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This study examines street-level bureaucrats’ discretion as it informs their enforcement style during personal encounters with clients and considers how that style defines bureaucrats’ perceptions of their clients. A conceptual model is developed based on street-level bureaucracy theory and existing implementation literature and is tested using field data collected from a sample of 241 labor inspectors in the Malaysian Department of Labor. Structural Equation Modelling results show that discretion was positively related to client meaningfulness, and the relationship between discretion and client meaningfulness was significantly mediated by the accommodation and facilitation dimensions of enforcement style. The findings are significant as they illuminate street-level bureaucrats’ behavior and perceptions during encounters with clients and confirm that enforcement style is a three-dimensional concept. Moreover, this research argues that the perceptions of bureaucrats toward their clients redefines their behavior during the policy enforcement process and ultimately shapes their encounters with the public. Furthermore, theory and practical implications derived from the findings are discussed.

The public’s actions will likely have a significant effect on the course of the novel coronavirus (COVID-19) pandemic. Human behavior is conditioned and shaped by information and people’s perceptions. This study investigated the impact of risk perception on trust in government and self-efficacy. It examined whether the use of social media helped people adopt preventive actions during the pandemic. To test this hypothesis, the researchers gathered data from 512 individuals (students and academics) based in Malaysia during the COVID-19 pandemic. Our results suggested that risk perception had a significant effect on trust in government and self-efficacy. Moreover, these correlations were stronger when social media was used as a source for gathering information on COVID-19. In some cases, it even helped users avoid exposure to the virus. This study assessed the relationship between risk perception and the awareness gained from using social media during the pandemic and highlighted how social media usage influences trust in government and self-efficacy.

Background:Patients on Polypharmacy regime due to having a chronic illness are at a higher risk of developing some form of negative psychological outcome as a result of their disease. This study aims to determine the impact of polypharmacy on the psychological aspects of a patient living with a chronic disease.Method:A case-control study conducted amongst patients in an outpatient clinic of an Internist (July 1st to September 1st, of 2021) in the city of Erbil, Iraq. Data was extracted from a self-assessed questioner. 200 participants were divided into polypharmacy (case group) and non-polypharmacy group (control group). Polypharmacy, being defined as the use of 5 or more medication which meant that participants in the case group must fit into these criteria. A ‘Hospital Anxiety and Depression Scale’ (HADS) was used to determine the presence of symptoms of depression and/or anxiety.Results:A totally of 200 patients were included in the study. Of these 100 participants were from the non-polypharmacy group while the remaining 100 were from the polypharmacy group. Of these, depression among non-polypharmacy group (control) participants were 11% while 76% were found to be non-cases of depression. Compared to that, 31% of the polypharmacy group had depression while 51% were non-cases for depression. Also. the prevalence of depression and anxiety was increasing with an increase in number of medications taken by the patients. Depression was present in 11% of patients who took 4 or less medications while the prevalence increased to 21.1%, 34.9% and 42.1% in patients who took five, six to eight, and more than nine medications, respectively.Conclusion: There is a significant link between polypharmacy and psychological distress in patients with chronic diseases with a focus on depression and anxiety. Healthcare providers can help in detecting polypharmacy and in providing recommendations for simplifying medication regimes and reducing the outcomes of chronic diseases. Trial registration: - This article doesn’t contain any health care intervention on human participants.

Background: The rise of Primary Percutaneous Coronary Intervention (PPCI) procedure as an option for treating Coronary Artery Diseases demands addressing a variety of concerns in the recovery period and afterward including fasting the Ramadan month in the countries with the prevailing Muslim population. Therefore this study aims to assess the ability and the safety of fasting among patients who underwent PPCI within two specified periods.Method: This study was a prospective observational study with a sample size of 200 consecutive patients that have been divided into two groups based on the duration of their last PCI for an attack of Acute Myocardial Infarction (AMI). The patients were admitted to the Causality Department of the Surgical Specialty Hospital-Cardiac Center, Erbil/Iraq. The studied data have been analyzed using the Statistical Package for Social Science version 25 (SPSS), and a P-value of ≤0.05 was considered statistically significant.Results: The proportion of fasting and non-fasting patients showed a significant association with the duration of their last PCI procedure with a P-value of 0.001 as 14% in Group I (patients with less than 6 weeks duration post-PCI) successfully fasted the month while it was 54% in Group II (Patients with more than 6 weeks duration post PCI). Among our findings, there were significant associations with P-values of 0.001 between post-PCI symptoms and Ramadan fasting. In regards to NYHA classifications assessment, Group I had a higher proportion of patients classified as Class III and Class IV compared to Group II with a significant P-value of 0.001 with proportions of class III classification in Group I of 14.3% among fasting, 17.1% among non-fasting, and 58.3% among those who could not continue their fasting while in Group II, the proportions showed 3.7% among fasting, 6.7% among non-fasting, and 0% among those who could not continue their fasting.Conclusion: We discourage fasting among patients who have undergone Percutaneous Coronary Intervention within the first 6 weeks, as well as patients who have NYHA class III and above as they are highly liable for deterioration and can not continue their fasting.

Governments around the world have issued movement restrictions and quarantine to combat the SARS-CoV-2 (COVID-19) pandemic. However, the Swedish government has not implemented such measures but rather depended on individual responsibility. An important question regarding the extent to which individuals have been encouraged to trust in and be satisfied with government strategies and adopt personal health measures, such as social isolation, remains unanswered. This study aims to examine the direct effects of trust in the government and risk perception on self-efficacy. Most importantly, this study intends to explore whether satisfaction with government measures augments the relationships between trust in the government and self-efficacy and between risk perception and self-efficacy. Thus, we test our suggested hypotheses using survey data obtained from 403 Swedish citizens living in Sweden, and as predicted, the findings indicate that trust in the government and risk perception positively impact individual self-efficacy. Additionally, the findings reveal that satisfaction with government measures strengthens this relationship; more precisely, the impact of trust in the government and risk perception under a high level of individual satisfaction with government measures is much more positive than that under a low level of satisfaction. In practice, a focus on implementing successful policies or strategies and excellent individual self-efficacy are required to halt the pandemic, and the findings indicate that combining strictly attentive and adaptive individual strategies with government strategies can minimize the spread of infection.

The public’s actions will likely have a significant effect on the course of the coronavirus disease (COVID-19) pandemic. Human behavior is conditioned and shaped by information and perceptions of people. This study investigated the impact of risk perception on trust in government and self-efficacy. It examined whether the use of social media helps people adopt preventative actions during the pandemic. To test this hypothesis, data were gathered from 512 individuals (students and academicians) who were based in Malaysia during COVID-19. Our results suggested that risk perception had a significant effect on trust in government and self-efficacy. Moreover, these correlations were stronger when social media was used as a source for gathering information on COVID-19, and in some cases it even helped the user avoid being exposed to the virus. This study assessed the relationship between risk perception and the awareness gained from using social media during the pandemic and also highlighted how social media usage influences trust in government and self-efficacy.

Background Tuberculosis (TB) remains a major global public health problem and the leading cause of mortality by a single infectious agent. TB is a chronic infectious disease that is primarily caused by Mycobacterium tuberculosis (Mtb). Macrophage (Mφ) are the main hosts of Mtb, the interaction between Mtb and Mφ plays an important role in the pathogenesis of TB.Summary The macrophages used in the current study are mostly derived from tumor cell lines or peripheral blood mononuclear cells (PBMC), but the application of such cells still have many problems needed to be sloved, such as the loss of function due to changes in genetic structure and the difficulty in cell acquisition. Human induced pluripotent stem cells (hiPS) represent an innovative source for the standardized in vitro generation of Mφ, and show novel promise in exploring disease pathogenesis, particularly TB. Current studies have revealed that autophagy plays a central role in the interaction between Mtb and Mφ, but the molecular mechanism involoved remains unclear and the exact role of hiPS-derived macrophages (hiPS-Mφ) in regulating autophagy induced by Mtb also remains unclear. To investigate the similarities and differences in hiPS-Mφ and THP-1-Mφ in anti-tuberculosis immunity, this study successfully obtained macrophages derived from hiPS and THP-1, then explored the mechanism behind Bacillus Calmette-Guerin (BCG)-induced autophagy through transcriptome sequencing analysis, qPCR, Western Blot Analysis and cell submicroscopic structure observation etc.. Our findings revealed that BCG infection of hiPS-Mφ and THP-1-Mφ would promote autophagy by regulating the expression of autophagy-related genes, which also indicated that the BCG-induced autophagy in hiPS-Mφ and THP-1-Mφ may be associated with PI3K/AKT/mTOR signaling pathway. However, there are some differences in the mechanism by which BCG infects macrophages from different sources and induces autophagy. Considering the above findings, we have provided novel insights into the role of macrophages along with autophagy in the anti-tuberculosis immune mechanism and the possibility of establishing an in vitro hiPS-Mφ-TB disease model.