Assessment of water, sanitation and hand hygiene practices in rural households of Tamil Nadu: A cross-sectional study.

Context: Water is a basic human right essential to all for sustainable development. Sanitation is one of the determinants of quality of life and the human development index. Drinking unsafe water impairs health through illnesses such as diarrhoea, and untreated excreta contaminates ground waters and surface waters used for drinking, bathing and household purposes. Aims: To assess the existing facilities and practices related to drinking water, sanitation, and hygiene among household members in the rural population of Tamil Nadu and to assess whether accessibility and availability of safe drinking water and adequate sanitation under sustainable development goal 6 is being achieved in the rural population of Tamil Nadu. Methodology: This community-based cross-sectional study was carried out among 200 households in the rural field practice area of the Medical College and Hospital, Thiruvallur district, Tamil Nadu. The participants were interviewed using a predesigned semi-structured questionnaire on their existing water, sanitation, and hand washing facilities and practices. Results: Our study observed that 71.5% of households had piped water supply into their dwellings, 82% were using sanitary latrines and 28% had closed drainage for draining wastewater. Twenty-eight percent were using soap and water for hand-washing before food, and 82.5% were doing hand-washing with soap after using the toilet. In our study, the association between sanitary practices and education, occupation and socioeconomic status was statistically significant. Conclusions: Our study emphasized the need for strengthening health education and behaviour change communication regarding sanitation and hand hygiene practices.

Prevalence and Predictors of Domestic Violence in India: Complex Sample Analysis of a Nationally Representative Study Conducted Between 2019 and 2021.

BACKGROUND:  Violence against women has been one of the dreaded social evils that humanity is facing. There have been concerted efforts to eliminate this evil, and sustainable development goals goal 5.2.1 gave it a timeline. The current study was carried out to estimate the burden of domestic violence (DV) against women and to investigate the sociodemographic correlates of DV victims in India. METHODS:  Data were drawn from the fifth National Family Health Survey round. According to Demographic Health Survey guidelines, DV is measured using a 13-item questionnaire in the women's survey. Complex sample analysis was done using a primary sampling unit, sample weight, and stratification variables to estimate the weighted prevalence. Chi-square and multivariate logistic regression determine the unadjusted and adjusted odds ratio. The analysis is carried out using SPSS version 26 (IBM Corp., Armonk, NY). RESULTS:  The weighted prevalence of DV against women in India in 2019-2021 was 31.2%. Approximately 28.5%, 13.1%, and 5.7% of women reported experiences of physical, emotional, and sexual violence, respectively. Karnataka was the worst affected state, with 47.3% of women facing DV. Individual factors like education and occupation, household factors like husband's education, occupation, drinking habit, wealth index, and community-level factors like caste, religion, and place of residence were significant predictors of DV. Lower levels of education and lower socioeconomic status were essential predictors of DV. CONCLUSION:  The importance of education for both females and males has repeatedly been directly associated with DV, but the interventions have failed to improve the situation and warrant a new strategy. Awareness about the legal consequences of DV in lower socioeconomic classes also has the potential to cut down the numbers. Further research into the causality can improve the planning for better intervention modalities.

An analysis of cause-specific under-5 mortality in Bangladesh using the demographic and health survey 2011 and 2017-2018.

BACKGROUND: As the Sustainable Development Goal 3.2.1 deadline (2030) approaches, rapidly reducing under-5 mortality (U5M) gains more prominence. However, initiatives or interventions that aided Bangladesh in achieving Millennium Development Goal 4 showed varied effectiveness in reducing certain cause-specific U5M. Therefore, this study aimed to examine the predictors of the key cause-specific mortalities. METHODS: This cross-sectional study was conducted using the Bangladesh Demographic and Health Survey 2011 and 2017-18 data. Cause-specific U5M was examined using multilevel multinomial mixed-effects analyses, and overall/all-cause U5M was examined using multilevel mixed-effects analyses. The respective estimates were compared. RESULTS: The cause-specific analysis revealed that pneumonia and prematurity-related U5M were significantly associated with antenatal care and postnatal care, respectively. However, analysis of overall/all-cause U5M did not reveal any significant association with health services. Twins or multiples had a greater risk of mortality from preterm-related conditions (adjusted Relative Risk Ratio (aRRR): 38.01, 95% CI: 19.08-75.7, p < .001), birth asphyxia (aRRR: 6.52, 95% CI: 2.51-16.91, p < .001), and possible serious infections (aRRR: 11.12, 95% CI: 4.52-27.36, p < .001) than singletons. Children born to mothers 18 years or younger also exhibited a greater risk of mortality from these three causes than children born to older mothers. This study also revealed an increase in the predicted risk of prematurity-related mortality in the 2017-18 survey among children born to mothers 18 years or younger, children born to mothers without any formal education, twins or multiples and children who did not receive postnatal care. CONCLUSIONS: This research provides valuable insights into accelerating U5M reduction; a higher risk of preterm-related death among twins underscores the importance of careful monitoring of mothers pregnant with twins or multiples through the continuum of care; elevated risk of death among children who did not receive postnatal care, or whose mothers did not receive antenatal care stresses the need to strengthen the coverage and quality of maternal and neonatal health care; furthermore, higher risks of preterm-related deaths among the children of mothers with low formal education or children born to mothers 18 years or younger highlight the importance of more comprehensive initiatives to promote maternal education and prevent adolescent pregnancy.

Personal goal setting eHealth component associated with improved weight loss at 6 months: A mixed methods secondary analysis.

Objective: Goal setting is a behavior change technique associated with improved change in outcomes. Digital (eHealth, mHealth) behavior change interventions often prescribe all goals with no opportunity for participants to create and track their own; thus, little is known about the types of goals participants create for themselves and their impacts on behavioral outcomes. This analysis describes the goals created by participants using an optional personal goal-setting component and evaluates the association between participant goal creation and weight loss in an eHealth adult weight loss intervention. Methods: This represents a mixed methods QUANT-qual design to understand the types of goals users create for themselves and their impacts on behavior change outcomes. Qualitative codes were applied for the topic, behavior/outcome focus, adherence to SMART criteria, and repetition with count summaries. Quantitative analyses applied regression modeling to determine if the number of goals set was associated with the 6-month weight change, controlling for covariates. Results: Participants (n = 363) set an average of 23.4 goals (SD = 22.7) over 6 months. Those who reached at least 5% weight loss set significantly more goals than those who lost between 1% and 4.99% or who lost <1% or gained weight (p's < 0.0001). Setting more personal goals was associated with significant weight loss reduction at 6 months, controlling for covariates (p's < 0.05). Conclusions: Greater use of a personal goal-setting feature was associated with improved weight loss outcomes among active users. This can be a low-investment addition to digital behavior change interventions to contribute to improved outcomes.

Coaching doctors to improve ethical decision-making in adult hospitalized patients potentially receiving excessive treatment. The CODE stepped-wedge cluster randomized controlled trial.

PURPOSE: The aim of this study was to assess whether coaching doctors to enhance ethical decision-making in teams improves (1) goal-oriented care operationalized via written do-not-intubate and do-not attempt cardiopulmonary resuscitation (DNI-DNACPR) orders in adult patients potentially receiving excessive treatment (PET) during their first hospital stay and (2) the quality of the ethical climate. METHODS: We carried out a stepped-wedge cluster randomized controlled trial in the medical intensive care unit (ICU) and 9 referring internal medicine departments of Ghent University Hospital between February 2022 and February 2023. Doctors and nurses in charge of hospitalized patients filled out the ethical decision-making climate questionnaire (ethical decision-making climate questionnaire, EDMCQ) before and after the study, and anonymously identified PET via an electronic alert during the entire study period. All departments were randomly assigned to a 4-month coaching. At least one month of coaching was compared to less than one month coaching and usual care. The first primary endpoint was the incidence of written DNI-DNACPR decisions. The second primary endpoint was the EDMCQ before and after the study period. Because clinicians identified less PET than required to detect a difference in written DNI-DNACPR decisions, a post-hoc analysis on the overall population was performed. To reduce type I errors, we further restricted the analysis to one of our predefined secondary endpoints (mortality up to 1 year). RESULTS: Of the 442 and 423 clinicians working before and after the study period, respectively 270 (61%) and 261 (61.7%) filled out the EDMCQ. Fifty of the 93 (53.7%) doctors participated in the coaching for a mean (standard deviation [SD]) of 4.36 (2.55) sessions. Of the 7254 patients, 125 (1.7%) were identified as PET, with 16 missing outcome data. Twenty-six of the PET and 624 of the overall population already had a written DNI-DNACPR decision at study entry, resulting in 83 and 6614 patients who were included in the main and post hoc analysis, respectively. The estimated incidence of written DNI-DNACPR decisions in the intervention vs. control arm was, respectively, 29.7% vs. 19.6% (odds ratio 4.24, 95% confidence interval 4.21-4.27; P < 0.001) in PET and 3.4% vs. 1.9% (1.65, 1.12-2.43; P = 0.011) in the overall study population. The estimated mortality at one year was respectively 85% vs. 83.7% (hazard ratio 2.76, 1.26-6.04; P = 0.011) and 14.5% vs. 15.1% (0.89, 0.72-1.09; P = 0.251). The mean difference in EDMCQ before and after the study period was 0.02 points (- 0.18 to 0.23; P = 0.815). CONCLUSION: This study suggests that coaching doctors regarding ethical decision-making in teams safely improves goal-oriented care operationalized via written DNI-DNACPR decisions in hospitalized patients, however without concomitantly improving the quality of the ethical climate.

Barriers and Strategies to Effective Serious Illness Communication for Patients with End-Stage Liver Disease in the Intensive Care Setting.

Background: Patients with end-stage liver disease (ESLD) often require Intensive Care Unit (ICU) admission during the disease trajectory, but aggressive medical treatment has not resulted in increased quality of life for patients or caregivers. Methods: This narrative review synthesizes relevant data thematically exploring the current state of serious illness communication in the ICU with identification of barriers and potential strategies to improve performance. We provide a conceptual model underscoring the importance of providing comprehensible disease and prognosis knowledge, eliciting patient values and aligning these values with available goals of care options through a series of discussions. Achieving effective serious illness communication supports the delivery of goal concordant care (care aligned with the patient's stated values) and improved quality of life. Results: General barriers to effective serious illness communication include lack of outpatient serious illness communication discussions; formalized provider training, literacy and culturally appropriate patient-directed serious illness communication tools; and unoptimized electronic health records. ESLD-specific barriers to effective serious illness communication include stigma, discussing the uncertainty of prognosis and provider discomfort with serious illness communication. Evidence-based strategies to address general barriers include using the Ask-Tell-Ask communication framework; clinician training to discuss patients' goals and expectations; PREPARE for Your Care literacy and culturally appropriate written and online tools for patients, caregivers, and clinicians; and standardization of documentation in the electronic health record. Evidence-based strategies to address ESLD-specific barriers include practicing with empathy; using the "Best-Case, Worst Case" prognostic framework; and developing interdisciplinary solutions in the ICU. Conclusion: Improving clinician training, providing patients and caregivers easy-to-understand communication tools, standardizing EHR documentation, and improving interdisciplinary communication, including palliative care, may increase goal concordant care and quality of life for critically ill patients with ESLD.

Sex specific analysis of patients with and without reported statin intolerance referred to a specialized outpatient lipid clinic.

BACKGROUND: Lowering LDL-cholesterol is a fundamental goal for both primary and secondary prevention of atherosclerotic cardiovascular diseases. Our study aims to analyse potential sex disparities regarding the tolerability and effectiveness of lipid-lowering therapy in patients with and without reported statin intolerance who are being treated at a lipid-outpatient clinic. METHODS: From 2017 to 2022, n = 1062 patients (n = 612 men, n = 450 women) at high-risk were referred to our lipid-outpatient clinic because of difficulties in lipid control by primary healthcare providers. The main therapeutic objective was to optimize lipid-lowering therapy according to current treatment guidelines. RESULTS: Patients presented with high LDL-C baseline levels (4.97 ± 1.81 mmol/l (192 ± 70 mg/dL) in men and 5.46 ± 2.04 mmol/l (211 ± 79 mg/dL) in women). Intolerance towards statins was reported more frequently by women (48.2%) than by men (38.9%, p = 0.004). LDL-C continuously decreased with individual treatment adjustments across follow-up visits. In total, treatment goals (LDL < 1.4 mmol/l (< 55 mg/dl) or < 1.8 mmol/l (< 70 mg/dl)) were accomplished in 75.8% of men and 55.5% of women after the last follow-up visit (p < 0.0001). In men, these data are almost identical in subjects with statin intolerance. In contrast, treatment goals were reached less frequently in women with statin intolerance compared to women tolerant to statin therapy. CONCLUSION: Even if treated in a specialized lipid clinic, women are less likely to reach their target LDL-C than men, particularly when statin intolerant. Nevertheless, many patients with statin intolerance can be successfully treated using oral combination and PCSK9 inhibitor therapy. However, ongoing follow-up care to monitor progress and to adjust treatment plans is necessary to reach this goal.

We investigated patients at high cardiovascular risk who were referred to our specialized lipid outpatient clinic because of elevated lipid levels and difficulties in lipid-lowering treatment in the primary care setting. The primary goal of such a clinic is to help patients to achieve optimal lipid levels through personalized treatment plans. We focused on prescription behavior and differences in treatment tolerability and effectiveness between men and women.A large proportion of patients (more frequently women (48.2%) than men (38.9%)) reported intolerance towards statins and most patients' LDL-cholesterol levels were far away from treatment goals. However, when treated at a specialized lipid clinic providing ongoing follow-up care to monitor progress and to adjust treatment plans if necessary, many of those patients were able to tolerate lipid lowering medication to achieve better lipid control and to maintain their lipid levels within target ranges.However, women were less likely to reach LDL-cholesterol treatment targets compared to men, especially if they reported intolerance towards statins. Ongoing follow-up care to monitor progress and to adjust treatment plans is necessary to reach treatment goals.

An extended goal programming approach with piecewise penalty functions for uncertain supplier-material selection problem in cardboard box manufacturing systems.

In this study a real case multi-objective material and supplier selection problem in cardboard box production industries is studied. This problem for the first time optimizes the objective functions such as total wastage amounts remained from all raw sheets, total costs of the system including purchasing cost and transportation cost (including fixed and variable costs) of the raw sheets, and total overplus of produced cardboard boxes. To be closer to the real situations, as a novelty, the problem is formulated in belief-degree-based uncertain environment with normal distribution where this type of uncertainty applies the ideas of experts. A solution approach including two steps is proposed to solve the problem. In the first step, the proposed uncertain formulation is converted to a crisp form using a typical chance constrained programming scheme. In the second step, a new goal programming approach containing a piecewise penalty function is developed in order to solve the obtained multi-objective crisp formulation. In this approach, based on the ideas of experts, multiple goals are considered with different penalty values. A case study from cardboard box industries is considered to evaluate the proposed formulations and solution approach. According to the obtained results, the proposed solution approach is compared to similar approaches of the literature and its efficiency is studied.

Theoretical concepts as goal-derived concepts.

In this paper, I will focus on the nature of theoretical concepts, i.e., the psychological entities related to theoretical terms in science. I will first argue that the standard picture of theoretical concepts in twentieth-century philosophy of science understood them as representation-oriented common taxonomic concepts. However, I will show how, in light of recent pragmatist approaches to scientific laws and theories, several important theoretical concepts in science do not seem to fit such picture. I will then argue that these theoretical concepts should be understood instead as goal-derived concepts, since their construction and use exhibit the typical characteristics that cognitive scientists assign to goal-derived concepts. I will furthermore argue that the existence of theoretical concepts that are goal-derived concepts represents yet another example of the central role that human goals play in science.

Effects of fluid therapy combined with a preoperative glucose load regimen on postoperative recovery in patients with rectal cancer.

BACKGROUND: Patients with rectal cancer undergoing radical resection often have poor postoperative recovery due to preoperative fasting and water deprivation and the removal of diseased tissue, and have a high risk of complications. Therefore, it is of great significance to apply appropriate rehydration regimens to patients undergoing radical resection of rectal cancer during the perioperative period to improve the postoperative outcomes of patients. AIM: To analyze the effects of goal-directed fluid therapy (GDFT) with a preoperative glucose load regimen on postoperative recovery and complications in patients undergoing radical resection for rectal cancer. METHODS: Patients with rectal cancer who underwent radical resection (n = 184) between January 2021 and December 2023 at our hospital were randomly divided into either a control group or an observation group (n = 92 in each group). Both groups received a preoperative glucose load regimen, and routine fluid replacement and GDFT were additionally implements in the control and observation groups, respectively. The operative conditions, blood levels of lactic acid and inflammatory markers, postoperative recovery, cognitive status, hemodynamic indicators, brain oxygen metabolism, and complication rates were compared between the groups. RESULTS: The colloidal fluid dosage, total infusion, and urine volume, as well as time to first exhaust, time to food intake, and postoperative length of hospital stay, were lower in the observation group (P < 0.05). No significant differences were observed between the two groups in terms of operation time, bleeding volume, crystalloid liquid consumption, time to tracheal extubation, complication rate, heart rate, or mean arterial pressure (P > 0.05). Compared with the control group, in the observation group the lactic acid level was lower immediately after the surgery (P < 0.05); the Mini-Mental State Examination score was higher on postoperative day 3 (P < 0.05); the pulse pressure variability (PPV) was lower at 30 min after pneumoperitoneum (P < 0.05), though the differences in the PPV of the two groups was not significant at the remaining time points (P > 0.05); tumor necrosis factor-α and interleukin-6 levels were lower on postoperative day 3 (P < 0.05); and the left and right regional cerebral oxygen saturation was higher immediately after the surgery and 30 min after pneumoperitoneum (P < 0.05). CONCLUSION: GDFT combined with the preoperative glucose load regimen is a safe and effective treatment strategy for improving postoperative recovery and risk of complications in patients with rectal cancer undergoing radical resection.

An online delivered running and walking group program to support low-active post-secondary students' well-being and exercise behavior during the COVID-19 pandemic: a pilot randomized controlled trial.

OBJECTIVE: Examine the feasibility and acceptability of a social identity-informed, online delivered, running and walking group program to support low-active post-secondary students' exercise behavior and well-being during the COVID-19 pandemic. METHODS: A two-arm, non-blinded, parallel pilot randomized controlled trial was conducted whereby low-active post-secondary students at a Canadian university were equally randomized to an online delivered running/walking group program or an attention control condition. Primary feasibility and acceptability outcomes included program interest, study enrolment and retention, questionnaire completion, program attendance, program satisfaction, and affective exercise attitudes. Post-program interviews were conducted to ascertain participants' experiences with the program. Secondary outcomes included well-being, exercise behavior, social identity, social support, and exercise identity. RESULTS: Ninety-two individuals were screened for eligibility, and 72 were equally randomized to the online group program or attention control condition. Recruitment exceeded the target sample size (60), study adherence and questionnaire completion were above 90%, program attendance was moderate (M = 5.03/8), self-report program satisfaction was moderate-to-high (M = 4.13/5), and there was no condition effect for affective attitudes. During interviews, participants expressed satisfaction with the program. They also discussed challenges with developing a shared sense of identity and social connection with group members via online platforms. There were small condition effects for exercise-related well-being and exercise identity and no condition effects for the remaining secondary outcomes. Social identity scores were moderate (M = 4.63/7). CONCLUSIONS: The STRIDE program was feasible and acceptable but should be delivered and piloted in-person before a full-scale efficacy trial is conducted. TRIAL REGISTRATION: ClinicalTrials.gov NCT04857918; 2021-04-20.

Semantic learning from keyframe demonstration using object attribute constraints.

Learning from demonstration is an approach that allows users to personalize a robot's tasks. While demonstrations often focus on conveying the robot's motion or task plans, they can also communicate user intentions through object attributes in manipulation tasks. For instance, users might want to teach a robot to sort fruits and vegetables into separate boxes or to place cups next to plates of matching colors. This paper introduces a novel method that enables robots to learn the semantics of user demonstrations, with a particular emphasis on the relationships between object attributes. In our approach, users demonstrate essential task steps by manually guiding the robot through the necessary sequence of poses. We reduce the amount of data by utilizing only robot poses instead of trajectories, allowing us to focus on the task's goals, specifically the objects related to these goals. At each step, known as a keyframe, we record the end-effector pose, object poses, and object attributes. However, the number of keyframes saved in each demonstration can vary due to the user's decisions. This variability in each demonstration can lead to inconsistencies in the significance of keyframes, complicating keyframe alignment to generalize the robot's motion and the user's intention. Our method addresses this issue by focusing on teaching the higher-level goals of the task using only the required keyframes and relevant objects. It aims to teach the rationale behind object selection for a task and generalize this reasoning to environments with previously unseen objects. We validate our proposed method by conducting three manipulation tasks aiming at different object attribute constraints. In the reproduction phase, we demonstrate that even when the robot encounters previously unseen objects, it can generalize the user's intention and execute the task.

Enhancing task performance in adults with intellectual disability through modified goal management training and assistive technology with errorless learning: A randomized controlled trial.

Individuals with intellectual disabilities often fail to learn complex tasks. Modified Goal Management Training (mGMT) or Errorless Learning combined with assistive technology (App + EL) can help. The goal is to demonstrate the effectiveness of mGMT and/or App + EL in learning complex tasks. We employed a randomized controlled crossover design. One group started with mGMT (N = 16), and the other with App + EL (N = 15). We compared their performance with that of a passive control group (N = 15). The training consisted of six sessions of 30 minutes each. Success was analyzed using the Goal Attainment Scale (GAS). Three different tasks were assessed before and after each intervention period: "Practiced", "Non-Practiced", or "Previously Practiced". Generalization was evaluated through neuropsychological tests. Results indicated that both interventions significantly improved "Practiced" tasks compared with "Non-Practiced" tasks and the control group. Crossing the intervention did not interfere with the stable performance on the "Previously Practiced" task. However, starting with mGMT reduced, but did not eliminate, the efficacy of App + EL after crossing, but this pattern was not observed for the reverse sequence. Only the Tower of London task documented improvements related to interventions. In conclusion, the mGMT and App + EL were effective in learning complex tasks and retaining performance after learning a second task.Trial registration: German Clinical Trials Register identifier: DRKS00021674.

Impact of Health Care Management Workshops on the Health-Seeking Behavior of Traffic Police in Bhubaneswar.

Background: Sustainable development goals (SDGs) 3.9.1 and 11.6.2 call for a reduction in deaths and illnesses from air pollution, improving the air quality of cities. The above goals motivate us to organize workshops to improve the health of traffic police, who bear the brunt of air pollution. The paper examines the effect of workshops on the health-seeking behavior of the traffic police in Bhubaneswar city. Methods: The study conducted two workshops as a quasi-experimental, single-group study at an academic institution in Bhubaneswar. It included 20 traffic police officers (11 male and 9 female). The Kirkpatrick 4-level model was used to assess the effectiveness of the workshops. A paired t-test was used to compare pre- and postworkshop scores. Results: Thirteen traffic police officers rated the workshop sessions as excellent. The score before the workshop ranged from zero to three, with a mean (standard deviation [SD]) of 2.81 (1.0). The postworkshop score had a minimum to maximum score of three to five with a mean (SD) of 4.41 (0.7) (P < 0.005). The effect size dcohen (confidence interval [CI]) was 1.87 (3.27-4.71). The mean (SD) of absolute and relative gain was 1.6 (1.0) and 0.93 (1.02), respectively. All 20 traffic police officers showed improvement in health-seeking behavior. The significant lifestyle changes after the workshops ranged between 5% and 75%. Conclusion: The test scores indicated statistically significant improvement as the P value recorded was smaller than 0.05. This concludes that the improvement in understanding of the session was statistically significant because of the training imparted.

Intraoperative goal-directed fluid therapy in neurosurgical patients: A systematic review.

Background: Perioperative fluid management is critical in neurosurgery as over perfusion can lead to brain edema whereas under perfusion may lead to brain hypoperfusion or ischemia. We aimed to determine the effectiveness of intraoperative goal-directed fluid therapy (GDFT) in patients undergoing intracranial surgeries. Methods: We searched MEDLINE, Cochrane, and PubMed databases and forward-backward citations for studies published between database inception and February 22, 2024. Randomized controlled trials where intraoperative GDFT was performed in neurosurgery and compared to the conventional regime were included in the study. GDFT was compared with the conventional regime as per primary outcomes - total intraoperative fluid requirement, serum lactate, hemodynamics, brain relaxation, urine output, serum biochemistry, and secondary outcomes - intensive care unit and hospital length of stay. The quality of evidence was assessed with the Cochrane risk of bias tool. This study is registered on PROSPERO (CRD42024518816). Results: Of 75 records identified, eight were eligible, the majority of which had a low to moderate risk of overall bias. In four studies, more fluid was given in the control group. No difference in postoperative lactate values was noted in 50% of studies. In the remaining 50%, lactate was more in the control group. Three out of four studies did not find any significant difference in the incidence of intraoperative hypotension, and four out of six studies did not find a significant difference in vasopressor requirement. The majority of studies did not show significant differences in urine output, brain relaxation, and length of stay between both groups. None found any difference in acid base status or electrolyte levels. Conclusion: GDFT, when compared to the conventional regime in neurosurgery, showed that the total volume of fluids administered was lesser in the GDFT group with no increase in serum lactate. There was no difference in the hemodynamics, urine output, brain relaxation, urine output, length of stay, and biochemical parameters.

Rat anterior cingulate neurons responsive to rule or strategy changes are modulated by the hippocampal theta rhythm and sharp-wave ripples.

To better understand neural processing during adaptive learning of stimulus-response-reward contingencies, we recorded synchrony of neuronal activity in anterior cingulate cortex (ACC) and hippocampal rhythms in male rats acquiring and switching between spatial and visual discrimination tasks in a Y-maze. ACC population activity as well as single unit activity shifted shortly after task rule changes or just before the rats adopted different task strategies. Hippocampal theta oscillations (associated with memory encoding) modulated an elevated proportion of rule-change responsive neurons (70%), but other neurons that were correlated with strategy-change, strategy value and reward-rate were not. However, hippocampal sharp wave-ripples modulated significantly higher proportions of rule-change, strategy-change and reward-rate responsive cells during post-session sleep but not pre-session sleep. This suggests an underestimated mechanism for hippocampal mismatch and contextual signals to facilitate ACC to detect contingency changes for cognitive flexibility, a function that is attenuated after it is damaged.

Self-perceived functioning, goals and action plans: an evaluation of an ICF-based E-health application in an intervention for people with a combination of mental and physical health conditions.

PURPOSE: In the BigMove intervention, people with physical and mental health conditions assess their functioning, set goals, and define action plans to achieve their goals recorded in an e-health application using all categories of the International Classification of Functioning, Disability, and Health (ICF). This study investigates whether data from this application can provide insight into participants' self-perceived functioning, goals and action plans and observe changes over time. METHODS: Data from 446 participants were analysed with descriptive statistics to describe self-perceived functioning and the ICF categories related to the 15 most frequently chosen goals. Action plans were analysed using inductive analysis. Changes over time were investigated by comparing assessments before and after at least 4 months in the intervention. RESULTS: The data provided insight into the self-perceived functioning, goals and action plans. Also, changes over time were observed. Self-perceived functioning changed from being mainly negative before, to mainly positive after the intervention. While goals were mostly related to the same ICF categories, the action plans changed from more specific short-term to more general long-term plans. CONCLUSIONS: Our study demonstrates that all categories of the ICF can be used to record self-perceived functioning, goals and action plans and monitor changes over time.

The complete International Classification of Functioning, Disability, and Health (ICF) can provide a useful tool to record self-perceived functioning, goals, and action plans.Setting goals by using all ICF categories shows what is relevant to people themselves and can stimulate activities that foster functioning according to what people value.Assessments of self-perceived functioning, related goals, and action plans offer a novel approach to assessing health and comparing healthcare outcomes.

Is adding resources always beneficial? Multiplicative impact of psychological capital and goal-oriented climate on Spanish public worker satisfaction and engagement.

Introduction: The motivation process from personal resources to commitment of administrative employees is still little studied. This article uses the Job Demands-Resources model to investigate how the multiplicative effect of personal resources and a goal-oriented climate among public employees influences their satisfaction and engagement at work. Specifically, it proposes a model where the influence of psychological capital on engagement is mediated by job satisfaction and moderated by the goal orientation climate. Method: A total of 326 employees of the administrative staff of a Spanish Public Administration answered a self-reported survey. Partial Least Square-Structural Equation Modeling (PLS-SEM) approach was used to evaluate the validity and reliability of the data, as well as, to test the hypotheses formulated. Results: The SEM results show the positive impact of psychological capital on employee engagement, and the mediating role of job satisfaction in this relationship. Furthermore, the existence of a goal-oriented climate negatively moderated the relationship between Psychological Capital and Job Satisfaction, reducing the mediation effect. Discussion: These findings open new doors for future research in the necessary adaptation of human resource policies to improve the motivation process in the public administration context.

Context matters: task relevance shapes neural responses to emotional facial expressions.

Recent research shows that emotional facial expressions impact behavioral responses only when their valence is relevant to the task. Under such conditions, threatening faces delay attentional disengagement, resulting in slower reaction times and increased omission errors compared to happy faces. To investigate the neural underpinnings of this phenomenon, we used functional magnetic resonance imaging to record the brain activity of 23 healthy participants while they completed two versions of the go/no-go task. In the emotion task (ET), participants responded to emotional expressions (fearful or happy faces) and refrained from responding to neutral faces. In the gender task (GT), the same images were displayed, but participants had to respond based on the posers' gender. Our results confirmed previous behavioral findings and revealed a network of brain regions (including the angular gyrus, the ventral precuneus, the left posterior cingulate cortex, the right anterior superior frontal gyrus, and two face-responsive regions) displaying distinct activation patterns for the same facial emotional expressions in the ET compared to the GT. We propose that this network integrates internal representations of task rules with sensory characteristics of facial expressions to evaluate emotional stimuli and exert top-down control, guiding goal-directed actions according to the context.

Being a focused employee: Effects of job reattachment on cyberloafing.

Cyberloafing, the use of the Internet for non-work-related activities while at work, has become a growing problem in the workplace. Since cyberloafing is commonly regarded as counterproductive, anticipating and controlling employees' cyberloafing behaviour is becoming increasingly important. Previous research suggests that individuals who engage in cyberloafing may have difficulties regulating their attention to important tasks. Based on self-regulation theory, our study examines the influence of job reattachment on cyberloafing through the mediating role of mindfulness and the moderating role of goal commitment. Data for this study were collected in China through surveys conducted with 275 employees at three different time points. The results showed that: (1) job reattachment was significantly negatively associated with cyberloafing; (2) mindfulness mediated this relationship between job reattachment and cyberloafing; and (3) goal commitment moderated the direct effect of job reattachment on mindfulness as well as the indirect effect of job reattachment on cyberloafing through mindfulness. Overall, our research findings emphasize the importance of the impact of job reattachment on cyberloafing through mindfulness. Theoretical and practical implications of this study are discussed.