Investigation on the Knowledge, Attitude and Practice of Oral Health among Medical College and University Undergraduate

Objectives: This study aims to investigate the status of knowledge, attitude and practice (KAP) of oral health among medical undergraduate students, and provide reference for implementing oral health interventions. Methods: A total of 528 undergraduate students enrolled in Fuzhou Medical College from February 2023 to September 2023 were selected as the research subjects. Their oral health KAP were investigated, and the oral health behavior habits of different types of medical students were compared, and possible influencing factors were analyzed. Results: The total awareness rate of oral health knowledge among medical students is 77.0%, with an average score of 3.85 ± 1.16 points. The overall positive rate of oral health attitudes among medical students is 80.0%, with an average score of 3.19 ± 0.72 points. The total qualified rate of oral health behavior is 65.9%, with an average score of 4.61 ± 1.23 points. The scores of oral health knowledge, attitudes, and behaviors among medical students are related to gender, major, smoking status, and oral health status. The frequency of brushing teeth in the female group was higher than that in the male group, while the habit of brushing teeth before bedtime and the frequency of timely replacement of toothbrushes when deformed were lower, with statistical significance (p 0.05). The frequency of timely replacement of toothbrushes varies among medical students from different majors, and the difference is statistically significant (p 0.05). People who have a habit of eating hot and cold food have a higher frequency of brushing their teeth every day, and the difference is statistically significant (p 0.05). Non smokers have a better habit of brushing their teeth before bedtime and a higher frequency of timely replacement when their toothbrush deforms, with a statistically significant difference (p 0.05). The frequency of using fluoride toothpaste or medicated toothpaste, having a habit of unilateral chewing, and timely replacement of toothbrushes when deformed in patients with existing oral problems is higher than that of those without oral problems, and the difference is statistically significant (p 0.05). Conclusion: The knowledge, attitude, and behavior of oral health among medical students in this school are above average. Students with different genders, dietary and smoking habits, and oral health status have different oral health behavioral habits. It is recommended to include oral health education in mandatory courses for various medical majors.

Determinants of Knowledge, Attitudes, and Practices among Young Adults Type 2 Diabetes Patients in Selected Tertiary Hospitals in Shandong Province, China

Objective: The purpose of this study is to understand the current situation of knowledge, attitude, and practice of self-management in young patients with type 2 diabetes mellitus (T2DM) and to explore the relationship between general conditions (personal, social, and environment, clinical factors) and their knowledge, attitude, and practices (KAP) of diabetes self-management, This aims to provide patients with high-quality nursing care management and services, as well as to provide relevant recommendations for effective self-management. Methods: This study is a descriptive correlational study that used the purposive sampling method to investigate 359 patients with T2DM aged 18-25 years in four designated tertiary hospitals in Shandong Province. Results: Knowledge of self-management was correlated with sex, age, education level, occupation and work situation, monthly household income, medical payment method, family and friend support, frequency of diabetes health education, and diabetes complications. The attitude subscale was correlated with sex, age, education level, work situation, and family and friend support. The practice subscale was associated with age, education level, work situation, family and friend support, frequency of diabetes health education, and HbA1c values. Conclusion: Young adults aged 18-25 with T2DM have positive attitudes towards diabetes self-management, but there are still deficiencies in knowledge acquisition and behavioral practice. The KAP of self-management of diabetes is influenced by personal factors such as sex, age, and education level, and socio-environmental factors such as family income and family or friends’ social support. Additionally, clinical factors such as complications and HbA1c values significantly impacted the patient’s disease self-management ability.

Effects of Continuous Precision Nursing Model on Knowledge, Attitudes, and Practices (KAP) Behavior and Cardiac Function in Patients after Percutaneous Coronary Angiography and Stent Implantation

Objective:To explore the impact of a continuous precision nursing model on patients’Knowledge,Attitudes,and Practices(KAP)and cardiac function during the nursing process of patients undergoing percutaneous coronary angiography and stent implantation.Methods:Ninety patients who underwent percutaneous coronary angiography and stent implantation in our hospital from April 2022 to April 2023 were selected and randomly divided into the control group(45 cases),in which routine nursing support was carried out during the treatment process,and the observation group(45 cases),in which continuous precision nursing model was carried out during the treatment process.Comparisons were made between the two groups of patients on their KAP,cardiac function,and quality of life during recovery.Results:There was no difference in the left ventricular ejection fraction(LVEF),cardiac output(CO),and cardiac index(CI)levels before intervention.After the intervention,the levels of cardiac function in the observation group were higher than those of the control group(P<0.05).There was no difference in the Exercise of Self-Care Agency(ESCA)self-care ability scale scores before the intervention.After the intervention,the observation group had higher ESCA scores than the control group(P<0.05).Conclusion:Implementation of a continuous precision nursing model in the care of patients undergoing percutaneous coronary angiography and stent implantation improved the patient’s cardiac function,and KAP,and promoted recovery.

Midwives’s Knowledge and Practice in Preventing Mother-to-Child Transmission on Hepatitis B Virus in Brazzaville in 2023

Background: Maternal-fetal transmission is the most frequent mode of hepatitis B virus (HBV) contamination in Africa. Prevention of mother-to-child transmission (PMTCT) of hepatitis B is still poorly understood, and training of the health workers involved, such as midwives, is rare. Objective: The aim of this study was to assess the knowledge and practices of midwives prevention of HBV’ mother-to-child transmission (PMTCT) in Brazzaville. Patients and Methods: This was a cross-sectional analytical study conducted in Brazzaville from June 1 to July 31, 2023. Midwives present at the time of the survey in the various Brazzaville health centers visited and who agreed to answer the questionnaire during a face-to-face interview with the investigator were included. Univariate analyses were performed using epi info7.2 software. Pearson’s chi-square and Student’s t-tests were used to compare proportions and means, which were significant at the 0.05 level. Results: At the end of our study, 93 midwives out of 127 agreed to take part in the study, i.e. a participation rate of 73.2%. Their median age was of 41.7 years, a median professional experience of 13.7 years, and they worked mainly in primary health care facilities. Global knowledge of HBV PMTCT was satisfactory in 51 (54.3%) midwives. Knowledge of the HBV vaccine was significantly related to professional experience (p = 0.0167). PMTCT practice was poor in 48 (51.6%) cases. Overall, the practice of PMTCT was statistically associated with the midwives’ place of practice (p = 0.0262). Conclusion: Midwives had good knowledge but insufficient practice of PMTCT in Brazzaville. Training and awareness-raising are needed to reduce mother-to-child transmission of HBV.

Development of a Sports Safety Promotion Framework Based on KABP Theory and 4M Management

This study explores the significance,current research landscape,and conceptualization of sports safety promotion.Safety in sports is fundamental to youth physical activities,and an excessive focus on or neglect of safety is unwarranted.Globally,numerous countries have extensively researched sports safety promotion and implemented diverse strategies.Drawing from KABP(Knowledge,Attitude,Behavior,Practice)theory and 4M(Man,Machine,Medium,Management)management,this paper presents a conceptual framework for sports safety promotion.It integrates these theories to devise a comprehensive accident prevention model within a sports safety promotion system.The framework prioritizes enhancing students’safety literacy and underscores the practical application of safety knowledge and skills in simulated sports settings following structured safety education.It aims to enhance students’competency and proficiency in averting sports-related injuries.

Effects of the information–knowledge–attitude–practice nursing model combined with predictability intervention on patients with cerebrovascular disease

BACKGROUND Cerebrovascular disease(CVD)poses a serious threat to human health and safety.Thus,developing a reasonable exercise program plays an important role in the long-term recovery and prognosis for patients with CVD.Studies have shown that predictive nursing can improve the quality of care and that the information–knowledge–attitude–practice(IKAP)nursing model has a positive impact on patients who suffered a stroke.Few studies have combined these two nursing models to treat CVD.AIM To explore the effect of the IKAP nursing model combined with predictive nursing on the Fugl–Meyer motor function(FMA)score,Barthel index score,and disease knowledge mastery rate in patients with CVD.METHODS A total of 140 patients with CVD treated at our hospital between December 2019 and September 2021 were randomly divided into two groups,with 70 patients in each.The control group received routine nursing,while the observation group received the IKAP nursing model combined with predictive nursing.Both groups were observed for self-care ability,motor function,and disease knowledge mastery rate after one month of nursing.RESULTS There was no clear difference between the Barthel index and FMA scores of the two groups before nursing(P>0.05);however,their scores increased after nursing.This increase was more apparent in the observation group,and the difference was statistically significant(P<0.05).The rates of disease knowledge mastery,timely medication,appropriate exercise,and reasonable diet were significantly higher in the observation group than in the control group(P<0.05).The satisfaction rate in the observation group(97.14%)was significantly higher than that in the control group(81.43%;P<0.05).CONCLUSION The IKAP nursing model,combined with predictive nursing,is more effective than routine nursing in the care of patients with CVD,and it can significantly improve the Barthel index and FMA scores with better knowledge acquisition,as well as produce high satisfaction in patients.Moreover,they can be widely used in the clinical setting.

Knowledge,attitude,practice and factors that influence the awareness of college students with regards to breast cancer

BACKGROUND Breast cancer has the highest incidence of all global cancers.Recent data show that breast cancer is becoming more prevalent in the younger population.Therefore,preventing breast cancer in young populations is a significant priority for public health.Relevant investigations of the incidence of breast cancer in young females have already been undertaken in China;however,none of these previous studies investigated the awareness of female college students with regards to breast cancer.AIM To investigate the knowledge,attitude,and practice(KAP)of female college students in Yunnan with regards to breast cancer and a series of influential factors.METHODS A random sample of 1387 female college students from two universities in Dali city were investigated by questionnaires.RESULTS The total KAP scores for breast cancer were 9.86±2.50,3.19±2.01 and 13.31±2.49,respectively.Multiple linear regression analysis showed that educational grade was the most significant influential factor underlying the level of knowledge female college students had with regards to the treatment of breast cancer(P<0.05).Registered residence and educational grade were the most significant factors that influenced attitude(P<0.05).Age,registered residence,grade and major,were the most significant factors that influenced behavior(P<0.05).The KAP of female college students in western Yunnan with regards to breast cancer were low.CONCLUSION There is an urgent need to provide standardized publicity and educational strategies in China to improve the knowledge,attitude,and practice,of college students with regards to breast cancer.

Traditional agroecological knowledge and practices:The drivers and opportunities for adaptation actions in the northern region of Ghana

Agroecological practices are promoted as a more proactive approach than conventional agriculture to achieving a collective global response to climate change and variability while building robust and resilient agricultural systems to meet food needs and protect the integrity of ecosystems.There is relatively limited evidence on the key traditional agroecological knowledge and practices adopted by smallholder farmers,the factors that influence smallholder farmers’decision to adopt these practices,and the opportunities it presents for building resilient agricultural systems.Using a multi-scale mixed method approach,we conducted key informant interviews(n=12),focus group discussions(n=5),and questionnaire surveys(N=220)to explore the traditional agroecological knowledge and practices,the influencing factors,and the opportunities smallholder farmers presented for achieving resilient agricultural systems.Our findings suggest that smallholder farmers employ a suite of traditional agroecological knowledge and practices to enhance food security,combat climate change,and build resilient agricultural systems.The most important traditional agroecological knowledge and practices in the study area comprise cultivating leguminous crops,mixed crop-livestock systems,and crop rotation,with Relative Importance Index(RII)values of 0.710,0.708,and 0.695,respectively.It is reported that the choice of these practices by smallholder farmers is influenced by their own farming experience,access to market,access to local resources,information,and expertise,and the perceived risk of climate change.Moreover,the results further show that improving household food security and nutrition,improving soil quality,control of pest and disease infestation,and support from NonGovernmental Organizations(NGOs)and local authorities are opportunities for smallholder farmers in adopting traditional agroecological knowledge and practices for achieving resilient agricultural systems.The findings call into question the need for stakeholders and policy-makers at all levels to develop capacity and increase the awareness of traditional agroecological knowledge and practices as mechanisms to ensure resilient agricultural systems for sustainable food security.

Knowledge and Practices of Health Professionals on the Optimization of Radiation Protection in Diagnostic Radiology in Children and Adults in the General Referral Hospitals of Bukavu in South Kivu, DRC

The aim of this research was to assess the knowledge and practices of radiological versus non-radiological health professionals on the optimisation of radiation protection in paediatric and adult radiology in BUKAVU hospitals. To achieve this, we surveyed a convenience sample of 73 health professionals including 23 radiologists working in the hospitals surveyed to assess knowledge and level of implementation of radiation protection principles. Also, physical parameters were taken for the calculation of entry doses in paediatric and adult radiology units for comparison with the International Commission on Radiological Protection (ICRP) diagnostic reference levels. After analysis of the data, the following was found: although radiologists have sufficient knowledge of radiation protection standards, technical constraints do not allow them to observe the dose limitation principle recommended by the ICRP. This is why several radiology departments, including those of the HPGRB, the MWANZI clinic and CIRIRI hospital, have proved to be very irradiating for children. However, radiologists and non-radiologists alike do not contribute positively to the optimisation of radiation protection in the diagnostic use of X-rays. Therefore, support in the implementation of radiation protection principles and regular monitoring of the units as well as replacement of non-standard equipment is necessary to promote patient and environmental safety by optimising radiation protection.

Knowledge Attitudes, Practices and Factors Associated with Blood Donation in the Fatick Health District in 2019 (Senegal)

Introduction: Timely availability of safe blood or blood products is essential for all health care facilities where transfusion occurs, but in many developing and transitional countries, there is still a considerable gap between the need for blood and the supply available. The overall objective was to study knowledge attitudes, practices, and factors influencing blood donation in the general population in Senegal. Methods: This was a cross-sectional descriptive and analytical study conducted among the Fatick health district population from April 1 to 15, 2019. Thus, the sample is based on a two-stage survey. Data collection was conducted through a questionnaire designed, pretested, and administered to 466 people by selected and trained enumerators. The data collected on the smartphone was analyzed using Epi Info 7.2.1.0 software. A descriptive and bivariate analysis was performed with a 5% risk of alpha error. Results: The average age of respondents was 35 years (±13), with 34 years (±12) for women and 38 years (±15) for men, and more than half of them between 20 and 40 years of age. A proportion of 87% of respondents lived in rural areas and had agriculture as their primary income source. More than half of the individuals (70%) were married, and 68% were educated. The level of knowledge of individuals about blood donation was low at 91.8%. On the other hand, more than half of them had good habits (53.65%). A proportion of 68.0% of individuals had an intention to donate in the future. However, only 24.68% of the population surveyed had already donated blood. Eighty percent of the donations were voluntary. However, 26.09% had repeated this practice. Factors that could influence the practice of blood donation were age, male sex (ORb = 2.18 [1.40 - 3. 37]), high level of education, good knowledge of blood donation (ORb = 2.14 [1.07 - 4.26]), the existence of a relatives donor (ORb = 3.4 [2.19 - 5.26]) and individuals who did not necessarily require permission from a parent or spouse (ORb = 3.37 [2.13 - 5.31]). Conclusion: It is necessary to develop mass communication and proximity strategies, also strengthen the blood bank in terms of human resources and logistics to increase voluntary blood donations in the district. An increase and better planning of mobile clinic outings can facilitate and improve voluntary blood donation by improving accessibility to this service.

Knowledge, Attitudes and Practices of Caregivers of Children 0 - 23 Months in Eastern and Central Uganda

Introduction: Appropriate feeding and consequently good nutritional status of young children largely depends on their caregivers. Aim: The current study aimed at assessing maternal/caregivers’ current knowledge, attitudes, practices, and beliefs regarding different aspects of infant and young child feeding in Eastern and Central Uganda. Methodology: A cross-sectional survey design with mixed methods employing both qualitative and quantitative methods was used for data collection. Results: The study participants included 556 caregivers and 572 children. Results indicate that most caregivers (77%) were knowledgeable about key infant and young child feeding practices such as breastfeeding, complementary feeding and meal frequency. However, culture and economic hardships were a major barrier to the applicability of this knowledge. Nearly all (98%) children were ever breastfed with 41% having been initiated on breast milk in the first hour after birth and 68% of all the children below 6 months exclusively breastfed. Three percent of the children aged 6 - 23 months were classified as having either Moderate (2%) or Severe (1%) Acute malnutrition. The median birth weight was 3.2 Kgs with nine percent of the children classified as underweight at birth. The majority (78%) of the children consumed foods from at least four food groups however only 44% consumed heme-rich animal flesh food such as meat, poultry, organ meats and fish, 29% consumed milk and milk products while only 11% consumed eggs. The barriers to improved nutritional status and health-seeking behaviour in children from both regions were largely similar. Some of these included cultural practices which prohibit children from eating certain foods and lack of drugs in the health facilities. Lack of male involvement was a key barrier to health-seeking behaviour and the nutritional well-being of children. Males were, however, more knowledgeable about the key childcare practices that are critical to positive outcomes because they listen to radios, have access to social media and usually congregate at bars where this information is disseminated and exchanged. Conclusion: There should be continuous sensitization of mothers on the benefits of breastfeeding with special focus on early initiation and exclusive breastfeeding as well as child feeding practices during illness. To increase protein intake in children 6 - 23 months, interventions aimed at increasing consumption of these vital nutrients such as promotion of nutrition-sensitive agricultural enterprises like rearing of small livestock and chickens should be emphasized. Consumption of these foods is critical, especially during pregnancy and infancy. Finally, male involvement in maternal and child feeding should be encouraged.

Knowledge Attitude and Practices Related on Prevention of Mosquito Borne Diseases and Sanitation Conditions in a Salvadoran Urban Community

Introduction: In El Salvador Mosquito Borne Diseases (MBDs) is a serious public health problem due to produce morbidity and mortality. They produce a high economic loss, which contributes to the collapse of the public health system. Over the years, the Salvadoran public health system has invested large amounts of resources to minimize the problem through campaigns against MBDs. Despite this, the population is still affected by diseases such as dengue, and more recently chikungunya and zika outbreaks. The aim of this study is to evaluate sanitation conditions variables and identify knowledge, attitudes, practices related to the prevention of MBDs. Methods: A cross-sectional survey about sanitation conditions and knowledge, attitudes and practices on prevention of MBDs of inhabitant’s ≥ 15 years from an urban community of a municipality with the highest number of cases reported in 2015. Results: Majority of respondents (98.2%) had direct supply of drinking water;however 96.4% of respondents were agreed that they had an inconsistent water supply. Regarding MBDs prevention respondents showed high acceptable knowledge (76.8%), high favorable attitude (92.1%) and an acceptable implementation of practices toward prevention reproduction of mosquitoes (58.5%) and a poor implementation of practices to prevent mosquito bites (38.3%). Conclusions: The findings revealed high acceptable knowledge about MBDs and a high favorable attitude regarding to prevent them, but also revealed a scarce implementation of prevention practices. The generalized storage of water on non-covered barrels because the inconsistent water supplies, can be source of proliferation of mosquitoes and therefore increases the risk of transmission of MBDs. High population density of the community can magnify this risk. It is necessary to enhance education to promote better implementation of practices using the most common media together with the local health workers.

郑州市社区居民营养知识、态度及饮食行为调查

目的了解郑州市社区居民的营养知识、态度、行为状况(K-A-P),探索对居民进行营养教育、指导合理膳食的有效途径和方法,为相关政策措施的制定提供现实依据。方法采用多阶段抽样的方法,对郑州市西前街社区等4个社区的520名居民进行营养知识、态度、行为的问卷调查。结果社区居民的营养知识、态度及行为的及格率分别为63.7%、71.0%、31.5%,但知晓《中国居民膳食宝塔》者仅为33.1%,76.3%的居民在营养态度上是积极的,会主动通过电视、广播和报刊获得营养知识;营养知识、态度、行为之间存在关联(P<0.05)。结论社区居民对营养知识的掌握情况不太理想,应加强营养知识的普及以及正确饮食行为的宣传。

新疆大学生与性相关的知识、态度、行为调查分析

目的了解新疆大学生与性相关的知识、态度和行为现状,为新疆教育部门制订及开展符合新疆区情的大学生性健康教育提供科学依据。方法采用多级抽样方法,对新疆7所高校不同民族大学生用匿名问卷进行调查,共调查大学生5 110名。采用非条件Logistic回归分析影响婚前性行为的各种因素。结果新疆大学生对与性相关的知识知晓率较低。78.2%的大学生对婚前性行为持赞同或理解态度,新疆大学生婚前性行为发生率为17.4%。Logistic回归分析显示影响新疆大学生发生婚前性行为的因素有"是否谈过恋爱、亲密行为及对婚前性行为态度"等。结论必须加强新疆大学生的性健康教育,充分考虑不同民族大学生的文化背景,采取有针对性、行之有效的干预措施。

Son Preference and Family Planning Practices among Married Men in Mumbai, India

ve To study son preferences and the contraceptive knowledge, attitude and practices of Indian Male

Clinical and epidemiological features of patients with clonorchiasis

AIM:To study the clinical and epidemiological features of patients with clonorchiasis so as to provide scientific evidences for the diagnosis and prevention of clonorchiasis. METHODS:Stools from 282 subjects suspected of having clonorchiasis were examined for helminth eggs with modified Kato's thick smear and sedimentation methods,and their sera were tested for HAV-DNA,HBV-DNA,HCV-RNA,HDV- RNA and HEV-RNA with polymerase chain reaction (PCR). Clinical symptoms of patients with clonorchiasis only were analyzed,and their blood samples were tested for circulating antigen (CAg) with Dot-ELISA,esoinophilic granulocyte count, and alanine aminotransferase (ALT).Meanwhile,they were asked to provide data of occupation,eating habit,hygienic habit and knowledge of donorchiasis.In addition,the ecosystem of the environment in epidemic areas was surveyed. RESULTS:Among the 282 patients,61 (21.43%) were infected with clonorchis sinensis only,97 (34.64%) were co-infected with clonorchis sinensis and other pathogens, 92 (32.86%) were infected with hepatitis virus only and 31 (11.07%) neither with clonorchis sinensis nor hepatitis virus. Among the 61 patients with clonorchiasis only,there were 14 (22.95%) subjects with discomfort over hepatic region or epigasfrium,12 (19.67%) with general malaise or discomfort and inertia in total body,6 (9.84%) with anorexia,indigestion and nausea,4 (6.56%) with fever,dizziness and headache (6.56%),and 25 (40.98%) without any symptoms;sixty one (100%) with CAg (+),98.33% (59160) with eosinophilic granulocytes increased and 65.00% (39/60) with ALT increased.B-mode ultrasonography revealed 61 cases with dilated and thickened walls of intrahepatic bile duct,and blurred patchy echo acoustic image in liver.Twenty-six cases had stones in the bile duct,39 cases had slightly enlarged liver with diffuse coarse spots in liver parenchyma.Twenty cases had enlarged gallbladder with thickened coarse wall and image of floating plagues,9 cases had slightly enlarged spleen.By analysis of epidemiological data,we found that the ecologic environment was favorable for the epidemiology of clonorchiasis.Most patients with clonorchiasis were lack of knowledge about the disease.Their living environment, hygienic habits,eating habits and their occupations were the related factors that caused the prevalence of the disease. CONCLUSION:The clinical symptoms of clonorchiasis are non-specific,and the main evidences for diagnosis of clonorchiasis should be provided by etiologic examination, B-mode ultrasonography and clinical history.The infection of clonorchis sinensis is related to occupations,bad eating habits and lack of knowledge about prevention of the disease.

Prediabetes and cardiovascular complications study:Highlights on gestational diabetes, self-management and primary health care

International collaboration on the prediabetes and cardiovascular complications study started in 2013.In 2017,a reflection was reported.Incompleteness of documentation and screening of antenatal cases for gestational diabetes mellitus(GDM)was concerning.Hence,further observations have been made that warrant an update.The objective of this review is to highlight gaps between clinical knowledge and practice in GDM,diabetes self-management and primary health care(PHC)for rural dwellers.We followed a descriptive field notes method.Antenatal records of patients screened for GDM with incomplete documentation were examined to determine incompleteness of data in those that also met the criteria for GDM risk assessment.Experiences on development of a diabetes register and education and notes on behavioural change wheel were also reviewed.Other data included cross-sectional evaluation of activities of daily living at two private hospitals.Up to 29%had high GDM risk factors,which fulfilled selection criteria for laboratory screening.Demographic data was complete in all women;however,incomplete documentation was observed with as much as 98%of basic data.High levels of physical activity were found in the population,and health lectures proved effective in food choices.The workforce need for diabetes care seems underestimated,but this may be better understood with reactivation of PHC services.The observations highlight behavioural change wheel issues on GDM and PHC services that need concerted focus.Two proposals are to advance the use of a‘risk assessment and screening sheet’for GDM screening and enlightenment of stakeholders on the central hub role of PHC in diabetes management.

Disaster Management in Nepalese Context:An Ecological Perspective

This paper attempts to identify major natural hazards and disaster incidents damage and losses in Nepal.Using participatory and geographical diversity approach and for collecting information,multi-criteria decision making methods and analytical hierarchic process to identify the hazard prone area with type and intensity and location-specific innovative practices and their legitimization for integrating local knowledge and skills into mainstream development policy,science and technology through educational assessment to incorporate local knowledge as live science for disaster management,climate change adaptation and sustainable livelihood improvement.Findings of the study reveal that their variety of natural hazards,such as landslides,flood/inundation,droughts,soil erosion,earthquakes,thunderstorm/lightening and fire are exacerbated by environmental degradation processes.There are location specific local practices for resource conservation,utilization and disaster management for the well-being of communities before,during and after disasters.Such practices passed on from one generation to the next without being integrated into mainstream development strategies,disaster policy and science.Knowledge of ecology and local skills and materials for hazard prevention and mitigation have the important role to mitigate the hazards and ensure the sustainability for community life style.Moreover,this study proposed an action-oriented model i.e.political-ecological framework of the environmental resource conservation,disaster management and climate change adaptation practices in mostly vulnerable locations of Nepal.Moreover,measures are suggested to enhance the community capacity for managing their livelihood resources and are hindrance to policy making and scientific advancement at the community level with proper integration of local knowledge with science and mainstream development policy.

Effect of KAP Intervention Model on Resilience and Cancer-related Fatigue in Patients with Colorectal Cancer Undergoing Chemotherapy

Objective:To explore the effect of KAP intervention mode on resilience and cancer-related fatigue in patients with colorectal cancer undergoing chemotherapy.Methods:A prospective randomized trial was conducted.55 patients with colorectal cancer who received routine nursing from February 2018 to February 2019 were included in the control group,and 55 patients who received routine nursing+KAP intervention from March 2019 to March 2020 were included in the observation group.The scores of Resilience Scale and cancer-related fatigue scale(CFS)before and 6 months after intervention were compared between the two groups.Results:After 6 months of intervention,the score of resilience of the two groups was higher than that before intervention,and that of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05);The CFS score of the two groups was lower than that before intervention,and that of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).Conclusion:KAP intervention model can improve the resilience of patients with colorectal cancer chemotherapy,reduce cancerrelated fatigue.

Building towards Expertise in CME （Continuous Medical Education）： Suggestions for a New Paradigm

To build towards expertise, one has to accept to modify his way of practicing, including： （1） a need to reflect on and about the action; （2） a continuous concern about our competence to practice; （3） tireless effort to combine metacognition and mental practice in a trans-disciplinary approach; （4） adding research with neuroscience, understanding neuroplasticity, modulation and artificial intelligence. Usual practice actually does not include a continuous concern for CME （continued medical education） and is intermittent at best. This new paradigm constitutes the basis of our approach. Expertise starting in 2015 is described as an asymptotic curve unable to be obtained with usual practice and intermittent education. We suggest a new way of conceiving CME combining practice, reflection on action and in-situ simulation laboratory near work. We are describing TEE （technology-enhanced education） coupled with certain neuro-enhancers to achieve a break in the asymptotic curve of expertise. This is in reality a new conception of CME in medicine.