UNASSIGNED: To develop a structured process for a transparent, efficient, high-level review of a low-resource biosecurity system (limited by physical infrastructure, financial, and human resources), in order to identify and prioritise key areas for future focus which could then lead to interventions, tailored by country, to improve the system. A key requirement was that the approach developed was culturally sensitive and respectful to Pasifika people within the country.
UNASSIGNED: Animal health and biosecurity systems need to be urgently strengthened by Pacific Island countries and territories (PICTs) if they are to respond to current and future threats. Understanding where additional resources should be allocated to maximise benefit and ensuring buy-in from PICT stakeholders are critical for uptake of any recommendations made. However, there is little available literature on reviewing biosecurity systems, particularly where there is a need for efficiency, simplicity, and cultural sensitivity. A framework was developed through initial in-person consultation between four New Zealand experts who had experience working in international animal health development and support programmes. This was followed by input from informal discussions with selected heads of agriculture in PICTs and included their experiences with previous system reviews, as well as general advice from experts in Pasifika culture. Foundational objectives included simplicity, local inclusivity, and a structured approach, which could be undertaken over a relatively short period of time.A rapid evidence assessment methodology was used to search the available literature (published and grey, search terms biosecurity, system, Pacific, animal, framework, and review used in AND/OR combinations), to establish an evidence base for other methods of biosecurity system review. The developed framework for review of biosecurity systems in low-resource PICTs was based on elements from expert elicitation frameworks, the SurF surveillance evaluation framework and the Performance of Veterinary Services tool from The World Organisation for Animal Health.
UNASSIGNED: The developed framework involved bringing stakeholders together in a workshop environment and comprised up to 10 steps including mapping the PICT biosecurity system and exploring attributes of component activities. Understanding the system at a high level enables stakeholders to make informed recommendations on improvements to address future needs. Using the Delphi method, recommendations were then prioritised by stakeholders.
UNASSIGNED: A distinctive difference flowing from the use of the needs analysis described in this process was the empowerment of PICT stakeholders to determine their own needs and priorities, rather than have these developed by external parties.

This study explicates an Islamic approach to palliative care based on the results of a needs analysis regarding the development of an Islamic psychospiritual manual of palliative care alongside related elements. This article represents the first phase of a three-phase study using the design and development research (DDR) approach developed by Richey and Klein to study for design and development of manual either needed or otherwise. This project is a quantitative study that uses purposive sampling through a questionnaire instrument to investigate 210 participants from the general population in Malaysia that have experience in taking care of terminally ill patients. The findings of the study indicated that the majority of participants agreed with the development of an Islamic psychospiritual manual with mean values (x̅) of 4.57 and 4.66. Concurrently, the findings showed that the hierarchy of emphasis in terms of the elements to be included in the manual starts with emotional support, which exhibited the highest mean rate (x̅), followed by faith in God, spiritual and religious support, self and physical management, trauma management and social support. The correlations indicated that all the elements to be included in the manual were significant.

Background: As the European population ages, it becomes increasingly important to promote and facilitate healthy and active ageing and age-friendly societies. Professionals across a range of disciplines and sectors need knowledge and skills to support both. Objective: This scoping review aims to identify and map the literature on learning needs, learning outcomes and respective curricula in healthy and active ageing and age-friendly society concepts. Inclusion criteria: Studies focused on the teaching/learning process in healthy and active ageing and/or age-friendly society, of any design type, are eligible. Included studies may focus on undergraduate, postgraduate or continuing education and on any aspect of the educational process, such as needs analysis, content delivery, learner satisfaction/acceptability, or education outcome. Methods: This review will follow the Joanna Briggs Institute (JBI) methodology for conducting scoping reviews. Four electronic databases, PubMed, EBSCO (Academic Search Complete), Scopus and Applied Social Sciences Index and Abstracts (ASSIA), will be searched, limited to studies published from 1 st January 2000. Text language will be limited to English, German, Greek, Portuguese, Finnish, and Slovenian. Google Scholar and Research Gate will be searched for grey literature, limited to the first 50 results of each. Title and abstract screening, followed by full-text screening will be undertaken independently by at least two reviewers. The JBI extraction tool will be adapted for data extraction. Quality assessment will be conducted using a tool developed by Hawker and colleagues. A narrative synthesis will outline the data in relation to the aims and objectives outlined.

With both the quantitative and qualitative data from 628 responses to a set of questionnaire collected from the undergraduates of three educational institutions in central Vietnam, this study analyzed learners\' needs of intercultural communication competence (ICC) related to their studying of English for tourism purposes and future occupations. The methodology used for data analysis including semi-structured interviews, and the questionnaire. The findings showed that the students preferred intercultural language learning activities referring to authentic materials and real-life experience. The results also revealed the participants\' great needs of various ICC attitudes and regular tasks in tourism workplaces. Particularly, they had positive attitudes in intercultural communication, and higher needs of tasks for improving discourse and behavioural competences more than other ICC dimensions. The study has implications for tourism learners, educators and related stakeholders to raise their awareness in learning, teaching and developing this long-lasting competence.

BACKGROUND: Patients with unmet healthcare needs are more likely to access unscheduled care. Identifying these patients through data-driven and clinical risk stratification for active case management in primary care can help address patient need and reduce demand on acute services.
OBJECTIVE: To determine how a proactive digital healthcare system can be used to undertake comprehensive needs analysis of patients at risk of unplanned admission and mortality.
METHODS: Prospective cohort study of six general practices in a deprived UK city.
METHODS: To identify those with unmet needs, the study\'s population underwent digitally-driven risk stratification into Escalated and Non-escalated groups using seven risk factors. The Escalated group underwent further stratification using GP clinical assessment into Concern and No concern groups. The Concern group underwent Unmet Needs Analysis (UNA).
RESULTS: From 24 746 patients, 516 (2.1%) were triaged into the Concern group and 164 (0.7%) underwent UNA. These patients were more likely to be older (t = 4.69, P<0.001), female (X2 = 4.46, P<0.05), have a Patients At Risk of Re-hospitalisation (PARR) score ≥80 (X2 = 4.31, P<0.05), be a nursing home resident (X2 = 6.75, P<0.01), or on an end-of-life (EOL) register (X2 = 14.55, P<0.001). Following UNA, 143 (87.2%) patients had further review planned or were referred for further input. The majority of patients had four domains of need. In those who GPs would not be surprised if they died within the next few months, n = 69 (42.1%) were not on an EOL register.
CONCLUSIONS: This study showed how an integrated, patient-centred, digital care system working with GPs can highlight and implement resources to address the escalating care needs of complex individuals.

Introduction Kangaroo mother care (KMC) is an evidence-based, simple, time-tested, low-cost, and high-impact intervention for neonatal survival in hospitals and the community, particularly in resource-constrained areas. This has many beneficial effects on sick and stable low-birth-weight babies, lactating mothers, families, society, and the government. However, despite the World Health Organization (WHO) and United Nations International Children\'s Emergency Fund (UNICEF) recommendations for KMC, there is no satisfactory implementation of it in the community as well as in facilities. This study aimed to improve the duration of home-based kangaroo mother care (HBKMC). Material and methods  We conducted a before-and-after intervention hospital-based, single-center study in a level III neonatal intensive care unit (NICU) to improve the duration of HBKMC. The KMC duration was classified into four categories: short, extended, long, and continuous where KMC was provided for 4 hours/day, 5-8 hours/day, 9-12 hours/day, and more than 12 hours/day, respectively. All neonates with birth weight < 2.0 kg and their mothers/alternate KMC providers at a tertiary care hospital in India in the time period of five months from April 2021 to July 2021 were considered eligible for the study. We tested three sets of interventions by using the plan-do-study-act cycle (PDSA cycle). The first set of interventions was the sensitization of parents and healthcare workers regarding the benefits of KMC by comprehensive counseling to mothers and other family members using educational lectures, videos, charts, and posters. The second set of interventions was to reduce maternal anxiety/stress while maintaining maternal privacy by providing more female staff and teaching proper gown-wearing techniques. The third set of interventions was to solve lactation and environment temperature issues by providing antenatal and postnatal lactation counseling and warming of the nursery. The paired T-test and one-way analysis of variance (ANOVA) were used for statistical analysis, and p<0.05 was taken as significant.  Results  One hundred and eighty neonates were enrolled along with their mothers/alternate KMC providers in four phases, and three PDSA cycles were implemented. Out of 180 LBW infants, 21 (11.67%) infants received KMC < 4 hours/day. According to the KMC classification, 31% have continuous KMC in the institution, followed by 24% long KMC, 26% extended KMC, and 18% short KMC. After three PDSA cycles, HBKMC was 38.88% continuous KMC, followed by 24.22% long KMC, 20.55% extended KMC, and 16.11% short KMC. Continuous KMC was improved from 21% to 46% at the institute and 16% to 50% at home from phase 1 to phase 4 of the study after the implementation of three sets of interventions in three PDSA cycles. The phase-by-phase KMC rate and duration were improved after the application of the PDSA cycles, and this was maintained in HBKMC as well, but it was statistically not significant. Conclusion Sets of intervention packages based on needs analysis using the PDSA cycle were able to improve the rate and duration of KMC in the hospital and at home.

Globalization and international development in language education have inspired a shift from the learning of traditional College English to English for Specific Purposes (ESP). This article begins with a section on the methodology used to develop the literature review. From various literatures, a historical perspective was first presented for the period, 1962 to the present day, and accompanied by a review on the teaching approaches. The purpose was to reveal emerging trends in ESP development and forefront the strength of association between ESP development and the changes in teaching approaches. Then it focuses on the relationship between needs analysis and ESP, as needs analysis is well recognized as a vital ESP characteristic and it is given a comprehensive revisit as an update in ESP development. The review continues with some insights into recent studies from various countries to reflect on various aspectual developments of current ESP practices that illustrate the dynamics of growing research agendas that have implications for current and future ESP research directions. Finally, future vistas for ESP development and teaching are affirmed. The paper concludes on the note on the importance of knowing past and future ESP developments, and the prioritizing of effective teaching based on soundly designed materials tailored to particular student-centered needs and wants.

Consultation with sheep producers was used to quantify the mortality of triplet-bearing ewes and their lambs, identify management practices adopted by producers to reduce these losses and prioritise future research needs to improve the survival of triplet-bearing ewes and their lambs. Surveys were completed by 64 producers across Australia who identified and separated triplet-bearing ewes from twin-bearing ewes in 2017 and/or 2018. On average, 5.9% of all ewes mated were identified as carrying triplets (6.6% of non-Merino ewes and 2.9% of Merino ewes). The average mortality of triplet-bearing ewes was 6.4%, and ewe mortality did not differ significantly between ewe breeds. The average survival of triplet-born lambs was 59%, and survival was significantly higher for lambs from non-Merino compared to Merino ewes (60.1 vs. 52.9%, p < 0.05). The key strategies adopted to reduce the mortality of triplet-bearing ewes and their lambs included management of condition score, feed-on-offer, mob size at lambing and use of shelter. There were no differences (p > 0.05) in the average mortality of triplet-bearing ewes or their lambs between producers that prioritised the adoption of certain management practices. However, significant variation existed between producers in their targets at lambing for ewe condition score (2.8 to 3.5), mob size (10 to 150 ewes) and feed-on-offer (800 to 2500 kg dry matter/ha). Overwhelmingly, the highest priorities for further research identified by producers from surveys, workshops and a webinar were ewe condition score, mob size, feed-on-offer at lambing and mineral supplementation. This study informs benchmarks for mortality of triplet-bearing ewes and their lambs under extensive grazing conditions in Australia, and the priorities for future research to reduce these losses.

Swing to strength hold elements are important for a top ranking on still rings, require a high level of upper body strength of the gymnasts and have not yet been scientifically investigated. Therefore, the aim of this study was to determine force requirement profiles for these elements using a dynamometric measuring system. Two force sensors attached to the cables of each ring and synchronised with video recorded the forces exerted by the gymnast. For eight swing to strength hold elements (Uprise backward to support scale straddled, Uprise backward to swallow, Uprise backward to cross, Honma to cross, Uprise backward to support scale, Kip to cross, Back kip to swallow and Uprise backward to inverted cross), the variables maximal force (Fmax), minimal force (Fmin), time over Fhold (t1-3), rate of maximal force development (RFD) and impulse (p) were analysed. Honma to cross shows the highest force requirements (Median: Fmax = 120.4% BW, Fmin = 109.8% BW, t1-3 = 882 ms, RFD = 143.93% BW/s, p = 9.85% BWs) whereas back kip to swallow shows the least (Fmax = 102.3% BW, RFD = 34.99% BW/s and p = 0.84% BW/s). The biomechanical demand profiles can be used to provide feedback to coaches and gymnasts. In future research, they should be extended with kinematic and electromyographic data.

BACKGROUND: Injuries within law enforcement are a significant issue as they increase organisational costs and workforce strain. As one of the biggest risk factors of future injury is previous injury, minimising injuries suffered during academy has multiple beneficial and long-term effects, including a healthier and fitter police force. The purpose of this study was to profile the injuries sustained at a law enforcement academy to inform future injury mitigation strategies.
METHODS: Injury data were provided retrospectively (from May 2012 to September 2019) from the official insurance records of a law enforcement academy and included nature, location, and activity performed at time of injury. A total of 4340 (3288 males, 938 females, 114 sex not stated) recruits participated in academy training during this period. Inclusion criteria for the data were (a) injury record related to a recruit, and (b) the recruit was injured during academy training., with injury defined as tissue damage caused by acute or repetitive trauma, inclusive of musculoskeletal, neural, and/or integumentary systems but excluding general medical conditions such as cardiac (e.g. heart attacks) or respiratory (asthma) that was subsequently reported for worker\'s compensation. Injury incidence rates and proportions were calculated and a Spearman\'s correlation analysis was conducted between injury rates over successive classes.
RESULTS: An injury incidence rate of 368.63 injuries per 1000 recruits per year was calculated in this population, with a moderate correlation coefficient (rs = 0.60) of increasing injury rates over chronologically occurring classes. Females also had higher injury rates than male recruits, even across various fitness levels. Trauma to joints and ligaments (49.30%) was the most common injury, and the knee the most common location (23.17%) of injury. Physical training (56.10%) was the most common activity being performed at the time of injury.
CONCLUSIONS: This research demonstrates a large number of lower limb, musculoskeletal injuries that often occur during physical training. Further research is needed to assess suitable injury mitigation programs.