Práticas integrativas e complementares de saúde em Sergipe / Integrative and complementary health practices in Sergipe

A atenção primária em saúde (APS) é o primeiro nível de atenção em saúde, sendo um elo entre a população e o setor de saúde. Tem-se buscado a humanização dos atendimentos, e essa mudança, refletida pelas mudanças da sociedade, trouxe a implementação da Política Nacional de Práticas Integrativas e Complementares (PNPIC) no SUS. O objetivo deste trabalho foi realizar uma análise da tendência da quantidade das práticas integrativas e complementares realizadas nas regionais de saúde de Sergipe de 2017 a 2023, associando com a cobertura da atenção primária. Foi realizada análise de dados secundários através do Departamento de Informática do Sistema Único de Saúde (DATASUS), como forma de organização no período de junho/2015 a junho/2023 por regional de saúde de Sergipe. As análises dos dados foram descritivas e de correlação e por meio de análise de série temporal. A regional de saúde de Lagarto foi a que mais executou as práticas integrativas e complementares no período analisado e algumas regionais não tiveram continuidade na realização destas práticas. A regional de saúde com maior cobertura de APS foi Itabaiana. Não foi possível observar associação entre o número de práticas e a cobertura de atenção primária. Com o intuito de que o atendimento aos indivíduos seja cada vez mais humanizado, e em virtude da realização das práticas integrativas ter baixo índice ou descontinuidade em algumas regiões de Saúde de Sergipe, é relevante que os profissionais de saúde busquem conhecimentos sobre essas práticas, como também, os gestores em saúde incentivem esta ação.

Primary health care (PHC) is the first level of health care, being a link between the population and the health sector. The aim has been to humanize care, and this change, reflected by changes in society, has led to the implementation of the National Policy on Integrative and Complementary Practices (PNPIC) in the SUS. The objective of this work was to carry out an analysis of the trend in the number of integrative and complementary practices carried out in the health regions of Sergipe from 2017 to 2023, associating it with primary care coverage. Secondary data analysis was carried out through the Department of Informatics of the Unified Health System (DATASUS), as a form of organization from June/2015 to June/2023 by health region in Sergipe. Data analyzes were descriptive and correlational and through time series analysis. The Lagarto health region was the one that carried out the most integrative and complementary practices in the period analyzed and some regions did not continue to carry out these practices. The health region with the highest PHC coverage was Itabaiana. Observing an association between the number of practices and primary care coverage was impossible. With the aim that care for individuals is increasingly humanized, and because the implementation of integrative practices has a low rate or discontinuity in some Health regions of Sergipe, health professionals must seek knowledge about these practices as well as health managers encourage this action.

Literacia em saúde da pessoa internada em serviço de cirurgia oncológica / Health literacy of patients admitted to a surgical oncology unit / Alfabetización en salud de las personas ingresadas en un servicio de cirugía oncológica

Resumo Enquadramento: A literacia em saúde (LS) é a capacidade da pessoa obter e traduzir informações a fim de manter e melhorar a saúde. Objetivo: Caracterizar o nível de LS da pessoa internada num hospital oncológico; avaliar a fiabilidade do instrumento European Health Literacy Survey in Portuguese (HLS-EU-PT). Metodologia: Estudo transversal, quantitativo, descritivo e metodológico. Amostra de 188 pessoas internados num serviço de cirurgia oncológica entre maio e setembro de 2020, os dados foram colhidos através de formulário de caracterização sociodemográfica, de saúde e instrumento de avaliação da LS. Resultados: O HLS-EU-PT apresentou elevado nível de consistência interna. Todos os domínios e níveis de processamento do instrumento se correlacionam positivamente entre si. Os participantes apresentam em média um nível problemático de LS. Conclusão: Os resultados indiciam a necessidade de um maior investimento na capacitação da LS. São necessários mais estudos nesta e noutras populações e contextos de prestação de cuidados de saúde, de forma a direcionar a prática de cuidados na resposta eficaz aos problemas de saúde.

Abstract Background: Health literacy (HL) is the ability of an individual to obtain and translate information in order to maintain and improve their health. Objective: To characterize the level of HL of patients admitted to an oncology hospital and assess the reliability of the Portuguese version of the European Health Literacy Survey (HLS-EU-PT). Methodology: Cross-sectional, quantitative, descriptive, and methodological study. Sample of 188 patients admitted to a surgical oncology unit between May and September 2020. Data were collected through a sociodemographic and health characterization form and a HL assessment tool. Results: The HLS-EU-PT had a high level of internal consistency. All domains and information-processing levels correlated positively with each other. Participants had on average a problematic level of HL. Conclusion: The results indicate the need for greater investment in HL training. Further studies are needed in this population and in other populations and healthcare settings to provide an effective response to health problems.

Resumen Marco contextual: La alfabetización en salud (AS) es la capacidad de una persona para obtener y traducir información con el fin de mantener y mejorar su salud. Objetivo: Caracterizar el nivel de AS de las personas ingresadas en un hospital oncológico; evaluar la fiabilidad del instrumento European Health Literacy Survey in Portuguese (HLS-EU-PT). Metodología: Estudio transversal, cuantitativo, descriptivo y metodológico. Muestra de 188 personas ingresadas en un servicio de cirugía oncológica entre mayo y septiembre de 2020, se recogieron datos mediante un formulario de caracterización sociodemográfica y de salud, y una herramienta de evaluación de AS. Resultados: El HLS-EU-PT mostró un alto nivel de consistencia interna. Todos los dominios y niveles de procesamiento del instrumento correlacionaron positivamente entre sí. Por término medio, los participantes tienen un nivel problemático de AS. Conclusión: Los resultados indican la necesidad de una mayor inversión en formación en AS. Son necesarios más estudios en esta y otras poblaciones, y en entornos sanitarios para orientar la práctica asistencial hacia una respuesta eficaz a los problemas de salud.

Prevention & management of snakebite envenomation: A qualitative study on perspectives & practices in Maharashtra & Odisha.

Background & objectives Snakebite envenoming (SBE) is a major public health concern, with India bearing the highest global burden of SBE-related deaths. SBE is concentrated in rural and tribal regions of India, where the knowledge, attitude and behaviour of the dwelling communities largely influence mortality and morbidity. Understanding these factors is crucial to designing effective SBE prevention and management strategies. The present study's objective was to document the perspectives of community members and practices in selected blocks of Maharashtra and Odisha States regarding SBE prevention, first aid and health-seeking behaviour. Methods Between March and April 2022, 28 focus group discussions (FGDs) were conducted. Study sites included Shahapur block in Thane district, Aheri block in Gadchiroli district of Maharashtra, and Khordha block in Khordha district, Kasipur block in Rayagada district of Odisha. Separate FGDs were held for males (n=14) and females (n=14), involving about 8-16 participants above 18 yr. All discussions were audio recorded, and a grounded theory approach was employed to identify key themes from the translated transcripts. Results The findings of this study revealed a variety of perspectives and practices determining the SBE burden at the study sites. The findings included insufficient knowledge about snake species and their nature of toxicity, use of non-scientific first aid techniques, inaccessible health care and reliance on traditional healers, non-utilization of prevention methods, varied cultural beliefs and practices, and differential treatments based on gender. The findings have been collated in two simplistic frameworks; barriers to effective prevention and barriers to effective management. Interpretation & conclusions SBE burden results from a complex interplay between socioeconomic, cultural, and demographic factors, necessitating a collaborative inter-sectoral effort for adequate control. Through crucial regional inputs and the barriers to prevention and management models, this study provides critical insights and priority intervention areas to strengthen India's upcoming National Action Plan for Prevention and Control of Snakebite Envenoming (NAPSE) in all high-burden States.

Knowledge, attitude, and practices of tsunami-prone communities, Nias, Indonesia.

Nias Island is presently being confronted with a substantial and imminent threat of a tsunami. However, the level of knowledge of the communities on Nias Island regarding earthquake and tsunami hazards is limited. This study aims to evaluate the level of knowledge, attitudes, and practices (KAP) among the communities residing on Nias Island with respect to the hazard of tsunami. This study adopted a community participation method derived from a social inductive study. Data were collected from field observations and in-depth interviews with 210 communities. Data were analysed using a descriptive table form for comprehensive examination. The results showed that the majority of communities lacked comprehensive knowledge regarding both the sources of tsunamis and estimated times of arrival (ETAs) for tsunamis. The findings also indicated a lack of regular disaster evacuation drills or simulations conducted by the government in the area. Moreover, there is a prevailing belief among the communities that God will prevent loss of life in the event of a tsunami. This belief is concerning because of its potential contribution to a fatalistic attitude towards disasters, potentially resulting in inadequate preparedness. The findings of this research confirm previous research that found that people living on small islands in Indonesia have very limited knowledge of the tsunami hazard. Contribution: These findings highlight the important role of the government to carry out substantial efforts aimed at enhancing the resilience of communities residing in small islands. Currently, small islands receive less attention in efforts to reduce disaster risk.

Self-care practices among professional nurses employed in primary health care clinics.

BACKGROUND:  Professional nurses typically promote and advocate self-care practices to their patients to achieve better health outcomes, but rarely engage in these practices themselves. METHODS:  A qualitative, descriptive phenomenological approach was used in this study. Ten professional nurses employed in different primary health care facilities were purposively sampled. Semi-structured interviews were conducted to collect data, which were analysed using Colaizzi's data analysis strategy, and data saturation was reached. RESULTS:  Two themes were identified. Theme 1: the participants expressed that internal and external factors compromised self-care practices, such as subconscious self-neglect, insufficient resources, and a depressed economy, which encouraged them to work extended hours. Theme 2: participants' holistic well-being was compromised, as they neglected their mental well-being. CONCLUSION:  Self-care practices among professional nurses seem unachievable. The extent of this population's self-care neglect was evident during the coronavirus disease 2019 (COVID-19) pandemic when professional nurses globally gave of themselves relentlessly.Contribution: This is the first study conducted on the topic in the City of Ekurhuleni, and the findings will provide relevant stakeholders with a directive on what strategies, policies, and guidelines to develop and implement to make self-care practices attainable for professional nurses.

Exploring the Utility of a Novel Approach of Evaluating Application of a Validated Violence Risk Assessment Instrument.

Mental health nurses are often responsible for assessment/management of inpatient aggression. Validated instruments such as the Dynamic Appraisal of Situational Aggression (DASA), can aid risk assessment. However, limited attention has been paid to evaluating nurses' ability to administer risk assessment instruments. An entrustable professional activity may offer way of evaluating risk assessment clinical activities. DASA trainers' perceptions of the value and utility of an EPA were explored via collection of data through focus groups, with 17 participants from six countries. Thematic analysis was conducted to analyze the data. Three themes were interpreted: (1) DASA trainers-a way of knowing and being (2) An EPA-something you did not know you need until you see it; (3) The DASA-EPA supports the need for training and importance of integrity in assessment. Trainers engaged in innovative ways to ensure training is suitable and responsive to needs of nurses and their setting. Participants understood how an EPA could be used to evaluate DASA administration, monitor DASA use, provide feedback, and highlight the importance of training to ensure best practice.

Dr. Ignaz Phillip Semmelweis: The Unrecognized Pioneer of Aseptic Practices.

Modern medicine is well-versed in aseptic and infection control practices, such as hand hygiene, proper use of disinfectants, and personal protective equipment. The early 1800s lacked any concept of effective antisepsis because they predominantly believed in the miasma theory (now abandoned), which believed that disease was caused by bad air coming out of rotting organic matter. In the era of "miasma theory," Ignaz Semmelweis dared to pave the way for germ theory disease. Vienna General Hospital supported his work, but his hypothesis remained unpublished and unheard by the rest of the world. In 1861, his major publication, "The etiology, concept, and prophylaxis of childbed fever," sparked strong opposition and rejection of his theories. His mental condition deteriorated due to the strong rejection and criticism from his peers, leading to the development of amnesia, anxiety, and severe depression. He was unfortunately admitted to an Austrian asylum, where he was confined and beaten. Eventually, the man who conquered puerperal fever succumbed to septicemia due to an infected wound from the beating.

Reducing unnecessary outpatient group and screen testing at a regional cancer center.

BACKGROUND: Unnecessary group and screens (G&S) can lead to unnecessary antibody investigations, use of technologist time, and laboratory resources. LOCAL PROBLEM: A baseline audit at our institution identified that 25% of G&S from the cancer center were unnecessary. We aimed to reduce the ratio of monthly G&S to CBC samples processed from the cancer center by 10% (from 0.034 to 0.031) by January 2024. METHODS: This represents an interrupted time series design from November 2022 to January 2024. Using Plan Do Study Act (PDSA) cycles, we aimed to increase the use of an existing reflex testing system, termed "do not test." When this option is selected, the blood bank will only process the G&S sample if specific CBC criteria are met (e.g., hemoglobin <9.0 g/dL). Educational sessions increased awareness of this feature and sought feedback from end-users on its usability. With feedback, the design was updated to include a modifiable hemoglobin threshold for G&S testing, automatic re-selection of the "do not test" feature for future G&S orders, and aesthetic changes to make the feature more visible. RESULTS: The percentage of samples with "do not test" selected increased from 7.2% to 63.0% (p < .0001) and the ratio of G&S to CBC specimens improved from 0.034 to 0.028, exceeding the target of 0.031. We noted an improvement in the appropriateness of G&S orders from 75% at baseline (n = 20) to 97.5% (n = 80) post intervention (p = .003). CONCLUSIONS: We describe an effective strategy to improve G&S utilization at our institution's cancer center using a reflex testing system.

Plantain flour: production processes, technological characteristics, and its potential use in traditional African dishes - a review.

This review describes some processes for converting plantain pulp into flour and semolina and the influences that operating conditions can have on some of the technological characteristics (functional and pasting) of this flour. Some traditional African dishes that can be prepared with plantain flour are also presented. A literature review was conducted using a list of keywords and expressions on platforms such as Google, Google Scholar, and ResearchGate. The results show that work carried out to date has mainly focused on a few well known traditional bakery products such as bread, cakes, and biscuits. There has been relatively little research on transforming plantain pulp into flour as part of the preparation of traditional African dishes such as foutou or amala. This work has often been carried out in the laboratory, without any link to local artisanal processes or knowledge of consumer preferences. There is a need to standardize local culinary practices for processing plantain into flour or semolina. The data from this review opens the door for applied research into innovative technological procedures for processing plantain to add value to local dishes adapted to new urban lifestyles, to meet local consumer needs, and to reduce post-harvest losses. © 2024 Society of Chemical Industry.

Development of self-administered questionnaire on barriers, prescription practices, and guideline adherence of osteoporosis management among tertiary care clinicians: content validity and reliability analysis.

Objective: This study outlined the development of the barriers, prescribing practices, and guideline adherence for osteoporosis management according to the Clinicians' Osteoporosis Questionnaire (COQ) followed by an assessment of the content validity index and reliability test. Methods: The development of the COQ was performed in two stages. Stage I involved the development of the COQ, and stage II involved judgmental evidence and quantification of the questionnaire. Five panel experts related to the study area and five clinicians participated in the validity of the COQ assessment. Fifty clinicians took part in the reliability test evaluation by filling out the questionnaire twice at 2-week intervals. The content validity index (CVI) and content validity ratio (CVR) were analyzed using Microsoft Excel, while Cohen's kappa statistic was used to determine the test-retest reliability using SPSS version 29. Results: Forty items and three domains, namely, barriers, prescribing practices, and guideline adherence for osteoporosis management, were identified in the COQ (version 4.0). The scale-level CVI (S-CVI/Ave) for every domain was above 0.9, which is considered acceptable. The CVRs for all the items were above 0.7, except for two items in the barrier domain and two items in the guideline adherence domain. Two items were revised to improve the clarity of the item, and other items were retained based on consensus among the expert panel. Between the test and retest, the reliability of individual items ranged from moderate to almost perfect for the barrier domain (k = 0.42-0.86), prescribing practice domain (k = 0.79-0.87), and guideline adherence domain (k = 0.46-1). None of the items had "fair" or "poor" agreement. Thus, the 40-item COQ (version 4.0) was finalized following the content and face validity analysis. Conclusions: Through an iterative process, the development and assessment of the COQ showed a high degree of content validity and reliability in measuring the barriers, prescribing practices, and guideline adherence among clinicians managing osteoporosis. Future studies should aim to further validate this instrument across different populations and settings, as well as explore methods to enhance its reliability and validity.

Response Patterns and Behavior of Seropositive Blood Donors: A Comprehensive Analysis.

Background Blood transfusion services are vital in healthcare, ensuring a steady and safe supply of blood for patients in need. Identifying seropositive blood donors and understanding their response patterns and behaviors are critical for improving the safety and efficacy of blood transfusion practices. Aim Our study aims to determine the response rate and pattern of blood donors who test reactive for transfusion-transmitted infections (TTIs) and to understand the attitudes of reactive blood donors toward post-donation notification, follow-up, and counseling. Materials and methods Our study is retrospective audit analyzing the data record for a period of 24 months from October 2021 to October 2023 in the transfusion medicine department of a tertiary care hospital in southern India. All donations were screened for hepatitis B, hepatitis C, HIV, malaria, and syphilis. Results Of the total 8,276 donations during the study period, 117 (1.41%) were reactive for various TTIs. The highest prevalence was hepatitis B (0.61%), followed by hepatitis C (0.38%), then HIV (0.22%) and syphilis (0.14%). Of all the TTI reactive donors, 82 donors (70%) responded after communication, and the remaining 30% could not be contacted by any mode of communication. The most common reason for non-communication was the fabricated postal address given by the donors. Of the donors approached, 57 (48.7%) reinstated to our blood bank for further counseling and specific treatment. The donor's busy schedule and out-of-city residence were the main reasons for non-compliance with the follow-up protocol. Conclusion Informing donors of their serological status and providing post-donation counseling are crucial elements of blood transfusion protocol. Necessary knowledge about TTIs are to be instilled to the donors during the blood collection procedure. Moreover, its crucial for the donor to provide accurate demographic details aiding follow up and easy access during times of managing blood inventory.

Evaluating the psychometric properties of three WHO instruments to assess knowledge about human rights, attitudes toward persons with mental health conditions and psychosocial disabilities, and practices related to substitute decision-making and coercion in mental health.

Background: Instruments to assess the knowledge about the rights of persons with mental health conditions and psychosocial disabilities, the attitudes toward their role as rights holders, and mental health professionals' practices related to substitute decision-making and coercion are either missing or lack evaluation of their validity and reliability. Aim: The aim of this study is to evaluate the validity and reliability of three instruments developed to fill this gap in the literature, the World Health Organization's QualityRights (WHO QR) Knowledge questionnaire, the WHO QR Attitudes questionnaire, and the WHO QR Practices questionnaire. Methods: A sample of participants was recruited and completed an online survey. Content validity and face validity were assessed for the three questionnaires. Based on the characteristics of the questionnaires, different approaches were used to assess their construct validity (confirmatory factor analysis, known group validity, and convergent and divergent validity). Internal consistency was evaluated using Cronbach's alpha and test re-test reliability using Pearson's and Spearman's r coefficients. Results: The analyses conducted indicate that the three questionnaires are valid and reliable instruments to evaluate the knowledge about the rights of persons with mental health conditions and psychosocial disabilities, the attitudes toward their role as rights holders, and mental health professionals' practices related to substitute decision-making and coercion. Conclusion: This finding lends support to the use of these instruments both within mental health services and in the general population for a better understanding of current knowledge, attitudes, and practices related to a human rights-based approach to mental health in mental health services and the community.

Shifting the Paradigm for Establishing and Maintaining Milk Production in the Setting of Mother/Infant Separation.

Establishing lactation when mother and infant are separated, such as when the neonate is admitted to the neonatal intensive care unit (NICU), is challenging. The most common clinical advice is to express milk eight or more times per day, every 3 hours, around the clock. Sometimes, the first time that parents hear this is after the birth of their baby. This can be overwhelming and sometimes unachievable. A five-step paradigm shift is proposed that refocuses lactation care on providing evidence-based assistance and ongoing clinical education, and assessment beginning prenatally and extending past maternal discharge, to improve outcomes through curated support. Simple guidelines can begin with expressing milk at least five times a day by Day 5 of life (5 × 5), and expressing milk at least once between 0100 and 0500 (overnight pumping). With these measures, neonatal care in the NICU setting can provide personalized and achievable guidance on pumping schedules.

A survey of speech-language pathology service delivery in Australian schools.

PURPOSE: Speech-language pathologists (SLPs) work in Australian schools yet, little is documented about their service delivery practices. This study therefore explores Australian speech-language pathology service delivery in schools, inclusive of work activities, caseloads, and assessment and intervention practices. METHOD: An online survey comprising multiple choice, constant sum, Likert scale, and open text questions was completed by 105 SLPs. Quantitative data was analysed using descriptive statistics while open-text responses were analysed using content analysis. RESULT: Participants were predominantly government education department employees working in multiple schools, and caseloads ranged from 10 to 240 students for full-time SLPs. While responses varied considerably, some general trends emerged. Most time was spent on intervention, followed by non-contact tasks, and assessments, with differences across employment sectors. Language was the most common student need, followed by literacy and speech. Frequently reported factors contributing to client complexity and intervention frequency were co-occurring presentations, severity of student needs, caseload size, and impact on learning. Caseload manageability was a concern for participants who reported larger caseloads, spent more time in assessment or less time in therapy than others, and worked in education departments. CONCLUSION: Findings have implications for policy makers, professional bodies and employers, and provide direction for future systematic data collection.

Scalable and successful patient portal lifestyle coaching training for primary care clinical staff.

Maintaining a healthy weight postintentional weight loss is crucial for preventing chronic health conditions, yet many regain weight postintervention. Electronic health record (EHR) portals offer a promising avenue for weight management interventions, leveraging patient-primary care relationships. Our previous research demonstrated that coaching alongside self-monitoring improves weight maintenance compared to monitoring alone. Integrating weight management into routine clinical practice by training existing staff could enhance scalability and sustainability. However, challenges such as inconsistent staff qualifications and high coach turnover rates could affect intervention effectiveness. Standardizing services, training, and coaching continuity seem crucial for success. To report on developing, testing, and evaluating an EHR-based coaching training program for clinical staff, guided by an implementation tool for the MAINTAIN PRIME study. Conducted across 14 University of Utah primary care sites, we developed, tested, and evaluated a coaching training for clinical staff. Guided by a planning model and the Predisposing, Enabling, and Reinforcing (PER) tool, stakeholders actively participated in planning, ensuring alignment with clinic priorities. All clinical staff were invited to participate voluntarily. Evaluation measures included staff interest, training effectiveness, confidence, and readiness. Data collection utilized REDCap, with survey results analyzed using descriptive statistics. Despite increased clinical workload and reassignments posed by coronavirus disease 2019, we were able to train 39 clinical staff, with 34 successfully coaching patients. Feedback indicated high readiness and positive perceptions of coaching feasibility. Coaches reported satisfaction with training, support, and enjoyed establishing connections with patients. The PER strategies allowed us to implement a well-received training program found effective by primary care coaches.

This report describes a training program for medical staff like nurses and medical assistants. The goal is to teach them how to coach patients through an online portal to help them keep their weight off after making healthy lifestyle changes. We worked with different clinic groups and used a planning tool called PER worksheet (predisposing, enabling, and reinforcing) to set up the training program. From September 2021 to March 2023, we offered the training in 14 clinics, and most interested staff completed it. The results showed that the training worked well. People who took part felt they learned enough to coach patients and felt ready to coach. They liked the training and found it helpful. This study suggests that we can teach coaching skills in just four hours of training and that ongoing support and mentorship are important to the trained coaches. Furthermore, this training set-up allows new staff to be trained as they join, which is especially important in places where staff changes frequently. Overall, using the PER tool enabled us to create a training program that staff can use in outpatient clinics to help patients improve their weight management.

"Poor and Dirty": Unintended consequences in a hygiene material Distribution in Burkina Faso.

The practical interrelationships between the African environment and hygiene practices during a pandemic period is a topic of significant importance. Specifically, this research explores the intersection of cultural dynamics and hygiene practices in Burkina Faso, focusing on a recent example of distribution of hygiene materials. It highlights the negative reactions to these foreign interventions, perceived as patronizing and stigmatizing, which underscores the complexities of implementing health initiatives in diverse socio-cultural landscapes. These findings stress the importance of culturally sensitive approaches and greater engagement in public health initiatives like the latrine usage with specific designs for communities.

The effects of psychological safety and employee voice behavior on flight attendants' mindful safety practices adoption.

Introduction: Flight attendants, as the front-line staff in the cabin, play a crucial role in improving air travel safety. This research explores how psychological safety affects flight attendants' adoption of mindful safety practices through voice participation. This mechanism also identifies ethical leadership and traditionality as two moderators. Methods: A self-reported questionnaire was used to collect data from 621 flight attendants in Chinese private commercial airline companies. PLS-SEM (partial least square structured equation modeling) is used to examine the hypotheses proposed in the present study. Results: After data analysis, the results reveal that the underlying mechanism covering both mediating and moderating effects through which flight attendants' voluntary and extra-role safety behavior could be improved. Discussion: The findings extend the existing literature regarding the antecedents of flight attendants' mindful safety practices adoption and obstacles to employee voice participation. Managerial implications are also provided in the commercial aviation industry and discussed along with future research directions.

Cover cropping attenuates population growth of Macrophomina phaseolina by limiting weed biomass, despite asymptomatic colonization of cover crops.

Macrophomina phaseolina is a fungus that causes charcoal rot in strawberry and a wide variety of crop species. Little is known about its potential to asymptomatically colonize crop plants or grow saprophytically on their tissues, both of which would create a potential for alternate, asymptomatic hosts to lead to increases in inoculum. To test the impact of cover cropping on M. phaseolina abundance, we conducted randomized-block field experiments in soils infested by M. phaseolina. None of the fifteen cover crop varieties showed symptoms of charcoal rot. All Fabaceae and Brassicaceae varieties were asymptomatically colonized at varying rates, but among Poaceae, M. phaseolina was recovered from only one individual oat plant. Soil samples collected at the time of planting, tillage, and 8 weeks post-tillage showed that cover cropping attenuated the growth of M. phaseolina relative to fallow plots harboring the weedy legume Medicago polymorpha. This weed species was abundantly colonized by this pathogen in both living root samples and plant residue collected 8 weeks after tillage. Cover cropping also influenced the diversity and composition of bulk soil bacterial and fungal communities, but these effects were not associated with M. phaseolina population density. Although M. phaseolina was not detected in living wheat tissues, it was recovered from wheat residue, suggesting that it may be facultatively saprophytic. These results suggest that cover cropping does not pose a risk for increasing disease caused by M. phaseolina and could be beneficial as conducive weed species, such as M. polymorpha, are suppressed.

A systematic map of evidence on the relationship between agricultural production and biodiversity in tropical rainforest areas.

BACKGROUND: The tropical rainforest biome plays a significant role in providing habitats for terrestrial biodiversity and delivering ecosystem service values, contributing to agricultural production. However, the increasing demand for tropical commodities with high economic value threatens this humid ecosystem and its biodiversity. To our knowledge, no studies have systematically mapped the relationship between the impacts of agricultural production on biodiversity and the effects of biodiversity on agricultural production in tropical rainforest areas. METHODS: Since we were interested in systematically mapping the evidence measuring the impact of tropical agriculture on biodiversity (Map 1), and the vice versa relations, the influence of biodiversity on tropical agriculture production (Map 2), we developed a respective set of search strings, eligibility criteria, and subsequently performed independent searching, screening, and data coding processes. We searched articles from six peer-reviewed databases and 22 gray literature sources. Articles were screened based on the inclusion criteria at the title, abstract, and full-text levels. Individual articles that passed full-text screening were coded and synthesized to create heatmaps. Selected information of interest was also extracted and visualized in the graphics which were clustered based on the year of publication, geographical distribution, type of rainforest, exposure, outcome, farm commodity, and study comparators. REVIEW FINDINGS: Two heatmaps were generated from a contrasting number of references, with heatmap 1 extracted from 222 studies and heatmap 2 derived from 10 times fewer references (n = 20). In heatmap 1, impacts of land conversion to aboveground biodiversity and wild species and ecosystem functions in natural ecosystems were the most common relationships examined, with 115 articles and 62 articles, respectively. Conversely, heatmap 2 showed evidence that focused predominantly on the examination of the links between the impacts of genetic resource diversity on environmental factors and soil management in tropical agricultural production, with four articles each exploring these relations. CONCLUSIONS: These systematic maps reveal that while studies investigating the impacts of tropical agricultural production on biodiversity were abundant, studies examining the impacts of biodiversity on tropical agricultural production were lacking despite both systematic maps experiencing an increasing trend of publication during 2000-2020. Map 1 emphasized the examination of the effects of land conversion on aboveground biodiversity, and on wild species and ecosystem functions. Map 2 highlighted the influence of crop genetic resources on environmental factors, and on soil management as the most frequently studied. The evidence cluster identified here can be the starting point for further systematic review study (to assess, for example, their cause-effect significance).