Buddy System Research Articles

The Psychology Behind the Efficacy of a Buddy System for Enhancing Retention in Dermatological Clinical Trials

The Psychology Behind the Efficacy of a Buddy System for Enhancing Retention in Dermatological Clinical Trials

Feasibility and acceptability of a parent-child intervention to improve step count in childhood cancer survivors exposed to cardiotoxic therapy: The STEP UP for FAMILIES Study.

Late morbidity after childhood cancer may be mitigated by healthy lifestyle behaviors. We piloted a game-based, parent-child digital intervention to increase activity in sedentary survivors. Survivors aged 10-16 treated with cardiotoxic therapy and not meeting US physical activity guidelines were enrolled in a single-arm study with a parent. Following a 14-day run-in, participants chose a prespecified step goal and wore an accelerometer daily for 24weeks (12-week game-based intervention; 12-week follow-up). Participants completed the Acceptability of Intervention Measure (AIM) at 24weeks; a subset of dyads completed qualitative interviews. Among 129 eligible survivors, 27 enrolled (20.9% participation rate) with a parent. Four dyads were removed during the 14-day run-in period due to noncompliance. Among the 23 dyads who continued to the study, the tracker was worn for 95% of days during the 12-week intervention (95% confidence interval [CI]: 94-96) and 81% during the 12-week follow-up (95% CI: 79-82). Overall, the prespecified step goal was met for 64% (95% CI: 63-66) of days during the intervention and 37% (95% CI: 35-38) during the follow-up. At the end of study, 17/23 dyads responded to AIM; 82% of survivors and 94% of parents reported the intervention as acceptable. During qualitative interviews (n=5), dyads noted that they liked the accountability of the "buddy system," but would have liked more personalized goal-setting. Despite high ratings of acceptability among participants, difficulties with sustained adherence and retention were encountered in this parent-child gamification intervention. Alternate, tailored designs should be considered in the future.

Practices of Cultural Exchange Special Education Teachers on Teacher Buddy System: A Phenomenological Study

This comprehensive study examines the practices of the Teacher Buddy System for Cultural Exchange Special Education Teachers, who play a crucial role in addressing the diverse needs of students with disabilities. The system provides a valuable platform for Filipino special education teachers to engage in peer-to-peer support and collaboration with their international counterparts, allowing them to gain insights into international best practices and approaches. Employing a phenomenological research design, the study gathers data through interviews to understand how the Teacher Buddy System influences participants' professional development, cultural competence, and teaching methodologies. It also explores the perceived benefits and challenges experienced by Filipino Special Education Teachers in the Cultural Exchange program. Preliminary findings reveal that the Teacher Buddy System significantly enhances cultural understanding, fosters effective teaching practices, and creates a robust support network among special education teachers. However, challenges related to communication and limited resources persist. The implications of this study are considerable, providing insights into improving the experiences of Cultural Exchange Special Education Teachers and the overall effectiveness of the Teacher Buddy System. The findings underscore the potential of cross-cultural collaboration to enrich mentoring practices, ultimately benefiting students with diverse learning needs. The study concludes with recommendations aimed at strengthening the Teacher Buddy System's sustainability and impact, promoting continuous professional growth, and enhancing cultural competence among Cultural Exchange Filipino special education teachers, thereby supporting their critical role in the education system.

The Buddy System: African American Women with Self-Reported Hypertension and Their Experiences in a Peer (Dyadic) Support Intervention

INTRODUCTION: Hypertension is the leading modifiable risk factor for cardiovascular disease, and it disproportionately affects African American women, who face increased risks of heart disease, kidney disease, and stroke. The Dietary Approaches to Stop Hypertension (DASH) diet effectively reduces blood pressure, but African American women often face challenges with adhering to it. Peer support, a proven mechanism for improving health behaviors through social connections and community resources, may help these women better manage their diet and hypertension. This qualitative study explored the experiences of African American women participating in an eight-week peer (dyadic) support intervention to improve DASH diet adherence and lowering systolic blood pressure, with an emphasis on understanding the dyadic relationship. METHODS: A purposive sample of 40 African American women (20 dyads) was recruited for five focus groups that were conducted both online and in person. Content analysis was used to identify themes related to the nature and quality of peer interactions and relationships from the perspectives of the 34 women who completed the intervention (Mean age = 71.38 years; SD = 8.38). RESULTS: Four subthemes emerged: emotional support, shared experiences, informational/inspirational support, and accountability. The participants reported forming strong, supportive relationships that were crucial in improving diet and blood pressure management. CONCLUSION: This study underscores the benefits of peer support in managing hypertension among older African American women, suggesting the need for future randomized controlled trials to examine the effectiveness of the DASH diet with and without peer support.

Engaging With Health Consumers in Scientific Conferences-As Partners not Bystanders.

It is now widely recognised that engaging consumers in research activities can enhance the quality, equity and relevance of the research. Much of the commentary about consumer engagement in research focuses on research processes and implementation, rather than dissemination in conference settings. This article offers reflections and learnings from consumers, researchers and conference organisers on the 12th Health Services Research Conference, a biennial conference hosted by the Health Services Research Association of Australia and New Zealand (HSRAANZ). We were awarded funds via a competitive application process by Bellberry Limited, a national not-for-profit agency with a focus on improving research quality, to incorporate consumer engagement strategies in conference processes and evaluate their impact. Strategies included consumer scholarships, a buddy system, designated quiet space and consumer session co-chairs; the reflections explored in this paper were collected in the funded, independent evaluation. Our insights suggest a need for more structured consumer involvement in conference planning and design, as well as the development of specific engagement strategies. To move toward active partnership in scientific conference settings, our experience reinforces the need to engage consumers as members in designing and conducting research and in presenting research and planning conference content and processes. Consumer engagement in research dissemination at conferences is the focus of this viewpoint article. Consumers were involved in the conception of this article and have contributed to authorship at all stages of revisions and edits.

How Do Child Protective Service (CPS) Policies Keep Employees Safe: ACaseworker’s Perspective

Child Protective Service (CPS) workers experience workplace violence at the hands of their clients. Some of these incidents have led to severe injuries and fatalities. Legislation has been created to maintain workplace safety of employees in service- related fields; however, these policies have not extended into specific laws for CPS workers. Using grounded theory, this qualitative study examined the effectiveness of safety measures from the perspective of current and former CPS workers. A total of 10 former and current CPS workers were interviewed individually. This study found that workers believe increased legislation, funding, and training are needed to increase the safety of CPS workers as they investigate alleged child abuse and neglect cases. Legislative-related responses included police protections, armed self-defense, and a mandatory buddy system policy. Funding-related responses included hazardous duty pay, resources for families, employing more staff, and mental health services for CPS workers. Training-related responses included increased training for police officers and CPS workers.

Developing Social Enhancements for a Web-Based, Positive Emotion Intervention for Alzheimer Disease Caregivers: Qualitative Focus Group and Interview Study.

Alzheimer disease is a degenerative neurological condition that requires long-term care. The cost of these responsibilities is often borne by informal caregivers, who experience an elevated risk of negative physical and psychological outcomes. Previously, we designed a positive emotion regulation intervention that was shown to improve well-being among dementia caregivers when delivered through one-on-one videoconferencing lessons with a trained facilitator. However, the format required significant resources in terms of logistics and facilitator time. To broaden the reach of the intervention, we aimed to develop the Social Augmentation of Self-Guided Electronic Delivery of the Life Enhancing Activities for Family Caregivers (SAGE LEAF) program, an iteration of the intervention in a self-guided, web-based format with enhanced opportunities for social connection. The aim of this study was to gather feedback to inform the design of social features for the SAGE LEAF intervention. In the absence of a facilitator, our goal with the self-guided SAGE LEAF intervention was to integrate various social features (eg, discussion board, automated support, and profiles) to maximize engagement among participants. Qualitative data were collected from 26 individuals through (1) interviews with participants who completed a previous version of the intervention via videoconferencing with a facilitator, (2) focus groups with dementia caregivers who had not previously experienced the intervention, and (3) focus groups with Alzheimer disease clinical care providers. We conducted a qualitative thematic analysis to identify which social features would be the most helpful and how they could be implemented in a way that would be best received by caregivers. Interview and focus group feedback indicated that participants generally liked the potential features suggested, including the discussion boards, multimedia content, and informational support. They had valuable suggestions for optimal implementation. For example, participants liked the idea of a buddy system where they would be matched up with another caregiver for the duration of the study. However, they expressed concern about differing expectations among caregivers and the possibility of matched caregivers not getting along. Participants also expressed interest in giving caregivers access to a podcast on the skills, which would allow them to review additional content when they wished. Taken together, the discussions with caregivers and providers offered unique insights into the types of social features that may be integrated into the SAGE LEAF intervention, as well as implementation suggestions to improve the acceptability of the features among caregivers. These insights will allow us to design social features for the intervention that are optimally engaging and helpful for caregivers.

Strategies that enabled access to chronic care during the COVID-19 pandemic and beyond in South Africa.

The COVID-19 epidemic has revealed disturbing information about how chronic diseases are treated globally. Healthcare providers and coronavirus response teams have primarily reported on how individuals with chronic conditions sought care and treatment. However, individuals' experiences of patients are yet unknown. This study aimed to explore those strategies that enabled patients with chronic diseases access to chronic care and treatment during and beyond the COVID-19 pandemic. The study was conducted in the predominantly rural district of the Northwest Province, South Africa. An explorative qualitative research design was followed. Information-rich participants were chosen using a purposive sampling technique. Individual face-to-face interviews were used to gather data. Data saturation was achieved after interviewing n = 28 people in total. The six steps of Braun and Clarke thematic data analysis were used to analyse the data. The study revealed three themes, which includes improved healthcare structural systems, shift from traditional chronic care to digital care services and medication refill and buddy system. The findings of this study revealed a range of effective and noteworthy approaches that facilitated access to treatment and continuity of care. As a result, enhancing telemedicine as well as structural systems such as appointment scheduling, decanting choices, mobile and medication home delivery can improve access to care and treatment. The burden of disease and avoidable death will be eventually addressed by maximising the use of telemedicine and sustaining the new norm of ongoing care through digital and remote care and decanting strategies.

YOGA ADOPTION INTENTIONS AMONGST UNIVERSITY STUDENTS: VARIABLES AND LINKAGES

Introduction: Compared to earlier times, university students are showing low physical activity levels. Compared to university students in the USA, students at Indian higher education institutions are 30% less physically active. The habits and beliefs formed at this stage of life are expected to have a long-term influence. Yoga is considered an alternative therapy effective in improving physical and mental health. Assessing the factors influencing university students' yoga adoption intentions is essential. Aims: To evaluate the selected university students' physical activity level and the mediating role of cues to action. Methods: The research design is cross-sectional and causal. The response of 120 university students was collected. The analysis is based on Structural Equation Modelling (SEM), and the software used includes SmartPLS and Microsoft Excel. Results – The study confirms the full mediation role of cue to action on the relationship between positive attitude for yoga and behavioral intentions to adopt yoga (effect = 0.179, t = 3.098, p < 0.002). Similarly, cue to action partially mediates the relationship between friend's support for yoga and behavioral intentions to adopt yoga (effect = 0.102, t = 2.34, p < 0.019). Conclusion: The university administrators should increase the cue to action for adopting health promotion behavior, including yoga at all levels, i.e., individual, relationships, community, social and policy making. To begin with, interventions such as developing educational videos, mandatory health promotion courses, and a buddy system can be started.

Clinical competency: perceptions of nursing interns and clinical mentors

Abstract Objective To assess the clinical competency of nursing interns and the perception of clinical nurse mentors toward student nurses’ clinical competency. Methods A study was carried out among 104 nursing interns and 26 clinical nurse mentors using the purposive sampling technique. A self-reported perception scale was used to collect the data. Results In general, most nursing interns perceived themselves as clinically competent during the internship. The clinical nurse mentors too reported that the current internship is helping the nursing interns in becoming competent. Conclusions Frequent clinical evaluation, buddy system, provision of stipends, good leadership, and coordination between the academic institute and hospital are reported as the critical motivating factors for improving the clinical competency of student interns.

Teachers’ Challenging Experiences in Home Visitation During the New Normal Education: A Phenomenological Study

Home visits are intended to decrease the reading gap, improve parenting skills, foster parent-child contact and involvement, boost students' school preparedness and achievement, and advance literacy. The home visitation program was the only option for the teachers to validate their learners' academic performance during the Modular Distance Learning in the new normal education. This study explored the challenges that public elementary school teachers encountered in home visitation during the new normal education in Jimenez District, Division of Misamis Occidental. A phenomenological approach was utilized as a research design, with nine public elementary school teachers as participants in the study. They were selected through purposive sampling. Face-to-face interviews were conducted to gather the data from the participants. The responses were analyzed using Moustakas’ method of data analysis. Results generated the following themes: threats to one’s security and safety, inadequacies of interpersonal connections among teachers, parents, and learners, conflict of other school-related activities and teachers’ coping strategies. The study showed that teachers experienced different challenges in home visitation during the new normal education. When teachers leave the confines of the school campus to provide services in locations other than where they are employed, they expose themselves to a significant risk and face potential threats to their safety and security. When students and their parents are absent during a home visit, it can be difficult for teachers to administer assessments or validate student work. Teachers also find that overlapping school activities and home visitation make for an exhausting experience. However, the study showed that despite the challenges the teachers have encountered, they remain diligent and responsive to the needs of their learners. Teachers' coping strategies have assisted them in remaining optimistic and flexible in facing different challenges. The buddy system, total health, and time management among teachers are recommended in this study.

Experienced career perspectives of nursing students and their supervisors in learning departments: a qualitative study

BackgroundDue to the nursing shortage, positive work environments are needed to retain (student) nurses. More and attractive internships for students need to be ensured. In order to provide more internship places learning departments were developed, which are characterized by a buddy system and supervisors who coaches at least two students during a shift. Gaining knowledge about career perspectives and job satisfaction is essential within the context of learning departments, as both will contribute to quality and safety of care and will support lifelong learning. The current study aimed to investigate how nurses and nursing students working and learning in learning departments experience preconditions for career opportunities.MethodsUsing a generic qualitative approach, semi-structured interviews were conducted through videocalls between March and April 2021 in the Netherlands. Inductive qualitative analysis based on ‘The Data Analysis Spiral’ was used.ResultsCareer perspective is explored among six students and seven nurses. Five main themes were generated for both nurses and students; (1) personal goals; (2) skills and self-efficacy; (3) mentoring; (4) job satisfaction; and (5) career perspectives. Within the five main themes, subcategories were developed from 198 codes related to career opportunities. Results show career perspective is experienced differently. For students, the requirements to experience career perspective seem largely existing, as learning departments fits with personal goals, increases self-efficacy and provide coaching mentoring. Students felt learning departments contributed positively to becoming more skilled in working independently and collaborating with fellow students. This resulted in students feeling well prepared for the future. Nurses’ career perspectives varied from wanting more personal development to experiencing opportunities due to having great colleagues, a challenging patient category, satisfaction from sharing knowledge and a decreasing physical workload. Nurses who had affinity with coaching students experience more career perspective on learning departments.ConclusionInterviews provided in-depth insights. Interviews gave in-depth insight into the elements of learning departments that contribute to career perspectives of (student)nurses. The results can be used by nursing supervisors, teachers and policymakers to optimize nurses’ work environment, to eliminate leave intentions and improve quality of patientcare. The results should be taken into consideration when coaching students, developing manuals and implementing or optimizing learning departments.Future research is recommended to investigate which tools/interventions are effective for nurses and other healthcare professionals to support career guidance.

The School Community’s Role in Educating for Responsibility for Inclusion

This study explores responsibility for inclusion, a notion rooted in the belief and practices of various religions. It draws on the thoughts of Emmanuel Levinas, Hannah Arendt and Paolo Freire, all of whom were greatly influenced by their religious tradition. Ten qualitative interviews were performed with senior school leaders. Data were interpreted through thematic analysis, and the results show that inclusion starts from the self who welcomes the other. Inclusion of students with severe disabilities, especially with severe autism, remains problematic at schools in Malta, and headteachers seem to struggle to implement inclusive values and attitudes. Successful methods for better inclusion include collaboration of all school community members, the involvement of students in decision making, participation of all students in school events without any discrimination, the Peer Preparation Programme and the buddy system.

What you can read is what you can't execute

Due to the address space layout randomization (ASLR), code reuse attacks (CRAs) require memory probes to get available gadgets. Code reading is the basic way to obtain code information. In theory, setting the code to be unreadable can prevent code reading. However, the pages are loaded dynamically, and the existing methods cannot set all code as unreadable at one time. They can only control code permissions page-by-page via time-consuming page tracking. Moreover, since some special users need to read code, turning off the read permission will affect their execution. To solve these problems, this paper proposes a method AntiRead. It rebuilds the buddy system for memory allocation. The new buddy system places code pages in a specific memory pool to manage their read permissions. In the presence of AntiRead, what is obtained by adversaries through code reading is either randomized code or non-executable code. Experiments and analysis show that AntiRead can prevent the code that has been read from being used as gadgets without affecting the normal code reading. In addition, the CPU overhead introduced by AntiRead is 1.8%.

Diver-Robot Communication Glove Using Sensor-Based Gesture Recognition

Despite the popularity of the buddy system, where a pair of divers look out for each other, scuba diving still poses significant risks with 15–30 deaths per 100 000 divers per year. In the 2015 edition of “ <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Diving Medicine for Scuba Divers</i> ,” it is reported that 86% of diving fatalities involve a lone diver, yet divers still elect to dive alone for a variety of reasons including buddy unavailability. A solution to this may lie in a dedicated autonomous dive-buddy robot, which could also operate as an assistant. The challenge is how would the diver interact and communicate with the robot in underwater conditions often involving low visibility. In this article, we detail and demonstrate a technological solution that involves the direct motion capture of fingers and hand using a smart dive glove with integrated stretch sensors alongside an inertial measurement unit. The hardware and gesture recognition protocol were initially evaluated in a lab-based study where 10 users participated in a virtual reality environment setup and interacted with a virtual robot using gestures. In total, 140 out of 175 gestures were correctly recognized, resulting in diver-robot commands. A full sea demonstration of the underwater motion-capture system followed with the underwater dive glove used to send gesture-based acoustic commands to a dedicated dive buddy, a modified autonomous underwater vehicle. The diver was able to command the robot to move in six directions with a total delay of 6 s or less between the beginning of the gesture and the initiation of the action by the robot.

Midwifery care for a COVID-19 cohort of women in Northern Italy: two years of pandemic.

The rapid development of the COVID-19 pandemic has altered the context of healthcare around the world. SARS-CoV-2 positive pregnant and postnatal women, being at greater risk of complications, require continuous midwifery surveillance as well as specialized medical care. Scientific literature lacks studies related to midwifery care models in hospital settings during the pandemic. The aim of this work is to describe hospitalizations in an obstetric-gynecological COVID care unit and to provide a descriptive analysis of the organizational and care model adopted. A cohort retrospective descriptive study was carried out. The sample was stratified by COVID-related care complexity and by obstetric risk. The sample recruited pregnant women, postnatal women, and gynecological patients with confirmed SARS-CoV-2 infection admitted to the obstetric-gynecological COVID unit of a birth center in Northern Italy, from March 16, 2020, to March 16, 2022. A number of 1037 women were hospitalized, and of these, 551 were SARS-CoV-2 positive women. The 551 SARS-CoV-2 positive women included 362 pregnant women, 132 postnatal women, 9 gynecological patients with medical diagnosis while 17 with a surgical path, and 31 women undergoing voluntary interruption of pregnancy. The final sample included 536 women. 68.6% of women requested a low care complexity, 22.8% a medium one, and 8.6% a high care complexity. Among the obstetric women population, the majority (70.6%) showed a high obstetric risk. The COVID-19 cohort of women required different levels of care with various care complexity and levels of obstetric risk. The model adopted allowed the acquisition of new technical and professional skills as well as the sharing of responsibilities and competences according to the care model of the Buddy System. Future studies could investigate COVID-related care models adopted internationally, but also deepen the technical and professional skills developed by midwives during the pandemic in order to enrich, improve and support midwifery profession.

Co‐design of an Aboriginal Health Practitioner‐led dementia prevention program (DAMPAA) using a Theory of Change framework

AbstractBackgroundDementia prevalence and incidence in Aboriginal Australians is three to five times that of the general population. Many of the known risk factors for dementia in this population are modifiable (e.g., head injury, hypertension, previous stroke and poor mobility). However, there is currently no evidence‐base on how to delay or prevent cognitive decline and dementia in Aboriginal Australians. Therefore, a comprehensive program to target dementia risk factors in this population is required.MethodIn partnership with three Aboriginal Community Controlled Health Services (ACCHS) in Western Australia, we have developed an Aboriginal health practitioner‐led health program (DAMPAA) to target key dementia risk factors for Aboriginal people over 45 years. The DAMPAA program was co‐designed by the research team, Elders and Aboriginal community‐controlled organisations. Qualitative data to inform the co‐design was collected through ACCHS staff workshops, Elders yarning groups and interviews with DAMPAA Aboriginal and non‐Aboriginal researchers using a Theory of Change framework. Additionally, a small pilot study was conducted in 2020, which included participant exit interviews conducted by Aboriginal researchers. Qualitative data from all data sources was analysed thematically by a qualitative researcher, and member checked by two DAMPAA Aboriginal researchers and the Elders Governance group.ResultThe DAMPAA program includes group physical activity, education, goal setting and medication management. Program enablers identified by ACCHS, research staff and participants include (but not limited to) group Aboriginal community controlled organisation based walking and yarning sessions, with additional activities such as aqua aerobics, tai chi and boot scooting, a buddy system for home exercising, connecting with others, transport, healthy food, being Aboriginal led, and the ACCHS partnership. An additional enabler identified by the Elders governance group include Aboriginal language education sessions. Program barriers identified include (but not limited to) family commitments, caring for grandchildren, travel for funerals and other appointments and participant contact details changed.ConclusionThe barriers and enablers identified from participants, ACCHS and DAMPAA staff have informed the development of the program protocol. DAMPAA will be evaluated through a randomised controlled trial implemented at four sites in Western Australia and process evaluation using a Theory of Change framework.

Social Support in Relation to Self-Management Behaviors Among Diabetic Individuals of Poblacion II, Tagbilaran City, Bohol

This study delves into the relationship between social support and self-management behaviors among diabetic individuals in Poblacion II, Tagbilaran City, Bohol. Employing a descriptive correlational survey design and a stratified sampling method, 48 respondents were selected, revealing that a majority were middle to older adults, married, and residing below the official poverty threshold. Hypertension emerged as the predominant comorbidity, affecting 75% of respondents. Examining social support dimensions, the study found a moderate level across most aspects, except for smoking, which displayed lower support. Remarkably, the overall self-management level among respondents was very good. Significant relationships were identified between social support and self-management practices, particularly concerning Alcoholism/Drug Addiction, Obesity, and Stroke. The study rejects the null hypothesis, establishing a significant correlation (p-value – 0.001) between social support and diabetes self-management practices. Recommendations include tailored assessments considering comorbidities, emphasizing newly adopted practices, and implementing targeted programs like teleconsultations and a "buddy system" for specific demographics. This research contributes valuable insights for healthcare professionals and policymakers, urging a holistic approach to diabetes management that integrates social support dynamics.

PS-P11-7: DIABETES AND HYPERTENSION SELF-MANAGEMENT: CHALLENGES AND SOLUTIONS FROM SOUTH AFRICAN PATIENTS AND HEALTH CARE PROVIDERS: A QUALITATIVE STUDY

Objective: This study aimed to unravel experiences, identify barriers to self management of diabetes and hypertension and solicit solutions for enhancing chronic disease self management from patients and their healthcare providers. Design and Methods: This was a qualitative study which collected data from eight in-depth interviews conducted with healthcare providers and four focus group discussions among patients with type 2 diabetes and hypertension receiving chronic disease care from two health facilities in a large peri-urban Township in Cape Town, South Africa. The Self Management framework described by Lorig and Holman, based on work done by Corbin and Strauss was used to analyse the data Results: Patients experienced challenges across all three self management tasks of behavioural or medical management, role management and emotional management. Main challenges included poor patient self-control towards lifestyle modification, sub-optimal patient-provider and family partnerships and post-diagnosis grief-reactions by patients. Barriers experienced were stigma, socio-economic and cultural influences, provider-patient communication gaps, disconnect between facility-based services and patients lived experiences and inadequate community care services. Patients suggested empowering community-based solutions to strengthen their disease self-management including dedicated multidisciplinary chronic disease management services, counselling services, strengthened family support, patient buddy system, patient-led community projects and advocacy. Providers suggested contextualised communication using audio-visual technologies and patient-centred provider consultations. Conclusions: Patients experienced several barriers to self-management of their chronic disease. Community-based dedicated multidisciplinary chronic disease healthcare teams, chronic disease counselling services, patient-driven projects towards healthy lifestyle and diet, and advocacy are needed to improve patient self-management. This will contribute towards SDG 3

Factors influencing the adaptability and habitat use of rescued Malayan sun bears (

Context The lack of documentation and detailed assessment of previous sun bear (Helarctos malayanus) release programs raises concerns about bears’ capacity to adapt to their new habitats and key elements of release success. Aims We evaluated the influence of the sun bears’ individual profiles and environmental factors on their adaptability, and investigated their habitat use and movements in the wild. Methods We released 13 rescued sun bears (four wild-caught and nine rehabilitated) to natural habitats between December 2015 and August 2017, and inferred adaptability process by analysing their pre- and post-release data. Key results Post-release monitoring showed that sun bears required at least a month to acclimatise to their release area. No nuisance cases were reported, and bears were observed avoiding monitoring teams in a series of encounters. Principal-component analysis identified a previous history of ill health (e.g. malnutrition), low avoidance of humans prior to release and low potential of release sites as significant factors associated with poor adaptability of released bears. Rehabilitated bears also showed lower adaptability to hilly topography with an average elevation of more than 500 m. Individual profiles of adult physically fit wild-caught bears with high avoidance of humans prior to release were associated with high adaptability. Binary logistic regression indicated that habitat type was the main factor influencing bear movement. Bears had a high affinity for oil palm plantations adjacent to the forest edge. Most habitat use of released bears was close to the forest edge. Conclusions In terms of competition, predation, food availability, and adaptability, the selection of forest edges adjacent to other favourable habitats is perceived as a more opportunistic survival strategy, as long as the bears do not rely on humans to survive and endure with the natural interactions in the wild. Implications This study emphasises the importance of improving the likelihood of survival of rehabilitated bears, especially in the early release phase. Reducing human–bear interaction in rehabilitation centres by practising a buddy system and minimal human contact in captivity considerably enhances release effectiveness.