidermal water loss measurements peaked on day 14. • Dermal sebum measurements changed significantly across study day with highest mean on day 42. • Back dander scores of canines changed significantly across study day with highest mean on day 35. [ABSTRACT FROM AUTHOR]

In this paper, we derive closed-form formulas of first-order approximation for down-and-out barrier and floating strike lookback put option prices under a stochastic volatility model using an asymptotic approach. To find the explicit closed-form formulas for the zero-order term and the first-order correction term, we use Mellin transform. We also conduct a sensitivity analysis on these formulas, and compare the option prices calculated by them with those generated by Monte-Carlo simulation. [ABSTRACT FROM AUTHOR]

Background & Aim: One of the most important measures to reduce errors in operating rooms is to identify the causes of errors and their risk factors. The present study was conducted with the aim of determining the factors affecting the occurrence of errors and the barriers to reporting them from the perspective of surgical technology and anesthesia students at Alborz University of Medical Sciences, 2022. Materials & Methods: This is a cross-sectional descriptive study in which all verified undergraduate surgical technology and anesthesia students were enrolled by census method. Data collection tools included demographic data and factors affecting the occurrence of errors, and barriers to error reporting questionnaires. Collected data were analyzed using SPSS software version 26, descriptive, and analytical statistics with a significant level of 0.05. Results: 270 undergraduate surgical technology and anesthesia students took a part in this study. Findings indicate that the mean of the factors affecting the occurrence of errors was 2.62±0.74, and for the factors affecting error reporting it was 2.90±0.92. The highest mean score related to the field of environmental factors (2.82±0.85) among the factors affecting the occurrence of errors; and the scope of the reporting process (3.04±1.01) was one of the barriers to reporting errors. Conclusion: The results of this study showed providing standard clinical training fields can have a significant impact on reducing the occurrence of errors. On the other hand, reforming the error reporting process and encouraging students to report errors should also be a priority for the management of educational and therapeutic centers. [ABSTRACT FROM AUTHOR]

The Bronx-Whitestone Bridge was designed during the 1930s in an era of suspension bridges with decks stiffened by shallow plate girders, many of which were subsequently found to be vulnerable to aerodynamic instabilities such as vortex shedding and flutter. Following the occurrence of mild and benign wind-induced oscillations in the first several years after opening in 1939, the bridge has undergone a series of retrofits, from structural solutions such as stay cables, stiffening trusses, and a steel orthotropic deck, to aerodynamic enhancements such as a tuned mass damper and wind fairings. Wind tunnel studies in 2015 confirmed the improved aerodynamic performance due to the recently installed wind fairing system and stiffer orthotropic deck. A subsequent rehabilitation project gave the opportunity to assess measures to further improve the aerodynamic performance of the bridge. A 3 ft (0.91 m) tall solid screen added on top of the median barrier was found to act as an above-deck vertical baffle plate, disrupting the alternating pattern of vortices, reducing the susceptibility of the bridge to instabilities. This led to the conceptual design of a Median Barrier Extension (MBE) comprised of 3 ft (0.91 m) solid transparent acrylic panels fixed to the top of the existing median barrier posts, supported by a tubular steel frame. To ensure this unique barrier modification met current industry safety standards, the MBE design was iterated through a crash analysis study using non-linear finite element models before the final design proceeded to a full-scale physical crash testing program to MASH Test Level 4. This paper presents the full timeline of this innovative retrofit project, from conception during wind tunnel testing, through to design, crashworthiness studies and final construction in 2020. This project has demonstrated that a vertical extension to a median barrier can act as a simple and cost-effective enhancement to the aerodynamic performance of existing bridges. [ABSTRACT FROM AUTHOR]

A methodology is proposed to extend datasets in a database suitable for use as a reference tool to support an evaluation of damage mitigation by a barrier wall in a hydrogen refueling station (HRS) during a vapor cloud explosion (VCE) accident. This is realized with a computational fluid dynamic (CFD) analysis and machine learning (ML) technology because measured data from hydrogen explosion tests with various installed barrier models usually require considerable amounts of time, a secured space, and precise measurements. A CFD sensitivity calculation was conducted using the radXiFoam v1.0 code and the established analysis methodology with an error range of approximately ±30% while changing the barrier height from that was used in an experiment conducted by the Stanford Research Institute (SRI) to investigate the effect of the barrier height on the reduction in peak overpressures from an explosion site to far fields in an open space. The radXiFoam code was developed based on the open-source CFD software OpenFOAM-v2112 to simulate a VCE accident in a humid air environment at a compressed gaseous or liquefied HRS. We attempted to extend the number of datasets in the VCE database through the use of the ML method on the basis of pressure data predicted by a CFD sensitivity calculation, also uncovering the possibility of utilizing the ML method to extend the VCE database. The data produced by the CFD sensitivity calculation and the ML method will be examined to confirm their validity and applicability to hypothetical VCE accident simulations if the related test data can be produced during experimental research. The database constructed using core data from the experiment and extended data from the CFD analysis and the ML method will be used to increase the credibility of radXiFoam analysis results for VCE accident scenarios at HRSs, ultimately contributing to safety assurances of HRSs in Republic of Korea. [ABSTRACT FROM AUTHOR]

The present study aimed to examine the barriers faced by Taiwanese university English as a foreign language (EFL) instructors when incorporating mobile-assisted language learning (MALL) into their teaching, and to explore how these barriers are influenced by the instructors' background characteristics. To assess the variables, a survey questionnaire was developed and administered to a sample of 350 university instructors. Additionally, interviews were conducted with a subset of instructors to complement and clarify the quantitative data. The findings indicated that university EFL instructors encountered moderate barriers when integrating MALL into their teaching practices. Furthermore, the study identified significant differences in the barriers experienced based on the amount of time instructors dedicated to MALL on a daily basis. Both quantitative and qualitative data highlighted the importance of time as a critical factor for successful MALL integration. As a recommendation, it is advised that university administrators consider reducing instructors' workload to facilitate the seamless integration of MALL. [ABSTRACT FROM AUTHOR]

The skin functions as a physical barrier and represents the first line of the innate immune system. There is increasing evidence that toll-like receptors (TLRs) are involved in the pathomechanisms of not only infectious diseases, but also noninfectious inflammatory diseases. Interestingly, it has been demonstrated that TLRs recognize both exogenous threats, e.g. bacteria and viruses, and endogenous danger signals related to inflammation, cell necrosis, or tissue damage. Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease, which is associated with impaired skin barrier function, increased skin irritability to non-specific stimuli, and percutaneous sensitization. The impairment of skin barrier function in AD allows various stimuli, such as potential allergens and pathogens, to penetrate the skin and activate the innate immune system, including TLR signaling, which can lead to the development of adaptive immune reactions. In this review, I summarize the current understanding of the roles of TLR signaling in the pathogenesis of AD, with special emphasis on skin barrier function and inflammation. [ABSTRACT FROM AUTHOR]

Chronic airway inflammation is the cornerstone on which bronchial asthma arises, and in turn, chronic inflammation arises from a complex interplay between environmental factors such as allergens and pathogens and immune cells as well as structural cells constituting the airway mucosa. Airway epithelial cells (AECs) are at the center of these processes. On the one hand, they represent the borderline separating the body from its environment in order to keep inner homeostasis. The airway epithelium forms a multi-tiered, self-cleaning barrier that involves an unstirred, discontinuous mucous layer, the dense and rigid mesh of the glycocalyx, and the cellular layer itself, consisting of multiple, densely interconnected cell types. On the other hand, the airway epithelium represents an immunologically highly active tissue once its barrier has been penetrated: AECs play a pivotal role in releasing protective immunoglobulin A. They express a broad spectrum of pattern recognition receptors, enabling them to react to environmental stressors that overcome the mucosal barrier. By releasing alarmins—proinflammatory and regulatory cytokines—AECs play an active role in the formation, strategic orientation, and control of the subsequent defense reaction. Consequently, the airway epithelium is of vital importance to chronic inflammatory diseases, such as asthma. [ABSTRACT FROM AUTHOR]

Background: Nurses' competency in delirium care is important because delirium can extend hospitalization and increase patient mortality. Aim: This study aimed at identifying and comparing the perceived knowledge, barriers, importance, performance, and training priorities between the intensive care unit (ICU) and ward nurses working in delirium care. Study design: This cross‐sectional descriptive study included 71 ICU nurses and 149 ward nurses at one university hospital. Nurses' self‐reported knowledge, barriers, importance, and performance of delirium care were surveyed. Data were analysed using descriptive statistics, chi‐squared test or Fisher's exact test, Wilcoxon signed‐rank tests, Mann‐Whitney U tests, and the importance‐performance analysis matrix. Results: Compared to ward nurses, ICU nurses reported lower overall knowledge level (57.1% vs 60.7%, z = −2.005, P =.045) but higher overall gap between the importance and performance of delirium care (0.5 vs 0.2, z = −4.008, P <.001). The level of overall barriers to delirium care was similar between the two groups (3.8 vs 3.8, z = −1.190, P =.234). The highest training priority, showing high importance but low performance in the importance‐performance matrix, was "family involvement and education" for ICU nurses and "non‐pharmacological management" for ward nurses. Conclusions: The highest training priority for delirium care was different between ICU and ward nurses. To enhance the delirium care competency of hospital nurses, the nurse educator should develop training programs that target knowledge deficits, perceived barriers, and training priorities. Relevance to clinical practice: Acute cognitive disturbances are common in patients hospitalized in wards and ICUs and can lead to adverse patient outcomes if not properly assessed and managed. Nurse educators need to develop and implement a training program based on the needs assessment and priorities identified in this study so that ICU and ward nurses can obtain the optimal level of delirium care competency. [ABSTRACT FROM AUTHOR]

Carboxylated graphene (CG) with functional group was blended with polyphenylene sulfide (PPS), CG enhanced the tensile, thermal properties, crystallinity and barrier performance of PPS. Through tensile test, scanning electron microscopy, X-ray diffraction, differential scanning calorimetry, thermogravimetric analysis, evaluation of S. aureus inhibition, and barrier performance, the properties of pure PPS and PPS/CG nanocomposites were characterized and compared. The FTIR results demonstrate that the reaction between the sulfur-containing linkage in PPS and the carboxylic acid group in CG culminates in the creation of both a thioester bond and a hydrogen bond. The results showed that CG acted a role in heterogeneous nucleation and reinforcement. When the concentration of CG was 0.2 %, the tensile strength, elongation at break, thermostability, crystallinity and water vapor permeability coefficients (WVPC) approached maximum values, and the microscopic morphology changed from the original brittle fracture to a relatively tough fracture. Compared with pure PPS, when CG was added to PPS at 0.2 %, the tensile strength, elongation at break and WVPC of PPS were significantly increased by 23.9%, 17.2%, and 18.3% respectively. This improvement in barrier performance might be attributed to two reasons: (1) The presence of CG extended the penetration path of molecules; (2) The hydrogen bond from PPS matrix and CG nanofiller, so as to narrow the H2O transmission path. Antibacterial testing shows that both PPS and PPS/CG nanocomposite materials exhibit excellent antibacterial properties. [ABSTRACT FROM AUTHOR]

Obesity is the most common health concern all over the world. However, till now, there is no promising way to manage obesity or body‐weight control. The aim of the study is to develop an edible gel as a health supplement that temporarily attaches to the mucus of the intestines, forming an absorption barrier to block the nutrients. We modify the alginate with the thiol group as thiolated alginate (TA) that may stay on the mucosa layer for a much longer time to reduce nutrient absorption. In this study, the TA is synthesized successfully and proved a good mucosal adhesion to serve as a barrier for nutrient absorption both in vitro and in vivo. The results of in vivo imaging system (IVIS) show that the synthesized TA can be exiled from the gastrointestinal tract within 24 h. The animal study shows that the TA by daily oral administration can effectively reduce body weight and fat deposition. The biosafety is evaluated in vitro at the cellular level, based on ISO‐10993, and further checked by animal study. We do believe that the TA could have a greater potential to be developed into a safe health supplement to manage obesity and for body‐weight control. [ABSTRACT FROM AUTHOR]

Background: Linoleate-containing acylglucosylceramide (GLC-CER[EOx], where x = sphingosine [S], dihydrosphingosine [dS], phytosphingosine (P), or 6-hydroxysphingosine [H]) in the viable epidermis serve as the precursors to the linoleate-containing acylceramides (CER[EOx]) in the stratum corneum (SC) and the corneocyte lipid envelope (CLE), both of which are essential for the barrier function of the skin. Summary: CLE formation and envelope maturation take place across the SC. Hypoxic conditions in the epidermis and anaerobic glycolysis with the production of lactic acid are important in proper SC barrier formation. Key Message: CLE formation takes place across the SC. Its formation from linoleate-containing GLC-CER[EOx] requires lipoxygenase action, but anaerobic conditions leading to lactate production and hypoxia-inducible factors are essential for proper barrier formation. A number of unanswered questions are raised regarding formation of the CLE and the epidermal permeability barrier. [ABSTRACT FROM AUTHOR]

The hemicellulose was extracted from the Stachys floridana Shuttlew. ex Benth by ultrasonic-assisted, fractional alcohol precipitation method, mixed with chitosan solution, and coated on the surface of the paper with three layers, to explore the effect of its morphology, thermal stability, barrier, mechanical properties of coated paper. The results showed that the gas barrier property of the paper coated with hemicellulose – chitosan mixed solution decreased from 180 mL/min to 0.265 mL/min, the water barrier property increased from 0 to 84.8°, and the oil barrier property increased from 0 to Kit nº11. The tearing degree of paper increased by 9.2 %, the folding resistance increased by 1296.6 %, dry and wet tensile strength and dry and wet rupture resistance were also significantly improved. The thermal stability mixed solution coated paper is slightly lower than the base paper, but higher than the pure chitosan coated paper. The prepared S. floridana Shuttlew. ex Benth hemicellulose – chitosan blend coating has good barrier property and mechanical properties, and has a wide application prospect. [ABSTRACT FROM AUTHOR]

How do meso-level field relations shape the ways that sports organizations act on gender equality? In this paper, we approach international sports governance as comprised of meso-level fields of strategic action in which male dominance and relations of masculinity are centrally at stake. We focus on the Union Cycliste Internationale (UCI), showing how the organization's efforts to address gender inequality are shaped by its relations with adjacent actors in the field. These actors jockey to form strategic coalitions as they struggle over the influence and resources to define the field configuration of international cycling, with challenges to the gendered status quo requiring careful management. Based on semi-structured interviews with individuals who held an elected or staff position within the UCI between 2005 and 2020, we show how field relations shaped the work of the UCI Women's Committee during this period as well as the experiences of women who succeeded in accessing decision-making roles. The UCI emerges in our analysis as a central governance unit via which the historical accumulation of advantage to men is preserved. We suggest that studying meso-level fields of strategic action can advance sociological research more broadly on how sports organizations are shaped by their contingent, dynamic, and (gender) unequal context. [ABSTRACT FROM AUTHOR]

Copyright of Geologia USP: Série Científica is the property of Geologia USP and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Structures constructed on rivers induce downstream oscillating vortices. These vortices apply oscillating loads on the structure and harm its stability. This paper carried out numerical simulations in SOLIDWORKS to explore the effects of the barrier shape and size on the load applied by the vortex on structures constructed in water streams. It was found that a reduction in the barrier size diminished the vortices. The highest Strouhal number was calculated to be 5.2 at a Reynolds number of 5000 and a barrier diameter of 0.09. The maximum downstream vortices were induced by the triangular barrier, and the maximum Strouhal number occurred to be 7.8 at a velocity of 0.4 and a barrier diameter of 0.05. The maximum vortices induced by the square barrier occurred at a barrier diameter of 0.05. [ABSTRACT FROM AUTHOR]

This work presents a data-centric method to use IoT data, generated from the site, to monitor core functions of safety barriers on a batch reactor. The approach turns process safety performance indicators (PSPIs) into online, globally available safety indicators that eliminate variability in human interpretation. This work also showcases a class of PSPIs that are reliable and time-dependent but only work in a digital online environment: profile PSPIs. It is demonstrated that the profile PSPI opens many new opportunities for leading indicators, without the need for complex mathematics. Online PSPI analyses were performed at the Syngenta Huddersfield Manufacturing Centre, Leeds Road, West Yorkshire, United Kingdom, and shared with their international headquarters in Basel, Switzerland. The performance was determined with industry software to extract time-series data and perform the calculations. The calculations were based on decades of IoT data stored in the AVEVA Factory Historian. Non-trivial data cleansing and additional data tags were required for the creation of relevant signal conditions and composite conditions. This work demonstrates that digital methods do not require gifted data analysts to report existing PSPIs in near real-time and is well within the capabilities of chemical (safety) engineers. Current PSPIs can also be evaluated in terms of their effectiveness to allow management to make decisions that lead to corrective actions. This improves significantly on traditional PSPI processes that, when reviewed monthly, lead to untimely decisions and actions. This approach also makes it possible to review PSPIs as they develop, receiving notifications of PSPIs when they reach prescribed limits, all with the potential to recommend alternative PSPIs that are more proactive in nature. [ABSTRACT FROM AUTHOR]

The low implementation of green building through building certification in Jakarta is responsible for the decreased achievement of reducing greenhouse gas emissions in 2020. This is observed in the energy sector through the efficient use of power in commercial buildings, which is only 37,789 tons (0.72 %) of the 5.26 million tons of CO2e expected in 2030, potentially causing the effects of a climate change-related disaster. In this case, the low prevalence of green buildings is due to the barriers preventing their implementation, with the provision of incentives being a suitable solution regarding its significant influence on rapid development. Therefore, this study aims to determine the influential relationship between barriers, incentives, and the level of green building implementation, to identify the most effective applicable benefits in Jakarta. In this context, path analysis and structural equation modeling (SEM) was used with 101 participants selected from developer/owner institutions, consultants, contractors, and the government experienced in implementing the experimental data of the buildings. These data were subsequently analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The results showed that cost-risk and knowledge-information barrier significantly impacted the level of green building implementation in Jakarta. This led to the recommendation of non-financial incentives as an effective regional benefit, which relevantly affected the level of green building implementation, as well as cost-risk and knowledge-information barriers. These results were expected to assist policymakers and practitioners in formulating effective incentive policies for the implementation of green buildings in Jakarta. [ABSTRACT FROM AUTHOR]

The isolation and integrity of a territory are recognized by jurists as one of the criteria for determining the borders of municipalities. After analyzing geographical studies of the relationships between the morphology of the intraurban territory, territorial identity, and the potential for the development of local communities, the authors of the article concluded that these criteria are not yielded by the measurement methodology; as a result, studies are limited to demarcated areas with extreme morphological characteristics. The article proposes a methodology for assessing the isolation and integrity of intraurban districts. Considering pedestrian links as the basis of intraurban municipal connections, the authors developed a technique based on a pedestrian graph, which makes it possible to obtain more sensitive estimates compared to calculations of transport accessibility. The indices of the isolation and integrity of the territorial units of St. Petersburg—raiony and municipal okruga1, as well as the integral index summarizing them, are calculated. It is concluded that the isolation and integrity of an intraurban district have a weak negative relationship with each other and are established by urban policy. Island raiony and peripheral municipal okruga with large block buildings of the 1970s demonstrate the greatest compliance with the principles of isolation and integrity. The authors announce a study of the influence of the morphology of a territory on the level of development of local self-government based on the results presented in this article. [ABSTRACT FROM AUTHOR]

In this study, a novel diethylene triamine penta(methylene phosphonic acid) (DTPMPA)- and graphene oxide (GO)-modified superhydrophobic anodized aluminum (DGSAA) coating was fabricated. The obtained coatings were characterized by scan electron microscopy, X-ray diffraction, Fourier transform infrared spectroscopy, and Raman analysis. After immersion in the supersaturated CaCO3 solution for 240 h, the scaling mass of the DGSAA coating is only 50% of that of the SAA coating. The excellent anti-scaling performance of the DGSAA coating comes from three barriers of the air layer, the DTPMPA:Ca2+ chelate, and the lamellar GO, as well as the further active anti-scaling of DTPMPA:Ca2+ at the coating-solution interface. DTPMPA and GO at the surface of the DGSAA coating exhibit an insertion structure. In the electrochemical impedance spectroscopy measurement, the impedance modulus of the DGSAA coating is three orders-of-magnitude higher than that of the anodized aluminum. The synergistic effect of DTPMPA stored in the porous structure of anodized aluminum and the barrier protection of superhydrophobicity and GO contributes to the excellent comprehensive performance of the DGSAA coating. This research provides a new perspective for designing anti-scaling and anti-corrosion superhydrophobic bi-functional coatings. [ABSTRACT FROM AUTHOR]

Abstract Acute myeloid leukemia (AML) can affect individuals of all ages, but is more common in older adults. It has been estimated that AML accounted for 1% of all newly diagnosed cancers in the USA in 2022. The diagnostic process varies depending on the presenting symptoms and the healthcare facility that patients attend at diagnosis. The treatment process is long and prone to complications, requiring experienced medical professionals and appropriate infrastructure. Treatment of the disease did not change greatly over the years until 2017 when targeted therapies were licensed. The treatment of AML is associated with significant direct economic costs. A number of obstacles originating both from individual patients and the healthcare system may be encountered during the diagnosis and treatment of the disease, which may negatively impact the optimal management of the disease process. In this article, we focus primarily on the social, operational, and financial obstacles including the corona virus disease 2019 (COVID-19) pandemic experienced during the diagnosis and treatment of AML.

Cirrhosis-related hepatic and renal endothelial dysfunction is characterized by macrophage-endothelium adhesion-mediated inflammation, glycocalyx/barrier damage, and impaired vasodilation. Activation of adenosine A2A receptor (A2AR) protects cirrhotic rats from impairment of hepatic microcirculation post hepatectomy. This study evaluates the effects of A2AR activation on the cirrhosis-related hepatic and renal endothelial dysfunction in biliary cirrhotic rats receiving two weeks of A2AR agonist PSB0777 [bile duct ligated (BDL)+PSB0777] treatment.Endothelial dysfunction in cirrhotic liver, renal vessels, and kidney is characterized by downregulation of the A2AR expressions, decreased vascular endothelial vasodilatory (p-eNOS)/anti-inflammatory (IL-10/IL-10R)/barrier [VE-cadherin (CDH5) and β-catenin (CTNNB1)]/glycocalyx [syndecan-1 (SDC1) and hyaluronan synthase-2 (HAS2)] markers, and increased leukocyte-endothelium adhesion molecules (F4/80, CD68, ICAM-1, and VCAM-1). In BDL rats, PSB0777 treatment improves hepatic and renal endothelial dysfunction, ameliorates portal hypertension, and attenuates renal hypoperfusion by restoring of the vascular endothelial anti-inflammatory, barrier, glycocalyx markers and vasodilatory response as well as inhibiting the leukocyte-endothelium adhesion. In an in vitro study, conditioned medium (CM) of bone marrow-derived macrophage (BMDM) of BDL rats [BMDM-CM (BDL)] induced barrier/glycocalyx damage, which was reversed by the PSB0777 pre-treatment. The A2AR agonist is a potential agent that can simultaneously correct cirrhosis-related hepatic and renal endothelial dysfunction, portal hypertension, renal hypoperfusion, and renal dysfunction.

Abstract Background A minority of all individuals with alcohol use disorders (AUD) seek treatment. Since the suffering from AUD has severe consequences for both the individual and for society, it is important to improve the understanding of barriers to seeking treatment. Most studies of barriers thus far have been conducted in the United States of America or the United Kingdom. There is a need for studies from other contexts. The overall aim is to investigate barriers to treatment seeking for AUD. The specific aims are to: 1) describe barriers to AUD treatment at different levels of alcohol use. 2) compare gender differences regarding barriers to AUD treatment. Methods Study design: Cross-sectional. Participants: 1594 representative Danish adults from the general population aged 30–65 years. An online questionnaire was administrated by a market research company. The questionnaire covered demographic data, barriers to treatment and level of alcohol use. Analyses were performed by means of chi-2 test and logistic regression. Results The most common barriers were related to stigma and shame: admitting to others of having a problem, being labelled, fear of the consequences and that others would find out. Participants with higher severity of alcohol use were more likely to endorse a wish to handle alcohol problems themselves and to report barriers related to treatment services. Women with high severity of alcohol use, endorsed higher level of fear of the consequences than men. Conclusions There is an urgent need to reduce stigma around AUD. Individuals with higher severity of alcohol use report a lower willingness to seek professional treatment if a problem occurs. Especially among individuals with high severity of alcohol use there is a need to address gender specific barriers.

Purple rice is susceptible to the influence of internal and external factors such as temperature, humidity and oxygen during storage, and proper packaging can effectively inhibit aging and mildew of purple rice. In this study, purple rice was packed and stored for 98 days using four packaging materials with different barrier properties, AL/PE, PA/PE single-sided embossed, PA/PE, PE/EVOH/PA/PE, and the dynamic changes of moisture content, fatty acid value, protein content, mold count, electrical conductivity, color value, color difference, E-nose odor, morphological structure and other indicators of purple rice were measured periodically during storage and correlation analysis was performed for each indicator. The results showed that the moisture content of purple rice increased and then decreased, the conductivity increased and then decreased, the △E and fatty acid value increased, the protein content increased slightly and then decreased, the mold count increased and then decreased to stable, and the electronic nose could significantly distinguish purple rice in different storage periods and different packaging materials. From the moisture content, △E, color value, fatty acid value and morphological structure indexes, the quality of purple rice packed with high barrier material PE/EVOH/PA/PE was more stable, and from the indexes of mold count and conductivity, the quality of purple rice packed with PA/PE single-sided embossed material was more stable.

Background: Effective communication between health care professionals, admitted patients, and their families is crucial to improving the health care outcomes and patient satisfaction. Hence, barriers to effective communication cause a lot of confusion, frustration, and misunderstanding. The study aimed to identify the perceived barriers to effective communication between patients, their families, and health care professionals during the COVID-19 pandemic in public hospitals in Limpopo Province. The study was conducted in rural areas of Vhembe District, Limpopo Province. Methodology: A qualitative exploratory descriptive method was adopted to explore and describe the barriers of effective communication among patients, relatives, and health care professionals during the COVID-19 pandemic in public hospitals in the Vhembe District. Eleven (11) participants were purposively selected. Unstructured in-depth individual interviews were used to collect data and analyzed using thematic analysis following Tesch’s eight steps. Results: The study findings revealed that there was ineffective communication by health care professionals. This was discussed under three themes that emerged: poor communication of diagnosis and prognosis and treatment outcomes; lack of accurate knowledge regarding the virus morphology, variant, and treatment protocols; and the inconsistencies in the dissemination of COVID-19 protocols. Conclusions: Full communication benefits both patients, relatives, and health care professionals as knowledge and understanding are enhanced through communication. Therefore, health care professionals should provide the patients and their relatives with full information about the disease and the visitation protocols to be followed. The study contribution was to explore barriers to effective communication to the patients and relatives by the health care professionals.