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Antibody responses require the proliferative expansion of B cells controlled by affinity-dependent signals. Yet, proliferative bursts are heterogeneous, varying between 0 and 8 divisions in response to the same stimulus. NFκB cRel is activated in response to immune stimulation in B cells and is genetically required for proliferation. Here, we asked whether proliferative heterogeneity is controlled by natural variations in cRel abundance. We developed a fluorescent reporter mTFP1-cRel for the direct observation of cRel in live proliferating B cells. We found that cRel is heterogeneously distributed among naïve B cells, which are enriched for high expressors in a heavy-tailed distribution. We found that high cRel expressors show faster activation of the proliferative program, but do not sustain it well, with population expansion decaying earlier. With a mathematical model of the molecular network, we showed that cRel heterogeneity arises from balancing positive feedback by autoregulation and negative feedback by its inhibitor IκBε, confirmed by mouse knockouts. Using live-cell fluorescence microscopy, we showed that increased cRel primes B cells for early proliferation via higher basal expression of the cell cycle driver cMyc. However, peak cMyc induction amplitude is constrained by incoherent feedforward regulation, decoding the fold change of cRel activity to terminate the proliferative burst. This results in a complex nonlinear, nonmonotonic relationship between cRel expression and the extent of proliferation. These findings emphasize the importance of direct observational studies to complement gene knockout results and to learn about quantitative relationships between biological processes and their key regulators in the context of natural variations.

Mesoporous materials find widespread applications due to their high specific surface area, contributing to enhanced performance. Scanning electron microscopy (SEM) observation of mesoporous materials provides valuable insights into their mesostructures. However, direct observation of the outermost surfaces, which often dictate material properties, remains challenging, especially for highly insulating and fragile compounds. In this study, utilizing SEM observation with ultra‐low‐voltage acceleration directed by Gemini column is proposed to achieve direct surface imaging of mesoporous organic materials with highly insulating and fragile characteristics. By observing mesostructured polymers obtained through a soft‐templating method without washing, stuffed pores are identified allowing the differentiation of micelle templates and polymer walls. Moreover, leveraging SEM measurements, a polymerization mechanism is proposed for dopamine on the polymer micelles adhered to the graphene oxide nanosheets. These findings demonstrate the potential of SEM measurements with ultra‐low accelerating voltage in facilitating surface observations of polymer‐derived nanomaterials characterized by high insulating properties and a fragile framework. [ABSTRACT FROM AUTHOR]

Kush S Patel,1 Ronald J Anderson,1,* Carolyn B Becker,1,* William C Taylor,1,* Anne F Liu,1,* Anubodh S Varshney,2,* Nadaa B Ali,1,* Barbara J Nath,3,* Stephen R Pelletier,4 Helen M Shields,1 Nora Y Osman1 1Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA; 2Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Palo Alto, CA, USA; 3Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; 4Office of Medical Education, Harvard Medical School, Boston, MA, USA*These authors contributed equally to this workCorrespondence: Helen M Shields, Department of Medicine, Brigham and Women’s Hospital, 75 Francis St, Boston, MA, 02115, USA, Tel +1 617 678 6077, Fax +1 617 525 8740, Email hmshields@bwh.harvard.eduPurpose: Coaching is a well-described means of providing real-time, actionable feedback to learners. We aimed to determine whether dual coaching from faculty physicians and real inpatients led to an improvement in history-taking skills of clerkship medical students.Patients and Methods: Expert faculty physicians (on Zoom) directly observed 13 clerkship medical students as they obtained a history from 26 real, hospitalized inpatients (in person), after which students received immediate feedback from both the physician and the patient. De-identified audio-video recordings of all interviews were scored by independent judges using a previously validated clinical rating tool to assess for improvement in history-taking skills between the two interviews. Finally, all participants completed a survey with Likert scale questions and free-text prompts.Results: Students’ history-taking skills – specifically in the domains of communication, medical knowledge and professional conduct – on the validated rating tool, as evaluated by the independent judges, did not significantly improve between their first and second patient interviews. However, students rated the dual coaching as overwhelmingly positive (average score of 1.43, with 1 being Excellent and 5 being Poor), with many appreciating the specificity and timeliness of the feedback. Patients also rated the experience very highly (average score of 1.23, with 1 being Excellent and 5 being Poor), noting that they gained new insights into medical training.Conclusion: Students value receiving immediate and specific feedback and real patients enjoy participating in the feedback process. Dual physician-patient coaching is a unique way to incorporate more direct observation into undergraduate medical education curricula.Keywords: direct observation, immediate feedback, medical student education, real patients, virtual teaching

Antibody responses require the proliferative expansion of B cells controlled by affinity-dependent signals. Yet, proliferative bursts are heterogeneous, varying between 0 and 8 divisions in response to the same stimulus. NFκB cRel is activated in response to immune stimulation in B cells and is genetically required for proliferation. Here, we asked whether proliferative heterogeneity is controlled by natural variations in cRel abundance. We developed a fluorescent reporter mTFP1-cRel for the direct observation of cRel in live proliferating B cells. We found that cRel is heterogeneously distributed among naïve B cells, which are enriched for high expressors in a heavy-tailed distribution. We found that high cRel expressors show faster activation of the proliferative program, but do not sustain it well, with population expansion decaying earlier. With a mathematical model of the molecular network, we showed that cRel heterogeneity arises from balancing positive feedback by autoregulation and negative feedback by its inhibitor IKBG, confirmed by mouse knockouts. Using live-cell fluorescence microscopy, we showed that increased cRel primes B cells for early proliferation via higher basal expression of the cell cycle driver cMyc. However, peak cMyc induction amplitude is constrained by incoherent feedforward regulation, decoding the fold change of cRel activity to terminate the proliferative burst. This results in a complex nonlinear, nonmonotonic relationship between cRel expression and the extent of proliferation. These findings emphasize the importance of direct observational studies to complement gene knockout results and to learn about quantitative relationships between biological processes and their key regulators in the context of natural variations. [ABSTRACT FROM AUTHOR]

Purpose: To identify practice and social contextual factors that associate with physical activity (PA) levels of children during their participation in a youth soccer program. Methods: Twenty-seven youth soccer teams serving children ages 6–11 years participated. Research staff directly observed and recorded PA intensity and practice and social contextual factors using momentary time-sampling procedures. Each team was observed for 1 practice, during which approximately 6 children were each observed for twenty 30-s observation blocks (10-s observation, 20-s recording). In total, children were observed for 3,102 intervals. Multilevel logistic regression analyses were conducted to describe associations between PA intensity and practice and social contexts. Interaction terms were introduced into the models to determine if the associations differed across girls-only, boys-only, and coed teams. Results: A total of 158 children were observed across the 27 teams. Children were more likely to engage in moderate or vigorous PA while performing fitness (Odds Ratio [OR], 9.9, 95% CI = 5.34–18.04), game (OR, 4.0, 95% CI = 2.88–5.66), warm-up (OR, 2.8, 95% CI = 1.85–4.11), and drill (OR, 1.9, 95% CI = 1.41–2.67) activities compared to tactic/instructional activities. The associations between PA intensity levels and practice and social contexts did not differ across girls-only, boys-only, and coed teams. Conclusions: Fitness activities and full-team game play were associated with higher PA intensity levels during children's participation in youth soccer practices. Youth sport practice protocols can be modified to increase children's physical activity. [ABSTRACT FROM AUTHOR]

This study explores the implementation and use of blockchain technology in diverse sectors throughout Africa. The blockchain technology has garnered international recognition owing to its capacity to revolutionize business operations, improve transparency, and foster socioeconomic progress. Nevertheless, the application of this technology in Africa presents distinct challenges and possibilities. By employing both firsthand observations and a review of the existing literature, this study seeks to present a thorough understanding of the present status, obstacles, and potential linked to the integration of blockchain technology in Africa. This paper draws upon perspectives from various reputable sources within the realm of blockchain technology integration. The objective of this paper is to provide a nuanced understanding of the hurdles, possibilities, and factors that impact the adoption of blockchain technology in Africa. This study adds to the current body of literature by illuminating the unique circumstances surrounding blockchain adoption on the African continent, thereby enhancing the global conversation on this topic. [ABSTRACT FROM AUTHOR]

This exploratory study extends the literature on teachers' stress and self-efficacy in relation to behavior management. Sixty-six middle and high school teachers' use of praise and reprimand during a 20-min observation, in the general education setting, were examined. Following the observation, teachers completed stress and self-efficacy scales, related to student misbehavior. Teacher stress and teacher self-efficacy were significantly negatively related. Further, teachers who reported higher levels of stress used more reprimands, and teachers who reported higher levels of self-efficacy used fewer reprimands. Last, as teachers' behavioral difficulty ratings for their class increased, so did their use of reprimands. Implications and future directions are discussed. [ABSTRACT FROM AUTHOR]

Abstract Mesoporous materials find widespread applications due to their high specific surface area, contributing to enhanced performance. Scanning electron microscopy (SEM) observation of mesoporous materials provides valuable insights into their mesostructures. However, direct observation of the outermost surfaces, which often dictate material properties, remains challenging, especially for highly insulating and fragile compounds. In this study, utilizing SEM observation with ultra‐low‐voltage acceleration directed by Gemini column is proposed to achieve direct surface imaging of mesoporous organic materials with highly insulating and fragile characteristics. By observing mesostructured polymers obtained through a soft‐templating method without washing, stuffed pores are identified allowing the differentiation of micelle templates and polymer walls. Moreover, leveraging SEM measurements, a polymerization mechanism is proposed for dopamine on the polymer micelles adhered to the graphene oxide nanosheets. These findings demonstrate the potential of SEM measurements with ultra‐low accelerating voltage in facilitating surface observations of polymer‐derived nanomaterials characterized by high insulating properties and a fragile framework.

Junior faculty are often called upon to deliver high-stakes large-group presentations. Training in the skills needed to do this effectively is often lacking. We devised a 1.25 h coaching program. The coach analyzed a practice run of the presentation using a locally developed assessment tool. Areas covered included public speaking skills, promoting learner understanding and retention, creating a dynamic learning climate, and optimal use of slides. COVID-19 necessitated a switch to virtual coaching, and we studied the impact of virtual vs. in-person coaching. We added two additional coaches and studied the transferability of the coaching component. There was high uptake of the offered coaching. Participant surveys showed improved comfort levels with large-group presentations; had a sense that their presentation skills had improved; showed an increased likelihood of volunteering for future speaking opportunities; and were likely to recommend the program. Comparisons between virtual and in-person coaching showed no statistical difference, and there was little difference between the original coach and the subsequent two coaches. Qualitative assessments revealed broad areas in which faculty felt the program had been most impactful. The coaching program was well-received and resulted in concrete positive changes in presenter behavior. Conducting the coaching in a virtual manner may increase the feasibility of the intervention, as would expanding the coach pool.

Abstract Backgrounds Social skills are frequently impaired in neurodevelopmental disorders and genetic conditions, including 22q11.2 deletion syndrome (22q11DS) and autism spectrum disorders (ASD). Although often assessed with questionnaires, direct assessment provides a more valid estimate of the constructs. Role-plays (i.e., simulates situational settings) therefore appear to be an appropriate indicator of social skills in daily life. Methods This co-registered study involved 53 individuals with 22q11DS, 34 individuals with ASD, and 64 typically developing (TD) peers aged 12–30 years. All participants were assessed with role-plays as well as parent-reported questionnaires and clinical interviews focusing on social skills, functioning and anxiety. Results Both clinical groups showed impaired social skills compared to TD, but distinct social profiles emerged between the groups. Individuals with 22q11DS displayed higher social appropriateness and clarity of speech but weaker general argumentation and negotiation skills, with the opposite pattern observed in participants with ASD. No association was found between social skills measured by direct observation and caregiver reports. Social anxiety, although higher in clinical groups than in TD, was not associated with role-plays. Conclusions This study highlights the need to train social skills through tailored interventions to target the specific difficulties of each clinical population. It also highlights the importance of combining measures as they do not necessarily provide the same outcome.

Direct observation is a ground-truth measure for physical behavior, but the high cost limits widespread use. The purpose of this study was to develop and test machine learning methods to recognize aspects of physical behavior and location from videos of human movement: Adults (N = 26, aged 18–59 y) were recorded in their natural environment for two, 2- to 3-h sessions. Trained research assistants annotated videos using commercially available software including the following taxonomies: (1) sedentary versus non-sedentary (two classes); (2) activity type (four classes: sedentary, walking, running, and mixed movement); and (3) activity intensity (four classes: sedentary, light, moderate, and vigorous). Four machine learning approaches were trained and evaluated for each taxonomy. Models were trained on 80% of the videos, validated on 10%, and final accuracy is reported on the remaining 10% of the videos not used in training. Overall accuracy was as follows: 87.4% for Taxonomy 1, 63.1% for Taxonomy 2, and 68.6% for Taxonomy 3. This study shows it is possible to use computer vision to annotate aspects of physical behavior, speeding up the time and reducing labor required for direct observation. Future research should test these machine learning models on larger, independent datasets and take advantage of analysis of video fragments, rather than individual still images. [ABSTRACT FROM AUTHOR]

Photography and video footage, captured by researchers and tourists on board two vessels, provided insights into the predation techniques employed by an adult male killer whale Orcinus orca in Mossel Bay, South Africa. The incapacitation of its prey, a juvenile white shark Carcharodon carcharias (∼2.5 m TL), followed by consumption of the liver, occurred within less than 2 minutes, highlighting the predator proficiency of the killer whale. Notably, another adult male killer whale, and constant traveling companion with the first, was observed approximately 100 m away and was not involved during the predation. The following day a second carcass of a different eviscerated white shark (3.55 m TL) washed ashore in the vicinity, indicating that at least two white sharks may have been killed during the interaction. [ABSTRACT FROM AUTHOR]

Backgrounds: Social skills are frequently impaired in neurodevelopmental disorders and genetic conditions, including 22q11.2 deletion syndrome (22q11DS) and autism spectrum disorders (ASD). Although often assessed with questionnaires, direct assessment provides a more valid estimate of the constructs. Role-plays (i.e., simulates situational settings) therefore appear to be an appropriate indicator of social skills in daily life. Methods: This co-registered study involved 53 individuals with 22q11DS, 34 individuals with ASD, and 64 typically developing (TD) peers aged 12–30 years. All participants were assessed with role-plays as well as parent-reported questionnaires and clinical interviews focusing on social skills, functioning and anxiety. Results: Both clinical groups showed impaired social skills compared to TD, but distinct social profiles emerged between the groups. Individuals with 22q11DS displayed higher social appropriateness and clarity of speech but weaker general argumentation and negotiation skills, with the opposite pattern observed in participants with ASD. No association was found between social skills measured by direct observation and caregiver reports. Social anxiety, although higher in clinical groups than in TD, was not associated with role-plays. Conclusions: This study highlights the need to train social skills through tailored interventions to target the specific difficulties of each clinical population. It also highlights the importance of combining measures as they do not necessarily provide the same outcome. [ABSTRACT FROM AUTHOR]

While membrane separation has proven to be an outstanding method for separating oil in water (O/W) emulsions containing droplets smaller than 20 µm, it is severely limited due to fouling. Much research has been aimed at understanding the mechanism behind membrane fouling, particularly for ultrafiltration (UF) membranes. Interestingly, studies pointed out that the emulsifier, namely surfactant, is the main source of fouling in nanofiltration and reverse osmosis, while in the case of UF, oil is generally regarded as the main source of fouling. Herein, we study the fouling of UF membranes during separation of O/W emulsions stabilized by surfactants, with the explicit goal of determining the relative impact of the oil and surfactant present on fouling severity and dynamics. Results obtained from flux decline measurements, complimented by visualization using confocal microscopy, show that oil causes irreversible fouling to a certain extent, however, surfactant fouling dominates the observed membrane performance. The degree of fouling and flux recovery appears to be closely related to the properties the surfactant, namely charge and molecular weight, as has been observed in the past but attributed to the oil-membrane interactions, mediated by the surfactant. Further, to visualize the fouling mechanisms, direct observation via a confocal microscope set-up is used to capture real-time images of the membrane surface, which reveal that surface coverage of oil is not directly related to flux decline during the separation process. Our results suggest that membrane flux decline and fouling is dominated by membrane-surfactant interactions, the exact nature of which is a topic for future extensions of this work.

Abstract Background In the United States, the number of state policies mandating recess in schools has rapidly increased over the past decade; however, few policies specify recess frequency. Informed by an ecological model of physical activity (PA) policy, this study examined and compared total amounts and intensity of PA expended during recess among children attending schools in compliance with Arizona recess policy ARS§ 15–118 mandating 2 + daily recess periods versus not. Methods PA during recess was measured among grade three children (ages 8–10) in four randomly selected elementary schools (two complying averaging 30 daily recess minutes; two non-complying averaging 15 daily recess minutes) in Maricopa County, Arizona. Group-level PA was assessed by direct observation using the System for Observing Play and Leisure (137 observations). A subset of students (N = 134) from all schools wore ActiGraph GT3X + devices during recess to measure individual PA. General linear mixed effects models were used to analyze the impact of recess frequency on group and individual PA during recess. Results Students attending complying schools spent significantly greater proportions of time in moderate-to-vigorous PA (MVPA) based on direct observation (5%) and accelerometry (15%) and less time being sedentary based on accelerometry (14%) during recess. Across the school day, this would equate to 5.1 more MVPA minutes based on systematic direct observation and 9.5 more MVPA minutes based on accelerometry, and 4.1 less minutes being sedentary based on accelerometry if students received two daily 15-minute recess periods compared to one. Conclusions Students attending elementary schools implementing 2 + recesses, in accordance with state policy, demonstrated greater MVPA and less sedentary time, providing preliminary evidence that recess frequency is associated with greater PA intensity among children during recess. Schools that adhere to state-level PA policies may provide a more supportive environment for PA, resulting in increased movement among students. Specifying recess frequency should be considered in statewide recess policy.

Background: In the United States, the number of state policies mandating recess in schools has rapidly increased over the past decade; however, few policies specify recess frequency. Informed by an ecological model of physical activity (PA) policy, this study examined and compared total amounts and intensity of PA expended during recess among children attending schools in compliance with Arizona recess policy ARS§ 15–118 mandating 2 + daily recess periods versus not. Methods: PA during recess was measured among grade three children (ages 8–10) in four randomly selected elementary schools (two complying averaging 30 daily recess minutes; two non-complying averaging 15 daily recess minutes) in Maricopa County, Arizona. Group-level PA was assessed by direct observation using the System for Observing Play and Leisure (137 observations). A subset of students (N = 134) from all schools wore ActiGraph GT3X + devices during recess to measure individual PA. General linear mixed effects models were used to analyze the impact of recess frequency on group and individual PA during recess. Results: Students attending complying schools spent significantly greater proportions of time in moderate-to-vigorous PA (MVPA) based on direct observation (5%) and accelerometry (15%) and less time being sedentary based on accelerometry (14%) during recess. Across the school day, this would equate to 5.1 more MVPA minutes based on systematic direct observation and 9.5 more MVPA minutes based on accelerometry, and 4.1 less minutes being sedentary based on accelerometry if students received two daily 15-minute recess periods compared to one. Conclusions: Students attending elementary schools implementing 2 + recesses, in accordance with state policy, demonstrated greater MVPA and less sedentary time, providing preliminary evidence that recess frequency is associated with greater PA intensity among children during recess. Schools that adhere to state-level PA policies may provide a more supportive environment for PA, resulting in increased movement among students. Specifying recess frequency should be considered in statewide recess policy. [ABSTRACT FROM AUTHOR]

BackgroundMicroscale environmental features are usually evaluated using direct on-street observations. This study assessed inter-rater reliability of the Microscale Audit of Pedestrian Streetscapes, Global version (MAPS-Global), in an international context, comparing on-street with more efficient online observation methods in five countries with varying levels of walkability.MethodsData were collected along likely walking routes of study participants, from residential starting points toward commercial clusters in Melbourne (Australia), Ghent (Belgium), Curitiba (Brazil), Hong Kong (China), and Valencia (Spain). In-person on the street and online using Google Street View audits were carried out by two independent trained raters in each city. The final sample included 349 routes, 1228 street segments, 799 crossings, and 16 cul-de-sacs. Inter-rater reliability analyses were performed using Kappa statistics or Intraclass Correlation Coefficients (ICC).ResultsOverall mean assessment times were the same for on-street and online evaluations (22 ± 12 min). Only a few subscales had Kappa or ICC values

The Helmeted Guineafowl Numida meleagris is a widespread and abundant resident gamebird species in sub-Saharan Africa. It is hunted throughout the region, including in Ethiopia. However, knowledge of the species' ecology and behaviour in many parts of the country is limited. The present study aimed to assess the population size, habitat use and foraging habits of Helmeted Guineafowl in the Arjo-Didessa River Valley in southwestern Ethiopia. Point counts and line transects were conducted from January 2018 to December 2020 to estimate population sizes in different habitat types and in the wet and dry seasons. The species' foraging activity and habitat use were investigated using direct focal observations and scan sampling. The estimated population size of Helmeted Guineafowl in the 1 486-km2 study area was 276 ± 33 (mean ± SE), with flock sizes of up to 22 individuals. The highest numbers were recorded in farmland habitat during the wet season (103 ± 24) and in woodland habitat during the dry season (93 ± 12). Population sizes varied significantly among four habitat types across seasons. The food resources differed significantly between seasons, with the available dietary components consisting of mainly insects (52%) during the wet season, and seeds (53%) during the dry season. Anthropogenic disturbances, including illegal hunting and egg collection, are common practices in the study area, posing a threat to local populations of the species. Research efforts are essential to monitor population trends of this popular gamebird, while conservation efforts should focus on reducing the threats and maintaining adequate foraging habitats. [ABSTRACT FROM AUTHOR]

The production of defect-free castings leads to mechanical properties, production quality, and increasing productivity. It is important to control mold filling and solidification behavior. The casting filter is expected to control the fluidity during mold filling and remove inclusions. In this study, to clarify the effects of casting filters, direct observation of mold filling was done for an aluminum alloy gravity casting with and without foam, honeycomb, and strainer filters installed at the bottom area of the sprue. The velocity of the molten metal decreases and flows more laminarly after passing through the casting filter. Further, particle-based SPH (Smoothed Particle Hydrodynamics) software simulates the flow behavior during passage through the filter. The simulation also roughly reproduced the behavior before and after passing through the filter. [ABSTRACT FROM AUTHOR]

Background: Nationwide nursing shortages have led to higher patient-to-nurse ratios, nursing burnout, and decreased quality of care. Local Problem: Staffing challenges and nursing burnout were becoming growing concerns and success was contingent upon efficient use of existing resources. Methods: Direct observation current state assessment was completed on medical-surgical specialty units to better understand work activities of registered nurses (RNs) and unlicensed assistive personnel (UAPs). Results: RNs spent more time performing indirect care (eg, documentation) than direct patient care. Interruptions and problems consumed 17.4% and 5.6% of their time, respectively. UAPs performed more direct patient care but had a higher proportion of downtime. RNs underdelegated nonclinical tasks. Conclusions: Direct observation current state assessment offers a better understanding of workflow and workload inefficiencies. This information is critical to provide informed, evidence-based recommendations to develop future patient care models with more capacity to deliver high-quality care with greater efficiency and lessen nursing burden and burnout during the nursing shortage crisis. [ABSTRACT FROM AUTHOR]

This paper describes a study in which five physical science teachers were requested to take photographs and describe the science concepts embedded in these. Particularly, the science had to be relevant to the grade 10 -- grade 12 curriculum they were teaching. This study was an exploratory case study employing qualitative methods. To analyze data from the study, the four-field method for analyzing photographs was used (Käpylä, 2014). The analysis reveals that in all the narratives accompanying the captured photographs, the Indirect Observation -- Cognitive Domain dominated. The overall findings of the study demonstrate that the corresponding narrations reflect the cognitive role of photographs. However, this paper argues that phenomenological thinking about human experience connects emotions and personal and social meanings to factual knowledge and knowledge structures, therefore these purposes of pictures in teaching and learning of physical science could be divided into cognitive, affective and psychomotor domains. [ABSTRACT FROM AUTHOR]

This study was intended to exploit the possibility of using the quick gelation of alcogel that is induced by adding catalytic imidazole into a silicate-oligomer-based solution. For this purpose, the experimental viability of the direct observation of the gelation behavior was actually examined. The silicate oligomer, derived from tetraethyl orthosilicate hydrolyzed under an acidic condition (pH ~ 5), was used as the quickly gelling mother solution. The capability of the oligomer solution to form a non-flowable matter in only a few seconds when triggered by the addition of the catalytic solution of imidazole is promising, for example, for stabilizing a sandy ground surface, due to its simplicity. From the practical viewpoint, how long the gelation could take (=gel time) is a crucial parameter when the choice of an appropriate gelling chemical species needs to be made. Thus, this study focused its interest on as simple an experimental method as possible for evaluating the gel time of the gelling systems that actually underwent instantaneous gelation. The silicate oligomer solution was an appropriate material both in its quick gelling behavior and environmental friendliness. For such quick gelation, rheological approaches are not applicable for detecting the boundary in the mechanical properties that delineate the regime of "gel". In this study, instead, direct observation was employed to capture the short interval during which the gelation was completed. The silicate-oligomer-based gelling solution was observed to lose its flowability within only 0.2 s, as it was seen to come off the bottom of the shaken cylinder at 5 Hz. For a more quantitative estimation, the same gelling solution was observed by high-speed motion picture. The high-speed motion picture could clearly capture the instantaneous gelation as a sudden arrest of the flow. The sub-millisecond direct observation of the gelation behavior revealed that the timescale of the instantaneous termination of the flow was as quick as 1 ms in order of magnitude. Such instantaneous gelation in the sub-millisecond-order timescale could not be forecasted from the observable megascopic gelation, which appeared to last from 102 ms to 103 ms in our naked-eye observation. The noteworthy gap between the timescale of the naked-eye-observed gelation and that of the true gel time at a localized spot determined by the high-speed motion picture should be noted to avoid excess agitation, which can result in total collapse into gel fragments of the just solidifying or already solidified gel under strong deformational influence by mechanical agitation, for example. [ABSTRACT FROM AUTHOR]

Background: Direct observation is important, yet medical residents are rarely observed. We implemented and evaluated a direct observation program in resident clinics to increase the frequency of observation and feedback and improve perceptions about direct observation. Methods: We assigned faculty as observers in our resident clinics between June 2019 and February 2020. We surveyed residents and faculty before and after the program. Faculty completed a form for each observation performed. We analyzed surveys to examine changes in barriers, frequency and type of observations and feedback, and attitudes toward observation. The analytical sample included 38 and 37 pre- and postresident surveys, respectively, and 20 and 25 pre- and postfaculty surveys, respectively. Results: Resident survey response rates were 32.3% (40/124) pre- and 30.7% (39/127) postintervention. Most residents (76% [pre], 86% [post], P = 0.258) reported being observed in at least one of the four areas: history, examination, counseling, or wrap-up. We received observation tracking forms on 68% of eligible residents. Observed history taking increased from 30% to 79% after the program (P = 0.0010). Survey response rates for faculty were 64.7% (22/34) pre- and 67.5% (25/37) postintervention. Fewer faculty reported time (80% [pre], 52% [post], P = 0.051) and competing demands (65% [pre], 52% [post], P = 0.380) as barriers postintervention. Fewer faculty postintervention viewed observation as a valuable teaching tool (100% [pre], 79% [post], P = 0.0534). All faculty who did not view observation as valuable were the least experienced. Discussion: Assigning faculty as observers can increase observation, especially in history taking, though data suggest an increase in negative perceptions of observation by faculty. [ABSTRACT FROM AUTHOR]

Rubric-based observations of pre- and inservice teachers are common practice in schools. Popular observation tools often result in minimal variation in ratings between teachers, require extensive training and time demands for raters, and provide minimal feedback for professional development. Alternatively, direct observation methods are evidenced to effectively measure instructional behaviors. Applying direct observation to audio recordings would produce quantitative scores and provide valuable feedback to teachers about their instruction. As such, the purpose of the present pilot study was to examine the reliability and efficiency of using audio recordings to measure practices related to explicit instruction. Fleiss's kappa was modeled to determine the reliability of multiple raters. Regression and correlation examined the strength and direction of the relationship between the full length of a teacher's lesson and the first 20 min of the lesson. Results indicate that using audio recordings is reliable with kappas ranging from.45 to.80. Based on regression analyses, the first 20 min of a teacher's lesson is predictive of the rates of behaviors observed in a full lesson. Correlations suggest large, positive relationships between rates of behaviors in the first 20 min and the full lesson. Recommendations for future studies of audio-recorded observations and progress monitoring teacher behavior are discussed. [ABSTRACT FROM AUTHOR]

Direct observation is a ground-truth measure for physical behavior, but the high cost limits widespread use. The purpose of this study was to develop and test machine learning methods to recognize aspects of physical behavior and location from videos of human movement: Adults (N = 26, aged 18–59 y) were recorded in their natural environment for two, 2- to 3-h sessions. Trained research assistants annotated videos using commercially available software including the following taxonomies: (1) sedentary versus non-sedentary (two classes); (2) activity type (four classes: sedentary, walking, running, and mixed movement); and (3) activity intensity (four classes: sedentary, light, moderate, and vigorous). Four machine learning approaches were trained and evaluated for each taxonomy. Models were trained on 80% of the videos, validated on 10%, and final accuracy is reported on the remaining 10% of the videos not used in training. Overall accuracy was as follows: 87.4% for Taxonomy 1, 63.1% for Taxonomy 2, and 68.6% for Taxonomy 3. This study shows it is possible to use computer vision to annotate aspects of physical behavior, speeding up the time and reducing labor required for direct observation. Future research should test these machine learning models on larger, independent datasets and take advantage of analysis of video fragments, rather than individual still images.

Reported medication errors in an ICU at an academic teaching hospital raised concerns about adherence to safety protocols, including barcode scanning before medication administration. A group of nurse leaders, bedside nurses, and pharmacists formed a medication safety task force to increase compliance with barcode scanning and reduce reported medication errors in which failure to scan was a contributing factor. Three task force members observed nurses' workflow in ICU medication administration. The members observed three nurses administer medications before scanning the barcode and three other nurses scan medications in a location where they were unable to see alerts on the computer. After the observations, the task force implemented three interventions: medication tables to provide a surface in front of the computer where medications could be placed when scanning; standardized workflow; and nursing staff education. Task force members then conducted postimplementation observations to evaluate improvement in barcode scanning compliance. In the postintervention observations, all medications were scanned in front of the computer before administration, an increase of 27.3 percentage points (from 72.7% preintervention) in the barcode scanning compliance rate. The ICU also went 17 months in the postintervention period without a reported medication administration error in which failure to scan was a contributing factor. The task force's observation of medication administration led to interventions that made it easier for nurses to adhere to best practice. Medication tables were a simple, sustainable intervention that used human factors principles to increase barcode scanning compliance. A nurse-led initiative reduces medication errors by increasing adherence to safety protocols, including compliance with barcode scanning before medication administration. [ABSTRACT FROM AUTHOR]

During an experiment of Octopus maya fishing with baited lines during 2012 and 2013 off Lerma, Campeche, Mexico, 307 octopuses (18.3% of all sampled) shown recently caught 424 prey items in their webs. Preys were composed of crustaceans, mollusks, teleost fish, and sipunculans representing at least 52 species. Most prey occurrences were single (73.29%), but up to five prey items were found in some octopus. Crustaceans were the most frequent and abundant prey accounting for 61%FO, 59%N, and 20%W. The most important single prey was the majoid crab Pitho anisodon with 24%FO and 22%N. Molluscans occurred in half of octopus and represented more than a third of all preys and most of preys' weight. They were mostly bivalves. Fishes did not reach 2% of prey share by any account. Prey numbers differed significantly by year. O. maya feed on small preys, crustaceans, and bivalves in the range of 5–50 mm and gastropod and fishes mostly 50–120 mm in length. Size of prey was weakly or not related to octopus size, although only larger octopus feed on larger prey such strombid conchs. This work represents the first systematic study of octopus diet from direct observations on their recently taken prey. The advantages of this new method to study octopus food are discussed, as well as the feeding behavior associated to some prey. [ABSTRACT FROM AUTHOR]

Precursor liquid is a nanoscale liquid creeping ahead of the macroscopic edge of spreading liquids, whose behaviors tightly correlate with the three-phase reaction efficiency and patterning accuracy. However, the important spatial–temporal characteristic of the precursor liquid still remains obscure because its real-time spreading process has not been directly observed. Here, we report that the spreading ionic liquid precursors in a silicon corner can be directly captured on video using in situ scanning electron microscopy. In situ spreading videos show that the precursor liquid spreads linearly over time (⁠|${\rm{\Delta }}L\ \sim\ {\rm{\Delta }}T$|⁠) rather than obeying the classic Lucas–Washburn law (⁠|$l\ \sim\ {t}^{1/2}$|⁠) and possesses a characteristic width of ∼250–310 nm. Theoretical analyses and molecular dynamics simulations demonstrate that the unique behaviors of precursor liquids originate from the competing effect of van der Waals force and surface energy. These findings provide avenues for directly observing liquid/solid interfacial phenomena on a microscopic level. [ABSTRACT FROM AUTHOR]

Scoring of performance can be based on different modes of observation, which can include live and videotaped observations. Although live observations have been the traditional format of measuring examinee performance in education and in healthcare, videotaped observations provide educators and testing agencies the promise of unbiased and standardized evaluations, offering practical solutions to limitations of real-time scoring. This study proposes a measurement model taking into account different modes of observation, using an extension of the hierarchical rater model based on signal detection theory (HRM-SDT). A hierarchical rater model is motivated by the nested structure of scores assigned by raters – scores assigned by raters become indicators of performance quality, which in turn become indicators of examinee ability. This study extends the hierarchical structure of the scoring process to include modes of observation, which serves as an intermediary level between the latent categorical indicator of performance quality and examinee ability, forming a three-level HRM-SDT. Analyses based on real-world data showed differences in the quality of scores from live observations and videotaped recordings. Compared to the traditional HRM-SDT, the overall model fit improved when including modes of observation. Simulations using different sample sizes and conditions provide implications for uses of this model. [ABSTRACT FROM AUTHOR]

Good access and appropriate use of Water, Sanitation and Hygiene (WASH) is important in the control, elimination and eradication of a number of neglected tropical diseases (NTDs). Poor WASH access and use may explain continued high trachoma prevalence in Nabilatuk district, Uganda. This study aimed to investigate the level of WASH access and use through different WASH data collection methods and the triangulation of their results. A mixed-methods cross-sectional study was conducted in 30 households in Nabilatuk district, from 10 households in each of three nomadic villages. The data collection methods used were: (1) direct observations of routine WASH behaviours; (2) structured quantitative household questionnaires; (3) demonstrations of specific WASH behaviours. With regards to access, observations indicated less WASH access and use compared with questionnaire responses: the questionnaire indicated all households had access to an improved water source, but 70% had a >30-min round-trip, and no households had access to an improved latrine, whereas some observations indicated longer water collection times. In terms of behaviour, there were also differences between the data collection methods, with demonstrations revealing knowledge of good practice, such as thorough handwashing, but this was not routinely observed in the observations. Further systematic investigation of barriers to appropriate WASH access and use in the local context is needed, as is the development of feasible, valid and reliable WASH access and use assessment methods for use in national NTD programmes. [ABSTRACT FROM AUTHOR]

We sought to describe processes of psychosocial screening and discussion with immigrant Latino families in the context of group well-child care. We conducted longitudinal direct observations of the 1-, 2-, 4-, and 6-month visits of 7 group well-child care cohorts at an academic pediatric clinic using unstructured observations of visit and group processes as well as structured observations to code facilitators' behavior. A range of psychosocial and social determinants of health topics were incorporated into discussions. In general, providers skillfully navigated group discussions, but inconsistently introduced the visit purpose. Asking participants to define psychosocial terms (eg, stress) and conversations about managing fussy infants were effective strategies to engage families in psychosocial discussions (eg, about postpartum depression). Some challenges with workflow were identified. Strategies to enhance screening and discussion of psychosocial topics may benefit from adaptation to maximize the effectiveness of this care mechanism. [ABSTRACT FROM AUTHOR]

Khapra beetle, Trogoderma granarium Evert (Coleoptera: Dermestidae) is the most important stored pest and was first discovered in Jakarta grain storages in 1972. Since then, quarantine procedures have been massively carried out to prevent khapra beetles to spread in Indonesia. In 2009, Indonesia has been declared as free area from Khapra beetle. However, Indonesia still import grain from non-Khapra beetle free countries and supervision must be carried out continuously to prevent Khapra beetle reinfestation. This survey was conducted at warehouses in five areas of Jakarta, Tangerang, and Bekasi from October 2016 to February 2017 with high risk due to its role as one of the main entry ports and storage of imported grains. Observation was done using probe sampling, direct observation and traps with attractant. Results showed that several insects were found from imported seeds in the surveyed area, but no Khapra beetles were found. It showed that non-Khapra free countries have implemented the required Sanitary Phytosanitary. In addition, it implies that survey methods using attractant traps could complement the probe sampling methods and direct observation that are currently used.

Development of standardized diagnostic instruments has facilitated the systematic characterization of individuals with autism spectrum disorders (ASD) in clinical and research settings. However, overemphasis on scores from specific instruments has significantly detracted from the original purpose of these tools. Rather than provide a definitive "answer," or even a confirmation of diagnosis, standardized diagnostic instruments were designed to aid clinicians in the process of gathering information about social communication, play, and repetitive and sensory behaviors relevant to diagnosis and treatment planning. Importantly, many autism diagnostic instruments are not validated for certain patient populations, including those with severe vision, hearing, motor, and/or cognitive impairments, and they cannot be administered via a translator. In addition, certain circumstances, such as the need to wear personal protective equipment (PPE), or behavioral factors (e.g., selective mutism) may interfere with standardized administration or scoring procedures, rendering scores invalid. Thus, understanding the uses and limitations of specific tools within specific clinical or research populations, as well as similarities or differences between these populations and the instrument validation samples, is paramount. Accordingly, payers and other systems must not mandate the use of specific tools in cases when their use would be inappropriate. To ensure equitable access to appropriate assessment and treatment services, it is imperative that diagnosticians be trained in best practice methods for the assessment of autism, including if, how, and when to appropriately employ standardized diagnostic instruments. [ABSTRACT FROM AUTHOR]

Background: Hospital pharmacy dispensaries are busy work environments where staff are involved in a variety of work‐related tasks. The proportion of time spent on daily tasks, task prioritisation, multitasking, and interruptions remains largely unknown. Aim: To examine the tasks performed and proportion of time pharmacists and pharmacy technicians in a hospital pharmacy inpatient dispensary spend on various work‐related activities. Method: Pharmacists and technicians working in the inpatient dispensary of a large metropolitan health service were directly observed by trained researchers. Tasks were recorded using Work Observation Method By Activity Timing (WOMBAT), a validated technique developed for direct observation studies of health professionals. Timed tasks were allocated to domains detailing the task performed, who performed it, who they interacted with, and where the task was performed. Data were analysed descriptively with independence of 95% confidence intervals (CI) demonstrating statistical significance. Results: Twelve pharmacists and 13 technicians were observed for 107.4 h. Tasks that contributed the greatest proportion of time were: the preparation of discharge prescriptions: pharmacists 32.1% (95% CI 29.9–34.3%) and technicians 21.0% (95% CI 18.3–23.7%); inpatient medication supply 22.5% (95% CI 21.5–23.5%) and 49.3% (95% CI 47.3–51.3%) and; inter‐professional communication 13.6% and 14.7% (non‐significant [NS]). Tasks were completed independently 89.6% (pharmacists) and 88.9% (technicians) of the time. Pharmacists and technicians were interrupted 6.7 and 5.1 times per hour (p < 0.05), respectively; 8.6% and 9.5% (NS) of the time was spent undertaking at least two tasks simultaneously. Conclusion: This is the first study to examine task time distribution within a hospital inpatient dispensary. Pharmacists and technicians spend the greatest proportion of time on direct medication dispensing‐related activities. This study demonstrates a high frequency of multitasking and interruptions, both of which are known risks for dispensing errors. [ABSTRACT FROM AUTHOR]

الملخص: أهداف البحث: أخطاء إعطاء الدواء هي من بين أكثر أنواع الأخطاء الدوائية شيوعا وأهمية في جميع أنحاء العالم. هدفت هذه الدراسة إلى تقييم انتشار أخطاء إعطاء الدواء وأنواعها وشدتها، وتحديد العوامل المرتبطة بحدوث مثل هذه الأخطاء. طرق البحث: أجريت هذه الدراسة المقطعية على مدى ثلاثة أشهر في جناح الطب الباطني في مستشفى تعليمي ثلاثي في الأردن. خلال فترة الدراسة، تمت ملاحظة ما مجموعه 13 ممرضة أثناء تحضير الأدوية وإعطائها باستخدام طريقة الملاحظة المقنعة المباشرة. تمت مقارنة جميع الملاحظات المسجلة المتعلقة بالتحضير والإدارة مع أوامر الطبيب في سجل الأدوية لتحديد أي أخطاء محتملة. النتائج: لوحظ ما مجموعه 1012 فرصة للأخطاء، وتم تحديد 910 خطأ في إعطاء الأدوية. من بين هذه الأخطاء البالغ عددها 910، كانت أخطاء الالتزام هي النوع الأكثر شيوعا (العدد 364 ، 35.9٪)، يليها تحضير دواء غير صحيح (العدد 247، 24.4٪). لم يسفر أي من أخطاء إعطاء الأدوية عن ضرر جسيم للمرضى أو ساهم في البقاء في المستشفى لفترات طويلة. كانت الأدوية المضادة للميكروبات (العدد 210 ، 23.0٪) هي الفئة الأكثر شيوعا المرتبطة بـأخطاء إعطاء الأدوية، تليها أدوية أمراض القلب والأوعية الدموية (العدد 157 ، 17.2٪). أظهرت النتائج أن حدوث أخطاء إعطاء الأدوية كان أعلى بشكل ملحوظ في الأدوية غير الوريدية مقارنة بالأدوية الوريدية (القيمة الاحتمالية أقل من 0.001). الاستنتاجات: كشفت هذه الدراسة عن وجود معدل مرتفع من أخطاء إعطاء الأدوية. على الرغم من أن جميع الأخطاء التي تم تحديدها لم تسبب أي ضرر للمرضى، إلا أن الأخطاء كانت موجودة دائما. يوصى بشدة بحملات التوعية والتثقيف المستمرة للممرضين والممرضات حول أهمية الإدارة السليمة والآمنة للأدوية. Abstract: Objectives: Medication administration errors (MAEs) are the most common and significant type of medication errors worldwide. This study aims to assess the prevalence, types, and severity of MAEs. Furthermore, this study attempts to determine the factors associated with the occurrence of MAEs. Method: This cross-sectional study was conducted over a three-month interval in the internal medicine ward of a tertiary teaching hospital in Jordan. During the study period, 13 nurses were observed while they were preparing and administering medications using a direct disguised observation method. All the recorded observations about the preparation and administration were compared with the physician's orders in the medications' records to identify any possible MAEs. Results: Having observed a total of 1,012 opportunities for errors, 910 MAEs were identified. Among these 910 errors, adherence errors were found to be the most frequent type (n = 364, 35.9%), followed by incorrect drug preparation (n = 247, 24.4%). None of the MAEs revealed any serious harm to patients or contributed to prolonged hospitalization. Antimicrobial drugs (n = 210, 23.0%) was the most common class associated with MAEs, followed by the class of cardiovascular (n = 157, 17.2%) medicines. Results have shown that the occurrence of MAEs was significantly higher in the non-intravenous medications in comparison to the intravenous medications (p-value < 0.001). Conclusion: While this study revealed a high rate of MAEs, all the identified errors did not cause harm to the patients. Continuous awareness and education campaigns targeting the nurses about the importance of proper and safe drug administration are highly recommended.

Polyacrylamide gel electrophoresis (PAGE) with sodium dodecyl sulphate (SDS) and Coomassie brilliant blue (CBB) staining is widely used in protein research and requires time for electrophoresis, staining and destaining. Because the protein bands electrophoresed in the gel are invisible in most cases, the results cannot be observed until the whole process is complete. In this study, shadowgraph was applied to detect biomolecules such as proteins during electrophoresis. A simple optical system and camera-enabled real-time monitoring of migration and separation of individual protein bands in polyacrylamide gels without staining. The visibility was high enough that it was possible to visualize substances other than proteins, such as DNA. This method provides protein profiles instantly in the early stage of electrophoresis. The elimination of the staining and destaining steps will help save researchers' time. The method is also environmentally friendly and will help reduce the generation of waste solutions containing synthetic dyes. [ABSTRACT FROM AUTHOR]

Background: Feedback and assessment are difficult to provide in the emergency department (ED) setting despite their critical importance for competency‐based education, and traditional end‐of‐shift evaluations (ESEs) alone may be inadequate. The SIMPL (Society for Improving Medical Professional Learning) mobile application has been successfully implemented and studied in the operative setting for surgical training programs as a point‐of‐care tool that incorporates three assessment scales in addition to dictated feedback. SIMPL may represent a viable tool for enhancing workplace‐based feedback and assessment in emergency medicine (EM). Methods: We implemented SIMPL at a 4‐year EM residency program during a pilot study from March to June 2021 for observable activities such as medical resuscitations and related procedures. Faculty and residents underwent formal rater training prior to launch and were asked to complete surveys regarding the SIMPL app's content, usability, and future directions at the end of the pilot. Results: A total of 36/58 (62%) of faculty completed at least one evaluation, for a total of 190 evaluations and an average of three evaluations per faculty. Faculty initiated 130/190 (68%) and residents initiated 60/190 (32%) evaluations. Ninety‐one percent included dictated feedback. A total of 45/54 (83%) residents received at least one evaluation, with an average of 3.5 evaluations per resident. Residents generally agreed that SIMPL increased the quality of feedback received and that they valued dictated feedback. Residents generally did not value the numerical feedback provided from SIMPL. Relative to the residents, faculty overall responded more positively toward SIMPL. The pilot generated several suggestions to inform the optimization of the next version of SIMPL for EM training programs. Conclusions: The SIMPL app, originally developed for use in surgical training programs, can be implemented for use in EM residency programs, has positive support from faculty, and may provide important adjunct information beyond current ESEs. [ABSTRACT FROM AUTHOR]

Recent technological advances have made the remote recording of interactions and the automatic extraction of nonverbal, paraverbal, and verbal behavioral cues from the videos possible. The development of computer programs that can replace human observational coders is imminent. The increasing availability of such new technologies, accompanied by their lower costs and greater convenience, is likely to advance behavioral observation research, giving new insight into the fine-grained moment-to-moment interactional processes. We illustrate how couple researchers can use recent technological advances to bring behavioral observation research into the 21st century. (PsycInfo Database Record (c) 2022 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

The XXI century is known as the era or informational and / or knowledge society, at present it is impossible to conceive training without the presence of Information and Communication Technology. The objective of this work is to propose a training methodology in information management for the training and development specialists of the AICA Laboratories Company and verify its applicability in practice. An initial diagnosis was made. A methodology was proposed that has 4 stages, each with its explanation, objective, actions and expected results. The practical verification was made through direct observation and the Iadov satisfaction test. The Chi Square statistical method was used. The initial diagnosis made it possible to characterize the current state of these specialists in terms of their training in information management. The results of the abstraction process developed by the authors around the training process in this subject, allowed to base and elaborate the training methodology in information management. By comparing the results of direct observation with those obtained in the initial diagnosis, one can perceive the significant change observed in the improvement of the performance of training and development specialists in the workplace. The results of the statistical analysis show that the calculated value is greater than the tabulated one, which allows us to say that the change is considered significant positive and that the Working Hypothesis (H1) is accepted. The Iadov satisfaction test allowed to demonstrate the satisfaction of the specialists with the training received. The results obtained show the scientific value, relevance and applicability of the proposed methodology and its contribution to the improvement of the implementation in information management in the AICA Laboratories Company. [ABSTRACT FROM AUTHOR]

Physical activity (PA) volume, intensity, and qualitative contextual information regarding activity type and loads carried are limited during U.S. Army Basic Combat Training (BCT). The purpose of this study was to characterize daily (05:00-20:00 hours) PA during BCT using a comprehensive approach. During 2 10-week BCT cycles (n = 40 trainees per cycle), pedometers, accelerometers, and direct observation were used to estimate daily step count, PA volume, and intensity. Physical activity intensity was categorized by metabolic equivalents (METs) such as "sedentary" (1-2 METs), "light" (2-3 METs), "moderate" (3-6 METs), or "vigorous" (≥6 METs). Daily PA data were analyzed longitudinally using linear mixed models, with significance set at p ≤ 0.05. The mean daily step count was 13,459 ± 4,376 steps, and the mean daily accelerometer-assessed PA volume and intensity were as follows: sedentary: 505 ± 98 minutes, light: 190 ± 78 minutes, moderate: 168 ± 51 minutes, and vigorous: 14 ± 14 minutes, with no differences between cycles for all measures (p > 0.50). Cumulative time on feet (~50%) and sitting (20-25%) accounted for most daily activity types during both cycles. Trainees, on average, carried between 3 and 9 kg, and ≥9 kg, for 60% and 10% of the monitored day, respectively. Basic Combat Training's physical demands are high, where trainees achieved 1.7 to 2.7 times greater daily ambulation and 6 times the recommended weekly moderate-to-vigorous PA compared with civilian counterparts and performed weight-bearing load carriage for nearly half of the day. Basic Combat Training-associated PA may increase injury risk among trainees unaccustomed to arduous PA and exercise. Implementing national PA policies to improve physical fitness and facilitate acclimatization to BCT's high physical demands could reduce public health burdens and military nonreadiness. [ABSTRACT FROM AUTHOR]

Direct observation of postgraduate medical trainees with actual patients by clinical faculty has traditionally been a standard tool to assess knowledge and skills in clinical subjects. By assessing and providing feedback to medical trainees performing a medical interview, physical examination, or counselling patients, faculty can facilitate budding physicians to have successful practice of medicine in their future. Despite the advances in clinical skills evaluation, direct observation has been a most popular and time tested method. However, observation of postgraduate medical students by faculty is very subjective and unfortunately often sporadic and non-standardized. Substantial amount of literature identifies several threats to its construct validity as an assessment tool. Although many tried to demonstrate methods to minimize those threats, there are many lacunae that remain inherent to direct observation method. Hence the need of the time is to relook at the observation as an assessment tool, instead of discarding the whole as inappropriate one. The authors initially made an effort to analyse the problems in present settings in India. After an extensive literature search authors advocate few additions and modifications to the existing system. Thus the present study not only highlights the pitfalls in the direct observation method but also suggests solutions for the problem.

Abstract Background Clinical education across the professions is challenged by a lack of recognition for faculty and pressure for patient throughput and revenue generation. These pressures may reduce direct observation of patient care provided by students, a requirement for both billing student-involved services and assessing competence. These same pressures may also limit opportunities for interprofessional education and collaboration. Methods An interprofessional group of faculty collaborated in a sequential quality improvement project to identify the best patients and physical location for a student teaching clinic. Patient chief complaint, use of resources, length of stay, estimated severity of illness and student participation and evaluation of the clinic was tracked. Results Clinic Optimization and Patient Care: Five hundred and thirty-two emergency department (ED) patients were seen in the first 19 months of the clinic. A clinic located near the ED allowed for patients with higher emergency severity index and greater utilization of imaging. Patients had similar or lower lengths of stay and higher satisfaction than patients who remained in the ED (p

Abstract Background Hand hygiene using alcoholic hand rub solution is essential for the prevention of surgical site infections. There are several opportunities for hygienic hand disinfection (termed “hand hygiene” in the following) during immediate pre-, intra- and postoperative orthopedic patient care. However, the level of hand hygiene compliance among surgical and anesthesia staff in this context is unclear. Therefore, we conducted an observational study in operating theatres of an orthopedic university clinic in northern Germany during July and August 2020. Methods One trained person directly and comprehensively observed hand hygiene compliance of surgical and anesthesia staff according to the WHO “My 5 moments for hand hygiene” model (WHO-5). In addition to cross-tabulations with Chi2 tests, multiple logistic regression models were used to study associations between occupational group, medical specialty, and compliance (both overall and for each WHO-5 indication). Models were adjusted for hand hygiene opportunities being associated with female or male healthcare workers, being located within or outside the operation room, and occurring in adult or pediatric surgery. Results In total, 1145 hand hygiene opportunities during 16 surgeries were observed. The overall compliance was 40.8% (95% CI 37.9–43.6%), with a larger difference between surgical versus anesthesia staff (28.4% vs. 46.1%, p

Feeding behaviour plays a significant role in promoting good animal health and welfare. It is also reflective of the quality and quantity of available feed. In fact, grazing livestock do not select their feed randomly, rather their behaviour is influenced by the texture, taste, and smell of each pasture species. Although taste agents are often used to modify feed intake for captive livestock, the effect on the feeding behaviour of grazing livestock has not yet been extensively evaluated in native grasslands. To address this gap in knowledge, herein, we sprayed three types of taste agents—salty (SA), sweet (SW), and bitter (BT)—on alpine meadows to investigate their effect on the grazing behaviour of yaks (Bos Grunniens) on the Qinghai-Tibetan Plateau (QTP). Behavioural observations showed that grazing was concentrated primarily in the morning and afternoon, while ruminating/resting peaked at noon; however, the diurnal behavioural patterns of grazing yaks were not affected by the taste agents. Application of the SA agent significantly increased the yaks’ grazing time, bites per minute, bites per step, time per feeding station, and steps per feeding station, while significantly reducing walking time, steps per minute, and number of feeding stations per minute. Meanwhile, application of the SW agent significantly increased the yaks’ time per feeding station, however, significantly reduced the steps per minute and number of feeding stations per minute. In contrast, the BT agent significantly increased the yaks’ walking time, steps per minute, and number of feeding stations per minute, while significantly reducing grazing time, bites per minute, bites per step, and time per feeding station. Application of the SA agent also significantly increased the intake of favoured, edible, and inedible forage, while the SW agent improved inedible forage intake, however, had a more subtle effect on favoured and edible forage intake. Meanwhile, the BT agent had an inhibitory effect on grazing intake. Hence, the structural equation model suggested that taste agents may directly or indirectly influence grazing behaviour by regulating feeding behaviour. Our findings provide a theoretical basis for using taste agents in grasslands to control the grazing behaviour of livestock and provide a method to promote the stability of grassland communities, while mitigating the degradation of grasslands in the QTP.