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This paper reviews the current problems and prospects to overcome circular water economy management challenges in European countries. The geopolitical paradigm of water, the water economy, water innovation, water management and regulation in Europe, environmental and safety concerns at water reuse, and technological solutions for water recovery are all covered in this review, which has been prepared in the frame of the COST ACTION (CA, 20133) FULLRECO4US, Working Group (WG) 4. With a Circular Economy approach to water recycling and recovery based on this COST Action, this review paper aims to develop novel, futuristic solutions to overcome the difficulties that the European Union (EU) is currently facing. The detailed review of the current environmental barriers and upcoming difficulties for water reuse in Europe with a Circular Economy vision is another distinctive aspect of this study. It is observed that the biggest challenge in using and recycling water from wastewater treatment plants is dealing with technical, social, political, and economic issues. For instance, geographical differences significantly affect technological problems, and it is effective in terms of social acceptance of the reuse of treated water. Local governmental organizations should support and encourage initiatives to expand water reuse, particularly for agricultural and industrial uses across all of Europe. It should not also be disregarded that the latest hydro politics approach to water management will actively contribute to addressing the issues associated with water scarcity., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The first Pt IV -containing discrete polyoxoplatinate(II) [Pt IV Pt II 6 O 6 (AsO 2 (CH 3 ) 2 ) 6 ] 2- ( Pt 7 ) and polyoxopalladate(II) [Pt IV Pd II 6 O 6 (AsO 2 (CH 3 ) 2 ) 6 ] 2- ( PtPd 6 ) have been prepared and characterized in the solid state, in solution, and in the gas phase. The molecular structures of the noble metal-oxo clusters Pt 7 and PtPd 6 comprise a central, octahedral Pt IV with either K 6 hetero group surrounded by six square-planar MO 4 (M = Pt II , Pd II ) units, which are capped by six dimethylarsinate ligands. The polyanions were prepared under simple one-pot aqueous solution conditions by reacting H 2 Pt(OH) 6 with either K 2 PtCl 4 or Pd(NO 3 ) 2 in sodium dimethylarsinate buffer (pH 7) at 80 °C. Catalytic studies were performed on Pt 7 supported on SBA15-apts for o -xylene hydrogenation at 300 °C and 90 bar H 2 pressure and indicated excellent activity and recyclability with low activation temperature.

Aims and Objectives: This study aimed to assess depression and anxiety symptoms among older adult residents of long-term care facilities (LTCFs) in Jordan and to examine the relationships between stigmatization and social support with depression and anxiety., Methods: Data was collected between December 2019 and March 2020 using a cross-sectional design. A total of 90 LTCF residents responded to measures of cognition, anxiety, depression, stigmatization, and social support. Descriptive statistics and multiple regression analyses were used in this study., Results: The average scores of depression and anxiety were high among the participants, with 81.1% of the participants found to be at risk of developing clinical depression. Stigmatization was positively correlated with depression and anxiety, whereas social support was negatively correlated with depression. Stigmatization was a significant predictor of both anxiety and depression scores ( β = .19, p = .03; β = .32, p = .001, respectively)., Conclusions: Older adults residing in LTCFs in Jordan suffer from many psychological distress symptoms, which place them at risk of serious mental problems. Reducing stigmatization would improve the psychological well-being of LTCF residents., Relevance to Clinical Practice: Caregivers working at LTCFs should be aware that with the longer stay, older adult residents are expected to complain of psychological distress symptoms. Thus, frequent assessment of the residents is highly recommended. In addition, caregivers should provide the residents with appropriate social support to mitigate the negative impact of a lengthy stay., Competing Interests: The authors declare no conflict of interest., (© 2022 The Authors.)

The present study utilizes 18 years of long-term (2001-2018) data collected from six active AERONET sites over the Indo-Gangetic Plain (IGP) and the North China Plain (NCP) areas in Southeast Asia. The annual mean (±SD) aerosol optical thickness at 440 nm (AOT 440 ) was found high at XiangHe (0.92 ± 0.69) and Taihu (0.90 ± 0.51) followed by Beijing (0.81 ± 0.69), Lahore (0.81 ± 0.43), and Kanpur (0.73 ± 0.35) and low at Karachi (0.52 ± 0.23). Seasonally, high AOT 440 with corresponding high Ångström exponent (ANG 440-870 ) noticed during JJA for all sites, except Kanpur, suggesting the dominance of fine-mode particles, generally associated with large anthropogenic emissions. Climatologically, an increasing (decreasing) trend was observed over IGP (NCP) sites, with the highest (lowest) percentage of departures in AOT 440 found over Beijing (Karachi). We further identified major aerosol types which showed the dominance of biomass burning, urban-industrial followed by the mixed type of aerosols. In addition, single scattering albedo (SSA), asymmetry parameter (ASP), volume size distribution (VSD), and complex aerosol refractive index (RI) showed significant temporal and spectral changes, illustrating the complexity of aerosol types. At last, the annual mean direct aerosol radiative forcing at the top, bottom, and within the atmosphere for all sites were found in the range from -17.36 ± 3.75 to -45.17 ± 4.87 W m -2 , -64.6 ± 4.86 to -93.7 ± 10.27 W m -2 , and 40.5 ± 6.43 to 68.25 ± 7.26 W m -2 , respectively, with an averaged atmospheric heating rate of 0.9-2.3 K day -1 . A large amount of anthropogenic aerosols showed a significant effect of heating (cooling) on the atmosphere (surface) results obviously, due to an increased rate of atmospheric heating. Therefore, the thermodynamic effects of anthropogenic aerosols on the atmospheric circulation and its structure should be taken into consideration for future study over the experimental sites., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Purpose: To determine if findings from our preliminary study related to patient and nursing satisfaction with a pain management intervention could be replicated in a changed environment, and if contextual factors could impact the effectiveness of a pain management intervention on patient satisfaction with nursing staff's management of pain., Methods: A prospective, experimental design was used with six monthly assessments before, during, and after the intervention. Data were collected from 540 patients admitted to eight medical surgical and progressive care units and nurses that worked in these units at an academic health sciences center in the southern United States, from March to July 2015. The script-based, pain management communication intervention included three specific tactics: script-based communication, use of white boards, and hourly rounding. The Hospital Consumer Assessment of Healthcare Providers and Systems survey was used to assess two items: "pain is well controlled" and "staff did everything they could to help with pain." Contextual factors focused on the practice setting., Findings: Both scores for "pain is well controlled" (β = .028, p = 0.651) and scores for "staff did everything they could to help with pain" (β = .057,p = .385) did not change initially but then increased significantly and were sustained over time. Nurses had high levels of satisfaction with the intervention (M = 7.9, SD = 2.1) and compliance with the intervention (M = 8.0, SD = 1.9), and had little difficulty in implementing the intervention (M = 8.3, SD = 1.4). In terms of contextual factors, the number of beds on the unit and the number of patients being discharged negatively impacted scores for "pain is well controlled" and "staff did everything they could to help with pain." Hospital length of stay positively impacted scores for "pain is well controlled" by staff., Conclusions: Despite challenging contextual variables, the study extended the findings of an early preliminary study in showing the effectiveness of pain management intervention on patient satisfaction with staff's management of pain. In evaluating the impact of an intervention, it is essential to examine the contextual environment., Clinical Relevance: Using simple, clear, and consistent communication between patients and nurses related to pain can positively impact patient satisfaction with pain management over time. The health care environment can enhance nursing practice and patients' outcomes., (© 2017 Sigma Theta Tau International.)

Introduction: Scalp AVM (SAVM) is a rare condition. Although surgical excision is considered as definitive treatment for these lesions, troublesome intraoperative bleeding may pose a challenge. Embolization as an alternative modality is gaining popularity. Proximal feeding artery temporary clipping has been utilized by the authors in this series to address troublesome intraoperative bleeding., Presentation of Cases: The authors present their experience in the surgical management of 3 cases with SAVMs using proximal feeding artery temporary occlusion followed by total surgical excision. The clinical presentations and radiological features of these cases are discussed in the article. Intraoperative blood loss was less than 150ml in all patients. Postoperative period was uneventful with no morbidity or mortality., Discussion: Intraoperative bleeding during surgical excision of scalp AVMs can be troublesome and challenging. To combat this, the authors advocate proximal feeding artery temporary clipping prior to surgical excision of the lesion. The external carotid artery was temporarily clipped in one case and superficial temporal artery in two patients., Conclusion: Although most SAVMs can be operated by traditional method of excision, use of temporary clipping of feeding arteries (like Superficial temporal artery[STA], External carotid artery[ECA]) enables total excision of giant SAVMs with minimal blood loss for a definitive cure. This novel technique obviates the need for preoperative embolization., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The high incidence and prevalence of childhood obesity, coupled with significant morbidity and financial burden, clearly suggest the need for identification and implementation of effective pediatric obesity prevention strategies in primary care. A solution to this problem includes evidence based clinical guidelines that provide concise, culturally appropriate information on the identification and prevention of childhood obesity in primary care settings. The objective of this quality improvement project was to implement childhood obesity identification and prevention guidelines from evidence-based recommendations into practice. Guidelines were implemented during preventative care visits through the use of a tracking form. The development of the tracking form included input from practice staff resulting in increased fidelity. The tracking form included directions for clear and concise guideline implementation and provided opportunities to record patient BMI, nutritional intake, physical activity, familial obesity prevention education and motivational interviewing and facilitated a practice increase in childhood obesity identification and education. Presence of chart indicators, including nutrition and exercise history, were analyzed to determine the fidelity of the practice change in obesity identification and prevention education. Key outcomes included a significant ( p  < .0001) practice increase in childhood obesity identification as well as a significant increase ( p  < .05) in documentation of obesity prevention education through motivational interviewing. Practice change incorporating childhood obesity identification and familial prevention guidelines had positive effects in a pediatric population. Implementation of evidence-based guidelines can result in increased identification of children at risk for childhood obesity and enhanced familial obesity prevention education; leading to the long-term goal of creating healthier lifestyles and decreasing risk factors in a vulnerable population.

Aim: This in vitro study aimed to evaluate the efficacy of rotary ProFile, ProTaper, Hero Shaper and K-files in shaping ability, cleaning efficacy, preparation time and instrument distortion in primary molars., Methods: Sixty extracted primary mandibular second molars were divided into four equal groups: Group I K-file, Group II ProFile, Group III ProTaper file and Group IV Hero Shaper file. The shaping ability was determined by comparing pre- and post-instrumentation CBCT scans and data analysed with SPSS program using the Chi-square test. Cleaning efficacy was evaluated by the degree of India ink removal from the canal walls under stereomicroscopy. Instrumentation times were calculated for each tooth and instrument distortion was visually checked and duly noted. The cleaning efficacy and instrumentation time were determined using ANOVA with Tukey's correction. Instrument distortion was analysed using Chi-square test., Results: The canal taper was significantly more conical for rotary files as compared to K-files with Chi-square test (p < 0.05). Cleaning efficacy of rotary files with average scores (Groups II- 0.68, III- 0.48 and IV- 0.58) was significantly better than K-files (Group I- 0.93) (p < 0.05). Mean instrumentation time with K-file (20.7 min) was significantly higher than rotary files (Groups II 8.9, III 5.6, and IV 8.1 min) (p < 0.05). Instrument distortion was observed in Group I (4.3%), while none of the rotary files were distorted., Conclusions: Rotary files prepared more conical canals in primary teeth than manual instruments. Reduced preparation time with rotary files enhances patient cooperation especially in young children.

The effects of obesity on the balance and gait parameters like step width and foot angle (degree of toe out) in young adults were studied. 60 subjects of both the genders were taken. 30 were taken as a control group (non-obese, BMI < 25) and 30 were taken as experimental group (obese, BMI 30 >). Functional Reach Test (FRT) was used for Balance Testing and the Footprint method was used for Gait parameters measurements. The value of functional reach test in females was 11.90 +/- 0.12 inches in control group and 7.01 +/- 1.80 inches in experimental group (t = 5.31, P < 0.001) and in males, it was 16.45 +/- 0.72 inches in control and 11.66 +/- 0.53 inches in experimental group (t = 6.47, P < 0.001). The degree of toe out in females was 6.66 +/- 0.08 degrees for control and 8.13 +/- 0.21 degrees for experimental group (t = 4.08, P < 0.01) and in males, it was 6.59 +/- 0.04 for control and 9.79 +/- 0.51 for experimental group (t = 6.53, P < 0.001). The step width was found to be 4.41 +/- 0.15 inches (control group) and 6.27 +/- 0.35 inches (experimental) in males (t = 4.53, P < 0.01) and it was 3.95 +/- 0.03 inches (control) and 3.42 +/- 1.05 inches (experimental) in females (t = 0.77, P > 0.05). We concluded that obesity has a negative impact on balance of an individual. The degree of toe out was more in obese group as compared to normal BMI group in both genders. The Step Width measurement was more in males of obese group than that in males of normal BMI group but it showed statistically insignificant when compared in females of both groups.