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The use of WhatsApp in health care has increased, especially since the COVID-19 pandemic, but there is a need to safeguard electronic patient information when incorporating it into a medical record, be it electronic or paper based. The aim of this study was to review the literature on how clinicians who use WhatsApp in clinical practice keep medical records of the content of WhatsApp messages and how they store WhatsApp messages and/or attachments. A scoping review of nine databases sought evidence of record keeping or data storage related to use of WhatsApp in clinical practice up to 31 December 2020. Sixteen of 346 papers met study criteria. Most clinicians were aware that they must comply with statutory reporting requirements in keeping medical records of all electronic communications. However, this study showed a general lack of awareness or concern about flaunting existing privacy and security legislation. No clear mechanisms for record keeping or data storage of WhatsApp content were provided. In the absence of clear guidelines, problematic practices and workarounds have been created, increasing legal, regulatory and ethical concerns. There is a need to raise awareness of the problems clinicians face in meeting these obligations and to urgently provide viable guidance.In Italy, drug expenditure governance is achieved by setting caps based on the percentage increase in hospital spending compared to the previous year. This method is ineffective in identifying issues and opportunities as it does not consider an analysis of the number of treated cases and per capita consumption in local and regional settings. The IRCCS (Scientific hospitalization and treatment institute) Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori" in Meldola, has developed and adopted an effective management model designed to oversee pharmaceutical expenditure, guarantee prescription appropriateness and quality of care to patients. The budget setting follows a structured process which evaluates determining factors of the expenditure such as expected patients calculated according to the epidemiology and to national and regional indications of appropriateness, mean cost per patient calculated on the average period of demonstrated efficacy of the drug and use of drugs with the best cost-effectiveness ratio. Strict monitoring and integrated purchasing processes allow for immediate corrective actions on expenditures, as well as a continuous dialogue with the region in order to guarantee consistent funding of IRST activities. The model, presented in this article is efficient and implements concepts beyond the conventional "silos" approach and national and regional governance tools, in terms of patient centricity.Obstructive sleep apnea (OSA) has been reported to increase the risk of motor vehicle accidents. However, only few studies have investigated the effects of OSA on overall risk injury. The aim of study is to investigate whether OSA increases the risk of overall injury. The data were collected during 2000-2015 from Taiwan's National Health Insurance Research Database. A total of 8901 individuals diagnosed with OSA were inpatients, or outpatients at least three times were enrolled. Finally, 6915 participants with OSA were included as the study cohort. We matched the study cohort with a comparison cohort, at a ratio of 14. Cox proportional hazards regression was used to analyse the association between OSA and overall injury. Patients with OSA had 83.1% increased risk of overall injury, compared to non-OSA individuals [adjusted hazards ratio (HR) = 1.831, confidence interval (CI) = 1.674-2.020, p less then 0.001]. In the stratified age group, patients aged ≧65 years had the highest risk of injury (adjusted HR= 2.014; CI = 1.842-2.222, p less then 0.001). Patients with OSA were at a higher risk of falls, traffic injury, poisoning, suffocation, suicide, and abuse or homicide than non-OSA individuals, with falls and traffic injury as the leading causes of injuries. The data demonstrated that patients with OSA have a higher risk of overall injury. The study results can be a reference for developing injury prevention strategies in the future. The general population and clinicians should have more awareness regarding OSA and its negative effects on injury development.The Saudi ministry of health (MOH) started the preventive measures very early on before having a single case of COVID-19. There were very few studies regarding the awareness and adherence to the preventive measures against COVID-19 among the Saudi population in the literature. Objectives The study aims to examine the awareness and commitment to the strict Saudi government preventive measures against COVID-19. Methods A cross-sectional online survey targeted Saudi and non-Saudi populations aged 18+ in March-April 2020. The online questionnaire was designed to explore the participant's sociodemographic data, washing hygiene habits, the general level of awareness regarding COVID-19, and the extent to which they adhere to the government's strict instructions. Results Out of the 2958 participants in the survey, 23% washed their hands for between 20 and 30 s, 59.6% washed their hands after shaking hands with other people, 67.9% washed their hands after use of other's utilities, 65.9% had appropriately followed the MOH recommended guidelines for home quarantine and social distancing. People in different age groups differed significantly on their practiced hygienic practices score p less then 0.001. Respondents' educational level had converged considerably and positively on their clean proper prevention practices score, f(2838.3) = 15.70. check details Conclusion The majority of the participants adhere to the strict government instructions regarding COVID-19 as they have to obey the law. Health sector employees measured significantly greater hygienic preventive measures and precautions in comparison to other sectors. More public health efforts should increase hygienic best practice scores to achieve the best outcome.Caregiver smoking is a significant risk factor for children with acute and chronic diseases. Hospitalization presents an opportunity to explore caregiver smoking as a modifiable risk factor during a time of crisis when the motivation to change could be heightened. To date, there has not been a published review on inpatient smoking cessation interventions in pediatrics that focus on supporting caregivers of hospitalized children. The goals of this review were to identify and assess the reach and efficacy of tobacco cessation strategies implemented across inpatient units in pediatrics and mother-baby units. This review also proposes clinical and research implications along with program-building recommendations that can help inform future practice in tobacco cessation. A narrative review of the literature identified 14 peer-reviewed studies that described smoking cessation interventions between 2002 and 2021. There were five randomized controlled trials, seven prospective studies, and one retrospective study. The primary kinds of interventions were counseling to heighten caregiver contemplation to quit (n = 12), provision of Nicotine Replacement Therapy (NRT) medications (n = 7), and follow-up with the local Quitline (n = 12). A diverse range of deliverers implemented interventions across studies. Variation in defining quit attempts along with tobacco reduction and cessation outcomes contributed to mixed findings across studies.The global population aged 60 years and over rises due to increasing life expectancy. More older adults suffer from "geriatric giants". Mobility limitations, including immobility and instability, are usually accompanied by physical and cognitive decline, and can be further associated with gait changes. Improvements in physical and cognitive functions can be achieved with virtual reality exergame environments. This study investigated the usability of the newly developed VITAAL exergame in mobility-impaired older adults aged 60 years and older. Usability was evaluated with a mixed-methods approach including a usability protocol, the System Usability Scale, and a guideline-based interview. Thirteen participants (9 female, 80.5 ± 4.9 years, range 71-89) tested the exergame and completed the measurement. The System Usability Scale was rated in a marginal acceptability range (58.3 ± 16.5, range 30-85). The usability protocol and the guideline-based interview revealed general positive usability. The VITAAL exergame prototype received positive feedback and can be considered usable by older adults with mobility limitations. However, minor improvements to the system in terms of design, instructions, and technical aspects should be taken into account. The results warrant testing of the feasibility of the adapted multicomponent VITAAL exergame, and its effects on physical and cognitive functions, in comparison with conventional training, should be studied.The environmental Kuznets curve (EKC) expresses the relationship between environmental quality and economic growth. Based on the defects of previous studies on EKC using only environmental pollution indicators, this study holds that environmental quality is the result of pollutants after treatment, absorption, and self-purification, including two dimensions of pollution and absorption. Therefore, the environmental pollution and absorption data of 74 key environmental monitoring cities in China from 2005 to 2017 were selected, and a comprehensive index of environmental quality was constructed using the vertical and horizontal grading method. Then, based on the relevant economic growth indicators of these cities, they were divided into first-tier and new first-tier, second-tier, third-tier, and below. It was found that the EKC of the total sample, the first-tier and new first-tier cities, and the second-tier cities presented an inverted N-shape and had passed the second inflection point, where environmental quality continues to improve with the deepening of economic growth. There was no EKC in the third-tier and below cities. The findings have important implications. China can cross the second inflection point of the EKC and improve environmental quality at a low income level. Therefore, by vigorously developing cleaner production technologies and raising residents' awareness of environmental protection, it is possible to improve environmental quality at a lower income level than expected, which provides a useful reference for other developing countries.Recently, South Africa has seen a surge in violence, cyberbullying by learners against peers, and online malicious acts against teachers. In response, the South African Department of Basic Education invited the social crime prevention police to intervene. This study reports on the developmental issues contributing to cyberbullying and the police response to this violence in rural schools. An extensive literature review was conducted, and a conceptual framework was developed to guide the study and development of a mobile application. This framework was tested using data collected from focus groups, 8 police officers, 9 teachers, 52 grade-10 learners, and 27 grade-12 learners. The data were analyzed using thematic and quantitative techniques. The findings reveal some developmental issues. For instance, teachers are often targeted by learners online because they fail to take prompt action when learners report cyberbullying incidents. This finding is consistent with the developmental theory which predicts that lack of support would create a permissive context for cyberbullying.