Search results for: Insecticidal Efficacy

Authors: Abhimanyu Kumar, Chirag Gupta

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This work presents a comprehensive study on the employment of Model Predictive Control (MPC) for a three-phase voltage-source inverter to regulate the output voltage efficiently. The inverter is modeled via the Clarke Transformation, considering a scenario where the load is unknown. An LC filter model is developed, demonstrating its efficacy in Total Harmonic Distortion (THD) reduction. The system, when implemented with fault-tolerant multilevel inverter topologies, ensures reliable operation even under fault conditions, a requirement that is paramount with the increasing dependence on renewable energy sources. The research also integrates a Fuzzy Logic based fault tolerance system which identifies and manages faults, ensuring consistent inverter performance. The efficacy of the proposed methodology is substantiated through rigorous simulations and comparative results, shedding light on the voltage prediction efficiency and the robustness of the model even under fault conditions.

Keywords: total harmonic distortion, fuzzy logic, renewable energy sources, MLI

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Authors: Tanida Julvanichpong

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Exercise has been regarded as a necessary and important aspect to enhance physical performance and psychology health. Body weight statistics of students in junior high school students in Chonburi Province beyond a standard risk of obesity. Promoting exercise among Junior high school students in Chonburi Province, essential knowledge concerning factors influencing exercise is needed. Therefore, this study aims to (1) determine the levels of perceived exercise behavior, exercise behavior in the past, perceived barriers to exercise, perceived benefits of exercise, perceived self-efficacy to exercise, feelings associated with exercise behavior, influence of the family to exercise, influence of friends to exercise, and the perceived influence of the environment on exercise. (2) examine the predicting ability of each of the above factors while including personal factors (sex, educational level) for exercise behavior. Pender’s Health Promotion Model was used as a guide for the study. Sample included 652 students in junior high schools, Chonburi Provience. The samples were selected by Multi-Stage Random Sampling. Data Collection has been done by using self-administered questionnaires. Data were analyzed using descriptive statistics, Pearson’s product moment correlation coefficient, Eta, and stepwise multiple regression analysis. The research results showed that: 1. Perceived benefits of exercise, influence of teacher, influence of environmental, feelings associated with exercise behavior were at a high level. Influence of the family to exercise, exercise behavior, exercise behavior in the past, perceived self-efficacy to exercise and influence of friends were at a moderate level. Perceived barriers to exercise were at a low level. 2. Exercise behavior was positively significant related to perceived benefits of exercise, influence of the family to exercise, exercise behavior in the past, perceived self-efficacy to exercise, influence of friends, influence of teacher, influence of environmental and feelings associated with exercise behavior (p < .01, respectively) and was negatively significant related to educational level and perceived barriers to exercise (p < .01, respectively). Exercise behavior was significant related to sex (Eta = 0.243, p=.000). 3. Exercise behavior in the past, influence of the family to exercise significantly contributed 60.10 percent of the variance to the prediction of exercise behavior in male students (p < .01). Exercise behavior in the past, perceived self-efficacy to exercise, perceived barriers to exercise, and educational level significantly contributed 52.60 percent of the variance to the prediction of exercise behavior in female students (p < .01).

Keywords: predictive factors, exercise behaviors, Junior high school, Chonburi Province

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Authors: Ines Cherif, Ghassen Kharroubi, Leila Bouabid, Adel Gharbi, Aicha Boukthir, Margaret Mccarron, Nissaf Ben Alaya, Afif Ben Salah, Jihene Bettaieb

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Healthcare workers' flu vaccination prevents influenza disease among both patients and caregivers. We aimed in this study to assess influenza vaccine (IV) coverage in 2018-2019 among Tunisian physicians and to determine factors associated with IV receipt. A cross sectional study was carried out in Tunisian primary and secondary health care facilities in the 2018-2019 influenza season. Physicians with direct patient contact were recruited according to a self-weighted multistage sampling. Data were collected through a face to face questionnaire containing questions on knowledge, attitudes, and practices regarding IV. Bivariate analysis was used in order to determine factors associated with IV receipt. A total of 167 physicians were included in the study with a mean age of 48.2 ± 7.7 years and a sex-ratio (M: F) of 0.37. Among participants, 15.1% (95% CI: [9.7%-20.3%]) were vaccinated against influenza in the 2018-2019 influenza season. Bivariate analysis revealed that previous flu immunization in the four years preceding the 2018-2019 influenza season (OR=32.3; p < 10-3), belief that vaccinating healthcare workers may reduce work absenteeism (OR=4.7, p=0.028), belief that flu vaccine should be mandatory to healthcare workers (OR=3.3, p=0.01) and high confidence towards IV efficacy in preventing influenza among caregivers (OR= 4.5, p=0.01) were associated with a higher IV receipt in 2018-2019 among physicians. Less than one fifth of Tunisian physicians were vaccinated against influenza in 2018-2019. Higher vaccine uptake was related to a higher belief in vaccine efficacy in preventing influenza disease among both patients and caregivers. This underscores the need for periodic educational campaigns to raise physicians' awareness about IV efficacy. The switch to an IV mandatory policy should also be considered.

Keywords: influenza vaccine, physicians, Tunisia, vaccination uptake

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Authors: Sujeet Poudyal

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Introduction: After Holmium:yttrium-aluminum-garnet (Ho: YAG) laser has revolutionized the management of urolithiasis, the introduction of Thulium fibre laser (TFL) has already challenged Ho:YAG laser due to its multiple commendable properties. Nevertheless, there are only few studies comparing TFL and holmium laser in Retrograde Intrarenal Surgery(RIRS). Therefore, this study was carried out to compare the efficacy and safety of thulium fiber laser (TFL) and holmium laser in RIRS. Methods: This prospective comparative study, which included all patients undergoing laser lithotripsy (RIRS) for proximal ureteric calculus and nephrolithiasis from March 2022 to March 2023, consisted of 63 patients in Ho:YAG laser group and 65 patients in TFL group. Stone free rate, operative time, laser utilization time, energy used, and complications were analysed between the two groups. Results: Mean stone size was comparable in TFL (14.23±4.1 mm) and Ho:YAG (13.88±3.28 mm) group, p-0.48. Similarly, mean stone density in TFL (1269±262 HU) was comparable to Ho:YAG (1189±212 HU), p-0.48. There was significant difference in lasing time between TFL (12.69±7.41 mins) and Ho:YAG (20.44±14 mins), p-0.012). TFL group had operative time of 43.47± 16.8 mins which was shorter than Ho:YAG group (58±26.3 mins),p-0.005. Both TFL and Ho:YAG groups had comparable total energy used(11.4±6.2 vs 12±8 respectively, p-0.758). Stone free rate was 87%for TFL, whereas it was 79.5% for Ho:YAG, p-0.25). Two cases of sepsis and one ureteric stricture were encountered in TFL, whereas three cases suffered from sepsis apart from one ureteric stricture in Ho:YAG group, p-0.62). Conclusion: Thulium Fibre Laser has similar efficacy as Holmium: YAG Laser in terms of safety and stone free rate. However, due to better stone ablation rate in TFL, it can become the game changer in management of urolithiasis in the coming days.

Keywords: retrograde intrarenal surgery, thulium fibre laser, holmium:yttrium-aluminum-garnet (ho:yag) laser, nephrolithiasis

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Authors: Giti Sabri, Sohrab Imani, Ali Ahadiyat, Aref Maroof, Yahya Ostadi

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Recently, there has been a growing interest in research concerning the possible use of plant extracts as alternatives to synthetic insecticides. In this research, the insecticidal effects of Carum copticum essential oils against rice weevil adults were investigated in laboratory condition. Essential oils was extracted through distillation with water using Clevenger apparatus. Tests of randomized complete block included six concentrations and three replications for essential oils (fumigant toxicity) along with control treatment in condition of 27±1ºC degrees Celsius temperature, relative humidity of 65 ± 5 percent and darkness. LC50 values were calculated by SPSS.21.0 software which presented the value of LC50 of Carum copticum essential oils after 48 hurs, 187.35± 0.40 µl/l air on rice weevil adults. Results showed that increasing the concentration of essential oils increased the mortality rate cases. The results also showed that essential oils of Carum copticum are effective biological sources which can effectively protect stored grain from infestation by the rice weevil; although for application of these combinations further research may be needed.

Keywords: insecticidial effects, essential oil, Carum copticum, Sitophilus oryzae

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Authors: Jasna Hrncic

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Poor family relations predict depression, but also to other mental health issues. Mediating effect of self-efficacy and differentiation of self and moderating effect of decreased accessibility and/or success of other adaptive and defensive mechanisms for overcoming social disadvantages could explain depression as a specific outcome of dysfunctional family relations. The present study analyzes the mediation effect of self-efficacy and differentiation of self from poor family functioning to depressive symptoms and the moderation effect of deprivation of liberty on the listed mediation effect. Deprivation of liberty has, as a general consequence, a decreased accessibility and/or success of many adaptive and defensive mechanisms. It is hypothesized that: 1) self-efficacy and differentiation of self will mediate between family functioning and depressiveness in the total sample, and 2) deprivation of liberty will moderate the stated relations. Cross-sectional study was conducted among 323 male juveniles in Serbia divided in three groups: 98 adolescents deprived of their liberty due to antisocial behavior (incarcerated antisocial group - IAG), 121 adolescents with antisocial behavior in their natural setting (antisocial control group - CAG) and 105 adolescents in general population (general control group - CGG). The CAG was included along with GCG to control the possible influence that comorbidity of antisocial behavior and depressiveness could have on results. Instruments for family relations assessment were: for a whole family of origin the emotional exchange scale and individuation scale from GRADIR by Knezevic, and for a relationship with mother PCS-YSR and CRPBI by barber, and intimacy, rejection, sacrifice, punishment, demands, control and internal control by Opacic and Kos. Differentiation of self (DOS) is measured by emotional self scale (Opacic), self-efficacy (SE) by general incompetence scale by Bezinovic, and depression by BDI (Back), CES-D (Radloff) and D6R (Momirovic). Two-path structural equation modeling based on most commonly reported fit indices, showed that the mediation model had unfavorable fit to our data for total sample [(χ2 (1, N = 324) = 13.73); RMSEA= .20 (90% CI= [.12, .30]); CFI= .98; NFI= .97; AIC=31.73]. Path model provided an adequate fit to the data only for AIG - and not to the data from ACG and GCG. SE and DOS mediated the relationship between PFF and depressiveness. Test of the indirect effects revealed that 23.85% of PFF influences on depressiveness is mediated by these two mediators (the quotient of mediated effect = .24). Test of specific indirect effects showed that SE mediates 22.17%, while DOS mediates 1.67% of PFF influence on depressiveness. Lack of expected mediation effect could be explained by missing other potential mediators (i.e., relationship with that father, social skills, self-esteem) and lower variability of both predictor and criterion variable due to their low levels on the whole sample and on control subsamples. Results suggested that inaccessibility and/or successfulness of other adaptive and defensive mechanisms for overcoming social disadvantages has a strong impact on the mediation effect of self/efficacy and differentiation of self from poor family functioning to depressive symptoms. Further researches could include other potential mediators and a sample of clinically depressed people.

Keywords: antisocial behavior, mediating effect, moderating effect, natural setting, incarceration

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Authors: Yuan-Chung Tsai, Masao Kamimura, Kohei Soga, Hsin-Cheng Chiu

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In order to enhance the photodynamic/photothermal therapeutic efficacy on glioblastoma, the functionized upconversion nanoparticles with the capability of converting the deep tissue penetrating near-infrared light into visible wavelength for activating photochemical reaction were developed. The drug-loaded nanoparticles (NPs) were obtained from the self-assembly of oleic acid-coated upconversion nanoparticles along with maleimide-conjugated poly(ethylene glycol)-cholesterol (Mal-PEG-Chol), as the NP stabilizer, and hydrophobic photosensitizers, IR-780 (for photothermal therapy, PTT) and mTHPC (for photodynamic therapy, PDT), in aqueous phase. Both the IR-780 and mTHPC were loaded into the hydrophobic domains within NPs via hydrophobic association. The peptide targeting ligand, angiopep-2, was further conjugated with the maleimide groups at the end of PEG adducts on the NP surfaces, enabling the affinity coupling with the low-density lipoprotein receptor-related protein-1 of tumor endothelial cells and malignant astrocytes. The drug-loaded NPs with the size of ca 80 nm in diameter exhibit a good colloidal stability in physiological conditions. The in vitro data demonstrate the successful targeting delivery of drug-loaded NPs toward the ALTS1C1 cells (murine astrocytoma cells) and the pronounced cytotoxicity elicited by combinational effect of PDT and PTT. The in vivo results show the promising brain orthotopic tumor targeting of drug-loaded NPs and sound efficacy for brain tumor dual-modality treatment. This work shows great potential for improving photodynamic/photothermal therapeutic efficacy of brain cancer.

Keywords: drug delivery, orthotopic brain tumor, photodynamic/photothermal therapies, upconversion nanoparticles

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Authors: Mohd Najib Mansor, Nur Syamilah Md. Noor, Abdul Rahim Anuar, Shazida Jan Mohd Khan, Ahmad Zubir Ibrahim, Badariah Hj Din, Abu Sufian Abu Bakar, Kalsom Kayat, Wan Nurmahfuzah Jannah Wan Mansor

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This study aimed and focused on the behavior of youth entrepreneurs’ especially entrepreneurial self-efficacy and the performance in micro SMEs in Malaysia. Entrepreneurship development calls for support from various quarters, and mostly the need exists to initiate a youth entrepreneurship culture and drive amongst the youth in the society. Although backed up by the government and non-government organizations, micro-entrepreneurs are still facing challenges which greatly delay their progress, growth and consequently their input towards economic advancement. Micro-entrepreneurs are confronted with unique difficulties such as uncertainty, innovation, and evolution. Reviews on the development of entrepreneurial characteristics such as need for achievement, internal locus of control, risk-taking and innovation and have been recognized as highly associated with entrepreneurial behavior. The data in this study was obtained from the Department of Statistics, Malaysia. A random sampling of 830 respondents was distributed to 14 states that involve of micro-entrepreneurs. The study adopted a quantitative approach whereby a set of questionnaire was used to gather data. Multiple regression analysis was chosen as a method of analysis testing. The result of this study is expected to provide insight into the factor affecting entrepreneurial behavior and performance of youth entrepreneurs in micro SMEs. The finding showed that the Malaysian youth entrepreneurs do not have the entrepreneurial self-efficacy within themselves in order to accomplish greater success in their business venture. The establishment of entrepreneurial schools to allow our youth to be exposed to entrepreneurship from an early age and the development of special training focuses on the creation of business network so that the continuous entrepreneurial culture is crafted.

Keywords: youth entrepreneurs, micro entrepreneurs, entrepreneurial self-efficacy, entrepreneurial performance

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Authors: Catarina Ramos Pereira, Jorge Rodrigues, Natália Oliveira, Jorge Machado, Maria Begoña Criado, Jorge Machado, Henri J. Greten

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Background: Parkinson's disease is a multi-system neurodegenerative disorder characterized by motor and non-motor symptoms. To slow disorder progression, different treatment options are now available, but in most cases, these therapeutic strategies also involve the presence of important side effects. This has led many patients to pursue complementary therapies, such as acupuncture, to alleviate PD symptoms. Therefore, an update on the efficacy of this treatment for patients of PD is of great value. This work presents a systematic review of the efficacy of acupuncture treatments in relieving PD symptoms. Methods: EMBASE, Medline, Pubmed, Science Direct, The Cochrane Library, Cochrane Central Register of Controlled Trials (Central), and Scielo databases were systematically searched from January 2011 through July 2021. Randomized controlled trials (RCTs) published in English with all types of acupuncture treatment were included. The selection and analysis of the articles were conducted by two blinding authors through the Rayyan application. Results: 720 potentially relevant articles were identified; 52 RCTs met our inclusion criteria. After the exclusion of 35, we found 17 eligible. The included RCTs reported positive effects for acupuncture plus conventional treatment compared with conventional treatment alone in the UPDRS score. Conclusions: Additional evidence should be supported by rigorous methodological strategies. Although firm conclusions cannot be drawn, acupuncture treatment, in the framework of an interdisciplinary care team, appears to have positive effects on PD symptoms.

Keywords: systematic review, Parkinson disease, acupuncture, traditional Chinese medicine

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Authors: Janet Tolulope Olaseni

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Emotional well-being in adolescents is an important psychological factor that can enhance positive living, but if it is not well groomed, it can have adverse impacts on their development. Therefore, the present study examined the efficacy of psycho-education on the emotional well-being of adolescents who are visually impaired in Nigeria. A total of twenty-eight (28) participants, which comprisednineteen (19) males and nine (9) females (M=15.82, SD=2.23) from a Nigerian School for the Blind, participated in the quasi-experimental study. Randomized clinical trial designwas used to assigned the participants into three (Complete Psycho-education, Incomplete Psycho-education, and No Psycho-education) groups. Standardized scales were used to gather data from the respondents. The formulated hypotheses were tested using Dependent T-Test and Analysis of Co-Variance. The results showed that there was a significant effect of Psycho-education on the emotional well-being of the Visually Impaired Adolescents. Those who received complete Psycho-educationhad the highest level of emotional well-being compared to those in the other groups. In order to enhance the emotional well-being of the Visually Impaired Adolescents, the study recommended that complete Psycho-education programme should be incorporated into the school activities of the Visually Impaired Adolescents.

Keywords: emotional well-being, psycho-education, visually impaired adolescents, Nigeria

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Authors: Iveta Eimontaite, Sarah R. Fletcher, Michele Surico, Alfio Minissale, Fabio F. Abba

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Industry 4.0 offers possibilities for increased production volumes and greater efficiency whilst at the same time presenting new opportunities and challenges for the human workforce. Exoskeletons have been used in healthcare and are now starting to be adopted in manufacturing. The potential benefits of reducing fatigue and physical strain are attractive prospects of the technology for industry; however, the novelty of exoskeletons and surrounding ethical issues raise concerns amongst the stakeholders. The current case study investigated the introduction of an upper body exoskeleton designed to support posture but not increase physical strength in a factory over three time points: before the exoskeleton was introduced, and one and two months post-introduction once operators had experienced working with it. The main focus was to evaluate changes in operators' workload, situation awareness, technology self-efficacy, and physical discomfort following the introduction of the exoskeleton. After using the exoskeleton over two months, operators reported a decrease in temporal demand and an increase in performance of the NASA TLX instrument. Furthermore, over the second month, operators' self-reported technology self-efficacy scores increased, but at the same time, their situation awareness decreased. Interestingly, operators' physical discomfort after using the exoskeleton for two months increased from not uncomfortable to quite uncomfortable in the shoulder, arm, and middle back regions. The results suggest that self-perceived task efficiency improved; however, increased discomfort and decreased situation awareness scores indicate that two months might not be long enough for the exoskeleton to be integrated into operators’ mental body schema. The paper will discuss further implications and suggestions for exoskeleton introduction to manufacturing environments.

Keywords: exoskeleton, manufacturing, mental workload, physical discomfort, situation awareness, technology self-efficacy

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Authors: Sourav Ghosh, Antony Gomes

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Since 1894 anti-snake venom serum (ASVS) is the only available treatment against snake envenomation, although there are many side effects and limitations. The need for a supportive treatment was felt for a long time to overcome the side effects and limitations of ASVS. Andrographolide conjugated with gold nanoparticle (A-GNP) has been found to antagonize viper venom-induced local damages. The present study was aimed to study the protective efficacy of A-GNP against Viper venom-induced inflammatory response and organ toxicity in animal model. Ethical clearance was obtained from animal experiments. Physico-chemical characterization of A-GNP was done by DLS (diameter and zeta potential), FE-SEM and XRD. Swiss albino male mice were divided into 4 groups: Gr.1-Sham control, Gr.2- Russell’s Viper venom (RVV) control, Gr.3- andrographolide treated and Gr.4- A-GNP treated. The 1/5th minimum lethal dose of RVV (500µg/kg, s.c.) was induced in animals of group 2, 3 & 4 animals, followed by treatment with andrographolide (100mg/kg, i.p.) and A-GNP (100mg/kg, i.v.) in group 3 & 4 animals, respectively. Blood was collected after 18 h, serum was prepared, and inflammatory markers (IL 1β, 6, 17a, 10, TNF α) and biochemical markers (AST, ACP, LDH, urea, creatinine) were assessed. Values were expressed as mean±SEM (n=4), one way ANOVA was done, P<0.05 was considered as statistically significant. DLS size showed the hydrodynamic diameter of A-GNP to be 230-260nm with polydispersity index of 0.103 and zeta potential was -18.32mV. XRD data confirmed the presence of crystalline gold in A-GNP, and FESEM indicated the presence of nearly spherical particle with size18-24nm.Treatment with A-GNP significantly decreased viper venom-induced proinflammatory markers (IL 1β, 6, 17, TNF α) increased anti-inflammatory markers (IL 10) and decreased organ toxicity markers (AST, ACP, LDH, urea, creatinine) in animal model. Venom neutralization efficacy of A-GNP was > andrographolide, which confirmed the increased efficacy of andrographolide after gold nanoparticle conjugation. Venom neutralization by A-GNP was due to anti-oxidant/anti-inflammatory activity of andrographolide, which showed increased efficacy after gold nanoparticle tagging. Thus, A-GNP may serve as a supportive therapy in snake-bite (against inflammatory response and organ toxicity) subject to further detail studies.

Keywords: andrographolide, gold nanoparticle, inflammatory response, organ toxicity, snake venom, snake venom neutralization, viper venom

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Authors: A. Van Staden, N. Purcell

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Spelling development is complex and multifaceted and relies on several cognitive-linguistic processes. This paper explored the spelling difficulties of English second language learners with auditory processing delays. This empirical study aims to address these issues by means of an intervention design. Specifically, the objectives are: (a) to develop and implement a multi-sensory spelling program for second language learners with auditory processing difficulties (APD) for a period of 6 months; (b) to assess the efficacy of the multi-sensory spelling program and whether this intervention could significantly improve experimental learners' spelling, phonological awareness, and processing (PA), rapid automatized naming (RAN), working memory (WM), word reading and reading comprehension; and (c) to determine the relationship (or interplay) between these cognitive and linguistic skills (mentioned above), and how they influence spelling development. Forty-four English, second language learners with APD were sampled from one primary school in the Free State province. The learners were randomly assigned to either an experimental (n=22) or control group (n=22). During the implementation of the spelling program, several visual, tactile and kinesthetic exercises, including the utilization of fingerspelling were introduced to support the experimental learners’ (N = 22) spelling development. Post-test results showed the efficacy of the multi-sensory spelling program, with the experimental group who were trained in utilising multi-sensory coding and fingerspelling outperforming learners from the control group on the cognitive-linguistic, spelling and reading measures. The results and efficacy of this multi-sensory spelling program and the utilisation of fingerspelling for hearing second language learners with APD open up innovative perspectives for the prevention and targeted remediation of spelling difficulties.

Keywords: English second language spellers, auditory processing delays, spelling difficulties, multi-sensory intervention program

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Authors: Yasin Ibrahim, Hisham Almohandes, Chia Hsu, Regina Baronia, Jesse Worsham, Sara Abdelgawad, Mansour Shawky, Mohammed Abdelfattah, Nesif Alhemiary

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Background: The matrix model (MM) is an evidence-based program for treating substance use disorders. Since first translated into Arabic in 2010, the MM has been gaining popularity in Arabic countries. However, there is no published data as pertains to its efficacy and feasibility in Arabic communities. Here we aimed at exploring providers’ perspectives on its feasibility and efficacy. Methods: Eight addiction treatment centers from four Arabic countries, namely Egypt, Kingdom of Saudi Arabia, the United Arab Emirates, and Iraq, were contacted via email. They were asked to fill in a 21-item questionnaire. Results: Matrix model continues to be utilized in 6 out of the 8 contacted programs. One center in Egypt has discontinued the MM as the providers felt it was not suitable for substance disorders other than stimulants, which are not common in Egypt. Baghdad University Medical Center has substituted MM with Colombo Program as there have been more training opportunities available for it. Data showed wide variability in regards to number of clients treated with the MM (from 300 to 2500). The Arabic version was utilized for training providers in 5 out of the 8 centers while the providers of the other 3 have been trained in the United States. All providers reported that MM made their job significantly easier, and seven providers believed that MM has favorably affected the relapse rate. In all of the six centers, MM is being utilized for many substance use disorders in addition to stimulant use disorders. Reported challenges included the acceptability of patients and their families, difficulty understanding some concepts, and high drop rates in some centers. Conclusion: Matrix model seems to be a valuable modality for the treatment of substance use disorders in Arabic countries. It has its own challenges and limitations that call for more culturally adapted versions.

Keywords: addiction, Arabic countries, developing countries, matrix model

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Authors: Xing Ping Hu, Yuexun Tian, Jerome Hogsette

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Housefly, Musca domestica L., is a serious urban nuisance and public health/food safety concern. This study evaluated the topical toxicity of 17 essential oil components and 3 plant essential oils against permethrin-resistant adult females and insecticide-susceptible house fly strains. Results show that thymol had the lowest LD₅₀ values against permethrin-resistant strain (43.77 and 41.10 ug per fly) and permethrin-susceptible strain (35.19 and 29.16 ug per fly) at both 24- and 48-hours post treatments; (+)-Pulegone had the lowest LD₉₅ values against the permethrin-resistant strain (0.15 and 0.10 mg per fly) at 24- and 48-hours post treatments, whereas plant thyme oil had the lowest LD₉₅ value of 0.17 mg per fly at post-24h and post-48h against the permethrin-susceptible strain. Additionally, the LD₅₀s was slightly but not significantly negatively correlated with the boiling points of the compounds tested; but showed no correlation with the density and LogP. These results indicate that specific essential oils and compounds have topical insecticidal properties against house flies with low dose. They may have the potential for development as botanical insecticides.

Keywords: urban pest, public health, pest management, botanical chemical

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Authors: Baltazar Ndakidemi

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The resource-constrained farmers, especially those in sub-Saharan Africa, encounter significant challenges related to agriculture, notably diseases and pests. The sustainable means of pest management are not well known to farmers. As a result, some farmers use synthetic pesticides whose environmental impacts, ill health, and other negative impacts of synthetic pesticides on natural enemies have posed a great need for more sustainable means of pest management. Pesticidal plant resources can replace synthetic pesticides because their secondary metabolites can exhibit insecticidal activities such as deterrence, repellence, and pests' mortality. Additionally, the volatiles from these plants can have positive effects of attracting populations of natural enemies. Pesticidal plants can be grown as field margin plants or in strips for supporting natural enemies' populations. However, this is practically undetermined. Hence, there is a need to investigate the roles played by pesticidal plants in supporting natural enemies of pests and their applications in different cropping systems such as legumes. This study investigates different pesticidal plants with a high potential for pest control in agricultural fields. The information sheds light on potential plants that can be used for different crop pests.

Keywords: natural enemies, biological control, synthetic pesticides, pesticidal plants, predators, parasitoids

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Authors: Nadeem Munawar, David Galbraith, Tariq Mahmood

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Rodenticides are often included as part of an integrated pest management approach for managing rodent species since they are relatively quick and inexpensive to apply. The current field study was conducted to evaluate the effectiveness of formulated baits of zinc phosphide (2%) and the second generation anticoagulant brodifacoum (0.005%) against field rats inhabiting a wheat-groundnut cropping system. Burrow baiting was initiated at the early flowering stages of the respective crops, and continued through three growth stages (tillering / peg formation, flowering, and maturity). Three treatments were done at equal time intervals, with the final baiting being about 2 weeks before harvest. Treatment efficacy of the trials was assessed through counts of active rodent burrows before and after treatments at the three growth stages of these crops. The results indicated variable degrees of reduction in burrow activities following the three bait applications. The reductions in rodent activity in wheat were: 88.8% (at tillering), 92%, (at flowering/grain formation), and 95.5% (at maturity). In groundnut, the rodent activities were reduced by 91.8%, 93.5% and 95.8% at sowing, peg formation, and maturity stages, respectively. The estimated mortality at all three growth stages of both wheat and groundnut ranged between 60-85%. We recommend that a field efficacy study should be conducted with zinc phosphide and brodifacoum bait formulations to determine their field performance in the reduction of agricultural damage by rodent pest species. It is a promising alternative approach for use of the most potent second-generation anticoagulant (brodifacoum) in resistance management, particularly with respect to reducing environmental risks and secondary poisoning.

Keywords: brodifacoum, burrow baiting, second-generation anticoagulant, synergistic effect

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Authors: Peter Adly Hamdy Fahmy

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The aim of the study was to examine the effects of a physical education program on student learning by combining the teaching of personal and social responsibility (TPSR) with a physical education model and TPSR with a traditional teaching model, these learning outcomes involving self-learning. -Study. Athletic performance, enthusiasm for sport, group cohesion, sense of responsibility and game performance. The participants were 3 secondary school physical education teachers and 6 physical education classes, 133 participants with students from the experimental group with 75 students and the control group with 58 students, and each teacher taught the experimental group and the control group for 16 weeks. The research methods used surveys, interviews and focus group meetings. Research instruments included the Personal and Social Responsibility Questionnaire, Sports Enthusiasm Scale, Group Cohesion Scale, Sports Self-Efficacy Scale, and Game Performance Assessment Tool. Multivariate analyzes of covariance and repeated measures ANOVA were used to examine differences in student learning outcomes between combining the TPSR with a physical education model and the TPSR with a traditional teaching model. The research findings are as follows: 1) The TPSR sports education model can improve students' learning outcomes, including sports self-efficacy, game performance, sports enthusiasm, team cohesion, group awareness and responsibility. 2) A traditional teaching model with TPSR could improve student learning outcomes, including sports self-efficacy, responsibility, and game performance. 3) The sports education model with TPSR could improve learning outcomes more than the traditional teaching model with TPSR, including sports self-efficacy, sports enthusiasm, responsibility and game performance. 4) Based on qualitative data on teachers' and students' learning experience, the physical education model with TPSR significantly improves learning motivation, group interaction and sense of play. The results suggest that physical education with TPSR could further improve learning outcomes in the physical education program. On the other hand, the hybrid model curriculum projects TPSR - Physical Education and TPSR - Traditional Education are good curriculum projects for moral character education that can be used in school physics.

Keywords: approach competencies, physical, education, teachers employment, graduate, physical education and sport sciences, SWOT analysis character education, sport season, game performance, sport competence

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Authors: Pontsho E. Tseke, Phatu W. Mashela

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Cucurbitacin-containing phytonematicides had been consistent in suppressing root-knot (Meloidogyne species) when used in dried crude form, with limited evidence whether the efficacy could be affected when fresh fruits were used during fermentation. The objective of this study was to determine the influence of Nemafric-BL phytonematicide prepared using fermented crude extracts of fresh fruit from wild watermelon (Cucumis africanus) on the growth of tomato (Solanum lycopersicum) plants and suppression of Meloidogyne species. Seedlings of tomato cultivar ‘Floradade’ were inoculated with 3 000 eggs and second-stage juveniles (J2) of M. incognita race 2 in pot trials, with treatments comprising 0, 2, 4, 8, 16, 32 and 64 % Nemafric-BL phytonematicide. At 56 days after inoculation, the phytonematicide reduced eggs and J2 in roots by 84-97%, J2 in soil by 49-96% and total nematodes by 70-97%. Plant variables and concentrations of Nemafric-BL phytonematicide exhibited positive quadratic relations, with 74-98% associations. In conclusion, fresh fruit of C. africanus could be used for the preparation of Nemafric-BL phytonematicide, particularly in cases where the dry infrastructure is not available.

Keywords: Cucurbitacin B, density-dependent growth, effective microorganisms, quadratic relations

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Authors: Norbayah Mohd Suki, Norazah Mohd Suki

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This study aims to examine relationships between attitude, self-efficacy, and subjective norm with students’ behavioural intention to use public computing facilities at a library. Data was collected from 200 undergraduate students enrolled at a higher learning institution in the Federal Territory of Labuan, Malaysia via a structured questionnaire comprising closed-ended questions. Data was analyzed using multiple regression analysis. The results show that students’ behavioural intention to use public computing facilities at the library is widely affected by subjective norm factor i.e. influence of the support of family members, friends and neighbours. The findings of this study provide a better understanding of factors likely to influence students’ behavioural intention to use public computing facilities at a library. It also offers valuable insights into factors which university librarians need to focus on to improve students’ behavioural intention to actively use public computing facilities at a library for quality information retrieval. Direction for future research is also presented.

Keywords: attitude, self-efficacy, subjective norm, behavioural intention

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Authors: Peter Adly Hamdy Fahmy

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The aim of the study was to examine the effects of a physical education program on student learning by combining the teaching of personal and social responsibility (TPSR) with a physical education model and TPSR with a traditional teaching model, these learning outcomes involving self-learning. -Study. Athletic performance, enthusiasm for sport, group cohesion, sense of responsibility and game performance. The participants were 3 secondary school physical education teachers and 6 physical education classes, 133 participants with students from the experimental group with 75 students and the control group with 58 students, and each teacher taught the experimental group and the control group for 16 weeks. The research methods used surveys, interviews and focus group meetings. Research instruments included the Personal and Social Responsibility Questionnaire, Sports Enthusiasm Scale, Group Cohesion Scale, Sports Self-Efficacy Scale, and Game Performance Assessment Tool. Multivariate analyzes of covariance and repeated measures ANOVA were used to examine differences in student learning outcomes between combining the TPSR with a physical education model and the TPSR with a traditional teaching model. The research findings are as follows: 1) The TPSR sports education model can improve students' learning outcomes, including sports self-efficacy, game performance, sports enthusiasm, team cohesion, group awareness and responsibility. 2) A traditional teaching model with TPSR could improve student learning outcomes, including sports self-efficacy, responsibility, and game performance. 3) The sports education model with TPSR could improve learning outcomes more than the traditional teaching model with TPSR, including sports self-efficacy, sports enthusiasm, responsibility and game performance. 4) Based on qualitative data on teachers' and students' learning experience, the physical education model with TPSR significantly improves learning motivation, group interaction and sense of play. The results suggest that physical education with TPSR could further improve learning outcomes in the physical education program. On the other hand, the hybrid model curriculum projects TPSR - Physical Education and TPSR - Traditional Education are good curriculum projects for moral character education that can be used in school physics.

Keywords: approach competencies, physical, education, teachers employment, graduate, physical education and sport sciences, SWOT analysis character education, sport season, game performance, sport competence

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Authors: R. S. Giraddi, B. Thirupam Reddy, D. N. Kambrekar

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Chilli (Capsicum annum L.) an important commercial vegetable crop is ravaged by a number of insect-pests during both vegetative and reproductive phase resulting into significant crop loss.Thrips, Scirtothripsdorsalis, mite, Polyphagotarsonemuslatus and whitefly, Bemisiatabaci are the key sap feeding insects, their infestation leads to leaf curl, stunted growth and yield loss.During flowering and fruit formation stage, gall midge fly, Asphondyliacapparis (Rubsaaman) infesting flower buds and young fruits andHelicoverpaarmigera (Hubner) feeding on matured green fruits are the important insect pests causing significant crop loss.The pest is known to infest both flower buds and young fruits resulting into malformation of flower buds and twisting of fruits.In order to manage these insect-pests a combi product consisting of imidacloprid and betacyfluthrin (Soloman 300 OD) was evaluated for its bio-efficacy, phytotoxicity and effect on predator activity.Imidacloprid, a systemic insecticide belonging to neo-nicotinoid group, is effective against insect pests such as aphids, whiteflies (sap feeders) and other insectsviz., termites and soil insects.Beta-Cyfluthrin is an insecticide of synthetic pyrethroid group which acts by contact action and ingestion. It acts on the insects' nervous system as sodium channel blocker consequently a disorder of the nervous system occurs leading finally to the death. The field experiments were taken up during 2015 and 2016 at the Main Agricultural Research Station of University of Agricultural Sciences, Dharwad, Karnataka, India.The trials were laid out in a Randomized Block Design (RBD) with three replications using popular land race of Byadagi crop variety.Results indicated that the product at 21.6 + 50.4% gai/ha (240 ml/ha) and 27.9 + 65% gai/ha (310 ml/ha) was found quite effective in controlling thrips (0.00 to 0.66 thrips per six leaves) as against the standard check insecticide recommended for thrips by the University of Agricultural Sciences, Dharwad wherein the density of thrips recorded was significantly higher (1.00 to 2.00 Nos./6 leaves). Similarly, the test insecticide was quite effective against other target insects, whiteflies, fruit borer and gall midge fly as indicated by lower insect population observed in the treatments as compared to standard insecticidal control. The predatory beetle activity was found to be normal in all experimental plots. Highest green fruit yield of 5100-5500 kg/ha was recorded in Soloman 300 OD applied crop at 310 ml/ha rate as compared to 4750 to 5050 kg/ha recorded in check. At present 6-8 sprays of insecticides are recommended for management of these insect-pests on the crop. If combi-products are used in pest management programmes, it is possible to reduce insecticide usages in crop ecosystem.

Keywords: Imidacloprid, Betacyfluthrin, gallmidge fly, thrips, chilli

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Authors: Valentine Ayo Mebu

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The study examined the efficacy of a brief intervention programme in the treatment of post-traumatic stress disorder (PTSD) symptoms exhibited by secondary school students exposed to conflict in Kano metropolis. The study tested three hypotheses that there is no significant difference between post-test re-experiencing, hyper-arousal, and avoidance mean scores of students exposed to the intervention and those who were not exposed to the intervention. The design of the study was an experimental design, specifically the pre-test and post-test control group design. The purposive sampling technique was used to select 60 research participants (male=30, female=30, Mean Age=15.50) for the study. These participants met the Diagnostic Statistical Manual of Mental Disorders (DSM-5) criteria of PTSD symptoms and were randomly assigned to experimental and control groups, respectively. Instrument for data collection was the University of California Post-Traumatic Stress Disorder Reaction Index (UCLA PTSD Index). Findings from the study indicated that there was a significant effect of the intervention on post re-experiencing symptoms scores [ F (1, 57) = 85.97, p=.00, partial eta squared η²=.60], hyper-arousal symptoms scores[ F (1, 57) = 27.81, p=.00, partial eta squared η² =.33], and avoidance symptoms scores [ F (1, 57) = 59.56, p=.00, partial eta squared η² =.51]. The efficacy of this brief psycho-educational intervention as an effective treatment in reducing PTSD symptoms among secondary school students exposed to conflict is supported by the results of this study and this will also add to the existing literature on the effectiveness of psycho-educational intervention in treating PTSD symptoms among students exposed to conflict.

Keywords: avoidance symptoms, hyper-arousal symptoms, re-experiencing symptoms, post-traumatic stress disorder, psycho-education

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Authors: Abdelkrim Cheriti, Mebarka Belboukhari, Nasser Belboukhari

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Launaea Cass. is a small genus of the family Asteraceae (tribe Lactuceae, subtribe Sonchinae), consisting of 54 species, of which 9 are presented in the flora of Algeria and is mainly distributed in the South Mediterranean, Africa and SW Asia. Plants in the Launaea genus have been used ethnobotanically as bitter stomachic, for treating diarrhea, gastrointestinal tracts, as anti-inflammatory, for skin diseases, treatment of infected wounds, hepatic pains, children fever, as soporific, lactagogue, diuretic and as insecticidal. Antioxidants are vital substances, which possess the ability to protect the body from damages caused by free radical induced oxidative stress. A variety of free radical scavenging antioxidants is found in a number of dietary sources. The main objective of this study focused on the screening of antioxidant activity of Launaea nudicaulis (Asteraceae) extracts. The in vitro antioxidant activity was investigated with DPPH radical scavenging assay. The quantitative evaluation of DPPH scavenging activity showed that n-BuOH and EtOAc extracts are the most active extracts with a percentage of antiradical activity of 89,62% and 71,57% respectively.

Keywords: Launaea, phytochemical, South Algeria, Sahara, endemic specie

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Authors: Eda Ozkara San

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Nurse educators have been charged by several nursing organizations and accrediting bodies to provide innovative and evidence-based educational experiences, both didactic and clinical, to help students to develop the knowledge, skills, and attitudes needed to provide culturally competent nursing care to patients. Clinical simulation, which offers the opportunity for students to practice nursing skills in a risk-free, controlled environment and helps develop self-efficacy (confidence) within the nursing role. As one simulation method, the standardized patients (SPs) simulation helps educators to teach nursing students variety of skills in nursing, medicine, and other health professions. It can be a helpful tool for nurse educators to enhance cultural competence of nursing students. An alarming gap exists within the literature concerning the effectiveness of SP strategy to enhance cultural competence development of diverse student groups, who must work with patients from various backgrounds. This grant-supported, longitudinal, one-group, pretest and post-test educational intervention study aimed to examine the effect of the Diverse Standardized Patient Simulation (DSPS) cultural competence education strategy on students’ (n = 53) transcultural self-efficacy (TSE). The researcher-developed multidimensional DSPS strategy involved careful integration of transcultural nursing skills guided by the Cultural Competence and Confidence (CCC) model. As a carefully orchestrated teaching and learning strategy by specifically utilizing the SP pedagogy, the DSPS also followed international guidelines and standards for the design, implementation, evaluation, and SP training; and had content validity review. The DSPS strategy involved two simulation scenarios targeting underrepresented patient populations (Muslim immigrant woman with limited English proficiency and Irish-Italian American gay man with his partner (Puerto Rican) to be utilized in a second-semester, nine-credit, 15-week medical-surgical nursing course at an urban public US university. Five doctorally prepared content experts reviewed the DSPS strategy for content validity. The item-level content validity index (I-CVI) score was calculated between .80-1.0 on the evaluation forms. Jeffreys’ Transcultural Self-Efficacy Tool (TSET) was administered as a pretest and post-test to assess students’ changes in cognitive, practical, and affective dimensions of TSE. Results gained from this study support that the DSPS cultural competence education strategy assisted students to develop cultural competence and caused statistically significant changes (increase) in students’ TSE perceptions. Results also supported that all students, regardless of their background, benefit (and require) well designed cultural competence education strategies. The multidimensional DSPS strategy is found to be an effective way to foster nursing students’ cultural competence development. Step-by-step description of the DSPS provides an easy adaptation of this strategy with different student populations and settings.

Keywords: cultural competence development, the cultural competence and confidence model, CCC model, educational intervention, transcultural self-efficacy, TSE, transcultural self-efficacy tool, TSET

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Authors: Ashit Syngle, Inderjit Verma, Pawan Krishan

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Therapeutic approaches used previously relied on disease-modifying antirheumatic drugs (DMARDs) that had only partial clinical benefit and were associated with significant toxicity. Spironolactone, an oral aldosterone antagonist, suppresses inflammatory mediators. Clinical efficacy of spironolactone compared with placebo in patients with active psoriatic arthritis despite treatment with prior traditional DMARDs. In the 24-week, placebo-controlled study patients (n=31) were randomized to placebo and spironolactone (2 m/kg/day). Patients on background concurrent DMARDs continued stable doses (methotrexate, leflunomide, and/or sulfasalazine). Primary outcome measures were the assessment of disease activity measures i.e. 28-joint disease activity score (DAS28) and diseases activity in psoriatic arthritis (DAPSA) at week 24. The key secondary endpoint was change from baseline in Health Assessment Questionnaire–Disability Index (HAQ-DI) at week 24. Additional efficacy outcome measures at week 24 included improvements in the markers of inflammation (ESR and CRP) and pro-inflammatory cytokines TNF-α, IL-6 and IL-1. At week 24, spironolactone significantly reduced disease activity measure DAS-28 (p<0.001) and DAPSA (p=0.001) compared with placebo. Significant improvements in key secondary measures HAQ-DI (disability index) were evident with spironolactone (p=0.02) versus placebo. After week 24, there was significant reduction in pro-inflammatory cytokines level TNF-α, IL-6 (p<0.01) as compared with placebo group. However, there was no significant improvement in IL-1 in both treatment and placebo groups. There were minor side effects which did not mandate stopping of spironolactone. No change in any biochemical profile was noted after spironolactone treatment. Spironolactone was effective in the treatment of PsA, improving disease activity, physical function and suppressing the level of pro-inflammatory cytokines. Spironolactone demonstrated an acceptable safety profile and was well tolerated.

Keywords: spironolactone, inflammation, inflammatory cytokine, psoriatic arthritis

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Authors: Chantel Snyman, Chrizanne van Eeden, Marita Heyns

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Autism spectrum disorder (ASD) is one of the most common disabilities in schools, with up to50% of children displaying behaviors that challenge, bringing about demanding teaching circumstances. The teachers and teaching assistants of such learners often experience a negative impact on their own quality of life. Research globally and in South Africa about the teachers of ASD learners and teaching interventions, especially positive psychology approaches aimed at supporting learners with ASD, is limited. The primary research aim of this study was to investigate the feasibility as well as the effect of a strength-based intervention for teachers on the behavior of their learners with ASD and on the wellbeing and self-efficacy of teachers and assistants over time. This quantitative study used a pre-experimental group design with a pre-test-post-test method for the proposed school-based intervention. Teachers and teaching assistants completed the Difficult Behavior Self-Efficacy Scale, the Mental Health Questionnaire, and the short Behaviors That Challenge Checklist for learners with ASD. The six-week intervention on character strengths was delivered by the researcher as part of Teacher Staff Development. Results were generally significant on a practical level (based on practical effect sizes), which indicate that the intervention had a visible effect on behaviors that challenge. Research scores over time suggested a positive effect of the intervention in the well-being of participants and an overall positive effect on behaviors that challenge of ASD learners. Results showed that the character strengths intervention shows promise as a simple but effective intervention for teachers and teaching assistants, with positive effects for learners and teaching staff in the ASD classroom. It is recommended that this intervention should be repeated over a longer period of time and with a larger sample to determine its validity.

Keywords: autism spectrum disorder (ASD), behavior that challenge, character strengths, disabilities, self-efficacy, teachers, teaching assistants, well-being

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Authors: Sancho-Esper Franco, Rodríguez Sánchez Carla, Sánchez Carolina, Orús-Sanclemente Carlos

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Water scarcity is a reality that affects many regions of the world and is aggravated by climate change and population growth. Saving water has become an urgent need to ensure the sustainability of the planet and the survival of many communities, where youth and social networks play a key role in promoting responsible practices and adopting habits that contribute to environmental preservation. This study analyzes the persuasion capacity of messages designed to promote pro-environmental behaviors among youth. Specifically, it studies how the efficacy (effectiveness) of the response (personal response efficacy/effectiveness) and the perception of distance from the source of the message influence the water-saving behavior of the audience. To do so, two communication frameworks are combined. First, the Construal Level Theory, which is based on the concept of "psychological distance", that is, people, objects or events can be perceived as psychologically near or far, and this subjective distance (i.e., social, temporal, or spatial) determines their attitudes, emotions, and actions. This perceived distance can be social, temporal, or spatial. This research focuses on studying the spatial distance and social distance generated by cultural differences between influencers and their audience to understand how cultural distance can influence the persuasiveness of a message. Research on the effects of psychological distance between influencers-followers in the pro-environmental field is very limited, being relevant because people could learn specific behaviors suggested by opinion leaders such as influencers in social networks. Second, different approaches to behavioral change suggest that the perceived efficacy of a behavior can explain individual pro-environmental actions. People will be more likely to adopt a new behavior if they perceive that they are capable of performing it (efficacy belief) and that their behavior will effectively contribute to solving that problem (personal response efficacy). It is also important to study the different actors (social and individual) that are perceived as responsible for addressing environmental problems. Specifically, we analyze to what extent the belief individual’s water-saving actions are effective in solving the problem can influence water-saving behavior since this individual effectiveness increases people's sense of obligation and responsibility with the problem. However, in this regard, empirical evidence presents mixed results. Our study addresses the call for experimental studies manipulating different subtypes of response effectiveness to generate robust causal evidence. Based on all the above, this research analyzes whether cultural distance (local vs. international influencer) and the perception of effectiveness of behavior (personal response efficacy) (personal/individual vs. collective) affect the actual behavior and the intention to conserve water of social network users. An experiment of 2 (local influencer vs. international influencer) x 2 (effectiveness of individual vs. collective response) is designed and estimated. The results show that a message from a local influencer appealing to individual responsibility exerts greater influence on intention and actual water-saving behavior, given the cultural closeness between influencer-follower, and the appeal to individual responsibility increases the feeling of obligation to participate in pro-environmental actions. These results offer important implications for social marketing campaigns that seek to promote water conservation.

Keywords: social marketing, influencer, message framing, experiment, personal response efficacy, water saving

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Authors: Bawa Inalegwu, Jacob A. Jato, Ovye Akyengo, John Akighir

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All humans will experience some type of wound in every lifetime. Most wounds heal quickly with little or no attention but, many people suffer from wounds that are complex and/or persistent therefore posing a burden. This study was designed to assess the efficacy of Mitrcarpus villous ointment against honey in diabetic rats. To achieve this, percentage wound closure and collagen assessments were used to express treatment efficacy. Results show that on day 21, rats treated with M. villosus ointment had the highest percentage closure (94.5%) while honey treated and non-treated recorded 90.0% and 83.3% respectively. Similarly, a significant difference (p < 0.05) was observed on day 21 in the total collagen deposited in wounds of diabetic rats (10.57 ± 0.7) and M. villous ointment treated wounds (11.77 ± 0.4) as compared with the non-treated diabetic rats. M. villosus ointment was efficacious in healing wounds in diabetic rats and heals wound faster than honey and may hold potential for wound healing in diabetes mellitus sufferers. However, the wound healing mechanism of this ointment

Keywords: collagen, diabetic rats, honey, Mitracarpus villosus, ointment, wound healing

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Authors: Sharon Jackson White

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Purpose: Nurse practitioners (NPs) practicing within hospital medicine play a significant role in caring for patients who might benefit from palliative care (PC) services. Using the Theory of Planned Behavior, the purpose of this study was to examine the relationships among facilitators to referral, barriers to referral, self-efficacy with end-of-life discussions, history of referral, and referring to PC among NPs in hospital medicine. Hypotheses: 1) Perceived facilitators to referral will be associated with a higher history of referral and a higher number of referrals to PC. 2) Perceived barriers to referral will be associated with a lower history of referral and a lower number of referrals to PC. 3) Increased self-efficacy with end-of-life discussions will be associated with a higher history of referral and a higher number of referrals to PC. 4) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the history of referral to PC. 5) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the number of referrals to PC. Significance: Previous studies of referring patients to PC within the hospital setting care have focused on physician practices. Identifying factors that influence NPs referring hospitalized patients to PC is essential to ensure that patients have access to these important services. This study incorporates the SNRS mission of advancing nursing research through the dissemination of research findings and the promotion of nursing science. Methods: A cross-sectional, predictive correlational study was conducted. History of referral to PC, facilitators to referring to PC, barriers to referring to PC, self-efficacy in end-of-life discussions, and referral to PC were measured using the PC referral case study survey, facilitators and barriers to PC referral survey, and self-assessment with end-of-life discussions survey. Data were analyzed descriptively and with Pearson’s Correlation, Spearman’s Rho, point-biserial correlation, multiple regression, logistic regression, Chi-Square test, and the Mann-Whitney U test. Results: Only one facilitator (PC team being helpful with establishing goals of care) was significantly associated with referral to PC. Three variables were statistically significant in relation to the history of referring to PC: “Inclined to refer: PC can help decrease the length of stay in hospital”, “Most inclined to refer: Patients with serious illnesses and/or poor prognoses”, and “Giving bad news to a patient or family member”. No predictor variables contributed a significant variance in the number of referrals to PC for all three case studies. There were no statistically significant results showing a relationship between the history of referral and referral to PC. All five hypotheses were partially supported. Discussion: Findings from this study emphasize the need for further research on NPs who work in hospital settings and what factors influence their behaviors of referring to PC. Since there is an increase in NPs practicing within hospital settings, future studies should use a larger sample size and incorporate hospital medicine NPs and other types of NPs that work in hospitals.

Keywords: palliative care, nurse practitioners, hospital medicine, referral

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