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Background Hand hygiene is the simplest and most effective method to prevent hospital acquired infections (HAI). Compliance with hand hygiene among health providers is, however, widely variable due to significant knowledge gaps and behavioral issues. The knowledge and practices of hand hygiene among medical undergraduate students, the future health workforce in the current COVID-19 pandemic will enable a reality check and ensure course correction at an early stage of their learning. Methods An online questionnaire-based survey based on a standard, validated WHO 25-point (multiple-choice question and Yes/No answers) hand hygiene survey was undertaken among medical undergraduate students in an urban city from April to June 2020. Each correct response was awarded 1 point, and an incorrect response was awarded 0 points. The maximum achievable score was 25, and the minimum score was 0. Results A total of 457 students with a mean age 20.24 ± 1.27 years completed the survey. A total of 415 (90.8%) students received hand hygiene training in the past three years. Overall 27.6% (n = 126) students had good knowledge, 65.4% (n = 299) had moderate and 7% (n = 32) had poor knowledge of hand hygiene practices. Conclusions There were significant knowledge gaps regarding hand hygiene among medical undergraduate students in the midst of the COVID-19 pandemic. There is a need to strengthen existing teaching methods to positively impact behavioral change and potentially translate into better hand hygiene compliance among the future health workforce of the country.

Anyone who desires to improve their standard of living, alleviate poverty, and have an opportunity over others regarding employment and profession needs to receive an education. However, there are various struggles that students encounter in their journey. Thus, this qualitative study scrutinized the financial challenges of grade 11 students and how they cope with them. Twelve (12) informants eligible to participate in the study were interviewed through focus group discussion (FGD). In utilizing Colaizzi’s method, three themes emerged, and these are (1) Insufficient amount of daily allowance, (2) Relying on one income, and (3) Prioritization of Wants over Needs. Most informants revealed that they only have an average daily budget of fifty pesos, with almost half of that amount going toward transportation expenses, forcing them to forgo buying food for their snacks. Also, relying on one source of income is seen as a financial challenge because some of the informants have siblings who are also enrolled in school, necessitating them to take on side jobs to supplement their income. They prioritize their wants over their necessities, another noteworthy response from the informants. They assert that they must change their perspective and put personal needs before personal wants when making financial decisions. The researchers concluded that teachers should spend some time engaging in in-depth dialogues with their students and giving them a variety of inquiries about their lives and daily activities.

Engagement with Russian civil society is the least contested part of the EU’s current and expected future approach to Russia. There is broad agreement on the need to conduct a dialogue with Russian citizens and to facilitate people-to-people contacts, as well as to support civil society as such. However, this general goal is not fully matched by a clear understanding of what the basic features and sentiments of Russian society are today. This article seeks to sketch an unvarnished picture of Russian society, knowledge of which is essential for the effective design and successful conduct of any engagement activities (their formats, channels of communication and content). The key problems include the lack of enthusiasm among ordinary Russians for the European project, and their growing confusion—fuelled by authoritarian control and disinformation—about European institutions and norms.

The problem of gross discrepancies between educational inclusive policy rhetoric for learners with disability and applicability of such intentions in implementation has raised concerns of stakeholders in Zimbabwe. This paper examines whether or not policy prescriptions by the Zimbabwe Ministry of Primary & Secondary Education (MoPSE) for the primary level learners with difficulties are aligned or mis-aligned to actual implementation actions that are a reality on the ground. The paper interrogates these issues with regards to provision of specialised support services, checking if these are fulfilled for learners with disabilities, and argues that if they do not occur, then learning is impeded. The study was located in the interpretive paradigm which used a qualitative approach and a case study design. Participants were drawn from the Metropolitan Provincial Psychological Services team, Parents of children from one selected school and a head of school in the same Province. Results showed that while to a limited extent the specialists identified a few children in the province as falling in the learning difficulties category, the greater number was not identified. Of those identified, specialists hardly serviced them because of lack of resources and this constituted a mismatch of the pronounced claims with what is happening. The paper advances calls for advocacy for policies to be suitably aligned to the expectations purported in ministry claims.

Expansion of JEV from its historical rural origin in the Oriental Realm has been evident. Apprehensions were raised by several investigators that the occurrence of Japanese Encephalitis (JE) in the urban areas is a possibility. Creating wetlands, rice farms, and piggeries close to the rural-urban periphery to support the increasing urban population facilitates the migration of mosquitoes, ardeid birds, and pigs in these areas. The presence of vectors (Culex vishnui complex), reservoirs (the ardeid birds), and the amplifying hosts (pigs) together in these urban and peri-urban areas creates highly conducive situations for the JE transmission thus, creating an urban ecotype for JE. Apart from the primary vectors, JEV has been isolated from several species of mosquitoes belonging to different genera. JE antibodies have also been detected in several birds and mammals other than the known reservoirs and amplifying hosts. Such mosquitoes, birds, and mammals might be acting as complementary or maintenance vectors and reservoirs, respectively, which likely can keep the virus circulating perennially in nature. The reported occurrence of JE in urban areas from different geographical locations is decidedly indicative of the reality of the urban JE. It is thus pertinent that an inclusive approach encompassing sustained epidemiological surveillance and monitoring be adopted to formulate season-wise and area-wise strategies to contain JE both in rural and urban areas. How to cite this article:Bhattacharya S, Sinha S, Bose C, Chatterjee P, Tilak R. Urban Japanese Encephalitis: Time for a Reality Check. J Commun Dis 2021; 53(1): 72-77. DOI: https://doi.org/10.24321/0019.5138.202112

How well are school library media programs realizing the mission, objectives and challenges set by Information Power? Teacher-librarians are struggling to realize its ideals in less than ideal circumstances. To gain a broader understanding of their work and success, this paper studies 48 good library media programs in New England Region, U.S. using a combination of qualitative and quantitative methods to ensure the perceived success of participating programs in conforming to the national guidelines.

By definition, Building with Nature solutions utilise services provided by the natural system and/or provide new opportunities to that system. As a consequence, such solutions are sensitive to the status of, and interact with the surrounding system. A thorough understanding of the ambient natural system is therefore necessary to meet the required specifications and to realise the potential interactions with that system. In order to be adopted beyond the pilot scale, the potential impact of multiple BwN solutions on the natural and societal systems of a region need to be established. This requires a ‘reality check’ of the effectiveness of multiple, regional-scale applications in terms of social and environmental costs and benefits. Reality checking will help establish the upscaling potential of a certain BwN measure when addressing a larger-scale issue. Conversely, it might reveal to what extent specific smaller-scale measures are suitable in light of larger regional-scale issues. This paper presents a stepwise method to approach a reality check on BwN solutions, based on the Frame of Reference method described in a companion paper (de Vries et al., 2020), and illustrates its use by two example cases. The examples show that a successful pilot project is not always a guarantee of wider applicability and that a broader application may involve dilemmas concerning environment, policy and legislation.

Artificial intelligence (AI) is being increasingly explored in different domains of gastroenterology, particularly in endoscopic image analysis, cancer screening, and prognostication models. It is widely touted to become an integral part of routine endoscopies, considering the bulk of data handled by endoscopists and the complex nature of critical analyses performed. However, the application of AI in endoscopy in resource-constrained settings remains fraught with problems. We conducted an extensive literature review using the PubMed database on articles covering the application of AI in endoscopy and the difficulties encountered in resource-constrained settings. We have tried to summarize in the present review the potential problems that may hinder the application of AI in such settings. Hopefully, this review will enable endoscopists and health policymakers to ponder over these issues before trying to extrapolate the advancements of AI in technically advanced settings to those having constraints at multiple levels. How to cite this article: Anirvan P, Meher D, Singh SP. Artificial Intelligence in Gastrointestinal Endoscopy in a Resource-constrained Setting: A Reality Check. Euroasian J Hepato-Gastroenterol 2020;10(2): 92–97.

The Andean Cordillera is generally regarded as the product of easterly subduction of oceanic lithosphere below South America since the Late Triassic, but recent syntheses have challenged this paradigm. In one model, W-dipping oceanic subduction pulls the continent west until it collides with a ribbon continent that now forms the coastal region and Western Cordillera of the Peruvian Andes. A second model involves westerly oceanic subduction until 120 to 100 Ma, without the involvement of a ribbon continent, to explain deep, subducted slabs revealed by mantle tomographic images. Both assume that “Andean-style” E-dipping subduction did not exist during the Jurassic and Early Cretaceous. Another model, also involving mantle tomography, assumes that a back-arc basin opened inboard of the trench between 145 and 100 Ma, displacing the E-dipping subduction zone offshore without changing its polarity. This article examines the implications of these hypotheses for southern Peruvian metallogenesis during the Mesozoic, when marginal basins opened and closed and were thrust eastward and then were intruded, between 110 and ~50 Ma, by a linear belt of multiple plutons known as the Coastal Batholith. The earliest mineralization in southern Peru is located on the coast and comprises major iron oxide and minor porphyry copper deposits emplaced between 180 and 110 Ma. This was followed by Cu-rich iron oxide copper-gold deposits and a large Zn-rich volcanogenic massive sulfide (VMS) deposit between 115 and 95 Ma, then minor porphyry Cu deposits at ~80 Ma. A second episode of localized VMS mineralization followed at 70 to 68 Ma, then a group of at least five giant porphyry Cu-Mo deposits in southernmost Peru formed between 62 and 53 Ma. The conventional model of Andean-style subduction, which explains many features of Mesozoic Andean metallogenesis in terms of changing plate vectors and velocities, is a poor fit with mantle tomographic anomalies that are thought to record the paleopositions of ancient trenches. A ribbon-continent model requires some plutons of the Coastal Batholith to have been separated from others by an ocean basin. West-dipping oceanic subduction does not account for Jurassic mineralization and magmatism in southern Peru. A model involving a back-arc basin that opened inboard of the existing trench, forcing E-dipping subduction to retreat offshore between 145 and 100 Ma, seems to best explain the metallogenic and tomographic data.

What can one say to the self-deceived? And – perhaps more importantly – who can say it? The attribution of self-deception depends heavily on the criteria for what is thought to be beyond dispute. For Galeotti, misperception of reality is a product of psychological and emotional pressure resulting in ‘emotionally overloaded wishes’, and her solution thus involves the construction of what an ‘impartial’ and ‘dispassionate’ observer would conclude when presented with the same evidence. Drawing on her examples of foreign policy decision-making, I discuss two objections. First, I ask whether being ‘dispassionate’ is enough get one off the hook from the sorts of value judgements that must be made in assessing evidence in complex situations. Second, I address the role of disagreement and dissent, and suggest that what is required are not actors with a lack of emotionally overloaded wishes, but actors with different goals and wishes. Thus, while Galeotti emphasizes solutions drawing on ideals of impartiality, we might more productively look for solutions that engage multiple forms of partiality.

The purpose of the study: This research explores issues related to human mobility trend reflecting an increasing outflow of intellectual talents by surveying the migration propensity of future professional labours in Malaysia using small samples from selected universities having different establishment orientation and student compositions. It also surveys factors of their migration intention decisions. Methodology: A quantitative approach utilizing a questionnaire survey distributed to final year students was adopted. A total of 193 usable responses are used in the analysis covering descriptive and mean differences across five identified dimensions of gender, race, academic performance, university type, and education financing. Main Findings: The results indicate that 51% of the respondents have the intention of leaving the country, the majority of whom are private university students, females, Malays, studies funded by education loans, and those from the average group of academic achievement. The low economic reward was ranked first as the main factor in influencing their migration decision. Surprisingly, the worldwide application of accounting-based knowledge plays little role in students’ decision of migrating abroad, signalling students' inability to appreciate the economic consequence of mastering such knowledge and skills. Implications: The research contributes to the public policy debate with respect to education and human mobility by providing a strong basis for a reality check on the sustainability of Malaysia’s future landscape of its professional labour market. It also feeds critical policy inputs for all stakeholders involved, particularly the employers, in providing future Malaysian professionals with a conducive, meaningful, and rewarding career to attract and retain them.

Changes in the higher education sector globally have resulted in the transition from an elite to a mass model of education, encouraging the participation of students who have traditionally been und...

To better study human neurodevelopment, researchers advance organoids as brain models.

The built environment is hard to decarbonize but has a pivotal role in climate-change mitigation amid rapid urbanization. Substituting conventional building materials with bio-based materials that store carbon offers one possible solution. Here, we reflect on the capacity of global forests to deliver the floor area required by mid-century.

In the context of the debate on the global imbalances, this study investigates the determinants of US trade balance in a Non-linear ARDL framework which accounts for the asymmetric and nonlinear effects of real effective exchange rate dynamics. Drawing on the data from 1994Q1 to 2018Q1, our key empirical findings suggest significant evidence of short and long-run asymmetries in the relationship between the real effective exchange rate, US trade balance and its determinants. An asymmetric cumulative dynamic multiplier analysis shows evidence of an asymmetric J-curve. Furthermore, we find that the price stability, productivity, domestic savings and fiscal deficit/discipline are crucial for the US trade balance in the short to long term. Empirical findings of this study contribute to the contemporary debate on the US trade deficit and have profound policy implications for the competitiveness of the US economy and its external balance.

With limited budgets and increasing enrollment demands, colleges need fast, free, and practical solutions supporting academic success and retention. The Academic Reality Check (ARC) tool helps to predict traditional freshmen awareness of their own academic expectations in college quickly, supporting the financial investment being made by all stakeholders. Similar inventories exist but they are costly, complicated, or both. The ARC tool is a valid, reliable, fast, free, and practical option. The ARC tool is available on a free website, so students, advisors, and faculty can access it easily. Students can complete the ARC tool in approximately 10 minutes and get an immediate academic success indicator score related to class attendance, attention, and note taking; time management and organization; study expectations and learning strategies; resources; and reading, writing, and homework.

The European project CONFIDENCE identified, conceptualised and addressed social uncertainties through a multi-method research approach. The research highlighted the uncertainties faced by publics, emergency management actors and decision-makers in nuclear emergencies and during the recovery phase. It showed that nuclear emergency management is dominated by decisions under uncertainties, that non-experts face also different uncertainties than experts, that emergency plans need a (continuous) reality check and that sound communication, openness and transparency about uncertainties may contribute to better decisions. It also suggests that national emergency response and recovery policies should consider and support the capacity of local actors to deal with an emergency or post-accident situation, for instance by carrying out their own measurements. This way, social uncertainties can be addressed and in some situations reduced, and the communication improved.

Populist parties in government show high levels of resilience despite their policy failures. The inevitable reality check and the failure of populist parties to implement their proposed policies do...

Environmental changes are about to invade every aspect of human life (and all life) across the planet. Young people will be particularly affected by these changes; regions where large youth populat...

Aim This study was conducted to evaluate the knowledge and the awareness on odontolegal practice with more emphasis on significance of maintaining dental records by the oral health professionals. Materials and methods A cross-sectional study was carried out among 120 dental practitioners of Jammu and Kashmir, Himachal Pradesh, Delhi, Punjab, Gujarat, and Odisha. A questionnaire was designed to assess their practice and knowledge regarding the importance of maintenance of dental records and the knowledge about dental jurisprudence. Total 120 questionnaire samples were distributed among dental health professionals, and the data obtained were studied and formulated for significance of dental records. Results Feedback obtained was then analyzed. Seventy percentage of the dentists are not maintaining clinical records of their patients and 20% of the dentists acknowledged that they are not keeping or maintaining dental records like X-rays and cast models of their patients. Eighty percentage of dentists were not known to the ethical importance of dental record, i.e., for how long they have to maintain records of their patients and other details. Conclusion This study concludes that the oral health professionals lacked the knowledge and awareness about odontolegal aspects and the significance of maintaining dental records. It was observed that there was insufficient knowledge about medicolegal systems and there is a need to bring awareness and knowledge of the same in the dental fraternity. Clinical significance With the increasing use of medical insurance and subsequently mediclaims, negligence suits, scientific evaluation, and research purposes, and health planning, etc., the "dental records itself have evolved as a separate science and therefore needs to be considered in the curriculum for dental students as this would introduce the concept for application in their future practice, thus avoiding legal complications in the future." How to cite this article Kaul B, Gupta S, Vaid V, et al. Emulating Odontolegal Practice: A Paradigm Shift in the Dental Practice Laying More Emphasis on Dental Records-A Perspective and Contemporary Study with a Reality Check. Int J Clin Pediatr Dent 2020;13(3):217-220.

As the college admissions scandal (Operation Varsity Blues) story evolved over the past year, the reporting covering it has reached a level of absurdity that is breathtaking. My breaking point came a few days ago, so I decided to try to contextualize the narrative. Here is a humble reality check for those who were misled into believing that this story is newsworthy. In the end, Operation Varsity Blues will produce little of enduring value beyond increasing media advertising revenue and advancing a few political careers.

The proliferation of digital theatre signals a new era of theatrical experiences. The Royal Shakespeare Company's (RSC) Dream is a recent example of how theatre companies are integrating cutting-edge technology to revolutionise their performances. Emerging from the Audience of the Future (AF) program, Dream combined gaming and theatre technology to create a virtual world for audiences to inhabit and explore digitally. The production incorporated motion-capture technology and Virtual Reality (VR) headsets, allowing seven actors to perform live from a purpose-built studio while audiences simultaneously accessed their performance from a compatible device via a bespoke website (https://dream.online). The resulting experience combined live and virtual performance elements to connect global audiences.This venture into technologically enhanced theatre, however, raises questions about the potential implications of audience engagement with digital productions. In this paper, we question how RSC's Dream combined both live and virtual theatre experiences to offer a more interactive viewing experience. We argue that while Dream signalled an exciting step in the development of digital theatre, the interactive features revealed some discrepancies between RSC's goals and the degree of involvement delivered. We thus contend that for theatre organisations to incorporate digital technologies, they must tend to the nuances of technological interventions and weave them seamlessly with theatrical elements to retain the fidelity of the theatre experience.

Antiphospholipid antibodies (aPL) comprise a panel of autoantibodies that reflect a potential prothrombotic risk in several autoimmune conditions, most notably antiphospholipid (antibody) syndrome (APS). aPL can be divided into those that form part of the laboratory criteria for APS, namely, lupus anticoagulant (LA), as well as anticardiolipin antibodies (aCL) and anti-β2-glycoprotein I antibodies (aβ2GPI) of the immunoglobulin G and M classes, and those that form a group considered as “noncriteria antibodies.” The noncriteria antibodies include, for example, antiphosphatidylserine antibodies (aPS), antiprothrombin antibodies (aPT), and antiphosphatidylserine/prothrombin complex antibodies (aPS/PT). COVID-19 (coronavirus disease 2019) represents a prothrombotic disorder, and there have been several reports of various aPL being present in COVID-19 patients. There have also been similarities drawn between some of the pathophysiological features of COVID-19 and APS, in particular, the most severe form, catastrophic APS (CAPS). In this review, we critically appraise the literature on aPL and COVID-19. This is a companion piece to a separate review focused on LA. In the current review, we primarily concentrate on the so-called solid phase identifiable aPL, such as aCL and aβ2GPI, but also reflect on noncriteria aPL. We conclude that aPL positivity may be a feature of COVID-19, at least in some patients, but in general, identified “solid-phase” aPL are of low titer and not able to be well-linked to the thrombotic aspects of COVID-19. Also, most publications did not assess for aPL persistence, and where persistence was checked, the findings appeared to represent transient aPL. Importantly, high-titer aPL or multiple aPL positivity (including double, triple) were in the minority of COVID-19 presentations, and thus discount any widespread presence of APS, including the most severe form CAPS, in COVID-19 patients.