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Introduction: The presence of a large physiologic shunt, defined as >20 left atrial microbubbles within 3 cardiac cycles on transesophageal echocardiography (TEE), is a key, randomized controlled trial-validated, indication for patent foramen ovale (PFO) with a closure device in patients with otherwise cryptogenic ischemic stroke. The frequency with which this information is available to treating physicians from clinical TEE reports has not been well delineated. Methods: Among consecutive ischemic stroke patients admitted to an academic medical center undergoing TEE between January-June 2023, TEE reports were reviewed to determine frequency with which formal, clinical-trial definition-adherent characterization of PFO shunt size was provided, frequency of informal PFO shunt size descriptions, and correlations with transcranial Doppler (TCD) formal shunt grades (Spencer Grades 1-5). Results: Among the 50 patients, median age was 64 (IQR 58-74.5), and 20 (40%) were female. On TEE, shunt presence was assessed by bubble study in 38 (76%), direct Doppler alone in 6 (12%), and neither in 6 (12%). Among patients with bubble study, a right-to-left shunt (RLS) potentially due to PFO was present 15 (39%). RLS severity was quantified in 27% (4/15) of PFO patients, all with formally small (

Objectives. This study evaluated the functional outcome of patients with acetabular injuries using the Majeed pelvic score. The specific objectives were to assess any differences in functional outcomes among patients treated with early versus delayed surgery and those with or without concomitant injuries. Methodology. Patients from our institution, Baguio General Hospital and Medical Center, with acetabular injuries from January 2019 to December 2022, were included. Patients with acetabular fractures with or without other injuries were included. All available data sources were reviewed, such as charts from hospital records, patient census, and electronic medical records. Patients underwent physical therapy before discharge and were followed up. The patients’ outcomes after surgical intervention were assessed using Majeed's pelvic score. Results. Thirteen patients were included in the study with follow-ups ranging from one to three years. A functional assessment using Majeed's pelvic score with a mean of 83 points (range 72–100). The majority had good functional outcomes. Conclusions. Early surgical intervention may have no advantage over delayed surgeries regarding functional outcomes. However, concomitant injuries and complications may contribute to a poor to fair functional outcome.

PURPOSEShared decision making (SDM) is an approach where clinicians and patients make decisions together using the best available evidence. Although much studied, recognized to be ethically imperative, and recommended in international health policies, it remains poorly implemented. In the Philippines, there are limited studies on patient decision making preferences and SDM. Practical guidance on the implementation of SDM or use of patient decision aids (PtDAs) is often not detailed in existing national clinical practice guidelines in oncology.METHODSWe performed a systematic search of Philippine literature on SDM in oncology and an iterative review of international literature on the philosophy and methods of SDM, the utility and effectiveness of PtDAs, and the facilitators and barriers to implementation or usage. We contextualized our review to the cervical cancer management and health service delivery in the Philippines.RESULTSLocal literature is limited to five scientific publications and two registered studies. International literature encompasses patient decisional preferences, the role of PtDAs and the standards for their development and evaluation, their effectiveness, and barriers and facilitators to their use in cancer-related decision making. We discussed the implications on the management of cervical cancer in the Philippines, challenges in health service delivery and standards, and SDM research.CONCLUSIONLocal SDM research is limited. Our preliminary experience in a multicenter clinical trial in Manila on PtDA use in the framework of SDM in cervical cancer suggest good patient and clinician acceptability. Challenges to implementation such as unfavorable financial situations, urgency of clinical decisions, low patient or caregiver educational attainment, and poor integration of multidisciplinary and SDM in organizational workflows will be important when implementing SDM in different settings.

The application of the resilience concept within socioecological systems has recently received much attention. Assessing the characteristics of cocoa agroecosystems in the dry and moist semi-deciduous ecological zones has become critical for resilience analysis in this era of climate change and the constant shrinking of cocoa suitability areas. Previous studies have used one of the dimensions of resilience to analyse complex adaptive systems, excluding critical factors and variables. This study applied a multi-criteria decision-making process, the Analytic Hierarchy Process (AHP) that accommodates the three dimensions of resilience, i.e., buffer capacity, adaptive capacity and self-organisation. The AHP is a multi-criteria decision-making tool that proceeds with the design of a hierarchy system for the goal, criteria, attributes and variables. Selected cocoa farmers were assigned weights related to criteria, attributes and variables in a comparison matrix. The resilience of the cocoa agroecosystems in Offinso Municipal and Adansi North Districts was 2.75 ± 0.06 (mean ± SD) and 3.23 ± 0.10 (mean ± SD), respectively. Buffer capacity contributed the highest proportion (44.3%) in the Offinso Municipal District, followed by adaptive capacity (38.7%) and self-organisation (17%). A similar trend was recorded for the Adansi North District: buffer capacity (42.9%), adaptive capacity (42.9%) and self-organisation (14.3%). Across the two study areas, shade trees, crop diversification, soil quality, cocoa variety, farm size, farm age, alternative livelihood, annual income and co-operative membership contributed prominently to the construction of cocoa agroecosystem resilience. The assessment of agroecosystem resilience is location-specific, and the study provides a simplified methodology for evaluating resilience. The paper aims to understand the importance of the components of the cocoa agroecosystem, and a simplified methodology for evaluating its resilience to perturbations. It presents a conceptual and methodological framework for the analysis and measurement of agroecosystem resilience in a participatory manner.

Background: In India, intimate partner violence against women is a major problem that leads to terrible physical, sexual, emotional, psychological and economic consequences. In 55-92% of women who have a history of being abused wives, high levels of symptoms of post-traumatic stress disorder have been discovered. Therefore, the quality of life is significantly low among them regardless of regions and countries. The purpose of the current study was to create and evaluate the effectiveness of a self-supportive intervention on the quality of life and post-traumatic stress symptoms among abused wives in Madhya Pradesh, India. Methods: The post-traumatic Symptoms Scale Interview version for DSM-5 (PSS-I-5) and WHO Quality of Life-BREF (WHOQOL) were used in this study as assessment tools. The Need assessment results showed that 51% of battered wives met the criteria of PTSD symptoms from moderate to severe and 83% experienced low quality of life. This study utilized a mixed research method and was executed in three phases, based on the main three elements of Conklin’s (1997) program development model, namely (1) planning; (2) design and implementation; and (3) evaluation of the newly created Self-Supportive Intervention program (SSI). The SSI program consisted of six modules, focused on addressing the issues that emerged through qualitative data and need assessments. Results: Excellent inter-rater reliability (.845) was found in the expert evaluation's findings, which supported the recommendation to use the SSI as it is with minor modification. The SSI was further pilot-tested for its feasibility with 10 battered wives and validated through the paired sample t-test, which showed a substantial decrease in post-traumatic stress symptoms and enhanced quality of life at 0.05 level of significance. Conclusion: This is an indication that the SSI program can be recommended as a psychological intervention in eliminating the PTSD symptoms and improving the quality of life.

This study examines the relationship between quality of work life (QWL) and employee performance in a specific industry (e.g., manufacturing, healthcare, etc.). Utilizing a mixed methods approach, the research combines quantitative and qualitative data to provide a comprehensive understanding of the factors influencing employee performance. The study surveyed 70 participants, revealing a diverse demographic profile. The majority of respondents were male (57.10%) and aged between 26-35 years (55.70%). The data analysis focused on identifying the correlation between QWL factors, such as job morale, safety, and work environment, and employee performance. In-depth interviews were conducted with two employees and two managers to gain a deeper understanding of the subjective experiences and perceptions of QWL. The interviews explored the impact of various QWL factors on employee motivation, job satisfaction, and overall performance. A statistically significant positive correlation was found between QWL and employee performance, indicating that improved QWL leads to increased employee performance. The study identified several key QWL factors that significantly impact employee performance, including: Job Morale a healthy work environment, fair treatment by supervisors, and opportunities for continuous learning contribute to high job morale and improved performance. Safety employees who feel secure and safe in their work environment are more likely to perform at their best. Information Sharing employees who feel empowered to express their opinions and contribute to decision-making processes demonstrate higher levels of engagement and performance. Human Resources Support a responsive and effective human resources department that addresses employee needs and concerns fosters trust and improves performance. Workplace Amenities adequate office furniture and a comfortable work environment contribute to employee well-being and performance. The findings suggest that organizations should prioritize QWL initiatives to enhance employee performance and achieve organizational goals. By fostering a positive work environment, providing adequate support, and empowering employees, organizations can create a culture that attracts and retains top talent, leading to improved productivity and overall success. The study is limited by its sample size and specific industry focus. Further research is needed to generalize the findings to other industries and populations. Future research should explore the long-term impact of QWL initiatives on employee performance, retention, and organizational success. Additionally, investigating the role of cultural factors and organizational leadership in shaping QWL and its impact on employee performance is crucial. [ABSTRACT FROM AUTHOR]

The study was conducted to describe the solid waste management of selected higher education institution in the city of Dasmariñas, Cavite. Specifically, it aimed to describe the school characteristics of private colleges; describe the types and volume of solid waste generated daily by the private colleges; determine the solid waste management practices employed by the private colleges for different type of solid wastes; identify the problems encountered by the private colleges on solid waste management; identify the solid waste management policies complied by the private colleges; and determine if there is a relationship between solid waste generated and school characteristics. The participant schools were 29 private colleges in the City of Dasmariñas, Cavite. The respondents are the Pollution Control Officer or the person in-charged of solid waste management of private colleges in Cavite. There was also the participation of 200 students divided proportionally by the number of private colleges to make the study more reliable. Most of the respondents revealed that among the top solid waste that they generate is recyclable wastes in Rank 1; followed by biodegradable wastes then hazardous wastes. The least generated among the wastes is residual waste, all of them generated less than 25kg of residual wastes per day. They used various ways of storing their wastes but the most used is garbage bags, with regards to the collection/transportation of solid wastes to disposal sites, most schools relied on the local government units and only a handful were in contract with private firms to collect and transport their solid waste. Solid wastes from these schools are collected by LGU's weekly and private firms on a daily basis. Schools also employed certain methods of disposing of their wastes. Most of them chose land filling as their own way of disposal (48.28%). The rest used open dumping, composting, and incineration. From the study it was also found that the type/volume of solid wastes generated by schools is significantly associated with the schools' years of existence, population of students, faculty and staff, and operation hours per day. [ABSTRACT FROM AUTHOR]

Adolescents exposed to interparental conflicts (IPC) are highly vulnerable regarding their externalizing behaviors. Interventions are therefore necessary in a situation like this. Research findings suggest a noteworthy correlation between externalizing behaviors and adolescents who experience IPC. The focus of this study was to develop, evaluate, and implement a pilot program for an intervention that would reduce the externalizing behaviors that adolescents exposed to IPC exhibit. Conklin's developmental model was utilized in the program's development, and focus groups, interviews, and the Youth Self-Report scale were employed to fathom the main problems. This newly developed 'Self-Empowerment Program' (SEP), which integrated self-efficacy and coping theories, was implemented over six weeks. Each session lasted 60 minutes and included specific activities and topics covered in each session. The program was conducted for 10 adolescents. The single-group pilot study results showed that the participants' pre-and post-test scores differed significantly. After participating in the Self-Empowerment Program (SEP), adolescents who exhibited externalizing behaviors due to the interparental conflict showed a considerable improvement in their sense of self-empowerment, self-efficacy, and coping. [ABSTRACT FROM AUTHOR]

Adolescents frequently experience stress from interparental conflict, and their perception of it has a significant role in the problem behaviors that they exhibit. The study aimed to develop and examine the efficacy of the Self- Empowerment Program (SEP) with nine modules in reducing the externalizing behaviors of adolescents exposed to interparental conflict. Conklin's three-phase program development model planning, design and implementation, and assessment and program validation were used in this study. Adolescents (N=385, 11-18 years old) from Assam, India, comprised the participants. They were randomly split into the experimental group (n = 21) and the control group (n = 21), using a randomization process to ensure unbiased group assignment. Focus group discussions, interviews, and the Youth Self-Report Scale evaluated the severity of the issue. The post-test results between the experimental and control groups made a noteworthy distinction. This distinction was seen for example, in the experimental group: Externalizing Behavior: M=26.61, SD=2.65,Social Problem: M=5.95, SD=1.49; Rule breaking, M=3.38, SD=.864; Aggressive behavior, M=6.57, SD=1.32; and in the control group, Externalizing behavior: M=25.23, SD=2.64, Social Problem=8.42, SD=1.07; Rule breaking: M=6.76, SD=1.22; Aggressive behavior: M=10.04, SD=1.71. The Pre-test and post-test scores of the experimental group (Pre-test: Experimental group: M=26.61, SD=2.65, Social Problem: M=8.76, SD=1.22; Rule breaking: M=7.0, SD=1.26; Aggressive behavior: M=10.8, SD=1.71; Post-test: Externalizing behavior: M=15.90, SD=2.27, Social Problem: M=5.95, SD=1.49; Rule breaking: M=3.38, SD=.864; Aggressive behavior=6.57, SD=1.32) indicated that the nine modular program of SEP has proved and helped to reduce the externalizing behaviors in adolescents exposed to IPC. [ABSTRACT FROM AUTHOR]

Background: Every year thousands of medical graduates go abroad to pursue higher education after completing MBBS in India. This consistent rush of medical graduates abroad can negatively impact India’s health care. This study is conducted to find the prevalence of intention among medical interns to pursue higher education abroad and to identify the factors influencing the pursuit of higher education abroad. Methods: Ethical Clearance: Institutional ethical clearance was given on May 11, 2023, vide letter no. SGRD/IEC/2023-190. Study Design: Cross-sectional study. Study Population: MBBS Interns of medical colleges in India. Study Tool - Predesigned and Pretested questionnaire. Data Collection Procedure: The questionnaire was shared through Google Forms in specific social WhatsApp groups. Data Collection Duration: Google forms were circulated on 1st June 2023, and closed on 1st July 2023. A total of 417 interns who gave consent were able to access the questionnaire and fill in their answers. Statistical Analysis: Relevant descriptive and inferential statistics were used to arrive at valid conclusions. Conclusion: Lower educational costs, greater stipends, less competition for admission, better healthcare facilities, opportunities for personal improvement, and better career option semerged as major influencing factors for the pursuit of higher education abroad. [ABSTRACT FROM AUTHOR]

Cultivation of dragon fruits (Selenicereus spp.) has health and commercial benefits, which are threatened by the presence of destructive diseases affecting this crop. In this study, a pathogenic isolate was obtained from a diseased stem of Selenicereus monacanthus (red peel, red flesh) in Luzon, Philippines. The causal agent of the disease was identified using combined morphological, cultural, pathogenicity, and molecular characterization. Colony and spore morphologies indicate that the pathogen belongs to the genus Colletotrichum. DNA sequences of the partial internal transcribed spacer, actin, glyceraldehyde-3-phosphate dehydrogenase, and beta-tubulin gene regions confirmed that the isolate was Colletotrichum tropicale. Anthracnose developed in S. undatus (red peel, white flesh) and S. monacanthus inoculated with C. tropicale. However, the isolate did not infect S. megalanthus (yellow peel, white flesh). To our knowledge, this is the first report of C. tropicale causing dragon fruit anthracnose. This study also provides evidence that resistance to anthracnose exists in the Selenicereus species. Because S. monacanthus and S. undatus have commercial significance, management strategies would be needed. Dragon fruit breeding programs using S. megalanthus as a source of resistance to anthracnose would be worthwhile. [ABSTRACT FROM AUTHOR]

The application of the resilience concept within socioecological systems has recently received much attention. Assessing the characteristics of cocoa agroecosystems in the dry and moist semi-deciduous ecological zones has become critical for resilience analysis in this era of climate change and the constant shrinking of cocoa suitability areas. Previous studies have used one of the dimensions of resilience to analyse complex adaptive systems, excluding critical factors and variables. This study applied a multi-criteria decision-making process, the Analytic Hierarchy Process (AHP) that accommodates the three dimensions of resilience, i.e., buffer capacity, adaptive capacity and self-organisation. The AHP is a multi-criteria decision-making tool that proceeds with the design of a hierarchy system for the goal, criteria, attributes and variables. Selected cocoa farmers were assigned weights related to criteria, attributes and variables in a comparison matrix. The resilience of the cocoa agroecosystems in Offinso Municipal and Adansi North Districts was 2.75 ± 0.06 (mean ± SD) and 3.23 ± 0.10 (mean ± SD), respectively. Buffer capacity contributed the highest proportion (44.3%) in the Offinso Municipal District, followed by adaptive capacity (38.7%) and self-organisation (17%). A similar trend was recorded for the Adansi North District: buffer capacity (42.9%), adaptive capacity (42.9%) and self-organisation (14.3%). Across the two study areas, shade trees, crop diversification, soil quality, cocoa variety, farm size, farm age, alternative livelihood, annual income and co-operative membership contributed prominently to the construction of cocoa agroecosystem resilience. The assessment of agroecosystem resilience is location-specific, and the study provides a simplified methodology for evaluating resilience. The paper aims to understand the importance of the components of the cocoa agroecosystem, and a simplified methodology for evaluating its resilience to perturbations. It presents a conceptual and methodological framework for the analysis and measurement of agroecosystem resilience in a participatory manner. [ABSTRACT FROM AUTHOR]

Ensuring good quality of life (QoL) among persons with diagnosed HIV (PWH) is a priority of the National HIV/AIDS Strategy (NHAS), which established 2025 goals for improving QoL. Goals are monitored through five indicators: self-rated health, unmet needs for mental health services, unemployment, hunger or food insecurity, and unstable housing or homelessness. Among the growing population of PWH aged ≥50 years, progress toward these goals has not been assessed. Data collected during the 2017--2022 cycles of the Medical Monitoring Project, an annual complex sample survey of U.S. adults with diagnosed HIV, assessed progress toward NHAS 2025 QoL goals among PWH aged ≥50 years, overall and by age group. The recent estimated annual percentage change from baseline (2017 or 2018) to 2022 was calculated for each indicator. Among PWH aged ≥50 years, the 2025 goal of 95% PWH with good or better self-rated health is 46.2% higher than the 2022 estimate. The 2025 goals of a 50% reduction in the other indicators range from 26.3% to 56.3% lower than the 2022 estimates. Decreasing hunger or food insecurity by 50% among PWH aged ≥65 was the only goal met by 2022. If recent trends continue, other NHAS QoL 2025 goals are unlikely to be met. Multisectoral strategies to improve access to housing, employment, food, and mental health will be needed to meet NHAS 2025 goals for QoL among older PWH. [ABSTRACT FROM AUTHOR]

Adolescents' general growth is greatly aided by their families, which are crucial in shaping their emotional, behavioral, social, and academic outcomes and interpersonal relationships. The conflict between parents can significantly hinder this growth, leading to externalizing and internalizing behaviors and affecting their overall functioning. This study compiles pertinent data to identify IPC's dimensions, elements, and effects on adolescents. This scoping review examined the literature using both inclusion and exclusion criteria. Out of 120 relevant publications, 15 were evaluated. The publications were found in electronic databases like PubMed, Scopus, Research Gate, and Google Scholar and were published between 2016 and 2023. The search strategy adhered to Arksey and O'Malley's five-step protocol, which included formulating a research question, locating pertinent literature, choosing a subset of the literature for assessment, graphing data from particular publications, and summarizing and presenting the findings. This literature review indicates that IPC is a serious problem that results in adolescents' externalizing behaviors. The results of this scoping review have consequences for policy and practice. Given the significant extent and weight of adolescent exposure to interparental conflict, the need of the time is to develop an intervention program to protect this vulnerable population and reduce their externalizing behaviors. [ABSTRACT FROM AUTHOR]