Education and Research Institute

BACKGROUNDHospitalization and intravenous (IV) procedures are known to provoke significant pain and anxiety in preschool children, potentially leading to long-term psychological distress. Despite growing evidence supporting distraction techniques, practical, low-cost interventions suited for resource-limited settings remain underutilized.AIMTo determine the effectiveness of a nurse-led multimodal distraction intervention – comprising balloon blowing, art therapy, and kaleidoscope use – in reducing pain and anxiety during IV therapy among hospitalized preschool children.METHODSA posttest-only controlled observational study was conducted at Shri Vinoba Bhave Civil Hospital, India. A total of 600 hospitalized preschoolers (aged 3-6 years) were randomly allocated to either an experimental group (n = 300; distraction intervention) or control group (n = 300; routine care). Pain was measured using the Wong-Baker FACES Pain Rating Scale, and anxiety was assessed using the Visual Analogue Anxiety Scale. The distraction intervention included daily 5-minute sessions: (1) Pre-procedure familiarization (balloon/art); (2) Intra-procedure distraction (kaleidoscope and balloon blowing); and (3) Post-procedure relaxation. Outcomes were evaluated on day 3. Data were analyzed using independent t-tests and correlation analysis.RESULTSChildren in the experimental group had significantly lower pain scores [mean ± SD (3.07 ± 1.39)] than the control group (8.80 ± 1.01) (t = 58.56, P < 0.00001). Anxiety levels were also reduced in the experimental group (5.85 ± 1.56 mm) compared to controls (9.39 ± 0.73 mm) (t = 35.55, P < 0.00001). A moderate positive correlation was found between pain and anxiety in both groups (experimental: r = 0.67; control: r = 0.66; P < 0.05). Significant associations were also found between pain levels and variables such as age, IV site, cannula size, and medication type (P < 0.05).CONCLUSIONThis study demonstrates that a simple, low-cost, nurse-led multimodal distraction strategy can significantly reduce pain and anxiety in preschool children undergoing IV therapy. Its ease of use and scalability make it highly suitable for immediate integration into pediatric care, especially in low-resource healthcare settings.

On March 11, 2020, the World Health Organization (WHO) declared that the world was facing a pandemic. The pandemic has made how people consume food different. With the onset of the pandemic, there are new experiences felt by the community. This study aims to find out how people's experiences, reasons, and expectations in using Online Food Delivery services. The research method used is phenomenological method. The data collection technique used is through semi-structural interviews. The participants of this study were people who used OFD, so researchers were able to take varied data. The technique of taking participants for this study is using purposive and snowball techniques then the participants are examined based on data that has been determined by the researcher. The results of the research that the researchers found are that people have experiences, expectations, and reasons to use OFD at various times before the pandemic, during the pandemic, and after the pandemic.

The rapid integration of artificial intelligence (AI) into education has shifted the paradigms of teaching and professional development. AI has been positioned not as a substitute for teachers but as a partner that relieves them from routine tasks, allowing greater focus on higher-order learning and reflective pedagogy. Professional standards and national regulations highlight the centrality of reflection and continuous professional growth as essential elements of teacher professionalism. Nevertheless, reflective practices backed by AI/technology lack empirical evidence, particularly for in-service teachers in primary and secondary education. To this end, this study employed an SLR design to investigate and synthesize how AI serves as a reflective partner in teachers’ PD. The review included 9,083 articles chosen from searches in the SpringerLink database and resulted in the selection of 26 articles using the PRISMA protocol. Thematically, these papers indicate AI’s contribution to enhanced reflective awareness, producing critical analyses of teaching practices, supporting reflection-informed decision making, prompting pedagogical innovation and experimentation, and promoting collaborative and continual professional learning. The results imply that AI supports teachers’ professional development and helps develop teacher noticing, providing data-driven feedback, speeding up personalization, and fostering professional learning communities. Instead of replacing teachers, AI should become a reflective partner to facilitate evidence-based pedagogy in a supportive educational policy system

Dear Editor: We sincerely thank Drs. Wang and Liu for their valuable comments on our article entitled “The Impact of Abnormal Uterine Bleeding on Adolescents’ Quality of Life: Results of the Adolescent Menstrual Bleeding Questionnaire [1].” Their thoughtful observations highlight key areas that warrant further consideration in future studies. The authors suggested in our article that we should be more objective, considering our subjective assessment [2]. In fact, as we mentioned in our article and cited in the reference section, we examined patients' laboratory values ​​and ultrasound findings in a previous study. In this study, we aimed to investigate whether the Adolescent Menstrual Bleeding Questionnaire (aMBQ) could be used as a tool to quickly distinguish between heavy and light menstrual bleeding in outpatient settings. Furthermore, this tool could be used as a screening tool in schools. Pictorial menstrual bleeding assessment tools can be challenging to use outside the hospital, but understandable and quick-to-administer questionnaires, such as the aMBQ, would be easier to administer. Secondly, the authors commented on the sample size of patients admitted to the hospital. Conducting the study with larger groups who do not present to the hospital could be considered in the future. However, we wanted to see how the quality of life of adolescents in more traditional societies, such as those in eastern Turkey, changes in treatment and non-treatment groups. Although the sample size is small, the results may inform future studies. Concerning questionnaire adaptation, the phrase “adult diaper” reflects terminology used in Turkish clinical practice and was retained to maintain linguistic and contextual accuracy. Finally, we share the authors’ view that multidisciplinary approaches—integrating clinical, psychological, and educational interventions—are essential to support adolescent girls affected by abnormal uterine bleeding. Such perspectives contribute to the collective goal of improving menstrual health awareness and adolescent well-being. We thank Drs. Wang and Liu, once again, for their constructive insights that enrich academic dialogue in this important field. The authors declare no conflict of interest.

This Viewpoint examines the emerging role of cannabidiol (CBD) in sports medicine, with a particular emphasis on its potential to support athlete health through indirect mechanisms. Rather than acting as a direct performance enhancer, CBD may contribute to improved readiness for training and competition by promoting better sleep, alleviating anxiety, and accelerating recovery. We also discuss challenges for antidoping compliance, including product contamination and regulatory gaps in Brazil, and highlight CBD's promise as a safer alternative to opioids for pain management in athletes.

Abstract Background and Aims Chronic kidney disease (CKD) is a major public health concern that has become an epidemic both globally and in our country. Iron deficiency and functional iron deficiency (FID) are common among CKD patients. The aim of our study is to investigate the prevalence of FID and its impact on mortality in hemodialysis (HD) patients. Method Our study was conducted between 2010 and 2024 in patients undergoing hemodialysis in Hatay province. Patients included were those aged 18 and above who had been on HD for at least three months and had accessible records of serum iron, total iron-binding capacity, and ferritin levels. Patients undergoing home HD, peritoneal dialysis, and those under the age of 18 were excluded. The prevalence of anemia, absolute iron deficiency (AID), and functional iron deficiency (FID) was calculated, and their relationships with mortality were evaluated. Results A total of 3.086 HD patients were included in the study. The prevalence of FID was found to be 14.7%, and AID was 4.1%. Five-year survival rates based on iron deficiency status were 44.1% for FID, 58% for AID, and 54.2% for normal patients. Mortality was higher in functional iron deficiency than in other groups (P &amp;lt; 0.05). The mortality rate in patients with absolute iron deficiency was lower compared to other groups, but no statistical difference was observed compared to normal patients. Patients with transferrin saturation &amp;lt;20% had a statistically significantly higher mortality risk than those with transferrin saturation between 20%–30% and 30%–50%. There was no statistical difference between ferritin levels and mortality. However, the lowest mortality rate was observed in individuals with ferritin levels &amp;lt;300 µg/L, and the highest mortality rate was observed in those with ferritin levels &amp;gt;800 µg/L. The highest mortality risk was observed in patients with Hb levels &amp;lt; 8g/dL. Patients with Hb levels &amp;gt;10 g/dL had lower mortality risk. The highest mortality risk was observed in patients with Hb levels &amp;lt;8 g/dL. Patients with Hb levels &amp;gt;10 g/dL had lower mortality risk (P &amp;lt; 0.001). Conclusion Anemia is common in HD patients. We identified an FID prevalence of 14.7%, with mortality risks higher in FID compared to normal and AID patients. Patients with transferrin saturation &amp;lt;20% had a statistically significantly higher mortality risk. These results suggest that clinicians should focus more on transferrin saturation rather than ferritin in HD patients.

ABSTRACT This article contributes to the critical discourse on neoliberalism’s impact on shaping how future generations understand their world by examining its localisation and ideological reflections in Turkish Social Studies Textbooks (SSTB). Drawing on Apple’s and Harvey’s transformative ideas on neoliberal ideology, it explores how neoliberalism, often analysed from a Western perspective, takes different forms under local dynamics and influences textbook content. Using Critical Discourse Analysis (CDA), the study uncovers numerous neoliberal discourses embedded in SSTB. Findings show that textbooks adapt to the demands of the business world and reflect neoliberal values shaped by socio-political changes. They emphasise consumption, competition, and entrepreneurship as dominant educational paradigms while downplaying or ignoring the social functions of education, such as rights. Based on the findings, it is emphasised that SSTB should strengthen democratic values to balance neoliberal influences and provide more inclusive and community-centered perspectives.

Conjunctivitis, a common ocular condition, can be caused by various viral pathogens, leading to significant morbidity and occasional outbreaks. This study aimed to investigate the epidemiology, prevalence, molecular detection, and typing of viral pathogens in conjunctival specimens. A total of 450 conjunctival swabs were collected from patients presenting with conjunctivitis symptoms at Shri Vinoba Bhave Civil Hospital (SVBCH) between January 2024 and December 2024. Molecular techniques such as reverse transcription polymerase chain reaction (RT-PCR) and sequencing methods were employed to detect and characterize viral agents, including adenovirus, herpes simplex virus (HSV), enterovirus, and others.The overall prevalence of viral pathogens was found to be 69.3%, with adenovirus being the most prevalent, detected in 238 samples (52.9%), and identified as the dominant etiological agent. Molecular typing revealed the circulation of common serotypes, including Ad8 (n = 82, 39.0%), Ad19 (n = 54, 25.7%), Ad37 (n = 36, 17.1%), Ad5 (n = 22, 10.5%), and Ad11 (n = 16, 7.6%), providing insights into strain diversity and potential transmission patterns. Epidemiological analysis identified key risk factors, seasonal trends, and demographic associations. These findings enhance our understanding of the etiology of viral conjunctivitis, supporting improved diagnostic strategies, outbreak control, and public health interventions.

Background: Coronary artery bypass grafting (CABG) is a widely performed procedure for advanced coronary artery disease. However, postoperative complications and mortality remain major concerns. Systemic inflammation and nutritional status are critical factors influencing surgical outcomes. The prognostic value of biomarkers reflecting both parameters postoperatively is not well established. The C-reactive protein to albumin ratio (CAR) has emerged as a novel marker of inflammation and nutritional status. Aims: This study investigates the role of postoperative CAR in predicting early mortality after CABG. The impact of postoperative inflammatory response and nutritional status on patient outcomes is analyzed. Methods: A retrospective study of 350 CABG patients was conducted. Preoperative and postoperative biochemical markers, including C-reactive protein, albumin, and CAR, were evaluated. The primary outcome was 30-day mortality. Logistic regression models assessed the independent association between postoperative CAR and mortality, adjusting for confounders. Results: Higher postoperative CAR was significantly associated with increased mortality (p = 0.0155). Preoperative CAR showed no significant correlation with mortality (p = 0.5178), whereas postoperative levels emerged as a strong predictor. Elevated postoperative urea levels were also independently linked to mortality (p &lt; 0.0001). Conclusions: Postoperative CAR is an independent predictor of early mortality in CABG patients. The interplay between systemic inflammation and nutritional status plays a crucial role in postoperative outcomes. Routine postoperative CAR assessment may enable early risk stratification and improve targeted clinical management.

This study aims to evaluate the effectiveness of student practice in a surgical skills curriculum and their evolution during the process and, therefore, evaluate the relevance of training surgical skills in medical graduation. The study design was prospective observational and analytical, the participants were fourth-year medical students from the Bahiana School of Medical Education and Public Health, and the sample size was 300. The sampling method used was a non-probability sampling method, and data collection was realized through a questionnaire in a QR code with a study overview and a pre-assessment and post-assessment survey link. Data analysis was performed using Microsoft Excel 2021 (Microsoft Corp., Redmond, WA, US). The Shapiro-Wilk test was first conducted to test for normality. Due to the normal distribution of the data, a parametric paired t-test with a 95% confidence interval was used to analyze statistical differences in diagnostic accuracy and knowledge acquisition scores between the pre- and post-assessment and provided the collection of data to assess the impact of a second review moment of surgical skills (SRMSS) for medical students. Perceived readiness to teach improved across all weeks. Pre- and post-assessment scores showed significant increases (p < 0.05), with mean differences ranging from 0.89 to 1.32, the largest change occurring in Week 1 (1.32). Perceived readiness to apply topics in professional life improved across all weeks, with mean differences ranging from 0.52 to 1.32 (p < 0.05). The results show that the SRMSS implemented over the six-week period were effective in enhancing participants' perceived learning, readiness for assessments, readiness to teach, and readiness to apply learned topics in practical or professional contexts.