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AbstractThe practice of information technology (IT) in academic libraries is changing rapidly, not only with new and evolving developments in the technologies themselves but also with the organization and management of IT at both the library and institution levels. This study presents the results of an online survey of Association of Research Libraries (ARL) academic library members to identify the biggest challenges they perceive in the area of information technology organization and management. This article compares their responses with challenges reported in earlier studies to identify new and changing trends as well as ongoing challenges that remain. [ABSTRACT FROM AUTHOR]

Urban big-system library systems have undergone seismic change over the past 20 years, becoming community centers in addition to repositories of information. As a result, contemporary library staff are facing new needs and challenges that their predecessors did not. This article explores different ways in which library leaders can hire, train, and support staff to successfully serve their communities. [ABSTRACT FROM AUTHOR]

The current study explored coach and athlete reactions and challenges leading up to the Tokyo 2020 Paralympic Games, with a specific focus on the impacts of the COVID-19 pandemic and the Games' postponement. Nine Australian Paralympic coaches (n = 3) and athletes (n = 6) shared their experiences in semistructured interviews. The thematic analysis highlighted how participants experienced the emergence of the pandemic in different ways, but all were relieved when the late but eventual decision to postpone the Games was made. Regarding lockdown periods (i.e., social-distancing restrictions), some coaches and athletes thrived under the new reality (i.e., training from home, online coaching) while others had more difficulty adjusting. Furthermore, results highlight the many uncertainties still remaining, which continue to influence participants' sport and personal lives. The experiences of coaches and athletes during the COVID-19 pandemic sheds light on strategies and resources that could support Paralympic coaches and athletes during current and future crises. [ABSTRACT FROM AUTHOR]

Aims Background Design Methods Results Conclusion Impact Patient Contribution The aim was to explore how representatives from the different professions in the surgical team experience roles, responsibilities and challenges in positioning the surgical patient.Appropriate patient positioning on the operating table during surgery is vital for optimal anatomical exposure, access to essential equipment, patient comfort and to minimize the risk of injuries. Patient positioning has been described as a shared responsibility of the entire surgical team. The research on roles and responsibilities in patient positioning during surgery is sparse.The study had a qualitative design, including 16 individual, semi‐structured interviews, conducted in November and December 2023.Participants included surgeons (n = 4), anaesthetists (n = 4), operating room nurses (n = 4) and nurse anaesthetists (n = 4) in a hospital in Southeastern Norway. The data were analysed using Braun and Clarke's six‐step Reflexive Thematic Analysis.Three main themes with subthemes were identified, namely (1) A teamwork approach, with subthemes (a) facilitating surgery and (b) health professionals' roles and responsibilities. (2) A patient safety issue, with subthemes (a) risk patients and (b) procedural challenges. (3) Absence of a systematic approach, with subthemes (a) various approach to second time‐out and (b) documentation and feedback issues.Appropriate and safe positioning during surgery is a common responsibility of all members of the surgical team. Despite the common assumption that surgeons hold the primary responsibility, the operating room nurses seemed to hold the hands‐on responsibility. Different health professionals emphasized different risk patients, risk procedures and perceived challenges. This suggests a connection between the specific focus of distinct professional domains, their tasks and expertise within the surgical context.There is a lack of clear guidelines outlining roles and the distribution of responsibility in patient positioning, which may be a safety concern. A need for reviewing responsibilities and defining roles is identified.Systematic follow‐up of documentation of post‐operative observation and documentation of skin status and the “second time‐out” procedure is crucial to establish measures rooted in guidelines supported by both professional and administrative management. This dual commitment may ensure a comprehensive strategy for systematic follow‐up, fostering a culture of continuous improvement.Not applicable. [ABSTRACT FROM AUTHOR]

Historically, interventions have focused on female victims due to intimate partner violence (IPV) disproportionate occurrence. Consequently, male victims face significant challenges and unmet needs due to lack of tailored interventions. In under-resourced countries like Nigeria, where male victimization is under-researched and under-documented, the situation is even worse. Using the grounded theory methodology, this study examined the needs and challenges of male victims from the perspective of victims, and professionals who served as key informants. Data were collected using semi-structured interviews from 35 male victims aged ≥18 across 12 states in the southern region of Nigeria, and four professionals were interviewed based on their availability. Data were analysed using content analysis based on category development of the grounded theory method. The challenges and needs identified include balance in the law, need for mental health services, creating a safe space, communal involvement, and victims need to speak up. They were all discussed around an overarching theme of masculinity and societal stereotypes. Re-examination of the existing laws as they apply to male victims, enlightenment campaigns, establishment of tailored institutions or rebranding of existing institution, and creation of support groups were recommended. [ABSTRACT FROM AUTHOR]

The purpose of this study is to explore immigrants' perceptions of their daily lives in a state with anti-immigrant policies in the United States. Using snowball sampling, researchers recruited a sample of 30 Latino immigrants in southwest Montana. The research team conducted semi-structured interviews in Spanish and analyzed the data using thematic analysis. We identified four themes: difficulty accessing healthcare, frustration over the inability to obtain driver's licenses, challenges related to employment, and desire to make a life in Montana. Fear permeated all topics. Lack of documentation presents complex economic, health, and social challenges that prevent immigrants from fully integrating into their communities. These are exacerbated in states that employ anti-immigrant policies. As Western states continue to experience growth in immigrant populations, it is critical to develop policies to support integration and equitable access to health and social services. [ABSTRACT FROM AUTHOR]

In the countries where we have the construction of the legal system with the new laws, the ambiguity of the legal norms in the new laws in some cases is almost inevitable. But commenting on laws and judicial practice will be of great help to bring about the implementation of all legal norms as was the intention of the legislator, because the correct interpretation of legal provisions is a necessity of any legal order that creates a legal security for all citizens equally. Of course, the object of legal interpretation or clarification is not only written legal-civil norms, but also those that are part of customary law. The issue of interpretation of laws currently represents a fundamental concern for citizens and legal institutions, looking for a smart and innovative approach to address this issue effectively and sustainably. In this context, this paper aims to identify and analyze the advantages and challenges of legal doctrine and interpretation in the contemporary context. [ABSTRACT FROM AUTHOR]

In Brazil, the Unified Health System (SUS) is the national health system that offers free medical services to all citizens including all levels of treatment and prevention of diseases, subsidized by the government. Although SUS is universally offered, people with intellectual and developmental disabilities (I/DD) face challenges regarding healthcare. This article aims to present a description of the healthcare framework for people with I/DD in Brazil, as well as to characterize the Care Network for Person with Disabilities. This is a descriptive study that reports aspects of the structure and functioning of the health system in the country. In addition, we summarize core data from the National Health Survey that characterizes the health condition of people with I/DD in the country. Although Brazil has promoted legislation in favor of the health of people with I/DD and other disabilities, the obstacle is the implementation. Overall, there have been advances in SUS efficacy. However, challenges include long waiting times for diagnosis, habilitation/rehabilitation, inadequate transportation, and insufficient staff training on disability and I/DD, particularly. In this sense, it is necessary to monitor laws and inclusive actions so that the principles of the SUS are actually applied. [ABSTRACT FROM AUTHOR]

Minimally invasive spine surgery continues to grow and develop. Over the past 50 years, there has been immense growth within this subspecialty of neurosurgery. A deep understanding of the historical context and future directions of this subspecialty is imperative to developing safe adoption and targeted innovation. This review aims to describe the advancements, and challenges that we face today in minimally invasive spine surgery. [ABSTRACT FROM AUTHOR]

The purpose of this article is to investigate and analyze the practices of scientific management within the County Departments of Sports and Youth (CDSY) in Romania. Conducted through a comprehensive research endeavor spanning from January to June 2022, the study utilized a standardized questionnaire as its primary instrument for data collection, distributed among CDSY directors. A notable finding from the study indicates that a significant proportion of respondents (44.9%) perceive notable disparities in the normative-functional elements governing the National Sports System in Romania compared to international standards. Moreover, the majority (51%) consistently adhere to regulatory acts, while a substantial portion (69.4%) underscore the importance of strict adherence to internal regulations in strategy formulation. Furthermore, an overwhelming majority (88.9%) acknowledge the substantial influence of available resources on strategy development, with collaboration with authorities primarily occurring through direct communication channels. Respondents prioritize multiple objectives (44.9%), affirm the necessity of various competencies (53.1%), and identify a lack of human and financial resources (59.2%) as the most significant obstacle. Notable achievements highlighted in the study include the improvement of the county's sports performance (53.1%). Respondents also believe that setting clear and realistic objectives (38.8%) is pivotal to enhancing CDSY management, while considerations in formulating strategies emphasize trends in the sports domain (42.9%) and the specific needs of the local sports community (42.9%). Overall, this research contributes to the understanding and promotion of more efficient practices in managing sports and youth departments within Romania's counties. [ABSTRACT FROM AUTHOR]

Glioma is one of the most severe central nervous systems (CNS)-specific tumors, with rapidly growing malignant glial cells accounting for roughly half of all brain tumors and having a poor survival rate ranging from 12 to 15 months. Despite being the most often used technique for glioma therapy, conventional chemotherapy suffers from low permeability of the blood-brain barrier (BBB) and blood-brain tumor barrier (BBTB) to anticancer drugs. When it comes to nanocarriers, liposomes are thought of as one of the most promising nanocarrier systems for glioma treatment. However, owing to BBB tight junctions, non-targeted liposomes, which passively accumulate in most cancer cells primarily via the increased permeability and retention effect (EPR), would not be suitable for glioma treatment. The surface modification of liposomes with various active targeting ligands has shown encouraging outcomes in the recent times by allowing various chemotherapy drugs to pass across the BBB and BBTB and enter glioma cells. This review article introduces by briefly outlining the landscape of glioma, its classification, and some of the pathogenic causes. Further, it discusses major barriers for delivering drugs to glioma such as the BBB, BBTB, and tumor microenvironment. It further discusses modified liposomes such as long-acting circulating liposomes, actively targeted liposomes, stimuli responsive liposomes. Finally, it highlighted the limitations of liposomes in the treatment of glioma and the various actively targeted liposomes undergoing clinical trials for the treatment of glioma. [ABSTRACT FROM AUTHOR]

In recent years, university research in Cambodia has seen new developments and potential transformations although many challenges remain. Drawing on data from in-depth interviews with 22 Cambodian academics, this study shows that the development of university research in Cambodia is constrained by various challenges and barriers to research, preventing Cambodia from promoting higher education internationalization and transforming itself into a knowledge-based society. The study highlights key challenges that limit possibilities for further positive developments of higher education research and suggests the need for policy reforms to make a difference to the university research landscape in Cambodia. The study also points to the broader issues of North-South knowledge divide and calls for national and institutional initiatives to support Cambodian academics and empower them to enhance their research engagement. Finally, the study discusses implications for future research. [ABSTRACT FROM AUTHOR]

Early childhood teachers are instrumental in creating cognitively, emotionally, and socially supportive environments for their students and an ethic of care is an integral part fostering such an environment. One possible way to redesign schools is to integrate an ethic of care with the tenets of social and emotional learning (SEL). Although SEL practices, tools, and programs align with understandings of the theory of ethic of care, teachers may continue to struggle on a day-to-day basis as they confront barriers in implementing such supports. In this research study, we explore the barriers teachers face in their schools as they work to understand SEL and grapple to foster an ethic of care in their early childhood spaces. The study participants included 1,313 early childhood teachers (preschool through 2nd grade) from the state of Colorado who filled out an online survey. The findings revealed five dominant barriers: (a) a lack of support, (b) minimal time, (c) scarcity of resources and training, (d) large classes, and (e) a lack of fit between SEL programs and the age groups they taught. The study highlights the need to go beyond supporting teachers' knowledge, skills, and their attitudes in their efforts to foster an ethic of care. [ABSTRACT FROM AUTHOR]

Humanitarian organizations in Bangladesh introduced emergency services to protect Rohingya refugees from COVID-19. This article aims to explore the roles front-line leaders from those organizations played in reducing the spread of the infection and protecting the refugees. By using in-depth interviews with 42 first-line managers (FLMs), it explores the innovative actions and strategies adopted by these managers to implement COVID-19-related programs and services. Initiatives such as training and engaging Rohingya volunteers and developing services promptly in order to raise awareness and manage testing, treatment, and psychosocial interventions contributed significantly to pandemic management in Rohingya refugee camps. Humanitarian groups must realize the crucial role first-line managers (FLMs) play in managing their staff while providing high-quality services in times of crisis. FLMs must be both leaders and managers in order to deal with a pandemic, in which uncertainty and a lack of knowledge create a complicated and demanding environment. Both functions are critical to providing quality services when resources are limited and only a few workers are available. The FLMs focused on mass-level awareness programs with active community engagement and participation, counseling for behavioral change, the provision of information in order to address socio-cultural barriers to community engagement, better utilization of agency services and resources, and pandemic management so as to reduce the spread and the rate of infection of COVID-19 among Rohingya refugees. Senior and middle management commitment was required to help FLMs manage a pandemic, even in the face of uncertainty, unpredictability, ambiguity, and a lack of information about the virus and its cure. They must serve as role models. FLMs should be empowered to fulfill their leadership roles through the better use of community strengths and resources during pandemics or other crises by strengthening local leadership skills, community capabilities, and an overall sense of communal responsibility. [ABSTRACT FROM AUTHOR]

Social work education is considered essential in developing the social work profession in Vietnam to set a foundation for the profession in the late 1980s. Since officially given a training code in 2004 and recognition of the professional status in 2010, the development of social work education has been significantly expanded in the number of training institutions and programs provided at various levels with only two schools providing undergraduate programs in 2003 to 35 in 2024, including 10 MSW and two PhD programs. After two decades of fast development, there have been considerable issues and challenges in maintaining the quality and professionalization of social work education. As an imported discipline, social work education depends on programs and resources from other countries. Hence, indigenization has become an increasing issue and challenge in Vietnam and other countries in the Global South. This paper presents the result of a short survey of 30 training institutions and an online questionnaire of 116 social work educators, practitioners, policymakers and social service managers. The paper examines the process of development, challenges and how to promote indigenous social work training programs to appropriately meet local needs and context and ensure regional and global standards. [ABSTRACT FROM AUTHOR]

Summary As a consequence of continuing demand for additional capacity and higher quality data transmission, channel coding as a key component of a digital communication network has progressed from a classical single pair, point‐to‐point information theoretic application to a class of coding techniques with diverse parameters. The heterogeneous requirements of B5G/6G networks technology have made flexibility of code parameters the main desired feature while designing channel codes. Owing to this, channel coding techniques have evolved to support enabling applications that depend on different factors such as latency, reliability, energy efficiency and throughput. We review and discuss the application of new techniques, modifications in the design and construction of modern channel coding schemes, including block, convolutional, rateless and space‐time codes. Further, the error correction performance of mainstream channel decoders for LDPC, polar and turbo codes is compared and analysed for their attainable error rate. The aim of this study is to highlight the adaptability of the discussed coding schemes for the forthcoming cellular network landscape. This article also addresses the implementational challenges of high throughput, low latency and machine type communication scenarios. Moreover, some recent studies exploring the role of machine learning for optimisation of B5G/6G networks are classified and discussed. Concluding, research areas pertaining to the scalability of error control coding for next generation networking are addressed. [ABSTRACT FROM AUTHOR]

Undoubtedly, the mental health of healthcare workers (HCWs) was negatively affected because of caring for patients during the COVID-19 pandemic. However, literature is limited on mapping the challenges and needs of HCWs during COVID-19 pandemic. A widely used framework in public health for mapping evidence includes the socio-ecological models, suggesting behavior can be influenced by individual, interpersonal, organizational, and community factors. The aim of this rapid scoping review was to use the socio-ecological model to map and compile lessons learnt from the literature regarding primarily the challenges and needs and secondly available psychological interventions for HCWs caring for COVID-19 patients. PubMed, CINAHL and Scopus databases were searched, with 21 studies finally included examining challenges and needs of HCWs and 18 studies presenting psychological interventions. Organizational-level challenges and needs such as inadequate staff preparation and supplies of protective equipment, flexible work policies and paid rest periods were the most reported. Individual-level challenges and needs included COVID-19-related fears and reduced mental health, whereas interpersonal-related needs included support provision. Community-level challenges included societal stigma. Certain psychological interventions were found to be promising for HCWs, but these were utilized to address only individual-level challenges and needs. Given that well-being entails an interaction of factors, multi-level interventions addressing multiple socio-ecological levels (interpersonal, organizational, community) and that place HCWs in their social context should be administrated to increase and maintain intervention' effects long-term and possibly aid in better coping with future pandemics. [ABSTRACT FROM AUTHOR]

Background: Even though, laparoscopy has evolved as the gold standard of treatment for abdominal surgical pathologies, a lot of problems and challenges are still associated with its routine use in the treatment of such patients in Nigeria. The hurdles involved in the use of laparoscopy are still pervasive even though most of the procedures performed are not advanced. This study aims to enumerate, via a qualitative synthesis performed on the selected studies, the challenges of laparoscopy in Nigeria. Methodology: We assessed articles, written in English language in the last 20 years, from PubMed, African Index Medicus and Scopus. A few were also manually added from bibliography and references of articles. The search terms were "challenges," "laparoscopy," and "Nigeria." The inclusion criteria were studies on laparoscopy in Nigeria whose content could be assessed. The challenges and adaptations and reason for converting to open surgery were subsequently noted. The exclusion criteria included studies on gynecologic laparoscopy, case reports, articles with fragmented data and articles not discussing the challenges that were encountered. PRISMA guideline for systematic review was followed. Results: The search yielded 226 papers. Seventeen papers which met the inclusion criteria were studied in-depth. The challenges identified included incessant power outages during surgery, staff apathy, high cost of set-up and incessant strikes. The adaptive strategies noted include the use of uninterrupted power system (UPS), training of support staff, re-use of disposable instruments. The reasons for conversion to open surgery varied from excessive bleeding to difficult anatomy. Conclusion: The challenges facing the laparoscopic surgeon in Nigeria are peculiar and likely to snowball in the future. In order to ensure its sustainability, policymakers should solve the highlighted challenges and also provide enabling environment. This might promote the adoption of laparoscopy for treating patients with abdominal pathology in the future. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic prompted courts worldwide to swiftly transition to online operations, including virtual hearings, to maintain continuity amid health concerns. This shift signifies a lasting impact on the justice system. Despite this, research on the effectiveness and challenges of court videoconferencing, particularly in the Philippines, remains limited. This study aimed to address this gap by employing a descriptive-evaluative approach and surveying 213 respondents, including court officers, prosecutors, lawyers, jail officers, and police officers, in Angeles City. The study assessed challenges such as procedural integrity and technical glitches, as well as perspectives on judicial efficiency and cost effectiveness. Findings revealed significant hurdles in videoconference hearings, yet respondents recognized their benefits in expediting case resolutions and enhancing security. Interestingly, there was no significant difference in evaluations across respondent groups. Interviews corroborated survey results, highlighting concerns and benefits of videoconference hearings. Addressing challenges while leveraging benefits is crucial, requiring investment in technological literacy, internet connectivity, and procedural integrity safeguards. Policymakers should also explore solutions to infrastructure limitations, fostering widespread adoption of videoconference hearings for a more effective and fair legal system. [ABSTRACT FROM AUTHOR]

Purpose: How to evaluate the social impact of social innovation has emerged as an important question posed by academics, organizations, and policymakers in recent years. One reason for this is the increasing concern with the social impact of different types of organizations and social practices, particularly in response to a recognition of the urgency of developing more inclusive economies and societies. To find an answer to this question, this research seeks to investigate the state-of-the-art in terms of social innovation impact measurement, drawing on both scientific literature and practitioner literature. Originality/value: This research discusses the challenges posed by measuring the impact of social innovation initiatives and how these measurements may change the assessment process. The analysis finds that methodologies for measuring social innovation have mainly been undertaken in Europe, where these initiatives are largely addressed. Design/methodology/approach: This paper adopted a qualitative research approach based on the scoping review method. This method is widely used to identify emergent topics in scientific literature, aiming to identify implications for research and decision-making. The research was developed based on different steps to obtain information about the social impact measurement indicators and their overall contribution to the advancement of social innovation. Findings: The results also confirmed the lack of social innovation frameworks, methodologies, and tools capable of measuring the social impact of social innovations. Furthermore, a set of barriers in this field was identified, which can be used to channel better upcoming academic research on developing social impact indicators for social innovation. [ABSTRACT FROM AUTHOR]

Background: The healthcare systems in Asia vary greatly due to the socio‐economic and cultural diversities which impact haemophilia management. Methods: An advisory board meeting was conducted with experts in haemophilia care from Asia to understand the heterogeneity in clinical practices and care provision in the region. Findings: The overall prevalence of haemophilia in Asia ranges between 3 and 8.58/100,000 patients. Haemophilia A was more prevalent as compared to haemophilia B with a ratio of around 5:1. There is under‐diagnosis in the region due to lack of diagnosis, registries and/or lack of appropriate facilities in suburban areas. Most patients are referred to the haematologists by their families or primary care physicians, while some are identified during bleeding episodes. Genetic testing faces obstacles like resource constraints, services available at limited centres and unwillingness of patients to participate. Prophylaxis is offered for people with haemophilia (PWH) with a severe bleeding phenotype. Recombinant factors are approved in most countries across the region and are the preferred therapy. The challenges highlighted for not receiving a high standard of care include patients' reluctance to use an intravenous treatment, poor patient compliance due to frequency of infusions, budget constraints and lack of funding, insurance, availability and accessibility of factor concentrates. Prevalence of neutralizing antibodies ranged from 5% to 20% in the region. Use of immune tolerance induction and bypassing agents to treat inhibitors depends on their cost and availability. Conclusion: Haemophilia care in Asia has evolved to a great extent. However, some challenges remain for which a strategic approach along with multi‐stakeholder involvement are needed. [ABSTRACT FROM AUTHOR]

Cancer and cardiovascular disease (CVD) commonly coexist, with increasing evidence that long-term cancer survivors are more likely to die from CVD than the general population. Effective management of CVD and its risk factors requires identification of patients at increased risk who may benefit from early intervention and their appropriate monitoring across the disease trajectory. Improving outcomes requires new models of multidisciplinary cancer care supported by care pathways. Such pathways require a clear delineation of the roles and responsibilities of all team members and provision of appropriate enablers for their delivery. These include accessible point-of-care tools/risk calculators, patient resources, and the provision of tailored training opportunities for health care providers. [ABSTRACT FROM AUTHOR]

Paediatric kidney failure is a global problem responsible for significant childhood morbidity and mortality. The gold-standard treatment is kidney transplantation. However, the availability of kidney transplantation remains limited in some low- and middle-income countries (LMICs). Transplant Links Community (TLC) is a UK-based charity that mentors units in LMICs wishing to start kidney transplantation; the ultimate goal is for these units to become self-sufficient. TLC provides this support through in-person training visits and skill transfer, plus direct mentorship from the UK that is maintained over many years. From such mentoring programmes, it is evident that there are numerous challenges in the initial establishment and long-term maintenance of kidney transplant services, with specific and unique barriers applying to setting up paediatric transplant programmes compared to their adult counterparts. This review summarises TLC's first-hand experience of developing paediatric kidney transplantation services in LMICs over the past 15 years, the challenges encountered, and the major ongoing barriers that must be addressed to facilitate further progress in delivering transplantation services to children globally. [ABSTRACT FROM AUTHOR]

The purpose of this study was to provide an in-depth understanding of the challenges Ugandan parents of children with autism face. Caring for a child with autism poses unique challenges to families and deserves tailor-made remedies. Autism is understudied in Uganda and Africa. This qualitative study reports on results from focus group discussions with six parents of children with autism spectrum disorder (ASD) in Uganda. Using thematic analysis, six themes were identified: Social Stigma, Lack of Support, Financial Burden, Children Need Basic Living Skills, Physical Discipline, and Resilience. Parents reported lack of support in multiple services addressing many life domains across the lifespan while continuously fighting for social stigma. The lack of support reverted parents to using physical discipline to manage behaviours, though parents also showed tenacity in the caregiving process. Parents require services from a multi-disciplinary team that caters to children and youth with ASD as well as their parental needs. [ABSTRACT FROM AUTHOR]

Background:Telemedicine is viewed as a crucial tool for addressing the challenges of limited medical resources at health care facilities. However, its adoption in health care is not entirely realized due to perceived barriers. This systematic review outlines the critical facilitators and barriers that influence the implementation of telemedicine in the Indian health care system, observed at the infrastructural, sociocultural, regulatory, and financial levels, from the perspectives of health care providers, patients, patient caregivers, society, health organizations, and the government. Methods:This review complies with the current Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols 2015. A total of 2,706 peer-reviewed studies published from December 2016 to September 2023 in the PubMed, Cochrane, Scopus, Web of Science, CINAHL, MEDLINE, and PsycInfo databases were considered for the title and abstract screening, after which 334 articles were chosen for the full-text review. In the end, 46 studies were selected for data synthesis. Results:Analysis of the literature revealed key barriers such as data privacy and security concerns, doctor and patient resistance to information and communications technology (ICT), infrastructure issues, and ICT training gaps. Facilitators included reduced health care delivery costs, enhanced patient access to health care in remote areas, and shorter patient wait times. The real-world experiences of Indian telemedicine practitioners and pioneers are also explored to complement literature-based perspectives on telemedicine implementation. Both stress the need for reliable internet connectivity, technological adoption, comprehensive ICT training, positive sociocultural attitudes, stringent data privacy measures, and viable business models as crucial for effective telemedicine adoption, with experts emphasizing practical adaptability alongside the literature-recognized facilitators. [ABSTRACT FROM AUTHOR]

Summary Underwater wireless sensor network (UWSN) connects the real world to the hidden resources available deep into the sea using sensor nodes deployed sparsely and are interconnected to gather information for any movement/change in the ocean. The computed information on nodes obtained from concurrently running UWSN's applications will be meaningful, only if the location of this change will be identified. Nevertheless, it is always difficult to obtain the exact location coordinates of any misadventure like tectonic plate's movement but using localization algorithms in UWSN helps to obtain the coordinates. Since localization algorithms for terrestrial networks are not feasible for UWSN because of environmental challenges. Moreover, GPS systems do not work after 15 m of depth and the radio frequency gets suppressed. So, the requirement arises to analyze existing localization approaches in the deep sea where acoustic signals are used for communication and data transfer. In this paper, along with describing the UWSN's applications and challenges, the underwater localization schemes are reviewed to present, summarize, and mention the scope of improvement. Further, classification into range‐based and range‐free categories of these schemes is depicted with implementation in the NS2.30 simulation environment of some of the recent techniques to showcase the reasons for better performance. [ABSTRACT FROM AUTHOR]

Despite the well-known neurosurgical workforce deficit in Sub-Saharan Africa, there remains a low number of neurosurgical training programs in Nigeria. This study sought to reassess the current status of specialist neurosurgical training in the country. An electronic survey was distributed to all consultant neurosurgeons and neurosurgery residents in Nigeria. Demographic information and questions relating to the content, process, strengths, and challenges of neurosurgical training were explored as part of a broader survey assessing neurosurgical capacity. Descriptive statistics were used for analysis. Respondents identified 15 neurosurgical training centers in Nigeria. All 15 are accredited by the West African College of Surgeons, and 6 by the National Postgraduate Medical College of Nigeria. The average duration of core neurosurgical training was 5 years. Some identified strengths of Nigerian neurosurgical training included learning opportunities provided to residents, recent growth in the neurosurgical training capacity, and satisfaction with training. Challenges included a continued low number of training programs compared to the population density, lack of subspecialty training programs, and inadequate training infrastructure. Despite the high number of neurosurgery training centers in Nigeria, compared to other West African countries, the programs are still limited in number and capacity. Although this study shows apparent trainee satisfaction with the training process and contents, multiple challenges exist. Efforts at improving training capacity should focus on continuing the development and expansion of current programs, commencing subspecialty training, driving health insurance to improve funding, and increasing available infrastructure for training. [ABSTRACT FROM AUTHOR]

This study investigates the scope, trends, and challenges of neurosurgical research in Nigeria since inception of the specialty in 1962. A bibliometric review of the neurosurgical literature from Nigeria was performed. Variables extracted included year and journal of publication, article topic, article type, research type, study design, article focus area, and limitations. Descriptive and quantitative analyses were performed for all variables. Trends of research publications were described in three periods: pioneering (1962–1981), recession (1982–2001), and resurgent (2002–2021). Of the 1023 included articles, 10.0% were published in the pioneering period, 9.2% in the recession period, and 80.8% in the resurgent period. Papers were predominantly published in World Neurosurgery (4.5%) and Nigerian Journal of Clinical Practice (4.0%). A total of 79.9% of the 4618 authors were from Nigerian institutions; 86.3% of the articles covered clinical research and were mainly focused on service delivery and epidemiology (89.9%). The most prominent topics were traumatic brain injury (25.8%) and central nervous system malignancy (21.4%). Only 4.4% of the publications received funding, mostly from agencies in the United States (31.7%). Barriers to neurosurgical research included lack of clinical databases (18.0%), increasing burden of disease (12.5%), and diagnostic challenges (12.4%). Neurosurgical research in Nigeria continues to grow due to increased training, workforce, and infrastructural improvements. Addressing the major challenges through establishment of research databases, development of evidence-based management guidelines, and increasing research training, funding and opportunities can increase research capacity in Nigeria. [ABSTRACT FROM AUTHOR]

Both diabetes mellitus (DM) and tuberculosis (TB) are prevalent all across in India. TB‐DM comorbidity has emerged as a syndemic and needs more attention in India considering gaps in screening, clinical care, and research. This paper is intended to review published literature on TB and DM in India to understand the burden of the dual epidemic and its trajectory and to obtain perspectives on the gaps, constraints, and challenges in care and treatment of this dual epidemic. A literature search was carried out on PubMed, Scopus, and Google Scholar, using the key words 'Tuberculosis' OR 'TB' AND 'Diabetes' OR 'Diabetes Mellitus' AND 'India', focusing on the research published between the year 2000 to 2022. The prevalence of DM is high in patients with TB. Quantitative data on the epidemiological situation of TB/DM in India such as incidence, prevalence, mortality, and management are lacking. During the last 2 years convergence of TB‐DM syndemic with the COVID‐19 pandemic has increased cases with uncontrolled DM but also made coordinated control of TB‐DM operationally difficult and of low effectiveness. Research regarding TB‐DM comorbidity is required in the context of epidemiology and management. Detection and bidirectional screening are aggressively warranted. Management of DM in those with TB‐DM comorbidity needs more efforts, including training and supervision of frontline workers. [ABSTRACT FROM AUTHOR]

The medical humanity issue presents a significant obstacle to the healthcare profession, raising concerns about the ethical standards, compassion, and empathy that are vital aspects of patient-centered care. Amidst the prevalence of technological progress and a focus on measurable results, there is a rising apprehension that healthcare providers are becoming increasingly detached from their patients, viewing them as just medical cases rather than individuals who deserve comprehensive care. The erosion of medical humanity not only weakens the bond between patients and healthcare providers but also has consequences for patient outcomes and the overall quality of service. Healthcare organizations must prioritize activities focused on cultivating a culture of empathy, providing training in communication skills, and promoting mindfulness practices among healthcare staff. To tackle this problem and guarantee the provision of compassionate care that respects the dignity and well-being of every patient, we need to shift our attention towards humanistic ideals and recognize the significance of emotional intelligence in medical practice. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To explore the challenges of clinical education from the perspective of clinical instructors and clinical staff at Dire Dawa University College of Health Science. METHODS: An institutional-based phenomenological qualitative study was conducted. Clinical instructors and staff provided data through in-depth interviews and key informant discussions, which were facilitated by a semistructured tool and a voice recorder. A total of 17 participants, including 11 in-depth interviews (IDIs) with clinical instructors (including two key informants) and six IDIs with clinical staff were included in this study. A purposive sampling method was used to select study participants, and the data were analyzed thematically using the computer-assisted qualitative data analysis software Atlas.ti7. The thematic analysis with an inductive approach involves six steps: familiarization, coding, generating themes, reviewing themes, defining and naming themes, and writing. RESULTS: Clinical instructors and clinical staff noted a number of challenges in clinical education, including insufficient medical equipment, low incentives, clinical site repetition, unfavorable clinical practice sites, lack of communication from instructors, skill attrition, lack of orientation for instructors and students, client/patient unwelcomingness, uncooperative healthcare workers, and poor university cooperation. CONCLUSION: The aforementioned issues contributed to the quality of clinical education and its desired impact, as outlined in this research. A multidisciplinary and collaborative effort is needed to address these challenges. [ABSTRACT FROM AUTHOR]

AbstractShifting from high- to low-malaria transmission accompanies a higher proportion of asymptomatic low-density malaria infections (LDMI). Currently, several endemic countries, such as India, are experiencing this shift as it is striving to eliminate malaria. LDMI is a complex concept for which there are several important questions yet unanswered on its natural history, infectiousness, epidemiology, and pathological and clinical impact. India is on the right path to eliminating malaria, but it is facing the LDMI problem. A brief discussion on the concept and definitions of LDMI is beforehand presented. Also, an exhaustive review and critical analysis of the existing literature on LDMI in malaria-endemic areas, including India, are included in this review. Finally, we opine that addressing LDMI in India is ethically and pragmatically achievable, and a pool of sine qua non conditions is required to efficiently and sustainably eliminate malaria. [ABSTRACT FROM AUTHOR]

AbstractObjectivesMethodResultsConclusionThis scoping review presents an overview of the available research on symptoms, comorbidities, and associated challenges among older adults with ADHD.The literature study followed Arksey and O’Malley’s five-stage framework. The search was conducted in ProQuest Central, Scopus, PsycInfo, CINAHL, and PubMed. Articles were included if they were peer-reviewed, ethically approved primary studies, written in the English language, concerning ADHD, and including people 60 years of age and older.The review included 17 articles. Symptoms of ADHD persist throughout life. Older adults with ADHD experience similar core symptoms as younger individuals, but their manifestation and intensity may differ. The most common comorbidity found was mental illness, for example depression and anxiety. ADHD in older adults is linked to several challenges, such as difficulty with relationships and social isolation.Older adults with ADHD face various symptoms, comorbidities, and challenges that affect their quality of life. Age-related changes can amplify ADHD symptoms and increase the perceived burden of illness. More research is needed to understand the complex relationship between these factors and enable tailored interventions to improve their quality of life and well-being. [ABSTRACT FROM AUTHOR]

Essential medicines or drugs are recognized as highly cost-effective components within contemporary healthcare, demonstrating significant potential for improving health outcomes. The provision of essential medicines directly impacts the functioning of healthcare facilities, resulting in financial hardship. This review aims to fill knowledge gaps by examining obstacles hindering access and utilization of essential medicines in India. This study conducted a comprehensive evidence synthesis, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to analyse articles on the availability and utilization of essential medicines in India. The search strategy included various databases and keywords. Published, peer-reviewed articles focusing on the National/State List of Essential Medicines and meeting specific criteria were considered. Data items included essential medicines, drug availability, utilization, and challenges. Data was extracted, synthesized, and analysed using thematic framework analysis. Out of 1,129 articles, 11 were selected for review. Studies consistently highlighted the inadequate availability of essential medicines in different Indian states. Availability of essential medicines varies in the range of 17-51 percent across major states of India. Stock-outs of medicines vary from 4 to 14 weeks. Governance issues including differential procurement mechanisms across states of India, hinder seamless availability of essential medicines. Other challenges included distribution and purchasing system inefficiencies, governance-related issues, and facility/user-level challenges impacting drug utilization. Disruptions in utilization were observed due to improper prescription practices and non-availability of affordable options. Accessibility and affordability also affected drug utilization. Issues with supply chain management and conflicting guidelines further contributed to the obstacles faced in ensuring availability and utilization of essential medicines in India. Ensuring the availability, accessibility, and affordability of essential medicines is of utmost importance. The public health system needs to strengthen its procurement and distribution management. Strengthening the logistics support for an efficient supply of essential medicines will reduce the time lag in receipt of drugs. Guidelines on essential drugs prepared by the National Health System Resource Centre need to be strictly adhered to and monitored in inventory management system. There is an urgent need to develop a sustainable model for achieving uniformity in the availability and utilization of essential medicines in India. [ABSTRACT FROM AUTHOR]

Objective: Population aging creates various individual and public challenges, including physical and mental health, economic challenges, and care needs. Governments' response to population aging is active aging. Promoting successful, active aging is an international priority for addressing the challenges of increasing life expectancy. Active aging allows individuals to overcome the challenges of an increasingly aging population. Accordingly, the present study explores the perspective, challenges, and strategies of active aging in female elderly adults who retired from the education department. Methods: The present study was conducted via a qualitative grounded theory using the data collected from semi-structured interviews with 21 retired women from the Ministry of Education aged over 65 years in Tehran City, Iran, in 2023. The collected data were analyzed using the Charmaz (2012) method. Results: Data analysis revealed 49 open codes, 16 axial codes, and 4 selective codes. The four selective codes were old age challenges, achieving active aging, psycho-social retirement concern, and social neglect of older adults. The axial codes were public rejection, unavailability of facilities, interpersonal strategies, learning new skills, self-care, individual strategies, dilemmas and problems, old age concerns, unavailability of suitable urban space, and public view about old age. Conclusion: Active aging involves challenges and problems over which older adults have no control, such as the unavailability of suitable urban space for transportation, the unavailability of facilities, and restricting older adults' activities. These problems lead to the belief in disability, inefficiency, and isolation, resulting in a vicious cycle. [ABSTRACT FROM AUTHOR]

The primary objective of this study is to pinpoint the principal challenges in the implementation of positive behavior support methods on students with learning difficulties from the perspectives of their teachers. Applying a qualitative research approach, specifically adopting a case study design, the researchers conducted semistructured interviews as the primary data collection tool. The study involved 10 teachers instructing students with learning difficulties in middle and high schools in Jeddah, Saudi Arabia. Thematic analysis was then applied to scrutinize and interpret the findings. The study reviled several results such as; shortcomings in the application of positive behavior support methods, particularly concerning a nuanced understanding of the associated terminology. The scarcity of plans, regulations, and systems pertaining to the application of positive behavior support methods for students with learning difficulties in middle and high school. Also, there was a dearth of experience among teachers of learning difficulties in implementing positive behavior support methods. Additionally, shortcomings in integrating team tasks in terms of implementing positive behavior support methods. In light of the study's findings, the researchers propose some recommendations such as making visual and audio brochures on positive behavior support methods, creating a procedural guide for the teacher of learning difficulties with negative behaviors and managing them behaviorally through how to activate his/her role in applying positive behavior support methods, making plans, regulations, and systems for the behavioral and social aspect by special education supervisors and decision makers pertaining the activation of positive behavior support and applying its methods in learning difficulties programs at all academic levels. [ABSTRACT FROM AUTHOR]

Females with opioid use disorder (OUD) rarely seek help for addiction. We present a series of seven females with OUD attending a tertiary care addiction treatment setting in Assam between December 2022 to August 2023. Most of the patients were primary-educated, young adults, housewives, from lower to middle socioeconomic strata, and were residents of rural or semi-urban areas. All were married, and around half of them were separated. All the patients were dependent on heroin and tobacco. Five of them initiated heroin use while modeling their spouse. Three patients were injecting heroin, and one was seropositive with both HCV and HIV. Five patients received sublingual buprenorphinenaloxone, and three of them followed up subsequently. Financial difficulty, poor family support, and intimate partner violence were major challenges for treatment-seeking and regular follow-up. This case series highlights the need for systematic study and gender-responsive care of females with OUD in Assam. [ABSTRACT FROM AUTHOR]

The conditions caused by the spread of COVID-19 have compelled higher education to make new efforts in the education system to prepare new routes and new openings in the post-COVID era to avoid any disruption and reduce costs. In this regard, this study has considered the challenges of Iranian higher education institutions in the post-COVID era. The research approach was qualitative and phenomenological, and then, semi-structured interviews were conducted with 19 samples from two groups of chief executive officers and faculty members. The thematic content analysis method was used to analyze the qualitative data. The results showed four possible challenges in Iranian higher education institutions, which indicate the fact that it is necessary for universities' management in the post-COVID era to be prepared to advance its goals, and to prioritize the review of education, research, and executive methods, based on the circumstances. In the four challenges, this study improves current knowledge regarding university management in the post-COVID era. [ABSTRACT FROM AUTHOR]

Background: As many patients are spending their last days in critical care units, it is essential that they receive appropriate end-of -life care. However, cultural differences, ethical dilemmas and preference practices can arise in the intensive care settings during the end of life. Limiting therapy for dying patients in intensive care is a new concept with no legal definition and therefore there may be confusion in interpreting the terms 'no resuscitation' and 'comfort care' among physicians in Middle East. Therefore, the research question is 'What helps or hinders effective end-of-life care in adult intensive care units in Middle Eastern countries?' Methods: The authors conducted a comprehensive systematic literature review using five electronic databases. We identified primary studies from Medline, Embase, CINAHL, Psycinfo and Scopus. The team assessed the full-text papers included in the review for quality using the Joanna Briggs Institute checklist (JBI). We completed the literature search on the first of April 2022 and was not limited to a specific period. Results: We identified and included nine relevant studies in the review. We identified five main themes as end-of-life care challenges and/or facilitators: organisational structure and management, (mis)understanding of end-of-life care, spirituality and religious practices for the dying, communication about end-of-life care, and the impact of the ICU environment. Conclusions: This review has reported challenges and facilitators to providing end-of-life care in ICU and made initial recommendations for improving practice. These are certainly not unique to the Middle East but can be found throughout the international literature. However, the cultural context of Middle East and North Africa countries gives these areas of practice special challenges and opportunities. Further observational research is recommended to confirm or modify the results of this review, and with a view to developing and evaluating comprehensive interventions to promote end-of-life care in ICUs in the Middle East. [ABSTRACT FROM AUTHOR]

Introduction: During the COVID‐19 pandemic, there was a remarkable increase in public volunteering for the care of hospitalized patients. They faced challenges during their voluntary care provision. This study aimed at exploring public volunteers' experiences of the challenges of the voluntary care provision to hospitalized patients with COVID‐19. Methods: A descriptive qualitative study with an inductive content analysis method was conducted, 2022–2023. Eighteen public volunteers providing care to hospitalized patients with COVID‐19 were purposefully selected among 10 hospitals, specialized in COVID‐19 care in Tehran and Shiraz, Iran. Data were collected over 7 months through in‐depth semistructured interviews and concurrently analyzed using conventional content analysis methods. Findings: The challenges of voluntary care provision to hospitalized patients with COVID‐19 were illustrated in five main categories, each with two subcategories. The categories included structural challenges, interpersonal conflicts, financial constraints, covert participation and the deteriorating condition of care provision. The subcategories comprised lack of volunteer recruitment bases, ineffective organization of voluntary activities, pervasive distrust, heightened risk of clinical errors, conflicts between volunteer commitments and primary occupation, lack of financial support, lack of family support, isolation by friends, mental trauma and physical exhaustion. Conclusion: Public volunteers encounter diverse challenges while providing care to hospitalized patients with COVID‐19, which negatively impacts their motivation to serve. By addressing these challenges, we can create a more supportive environment for volunteers and enhance the quality of care provided to patients during public health emergencies. Identifying such challenges can assist healthcare managers and policymakers develop effective strategies to mitigate mounting difficulties and enhance volunteer services, thereby improving the overall quality of care provided to patients during public health crises. Patient Contributions: Participants were identified and recruited after the study objectives were explained in person to the managers. The participants were approached and interviewed by one author. Participation was voluntary and the participants did not receive any financial compensation for their time. [ABSTRACT FROM AUTHOR]

Ghana's customary land sector holds great prospects in lending impetus to the country's socio-economic development. Using the Bolgatanga Customary Land Secretariat in the Bolgatanga Traditional Area as the study area, this study examined the current challenges encountered by Customary Land Secretariats in Ghana in delivering on their mandates of streamlining customary land administration. Findings indicate that the Bolgatanga Customary Land Secretariat is well committed to streamlining customary lands management in the Traditional Area. Nonetheless, staff inadequacy, absence of technological integration, low level of patronage, and inadequate cooperation between stakeholders are impeding the Secretariat in achieving the intended objectives. [ABSTRACT FROM AUTHOR]

This article analyzes the challenges and opportunities facing communication in Latin America towards the year 2030. Aspects such as technology and digitalization, social and political challenges, environmental sustainability, cultural diversity, freedom of the press and participation are examined. citizen. The implications of the UN's 2030 agenda are discussed and the social metamorphosis driven by events such as the pandemic and climate change is reflected on. [ABSTRACT FROM AUTHOR]

The purpose of this study is to figure out the impact of the proposed leadership based value model at Princess Nourah bint Abdulrahman University in developing educational attainment and facing the challenges of distance education during COVID-19 pandemic in the course of Ecology. The current study is a mixed study (qualitative and quantitative). The study adopts the experimental approach of semi experimental design. The research sample consisted of (163) fourth-level students in the Department of Biology at Princess Nourah bint Abdulrahman University, (81) in the experimental group, and (82) in the control group, and consisted of research tools from a learning test and self-reflection records of the professor of course. The results showed that there were statistically significant differences (at the ≤0.05) score between the two groups in the academic achievement test in favor of the experimental group students. The results also showed an impact on the proposed model in Overcoming the challenges of distance education during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Producing recombinant proteins is a major accomplishment of biotechnology in the past century. Heterologous hosts, either eukaryotic or prokaryotic, are used for the production of these proteins. The utilization of microbial host systems continues to dominate as the most efficient and affordable method for biotherapeutics and food industry productions. Hence, it is crucial to analyze the limitations and advantages of microbial hosts to enhance the efficient production of recombinant proteins on a large scale. E. coli is widely used as a host for the production of recombinant proteins. Researchers have identified certain obstacles with this host, and given the growing demand for recombinant protein production, there is an immediate requirement to enhance this host. The following review discusses the elements contributing to the manifestation of recombinant protein. Subsequently, it sheds light on innovative approaches aimed at improving the expression of recombinant protein. Lastly, it delves into the obstacles and optimization methods associated with translation, mentioning both cis-optimization and trans-optimization, producing soluble recombinant protein, and engineering the metal ion transportation. In this context, a comprehensive description of the distinct features will be provided, and this knowledge could potentially enhance the expression of recombinant proteins in E. coli. [ABSTRACT FROM AUTHOR]

Migrants' children face challenges when returning to their parent's home country, which is usually unfamiliar to them. This qualitative study explores this phenomenon to understand more about the experiences of returnee children regarding their social-educational (re)integration and adaptation, the challenges they faced, and the mechanisms they have developed to overcome them. Results are discussed from the perspective of acculturative stress and social networks, identifying the struggle that returnees have to adapt and acculturate to their new home because of the lack of competence in the Spanish language and the consequences of the discrimination they suffer in the social environment, namely school and in their parents' hometowns. However, results also shed light on how returnees create social networks with classmates and family members who help them overcome these challenges, fears, and feelings of alienation. [ABSTRACT FROM AUTHOR]

Background Pharmacogenomics is an emerging field that explores the relationship between a person's genetic makeup and their response to drugs. Objectives Computer applications have been instrumental in advancing pharmacogenomics research and facilitating personalized medicine. In this abstract, we review some of the key computer applications used in pharmacogenomics research, including bioinformatics tools for analyzing genetic data, machine learning algorithms for predicting drug response, and clinical decision support systems for guiding drug selection and dosing. We also highlight the challenges and opportunities in the field of pharmacogenomics, including the need for large-scale, multi-omics datasets, and the importance of developing robust and interpretable machine learning models. Overall, computer applications have played a critical role in enabling pharmacogenomics research and have the potential to revolutionize the practice of medicine by facilitating the development of more personalized and effective drug therapies. [ABSTRACT FROM AUTHOR]