Introduction: Many studies to assess the efficacy of Internet-based learning in clinical nurses have been undertaken. The study aimed to compare the resultant learning outcomes following applying blended mode in teaching-learning alongside conventional instructional approaches. The research hypothesized a non-significant difference in academic performance outcomes before and after implementing blended teaching-learning intervention among nursing students in Kenya's selected universities. Methodology: This study applied mixed design methods to obtain detailed information from the study participants of interest to the researcher. Four out of nineteen (4/19) universities in Kenya that offered Bachelor of Science in Nursing were sampled using convenience nonprobability sampling. The sample population included an experimental group and a control group. Only general nursing lecturers and nursing students participated. Data was collected by the use of observation, self-reported questionnaires. Descriptive and inferential data were processed and analyzed in order to generate simplified information. Results: A total population of (n= 486) comprised of 175 (36.0%) male and 311 (64%) female participants who consented for the study. The students had a mean age of 22 years. 302(62.1%) students were motivated to adopt and use the blended mode of learning during the intervention phase while participants strongly agreed during the preintervention phase, 405/486 (83.33%) agreed, 27/486 (5.56%) were neutral, while 39/486 (8.03%) disagreed. There were 353 observations in the Intervention group and 133 observations in the Control group. The result of the two-tailed Mann-Whitney U test was significant based on an alpha value of 0.05, U = 19280.5, z = -3.04, p = .002. The mean rank for the Intervention group was 65.03and the mean rank for the group Control group was 61.62. This suggests that the distribution of academic performance for the group Intervention group was significantly different from the distribution of academic performance for the Control group category. Recommendations: Although this is observed, there is a need to emphasize sensitization to reduce student's anxiety further and increase to a higher level the engagement and utilization. Further researchers should consider co-operating other relevant variables that were not featured in the current study to reduce the current Knowledge gap in the adoption and implementation of blended learning-teaching in Universities. Conclusion: There is a significant correlation between the utilization of blended teaching and learning mode and nursing students' academic performance among universities offering Bachelor of Science in Nursing in Kenya.

The need to improve clinical judgment competencies during training has been necessitated by the demand for the preparation of new nurse graduates to face an arena characterized by nurse shortage and acutely ill yet more informed clients. In Kenya, the nursing process has been the primary tool to help student nurses develop clinical judgment skills. However, local studies show glaring clinical judgment gaps among new nurse graduates that threaten safe patient care. There is, therefore, a need to examine how a combination of more evidence-based tools can enhance clinical judgment development to improve training outcomes. A quasi-experiment was used to conduct the study. This involved a case study based on pre-test and post-test used to evaluate clinical judgment development in both groups. Furthermore, the groups were used to evaluate the effect of combining two clinical teaching tools on clinical judgment competency scores. The study involved 82 undergraduate nursing students. The respondents had a mean age of 21.50±1.34 years for the Intervention group and 21.59±1.43 years for the control group. 34.15% of the respondents were male, while 65.85% were female. The outcomes of the pre-test and post-test scores across the year of study depict a significant improvement with below expectation <49% reducing from 39.02% to 28.99% among second-year student and 28.05% to 7.25% among the third-year students. Scores of relationships between improvement of CJ Skills Scores across Gender, Cluster, and Cohort proved to be insignificant with cohort only significant (P<0.035). There was a significant difference in the scores for Control Post-Test-Control Pre-test and (M=2.947, SD=15.174) and Intervention post-test-Intervention Pre-test (M=14.100, SD=14.398) conditions; t (38) =-6.116, p = 0.0001.” The findings showed a significant effect in combining clinical teaching tools on clinical judgment competency scores compared to the nursing process alone (p= 0.0000). The study findings imply the need to review clinical nurse training to incorporate more evidence-based strategies. However, the study recommends similar research to be carried out in multiple clinical sites to enhance the evidence's strength and the generalizability of the results and outcomes.

Plastic waste has become one of the most serious threats to the marine environment. Among the plastic waste that is of particular concern are microplastics because of their small size. The purpose of this study was to analyze the level of microplastic intake through fish consumption in the coastal area of Tamasaju Village, North Galesong, Takalar Regency. This research is a type of qualitative research with a descriptive approach. The samples in this study were 30 respondents and 20 fish with the types of mackerel and red kurisi fish. Data obtained by interview using questionnaires, identification of microplastics in fish in the laboratory, and identification of polymer types using FTIR spectroscopy. The results showed that the total number of microplastics found was 18 particles. The type of microplastic found was a line shape with different color and size variations, with the blue line dominating, namely 77.77%. The average concentration of microplastics found in fish was 3.1 mg/kg, with polystyrene polymer content. It is known that the average intake of non-carcinogenic microplastics by the community is 0.04 mg/kg/day (non-carcinogenic) and as much as 0.02 mg/ kg/day (carcinogenic). This shows that the intake of microplastics by humans through fish consumption is still categorized as safe.

Objective: Reflect on the use of digital technology as a teaching strategy to face the pandemic. Method: Reflective study. Results: The study allowed reflections on the use of digital technologies for the teaching and learning process in order to reduce the damage caused by the pandemic. Final considerations: This reflection can contribute to rethinking about digital technologies as a teaching strategy to face the pandemic.

Cervical cancer is the fourth most frequent cancer in women with an estimated 570,000 new cases in 2018 representing 6.6% of all female cancers. Cervical cancer is the leading cause of cancer death in women in low-HDI countries. Cervical cancer ranks first among the female cancer in Nepal with age-adjusted incidence rate 21.5, 2,942 new cases and 1,928 deaths. The high mortality rate from cervical cancer globally could be reduced through prevention, early diagnosis, effective screening and treatment. The study aim to identify the knowledge and practice of cervical cancer screening among women attending gynecology OPD. A descriptive cross-sectional study design was used in this study. Hundred and fifty women were selected through purposive sampling technique. A pretested semi structured interview schedule was used to measure research variables. Frequency, percentage, mean and chi-squired test were used to analyze the data. Out of 150 women, mean age was 39.41 ± 10.26 and 78.7% respondents were Hindu. More than three fourth (84.7%) were literate. Slightly more than one third (34.7%) of the respondents herd about cervical cancer screening. Among them, less than half (46.2%) had adequate knowledge and only 8.7% of women had practice of cervical screening. There were no association between knowledge and socio-demographic variables but the practice were associated with residence (p=<0.05) and family income (p=<0.05. A majority of women have inadequate knowledge and low practice of cervical cancer screening. Therefore cervical cancer screening and awareness program should be emphasized.

In line with the fundamental responsibilities of a nurse to promote health, prevent illness, restore health and to alleviate suffering, advanced practice nursing roles are developing globally to provide expert nursing care at an advanced level of practice though these are not without challenges to the practice. In Nigeria, advanced practice nursing is still evolving and for the practice to be effectively and successfully adopted, the many challenges and limitations to nursing practice in the country need to be identified and solutions proffered. This paper seeks to explain the concept of Advanced Nursing practice, the global practice taking into cognizance the challenges/barriers to the practice and the strategies adopted to overcome these barriers. Also the challenges to the practice in Nigeria will also be discussed and possible ways forward recommended.

Heavy metal pollution is a serious challenge because of its bioaccumulation capabilities in the food chain. Cadmium (Cd) and chromium (Cr) are unsupported which are not needed by all residents, this requires a lot of money. human. This study uses ARKL studio which is used to determine the level of health risks from the consumption of shellfish containing heavy metals Cd and Cr in the Jeneponto Coastal community. Samples were taken in two villages namely Mallasoro Village, Bangkala District, and Bonto Ujung Village, Tarowang Sub-District, Jeneponto Regency, South Sulawesi. Sampling was done by purposive sampling. Air samples are taken, sediments and shellfish are taken directly from the area. Analysis of heavy metal concentrations (Cd and Cr) in air, sediments and shells was carried out with Atomic Absorption Spectrophotometer (AAS). Average concentrations of Cd and Cr in the sample as follows Cd Water (0.048mg / L); Cr Water (0.374 mg / L); Sediment CD (2,054 mg / kg); Cr Sediment (12.69 mg / kg); CD shells (1,236mg / kg); Cr shells (2,861mg / kg). The results showed the intake of Cr; 2,8611 mg / kg and Cd; 0.007 mg / kg / day, Analysis of the level of risk to get RQ> 1. (Risk Qotient) with an average CD; 13.509 and Cr; 5.212 which means "high risk". The high health risk obtained from the accumulation of Cd and Cr indicates that shellfish are no longer safe for consumption. The recommendation obtained from this study is about the consumption of shellfish by the people around the Jeneponto Coastal Coast. High levels of heavy metals in sediment media that show shells have accumulated to the bottom of the coastline so that environmental quality is needed. Health risk assessments that have been carried out indicate that marine and shellfish products on the coast have exceeded safe limits.