Background: Organ donation is vital for sustaining the lives of individuals with organ failure, yet transplant rates remain low in Türkiye and globally. While nurses have a key role to play in public education and supporting donation decisions, limited research has explored nursing students’ metaphorical perceptions of organ donation – an approach that can reveal underlying values, beliefs and professional attitudes. Aim: To explore nursing students’ perceptions of organ donation through metaphor analysis, providing insights for nursing education and public awareness strategies. Method: This descriptive qualitative study, grounded in Conceptual Metaphor Theory, was conducted with 205 undergraduate nursing students at a university in Ankara. Data were collected using an open-ended form in which participants completed the sentence: ‘Organ donation is like . . . because . . .’. Using purposive sampling, 63 invalid metaphors were excluded, leaving 142 valid responses. A five-stage thematic analysis was undertaken, involving metaphor identification, categorisation, thematic structuring, validation and reporting with illustrative quotations. Results: Analysis identified four main themes and eight subthemes: Life (‘giving life’, ‘being’); Hope and Future (‘a light in despair’, ‘expectation of a new beginning’); Altruism and Sacrifice (‘giving selflessly’, ‘responsibility to do good’) and Rebirth (‘a second chance’, ‘returning to life’). Common metaphors included ‘water’, ‘hope’, ‘rebirth’ and ‘sharing’. Conclusion: Nursing students conceptualised organ donation as a holistic act encompassing emotional, ethical and humanistic dimensions, often linking it to continuity of life and hope, and second chances. These findings highlight the value of incorporating metaphor analysis into nursing curricula to foster ethical awareness, empathy and advocacy skills. Public awareness campaigns should also integrate values-based messages that emotionally engage target audiences.

Introduction: Adolescence is a pivotal period for establishing lifelong health behaviours, yet many school-based health education initiatives in India rely on passive, didactic methods that fail to engage students effectively. Skills-based health education, which emphasises interactive and participatory learning, has shown promise globally but remains underutilised in Indian school settings. This study aimed to evaluate the impact of a skills-based intervention on improving healthy lifestyle knowledge and health-promoting behaviours among early adolescents in Puducherry. Objective: To evaluate the efficacy of a school-based, skills-based health education intervention in promoting healthy lifestyle knowledge and behaviours among early adolescents in Puducherry, India. Study Design: Quasi-experimental study employing a two-arm design with pre- and post-intervention assessments at 1 and 3 months. Study Setting: Government and private schools in rural and urban areas of the Puducherry district, India. Methods: A total of 410 students aged 10–13 years were recruited using stratified cluster random sampling and allocated to either an intervention or control group. The intervention group received a 2-day skills-based programme incorporating interactive methods and ongoing reinforcement, while the control group received conventional didactic lectures. Outcomes were assessed using a validated 25-item Healthy Lifestyle Knowledge Questionnaire and the Adolescent Health Promotion Scale (AHPS). Results: At baseline, both groups were comparable in sociodemographic variables and outcome scores. Post-intervention, the intervention group showed statistically significant improvements in healthy lifestyle knowledge (median increased from 11 to 21) and in all six AHPS domains ( p < .001), with maintained improvements at 3-month follow-up. The control group showed minimal or no improvement. Conclusion: Skills-based health education significantly improved adolescent health knowledge and behaviour. The findings highlight the efficacy and scalability of interactive, school-based interventions, particularly for early adolescents.

Objective: Providing basic health education to older adults with limited reading skills is increasingly important due to demographic change. Health literacy enables older adults to navigate healthcare more successfully and make informed decisions, but educators in adult basic education often struggle to find materials that are both relevant and suitable. This study explored two key aspects of this challenge. First, it investigated how adult educators from Germany perceived the relevance of health literacy for adults aged 65 years and above. Second, it examined the effectiveness of a language-adaptive search engine, KANSAS, in identifying linguistically appropriate health-related texts for this target group. Design: Mixed-methods design, combining a survey and an experimental comparison of perceptions and search results of two search engines. Setting: Data were collected via an online platform used by adult educators working in basic education contexts. Method: A total of N = 58 adult educators participated in a between-subjects study in October 2022, comparing the KANSAS search engine with a similar looking search engine without linguistic functionalities. Participants were asked to evaluate retrieved health-related reading texts regarding their linguistic suitability. Texts were analysed for readability, word and syllable count, and targeted grammatical features. Results: Many educators considered health literacy for older adults important in their professional context, although some reported limited experience working with members of this learner group. Texts retrieved via KANSAS showed significantly better readability and lower linguistic complexity. Although the frequency of targeted grammatical constructions did not differ significantly, participants rated KANSAS as more suitable for educators in identifying relevant linguistic features. Conclusion: KANSAS can support literacy educators by facilitating the selection of appropriate health texts. Combined with growing educator awareness of language-adaptive reading material, such tools may help integrate health literacy more effectively into various adult education contexts.

Objective: Negative consequences from alcohol use continue to be a concern on university campuses in the USA. In this paper, we describe the development and formative evaluation of an ongoing event-specific bystander intervention to encourage personal and bystander protective behavioural strategies among college students. Methods: The Rams Take Care, Rams Take Action intervention takes place within the context of a US college football home game. The programme incorporates several empirically supported behaviour change strategies including motivational interviewing, public commitments and the use of branded merchandise. The programme is delivered by trained peer educators. Participants: The programme was evaluated by means of a survey of undergraduate students who obtained tickets to a home football game during the 2018 season ( N = 595). Results: Students who pledged to engage in protective behavioural strategies, and subsequently remembered their pledge, reported greater use of both personal (i.e. using a sober driver) and bystander (e.g. encouraging friends to use the buddy system) protective behavioural strategies. Conclusions: This inexpensive, brief intervention holds promise for reducing the negative consequences of US college students’ alcohol use and raises the possibility that event-specific interventions could have broader preventive effects than previously documented.

Background: Approximately 450,000 out-of-hospital incidents of cardiac arrest occur annually in the USA; of those cases, approximately 10% will survive. High quality and timely cardiopulmonary resuscitation (CPR) can have a significant impact on a patient’s chance of survival. The purpose of this study was to investigate how a peer-assisted learning (PAL) community might affect undergraduate pre-professional healthcare students’ skills and knowledge retention, as well as their confidence when performing CPR. Methods: An 8-week CPR course was offered at a 4-year higher education institution in the USA. Forty-five participants were recruited by convenience sampling and groups were assigned based on which CPR course the student was enrolled in. Participants completed a Pre- and Post-Simulation CPR to assess their confidence and knowledge before and after the intervention; performance-based retention was measured using a Little Anne QCPR mannequin. Results: A repeated-measures ANOVA was conducted to compare responses in the Pre- and Post-Simulation CPR surveys. The only significant finding suggested that experimental group participants felt more confident in skills and knowledge to perform CPR. Specific CPR skills were collected from the Little Anne QCPR mannequin were analysed using a multivariate analysis of variance (MANOVA). All treatment findings were non-significant. Conclusions: Results indicated that participants felt more knowledgeable and confident in their skillset post-CPR course regardless of the learning environment. While PAL environments may not always result in heightened knowledge retention, their incorporation may assist with peer debriefing when completing repetitive skills practice.

Reproductive health is a topic that concerns everyone but its coverage in schools worldwide is patchy. Given current falls in total fertility rate and rises in the age at which women have their first child, there is an urgent need to ensure that teenagers and young adults understand fertility and reproductive health. This would help them to make informed choices about family building. Recent research has shown that even in England, one of the few countries that explicitly incorporates reproductive health education into its school curriculum, teenagers report being taught little about reproductive health and fertility. We conclude that there is an urgent need to improve the quality of the education that school students receive about reproductive health.

Background: Malnutrition among children under 5 is a critical public health concern in rural India and often associated with inadequate maternal knowledge about nutrition. Structured Teaching Programmes (STPs) can enhance understanding of the causes, signs, consequences, and prevention of malnutrition, thereby promoting healthier behaviours among mothers. This study evaluated the effectiveness of an STP on knowledge regarding malnutrition prevention among mothers in rural Gulbarga, Karnataka. Materials and Methods: A preexperimental, one-group pretest/posttest design was used, involving 100 mothers of children under 5, selected through purposive sampling from four rural villages in Gulbarga. A structured knowledge questionnaire (30 items) assessed knowledge before and after a 60-minute STP, which comprised lectures, visual aids, and interactive discussions on the causes, signs, and prevention of malnutrition. Data were analysed using descriptive statistics, paired t -tests, and Chi-square tests to evaluate the efficacy of the STP and associations with demographic variables. Results: The mean pretest knowledge score was 12.45 ± 3.21, which increased to 22.67 ± 2.89 posttest ( p < .001), indicating a significant improvement. Posttest, 78% of mothers achieved an adequate knowledge (score ⩾ 70%) compared to 15% pretest. Significant associations were observed between knowledge gain, education level ( p = .002), and family income ( p = .015). Conclusion: The STP significantly improved mothers’ knowledge about malnutrition prevention. Such interventions can be integrated into community health programmes to address child malnutrition in rural settings.

Background: Exercise referral schemes are widely perceived to generate health and wellbeing benefits for individuals with, or at risk of, health problems. Understanding the social value of exercise referral schemes – in terms of factors that influence service user engagement and experiences of attending an exercise referral scheme – is important to foster positive change and improve decision-making. Methods: A social value approach was adopted to qualitatively explore experiences of engaging with an exercise referral scheme in one local authority in the North-West of England. Thirty-five service users (men = 21, women = 14) took part in focus groups ( n = 5), paired interviews ( n = 1) or individual interviews ( n = 5). Data were thematically analysed to explore the perceived benefits (i.e. outcomes) of the exercise referral scheme when compared to the costs (i.e. barriers, inconveniences), and the extent to which participants attribute the benefits to the exercise referral scheme. Results: Findings were explored through two key social value areas: outcomes – personal-emotional, physical and social outcomes (both positive and negative, intended and unintended); and attribution and maintenance of change. Participants reported improved physical, mental and social health and were motivated by a sense of community spirit and camaraderie. They expressed the desire to continue attending exercise referral scheme sessions and maintain the changes experienced. Conclusion: The benefits of attending the exercise referral scheme were experienced beyond physical health to wellbeing on a personal-emotional and social level. Programmes should explore the inclusion of social value measurement in the longer term to provide services that are responsive to change, meet the needs of their communities and have tangible, measurable impacts.

Objective: Children with intellectual disabilities may experience poor motor development, communication difficulties and memory problems. This study aimed to determine the effect of handwashing education using coloured hand paint on handwashing skills in children with intellectual disabilities. Method: This study was undertaken using a controlled semi experimental research design. Children in the intervention group received handwashing education using coloured hand paint, while children in the control group received handwashing education with liquid soap and water. Data were collected using a demographic information form, a Social Handwashing Attitude Questionnaire and a handwashing checklist. Results: A significant difference was found between the pre-test and post-test mean scores for the intervention group that received handwashing education with coloured hand paint ( p < .05). Furthermore, it was found that the correct handwashing practices of students in both groups increased compared to pre-training levels. Conclusion: Education about handwashing has a role to play in improving the handwashing skills of children. Handwashing education using coloured hand paint has a useful role to play in improving the handwashing attitudes and skills of children with intellectual disabilities.

Objective: This study aimed to analyse the acute effects of active breaks (AB) on vigilance among sports college students in Portugal. Methods: Thirty-two students following a sports degree programme (24 males and 8 females, aged 20.7 ± 2.5 years) voluntarily participated in this crossover randomised study. All participants completed a psychomotor vigilance task (PVT), a reaction time task widely used to assess sustained attention and alertness, during a regular class session. Afterwards, they attended a 60-minute lecture before repeating the PVT. A 10-minute break ensued: half the participants remained seated passively (control condition), while the other half performed moderate-intensity individual calisthenic exercises (AB condition). A three-way repeated-measures analysis of variance (ANOVA) was conducted to examine the effects of condition (control vs AB), time-on-task (minutes 1–5) and assessment moment (baseline, pre, post). Results: No significant main effects of condition were found; however, a significant three-way interaction between condition, time and assessment moment ( p = .025) was evident. Post hoc comparisons revealed a significant increase in reaction time from minute 3 to minute 5 during the post-intervention PVT in the AB condition, suggesting potential fatigue or reduced vigilance over time. Conclusion: These findings indicate that ABs may transiently affect vigilance, but their effects may not persist during prolonged tasks. Further research is warranted to determine the optimal parameters for implementing ABs in an academic context, particularly among physically active populations.