and and in France. Age, family problems, psychiatric disorders, and hospitalization are risk factors for repeated suicide attempts. A prevention program for suicide attempts in youth may take into account family problems, screening for psychiatric disorders, and suicidal behavior.
  Many educational institutions around the world are implementing e-learning, but there are still many technical obstacles. Relatively many elements of e-learning must be improved in performance, so which elements should be selected which are prioritized to be improved first.
 
  This research applied a new method in order to select e-learning elements of health professionals' education that will be prioritized for improvement. This new method was called the Quadrant of Difficulty-Usefulness (QoDU). The subjects of this study were 200 students of Environmental Health School of Magetan, Indonesia.
 
  The elements that were sorted by priority were learning design, handout, book, link to resources, discussion forum, chatting, assignment, feedback, quiz and survey. The attributes used as the basis for determining priorities were difficulty and usefulness. Data regarding attributes were obtained through filling out the questionnaire. For each element the following were determined 1) difficulty and usefulness; 2) mean score of difficulty and mean score of usefulness. Furthermore, 4 quadrants were arranged based on 1) the difficulty position of each element compared to the mean-score of difficulty and; 2) the usefulness position of each element compared to the mean-score of usefulness.
 
  The order of elements of e-learning at the Environmental Health School of Magetan based on priority were assignment, quiz and discussion forum as the first priority; feedback and survey as second priority; link to resources and book as third priority; and learning design, handout and chatting as the last priority.
 The order of elements of e-learning at the Environmental Health School of Magetan based on priority were assignment, quiz and discussion forum as the first priority; feedback and survey as second priority; link to resources and book as third priority; and learning design, handout and chatting as the last priority.
  Necrotizing fasciitis (NF) is a rare skin and soft-tissue bacterial infection with high morbidity and mortality. Knowledge about the prevalence and incidence of NF in Thailand is quite sparse. The objective of this study was to determine the prevalence of NF in Thailand and factors that may be potentially associated with NF morbidity and mortality.
 
  A cross-sectional study using secondary data from Thailand's national health databases between 2014 and 2018 was conducted. Descriptive statistics using median and percentage formats were used. This was complemented by multivariable logistic regression to determine the association between various factors (such as age and underlying diseases) with NF morbidity and mortality. Univariate spatial data analysis was exercised to identify the geographical hot spots in which the disease appeared.
 
  During 2014-2018, we found 90,683 NF cases. About 4.86% of the cases died. The median age for all cases was 59.39 years old. The annual incidence of NF demonstrated an upwarn these groups of patients. Further studies that aim to validate the volume of actual NF cases and reported NF cases are recommended.
 As the elderly and those with chronic underlying diseases are likely to face non-preferable health outcomes from NF, healthcare providers should pay great attention to these groups of patients.  https://www.selleckchem.com/products/purmorphamine.html  Early and intensive treatment might be considered in these groups of patients. Further studies that aim to validate the volume of actual NF cases and reported NF cases are recommended.
  Pneumonia is one of the common complications of hip fracture. This study aimed to evaluate the risk factors and apply a nomogram to predict postoperative pneumonia in elderly hip fracture patients.
 
  From August 2014 to October 2019, 1113 hip fracture patients who were older than 65 years and underwent surgical treatment in our hospital were subjects of this study. Univariate and multivariate Cox analyses were used to identify independent risk factors. A predictive nomogram model was built, and the discrimination and calibration were determined by receiver operating characteristic and calibration plot.
 
  A total of 166 patients developed pneumonia after operation (14.91%, pneumonia group) while the remaining 947 patients did not (85.09%, non-pneumonia group). According to the results, body mass index (OR, 0.76, 95% CI, 0.70 to 0.84, P<0.001), serum albumin (OR, 0.86, 95% CI, 0.79 to 0.93, P<0.001), c-reactive protein (OR, 1.01, 95% CI, 1.00 to 1.92, P=0.011), functional status (OR, 2.94, 95% CI, 1.69 to 5.10, P<0.001) and time to surgery (OR, 4.56, 95% CI, 2.64 to 7.88, P<0.001) were identified as independent risk factors of pneumonia. The area under the curve value for postoperative pneumonia risk was 0.905, and the P-value of the Hosmer-Lemeshow calibration test was 0.529.
 
  Our nomogram model can be used to predict the risk of pneumonia in elderly hip fractures after surgery and provide clinicians with guidance for better perioperative intervention to improve prognosis and reduce mortality.
 Our nomogram model can be used to predict the risk of pneumonia in elderly hip fractures after surgery and provide clinicians with guidance for better perioperative intervention to improve prognosis and reduce mortality.
  Needlestick and sharp injury represent a major occupational hazard in the healthcare environment with nurses experiencing a large proportion of the burden. It is a potential for transmission of bloodborne pathogens including the human immunodeficiency virus, hepatitis B and C virus. Needlestick and sharp injuries are neglected and are often not reported. Few studies have been conducted in Ethiopia, and no study was conducted particularly in the Western part of a country. Therefore, this study aimed to assess needlestick and sharp injuries and associated factors among nurses working at health institutions in western Ethiopia, 2020.
 
  An institutional based cross-sectional study was conducted on 297 nurses, from January 15 to 30, 2020. The study participants were selected by a simple random sampling method and data were collected using a self-administered questionnaire. Multivariable logistic regression was used to identify associated factors of needlestick and sharp injury. The association between needle stick and sharp injury and associated factors were measured using the odds ratio at a 95% confidence interval.