Community Education Programs Research Articles

Carbon Neutral Strategies in the Case of Google Inc: A Case Study of Carbon Offset Mechanisms and Renewable Energy Projects

Abstract: Facing the serious challenge of global climate change, Google Inc. has adopted a series of innovative strategies to reduce its carbon footprint and promote corporate sustainability. This paper provides an in-depth analysis of how Google reduces carbon emissions and promotes sustainable development through a series of innovative measures, including large-scale investment in renewable energy, improving data center efficiency, implementing carbon offset projects, and promoting technological innovation in the field of transportation. These actions demonstrate Google's commitment to environmental protection and provide a model for other companies to follow. The study evaluated the economic feasibility and environmental benefits of Google's strategies through a cost-benefit analysis. The results show that despite technical challenges and market uncertainty, Google's environmental investments can bring significant economic benefits in the long term while having a positive impact on the environment. These strategies help Google achieve its carbon neutrality goals and provide momentum for the global transition to a low-carbon economy. In addition, the study emphasizes the importance of socio-cultural factors in promoting environmental strategies. Google has raised public awareness of climate change and enhanced social support for environmental actions through community involvement and educational programs. These findings reveal the need for companies to adopt environmental protection measures in the context of globalization and provide practical guidance for other organizations to implement sustainable development strategies.

Lived experiences of women with uterine rupture who were managed at Nekemte specialized hospital: a qualitative study

BackgroundUterine rupture is a rare but severe obstetric complication that poses significant risks to maternal and fetal health. Understanding the lived experiences of individuals who have undergone uterine rupture is crucial for improving care and support for those affected by this condition. This qualitative phenomenological study aimed to explore the experiences of individuals who have experienced uterine rupture.MethodThe study employed a qualitative phenomenological approach, conducting 12 in-depth interviews and four key informant interviews with individuals who had experienced uterine rupture. Data analysis was conducted thematically using Atlas ti software to identify patterns and themes within the participants’ narratives.ResultsThe analysis of the interviews highlighted six key themes: experience during diagnosis and initial symptoms, perceived predisposing factors of uterine rupture, challenges faced by individuals with uterine rupture, impacts on their lives, and coping and resilience strategies. The findings revealed that women often failed to recognise the initial symptoms of uterine rupture due to a lack of preparation, a preference for home deliveries, husband refusal, and a general lack of awareness. This delay in seeking care resulted in severe consequences, including the loss of their babies, infertility, fistula, psychological trauma, and disruptions to daily life and relationships. To cope, many women resorted to accepting their situation, isolating themselves, and using traditional healing techniques.ConclusionsThis study’s findings provide valuable insights into the complex and multifaceted nature of uterine rupture, shedding light on the experiences of those affected by this condition. To address the challenges, it is essential to enhance awareness and education through community education programs and comprehensive antenatal classes. Additionally, improving access to healthcare by strengthening health infrastructure and deploying mobile health clinics can ensure better prenatal care. Furthermore, encouraging hospital deliveries through incentives and the support of community health workers can reduce risks. Providing psychological counselling and establishing support groups can help affected women cope with the consequences. Moreover, engaging men in maternal health through educational programs and involving them in antenatal care can foster better support. Finally, promoting safe traditional practices by integrating traditional healers and respecting cultural sensitivities can increase acceptance and adherence.

The Role of Local Government and Environmental Management in Managing Tidal Floods in Bintan Regency

Indonesia is highly vulnerable to natural disasters, with tidal floods being a significant concern in Bintan Regency due to its exposure to sea tides and extreme weather events. The local government's role and environmental management strategies are crucial in mitigating these risks. This research seeks to evaluate these aspects by focusing on the measures implemented by Bintan Regency to manage tidal floods. The study employs a qualitative approach, relying on literature reviews to collect data from various sources such as scientific journals, books, research reports, and other relevant documents. This method provides a comprehensive understanding of the current practices and effectiveness of flood management and environmental management strategies in Bintan Regency. The research findings indicate that the Bintan Regency local government has undertaken significant initiatives to reduce tidal flood risks. These initiatives include spatial planning that integrates disaster risk considerations, the development of flood management infrastructure, and community education programs aimed at increasing preparedness. The effective implementation of environmental management practices, including the use of advanced technology for monitoring and evaluation, has been instrumental in these efforts. The local government’s approach reflects a proactive stance in addressing the challenges posed by tidal floods, emphasizing both preventative measures and responsive strategies. The study concludes that a holistic and sustainable approach is essential for effective tidal flood management. The integration of comprehensive spatial planning, infrastructure development, community engagement, and modern technology forms a robust framework for disaster mitigation.

Effectiveness of the active communication education program in improving the general quality of life of older adults who use hearing aids: a randomized clinical trial

BackgroundHearing loss in older adults affects general, generic health-related and disease-specific quality of life (QoL). The conventional strategy to address it is through hearing aids, which have been shown to improve disease-specific QoL. However, the long-term results regarding general quality of life are unknown, and communication problems and stigma associated with hearing loss may persist. An effective intervention strategy to address these problems is group communication programs, most notably Active Communication Education (ACE). This program has been shown to increase communication strategies and reduce communication activity limitations and participation restrictions. These precedents allow us to hypothesize that this program could improve general QoL.MethodsA randomized clinical trial was conducted on 114 older adult hearing aid users. Fifty-four subjects composed the intervention group that received the ACE program, while 60 subjects composed the control group that received an informational-lectures type intervention. The WHOQOL-BREF questionnaire was used to measure general QoL. Measurements were taken before and right after the intervention, with follow-ups at 6 and 12 months. Multilevel linear mixed models were estimated, considering the WHOQOL-BREF dimension scores and total score as the outcomes, and an interaction term between time since intervention and group as the predictor. Within- and between-group comparisons were made.ResultsCompared to the baseline time-point, the ACE group showed significant improvements right after the intervention, and at the 6-month and 12-month follow-ups for the dimensions of psychological health, social relationships, environment, and total score. Compared to the control group, the ACE group exhibited significantly greater improvements in the social dimension at all postintervention assessments, as well as in the environment dimension and total score at the 12-month follow-up.ConclusionsThe ACE program improved general QoL in terms of social relationships and environment dimensions, which lasted up to 12 months after the intervention. Therefore, ACE is positioned as an effective complement for HA users, enhancing and delivering new benefits related to broader aspects of QoL not necessarily tied to health.Trial registrationISRCTN54021189 (retrospectively registered on 18/07/2023).

Community Education and Diabetic Retinopathy: Effects on ERG Responses and Visual Acuity

The study investigates the impact of a community education program on diabetic retinopathy by analyzing changes in Electroretinogram (ERG) responses and visual indices. A purposive sampling method was used to target adults aged 20 to 50 at eye care centers, ensuring a demographically diverse group, including individuals without diabetes. The final sample included 195 participants, equally divided into healthy controls, diabetic patients, and high-risk individuals. Significant differences were found in ERG parameters and visual indices across healthy, diabetic, and high-risk groups, indicating that education programs may positively affect retinal function. Additionally, the study explores the correlation between ERG responses and visual indices, revealing significant positive relationships. Statistical analyses, including ANOVA and regression, were performed using SPSS (version 29), which confirmed improvements in retinal health, supporting the study's hypotheses. The findings suggest that educational programs can have a meaningful impact on visual health outcomes for diabetic patients.

Assessment of Knowledge and Practices Related to Non-Surgical Management of Osteoarthritis Among Patients in the Rural Community of Sri Ganganagar, Rajasthan.

Introduction: Osteoarthritis (OA) is a degenerative joint disease that represents a major public health challenge, especially in rural communities where access to advanced healthcare is limited. This study aims to assess the knowledge, attitudes, and practices (KAP) related to the non-surgical management of osteoarthritis among patients in the rural district of Sri Ganganagar, Rajasthan, India. Method: A cross-sectional descriptive study was conducted among 234 adult OA patients aged 45 and above, residing in selected rural areas of Sri Ganganagar. Participants were recruited using convenience sampling from local health centers and community clinics. The data were analyzed using descriptive statistics, Chi-square tests, and correlation analyses to explore associations between demographic variables and KAP levels. Results: The study revealed that 29.9% of participants had adequate knowledge about OA, while 18.8% had inadequate knowledge. Regarding practices, 21.4% of participants demonstrated good practices in managing their OA symptoms, whereas 20.9% exhibited poor practices. Significant associations were found between age and education level with both knowledge and practice levels (p < 0.05). A moderate positive correlation was observed between age and knowledge score (r = 0.45, p = 0.002), and a strong positive correlation was found between knowledge and practice scores (ρ = 0.60, p < 0.001). Conclusion: The findings underscore the need for targeted health education programs in rural communities like Sri Ganganagar to bridge knowledge gaps and improve adherence to non-surgical OA management practices. Enhancing patient education and integrating healthcare providers in the patient education process could significantly improve OA management and patient outcomes in rural settings.

Abstract B046: Factors influencing patient decision-making to complete Low Dose CT screening for lung cancer

Abstract As part of a randomized, controlled trial (RCT) to increase lung cancer screening (LCS) with low-dose CT scan (LDCT) within the Choctaw Nation of Oklahoma’s tribal health system, we conducted a qualitative study to explore the barriers behind patient decisions to forego screening. Thirty eligible participants who had been in the RCT for at least one year were identified as LCS completers (n=7) or non-completers (n=23). A single interviewer completed all interviews using a semi-structured interview guide, designed to explore experiences, barriers/facilitators to LCS, factors influencing screening decisions, and suggested strategies for expanding the LCS program into the community. Interviews were recorded and transcribed verbatim. Data were analyzed using conventional content analysis. Most non-completers reported having no conversations about the availability of LCS with their primary care provider (PCP) or receiving any information about the LCS program. In contrast, the completers all reported PCP-initiated discussions about the LCS program, their risk factors, and an overview of the testing process. Key themes that emerged included fears, e.g., being unsure about what the test involves, afraid of being diagnosed with lung cancer and what might follow, and afraid of dying. Some voiced concerns, e.g., feeling guilty as active smokers and being stigmatized should they be diagnosed with lung cancer. Many participants posited that there was no reason for screening without symptoms. Lack of understanding, especially about cancer care, was identified as a contributing factor. Suggested strategies to increase the reach into the community included using existing infrastructure within Choctaw Nation, such as disseminating information through the tribal newsletter, inserts in prescription refills, and notifications via the patient portal. Community education programs at local community centers, particularly around senior citizen meals, were offered as strategies to change the perception that lung cancer is a death sentence. Hosting an informational booth at the annual tribal Labor Day festival was commonly suggested. In conclusion, multiple reasons were cited for forgoing LDCT screening. In this tribal setting, findings are similar to ones documented in other settings. This suggests that interventions to overcome these challenges may build off known evidence-based interventions, such as the recommendations for cancer prevention documented by the Community Preventive Services Task Force. Addressing fears through multiple educational approaches and adapting strategies from the American Lung Association to address stigma could lead to enhanced interventions. Finally, capitalizing on tribal resources (newsletter) and tribal events to increase LCS awareness may be promising strategies to improve screening in the local tribal setting. Citation Format: Kathleen Dwyer, Zsolt Nagykaldi, Mark Doescher, Dorothy A. Rhoades. Factors influencing patient decision-making to complete Low Dose CT screening for lung cancer [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B046.

Abstract C179: Train the trainer series in Southern California a call to action for cancer prevention and screening

Abstract Background: Alarmed by low rates of cancer screening in disenfranchised communities and medical deserts in Southern California, City of Hope launched a cancer prevention and control training program to broadly disseminate cancer screening and healthy living educational resources to Health Educators who serve the most vulnerable within our Catchment areas. Methods: The project was IRB approved as exempt came internally from City of Hope. To increase cancer prevention and uptake of cancer screening, we focused on training of Community Health Workers (CHW) from Federally Qualified Health Centers (FQHC’s), community hospitals, faith-based organizations. This community co-designed training included Cancer 101 , on best practice for Breast, Cervical, Colorectal, Lung, and Prostate screening, and Clinical and Biospecimen Studies and SB 987. Complete and online redcap enrollment survey, along with 2 brief pre and post surveys per series topic. The presentations and surveys will be facilitated by COE staff. Trainees completed surveys via RedCap. Surveys will be conducted via Redcap. Results: TTT series trained 101 trainees on 8 topics. Trainees included: Asian (14.9%), Black/African-American (6.9%), Latino/Hispanic (73.3%), Pacific Islander (2.0%), White/European American (5, 5.0%), Mix (3.0%). The gender identities trained were Male (10.9%), Female (87.1%), Transgender: Female to Male (2.0%). Facilitators of screening included Someone to talk about worries/fears about cancer (73.0%), Someone to go with and help at the appointment (53.0%), Paid time off from work (63.0%), Clinical provider recommendation/encouragement (57.0%), Free/ Low cost exams (81.0%), Insurance to pay for exams (68.0%), Free transportation (64.0%), Child care services (53.0%), In-language educational materials (62.0%), Language Interpretation services (51.0%), Community education programs (66.0%), Gift Cards or Incentives (4.0%).The participants' education level was mostly college educated (64.0%), high school (33.0%), and less than high school (3.0%). The top 3 cancers affect our community the most are breast, colon, and lung. Conclusion: The conclusion is community partners are ready to be engaged and trained in cancer prevention and screening. Cancer centers, leveraging their COE, can respond to this call to action. Citation Format: Kimlin Ashing, Lauren D'Souza, Brenda Gascon, James Morrison, Veronica Tejada, Alexis Garden, Jose Gomez, Sophia Yeung. Train the trainer series in Southern California a call to action for cancer prevention and screening [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C179.

The Beautiful City of Jakarta, Indonesia

This research aims to analyze environmental conditions in Jakarta and identify practical solutions to air pollution, water pollution, and waste management. The research methods include air and water quality monitoring with modern sensors, analysis of emissions data, and interviews with stakeholders. Simulation models evaluate the impact of various interventions, such as public transportation improvements and pollution control technologies. The research results show that Jakarta faces significant challenges, with pollutant concentrations often exceeding safe limits. Simulation models estimate that reducing vehicle emissions and using renewable energy could reduce air pollution by up to 30% within five years. Pilot projects such as sensor-based air quality monitoring systems and household waste separation programs are progressing positively. However, budget constraints and resistance to change are still obstacles. The conclusions of this research emphasize the importance of integrating modern technology, strengthening environmental policies, and active community involvement. This research also offers a model that can be implemented by other cities in developing countries. Suggestions include policy adjustments, increased financial support, and community education programs to increase awareness and participation in environmental improvement.

COMMUNITY DEVELOPMENT THROUGH EDUCATION ON THE PROCESSING OF HOUSEHOLD WASTE INTO COMMERCIAL PRODUCTS

Community empowerment and household waste processing are two issues that need to be resolved by the government. An independent and educated society is an important pillar to support the development of country. Meanwhile, waste that continues to accumulate without processing has a negative impact on health and the environment. Public education about household waste processing can be a solution to the two problems above. Education was carried out at Junior High School YBPK Surabaya and residents of Dukuh Kupang Surabaya, and other participants who joined in a hibrid meeting with a total of 116 participants. Activities at YBPK Surabaya took place on 25 March and 5 August 2023 and activities at Dukuh Kupang Surabaya took place on 27 May and 26 August 2023. The types of waste processed are organic waste and used cooking oil, which are then converted into eco-enzymes and used cooking oil Activities are divided into 2 stages. there are community education activities and program sustainability monitoring activities. The community education activities includes presentation and workshop were hold in March 2023 at YBPK Surabaya Middle School and May 2023 at Dukuh Kupang Surabaya. The evaluation of sustainability program including individual practice and monitoring of activities was carried out in August 2023 at Dukuh Kupang Surabaya. Methods for implementing activities include presentation, practice accompanied by a mentor, individual practice, and monitoring program sustainability. Based on the analysis of participants' ability, the participant scores before and after the activity was increase. It means that this training succeeded in increasing participants' knowledge and skills in processing waste, especially organic waste and used cooking oil waste. A total of 72 out of 116 participants (62%) had processed household waste either individually or in groups. Activity evaluation data shows that these activities are necessary and on target to create an independent and creative society.

Enhancing Maternal Engagement for Effective Stunting Prevention Strategies

General Background: Stunting is a critical public health issue that affects child development and overall community well-being. Effective management programs, such as the Pregnant Mother Class Program, are essential for addressing this challenge. Specific Background: In Wonoayu Village, Sidoarjo Regency, the implementation of this program aims to enhance maternal awareness and education regarding stunting prevention. However, the effectiveness of such programs in engaging the community remains underexplored. Knowledge Gap: While various studies have examined stunting management initiatives, limited research has focused on the qualitative aspects of community participation and communication in these programs. Aims: This research aims to evaluate the implementation of the Pregnant Mother Class Program in stunting management, specifically focusing on community participation, resource allocation, and bureaucratic structure. Results: Utilizing qualitative descriptive methods, the study found that while resource and disposition aspects were optimal, communication efforts were lacking, leading to low community awareness and participation. Training of facilitators was adequately conducted, but engagement with pregnant women required improvement. Novelty: This study provides unique insights into the dynamics of community education programs in stunting management, highlighting the critical role of communication in fostering community participation. Implications: The findings underscore the need for enhanced communication strategies to raise awareness and improve participation in health programs. Strengthening community engagement through targeted outreach can significantly enhance the effectiveness of stunting prevention initiatives, ultimately contributing to better health outcomes for mothers and children in rural settings. Highlights: Communication efforts require improvement for effective stunting management. Resource allocation and facilitator training were adequately implemented. Community participation enhances awareness and program effectiveness. Keywords: stunting prevention, pregnant mother class, community engagement, qualitative research, health education

Re-emerging Chandipura vesiculovirus: A cause of concern for global health.

Chandipura vesiculovirus(CHPV) is an emerging neurotropic virus primarily affecting children and causing acute encephalitis syndrome (AES) in India. The virus, transmitted mainly by sand flies, has led to multiple outbreaks with high mortality rates, particularly in rural and resource-limited settings. CHPV infection is characterized by rapid disease progression, with symptoms ranging from fever and seizures to coma and death, often within 24 to 48h of onset. The current management of CHPV is limited to supportive care due to the lack of specific antiviral therapies. Diagnosis relies on laboratory methods such as RT-PCR, serology, and immunofluorescence, though these face challenges due to the rapid progression of the disease and the need for timely sample collection and analysis. Prevention strategies are focused on vector control through insecticide use and public health interventions, including community education and early detection programs. Despite some progress in understanding CHPV, significant research gaps remain, particularly in developing effective antiviral treatments and vaccines, understanding transmission dynamics, and improving diagnostic capabilities. The potential for the virus to spread globally due to factors like climate change and increased human movement underscores the need for international collaboration in surveillance and response efforts. Strengthening public health infrastructure, enhancing vector control measures, and fostering global partnerships are crucial steps toward mitigating the impact of CHPV and preventing future outbreaks. Continued research and proactive public health strategies are essential to protect vulnerable populations and control the spread of this potentially deadly virus.

Social Media Programs for Outreach and Recruitment Supporting Aging and Alzheimer Disease and Related Dementias Research: Longitudinal Descriptive Study.

Social media may be a useful method for research centers to deliver health messages, increase their visibility in the local community, and recruit study participants. Sharing examples of social media-based community outreach and educational programs, and evaluating their outcomes in this setting, is important for understanding whether these efforts have a measurable impact. The aim of this study is to describe one center's social media activities for community education on topics related to aging, memory loss, and Alzheimer disease and related dementias, and provide metrics related to recruitment into clinical research studies. Several social media platforms were used, including Facebook, X (formerly Twitter), and YouTube. Objective assessments quantified monthly, based on each platform's native dashboard, included the number of followers, number of posts, post reach and engagement, post impressions, and video views. The number of participants volunteering for research during this period was additionally tracked using a secure database. Educational material posted to social media most frequently included content developed by center staff, content from partner organizations, and news articles or resources featuring center researchers. Multiple educational programs were developed, including social media series, web-based talks, Twitter chats, and webinars. In more recent years, Facebook content was occasionally boosted to increase visibility in the local geographical region. Up to 4 years of page metrics demonstrated continuing growth in reaching social media audiences, as indicated by increases over time in the numbers of likes or followers on Facebook and X/Twitter and views of YouTube videos (growth trajectories). While Facebook reach and X/Twitter impression rates were reasonable, Facebook engagement rates were more modest. Months that included boosted Facebook posts resulted in a greater change in page followers and page likes, and higher reach and engagement rates (all P≤.002). Recruitment of participants into center-affiliated research studies increased during this time frame, particularly in response to boosted Facebook posts. These data demonstrate that social media activities can provide meaningful community educational opportunities focused on Alzheimer disease and related dementias and have a measurable impact on the recruitment of participants into research studies. Additionally, this study highlights the importance of tracking outreach program outcomes for evaluating return on investment.

Estimating the efficacy of Newborn-Communication, Health, Feeding and Swallowing Education Program (N-CHFSEP) for primiparous mothers

Background Primiparous mothers face diverse challenges during pregnancy and post-childbirth. There is a lack of comprehensive educational programs for primiparous mothers on maternal functioning and newborn care. This study aimed to explore the efficacy of a developed educational program on the attitude of primiparous mothers towards newborn communication, general health, feeding and swallowing. The objectives were (1) to develop an attitude questionnaire (AQ), a parent education program, and a feedback questionnaire (FQ); and (2) to estimate the efficacy of the education program pre- and post-delivery. Methods Ninety-eight primiparous mothers without any obstetric history, proficient in English or Kannada, and delivering healthy newborns were recruited for the study. Phase 1 involved the development and validation of AQ, the parent education program [Newborn Communication, Health, Feeding and Swallowing Education Program (N-CHFSEP)], and FQ; while Phase 2 comprised of administering them on the mothers. Both quantitative (descriptive statistics, paired t-test, and chi-square test) and qualitative analysis were done on the parameters of interest. Results The results of the study demonstrated a notable increase in the number of mothers (not all) reporting heightened confidence levels following receiving the N-CHFSEP (which was observed in all the domains). This observed change (pre and post) was statistically significant as per paired t-test analysis (p <0.05) indicating a significant increase in confidence levels post-N-CHFSEP intervention, as well as recognizing warning signs related to the same. Sociodemographic factors such as age, education, occupation, and family type were reported to have a significant effect (p <0.05) on maternal confidence levels before and after N-CHFSEP administration. Feedback from participants highlighted the effectiveness of the program in enhancing knowledge and awareness, while also suggesting areas for improvement. Conclusions This study demonstrates the effectiveness of N-CHFSEP in enhancing primiparous mothers' confidence in newborn care, thereby improving maternal and infant health.

Caracterização dos acidentes por mordeduras por serpentes na província de Benguela, período 2019 – 2021

Introduction: Snakebites are a public health problem affecting tropical countries in Africa, Asia, and Latin America. In Angola there are no rigorous statistics or scientific studies that allow us to know the situation of the country. Objective: to characterize snakebite accidents in Benguela province, in the period 2019-2021. Material and Method: Observational, descriptive, cross-sectional, and prospective study. Universe made up of the total number of families in the municipalities with the highest incidence: Cubal, Lobito, Caimbambo and Chongoroi. The sample size was calculated with a 95% confidence level for a total of 124 households, represented by 1014 people. The residences were selected by simple random sampling. A structured interview was given to the head of the family, with prior informed consent. Data were analyzed in SPSS through absolute frequencies and percentages. Results: Of the heads of household, 73.3% are men, 76.6% work in the fields and 56% had primary education. Of the total number of people, 2.6% were bitten by snakes (26 people) and 3 died. Of the survivors, 13% had physical sequelae. Regarding knowledge, 64.5% identified it as the place with the highest incidence at home, 33.8% from 6 pm to 12 pm, 48.3% in the summer season, 100% applied traditional treatments, 94.4% correctly identified at least one, and 70.9% recognized bitis arietans. Regarding prevention measures, 49.1% do not know, although of the remaining 54.8% consider it better to wear shoes or boots. Conclusion: Angola needs to continue and increase community education programs to alleviate human suffering.

Body Mass Index Trends for the Top Five Finishers in Men's Grand Tour and Monument Cycling Events from 1994-2023: Implications for Athletes and Sporting Stakeholders.

Weight-related issues can be prevalent in elite-level sports, especially in men's road cycling, where riders may exhibit harmful behaviours, with potentially adverse outcomes for mental and physical health. This study investigated Body Mass Index (BMI) values amongst the top five finishers in the three Grand Tours and the five Monuments races between 1994 and 2023 to assess longitudinal patterns. Publicly available height and weight figures were sourced from ProCyclingStats and BMI scores were calculated for n = 154 and n = 255 individual athletes for the Grand Tours and Monuments, respectively. Two analyses were conducted with correlations and ANOVAs: the first included the BMIs of all top-five finishes and the second focussed on the BMIs of new top-five entrants. The results from both analyses revealed consistent mean BMI decreases over the years and larger effect sizes were apparent in the Grand Tours compared to the Monuments. Although lower BMIs are associated with certain performance advantages, these declining trajectories suggest a need for enhanced awareness in the cycling community and possible regulatory measures and educational programmes to promote the sustainable wellbeing of riders. This may be particularly pertinent given the wider evidence of unhealthy weight-related attitudes and behaviours throughout the sport.

'Do it afraid': An arts-based reflexive collective case study exploring youth responses to post-concussion communication changes in daily life.

Concussion and communication researchers have yet to study how post-concussion communication changes affect youths' daily lives. The lack of attention paid to how young people respond to communication changes during concussion recovery constitutes a significant gap in current concussion management research and practices. To explore how youth respond to the effects of post-concussion communication changes in their daily life, including (1) daily routines, (2) relationships with family members, (3) relationships with peers and (4) participation in school/work and community activities. Five youths (16-25 years) and three family members participated in this arts-based reflexive collective case study. Ecocultural theory provided the theoretical framework for study design, data collection and analysis. Cases consist of (1) pre-interview demographic information, (2) three 60-90-min virtual interviews, (3) optional family member interviews, (4) multi-media arts-based participant-generated materials representing participants' experiences of communication change and concussion, and (5) researcher observations, discussions and reflexive journal entries. Reflexive thematic analysis was used to analyse the data. Analysis yielded four themes that illustrate the ways youth navigated and adapted to post-concussion communication changes: (1) navigating changes in communication tasks, daily roles, and identity; (2) re-negotiating relationships and emotional reactions; (3) seeking control and learning to let go during recovery; and (4) helping youth adapt to post-concussion communication changes. The study findings deepen our understanding of the impact of post-concussion communication changes on youths' daily lives and underscore considerations critical to the development ofcommunication-focused concussion education programs and interventions tailored specifically for youth. What is already known on the subject Youth is a critical period of social and emotional development. Communication is integral to identity, relationships, participation in daily activities and well-being. Concussions can affect speech clarity, fluency, understanding and use of language, and social interactions. Re-engaging in routine activities and pre-injury roles can be challenging for youth experiencing communication changes as part of complex concussion recoveries. What this paper adds to the existing knowledge Findings from this research illuminate how youth navigate and adapt to communication changes post-concussion and support the development of youth-focused communication education programs, assessments and interventions. Youth participants actively managed their recoveries by developing innovative strategies to support their communication during daily activities, learning about communication, practicing communication tasks sequentially, and facing fears. Youth also reframed and challenged narrow views of 'normal communication'. What are the potential or actual clinical implications of this work? Findings highlight the need for more youth- and communication-focused education materials and programs within youth concussion management protocols. Information about the specific ecological and sociocultural factors youth encounter during concussion recovery is needed to develop targeted communication-focused education and intervention programs for youth and their families to mitigate risks of isolation, loneliness, and mental health concerns and increase youths' participation in family, community and cultural life. By learning from youth about how communication changes affected their participation in daily activities, identity and relationships, clinicians can provide information and interventions to reduce adverse listener reactions and help young people feel supported and understood.

Social Interactions and Comprehensive Education Programs: What the Society Related to Parkinson's Disease Wants in the Context of Iran: Content Analysis and Delphi Approach

Background: The physical and psychological symptoms of Parkinson's disease can disrupt patients' social lives, leading them to withdraw from social situations. Objectives: The objective of the present study is to identify the social needs and priorities of patients with Parkinson's disease from the perspectives of patients, family caregivers, and health care providers. Methods: The present study employed a qualitative content analysis method to collect data to identify the needs of patients with Parkinson's disease. Semi-structured interviews were conducted with 28 participants using a purposive sampling strategy with maximum diversity in Tehran in 2023. Data analysis was performed using the conventional content analysis approach based on Granheim and Lundman's model. A two-stage Delphi technique was used to identify patients' priorities with 53 participants. Results: The 28 participants included 11 patients (7 male, 4 female, mean age = 66.27), 11 family caregivers (7 daughters, 3 spouses, 1 son, mean age = 43.81), 4 nurses, and 2 physicians. Three main categories and 12 subcategories were extracted. In the category of "Interactionism by leaving unwanted isolation," the subcategories identified were maintaining and promoting social interactions, maintaining aspects of the job and continuing some professional skills, voluntary membership in groups and institutional participation, and participation in social activities. The category "Continuity of healthcare services delivery" included four subcategories: Continued access to movement disorder specialists, access to coordinated multidisciplinary services, access to supporting organizations and associations, and appropriate insurance coverage. The category "Individual-oriented and community-oriented advocacy programs" included four subcategories: Financial support, social belonging and effective communication, self-care, and comprehensive education programs with multiple target groups. The prioritization was completed after two Delphi steps with a high agreement of 86.90% from 16 patients, 14 family caregivers, and 23 health care providers from eight disciplines. Conclusions: The results of the study show that patients with Parkinson's disease experience various social needs. Since the nature of Parkinson's disease affects social interactions, patients and their caregivers view social interactions as the missing link to addressing their social needs. Meanwhile, health care providers prioritize educating patients and families and holding specialized Parkinson's disease courses. Policymakers should consider necessary social support programs for these patients and focus on the specialized training of healthcare providers in the field of Parkinson's disease, in addition to providing appropriate care, support, and social services.

“Building bridges”—communication education for residents in radiology: a scoping review

BackgroundGood communication is an important professional attribute for radiologists. However, explorations of communication education and their outcomes in radiology residents are sparse. This scoping review aims to evaluate the existing literature on communication education for radiology residents, identify gaps in current practices, and suggest directions for future studies.MethodsA scoping review following the six-step approach of Arksey and O’Malley was undertaken. We searched through PubMed, Embase, ERIC, and Web of Science databases, focusing on communication education in radiology residents.ResultsSixteen of the 3096 identified articles were included in the analysis. Most studies (13/16) originated from the United States. The studies varied in study design, including quantitative, qualitative and mixed-methods approaches. The sample sizes of most studies were small to moderate, with more than half of the studies had fewer than 30 participants. The identified studies predominantly focused on communication with patients and healthcare professionals. The need for communication education, the efficacy of specific communication education programs, and the capability of some assessment tools for evaluating residents’ communication skills were investigated.ConclusionsThis scoping review reveals the gap between the need for communication education and the lack of comprehensive education programs in radiology residents globally. Future studies should develop tailored interventions and use reliable assessment tools, engaging more participants with extended follow-up periods, and expand the scope of communication training to include all relevant stakeholders.

Preserving Traditional Ghanaian Folklore through Storytelling

This study examines the role of storytelling in preserving traditional Ghanaian folklore, considering its significance in cultural continuity and identity formation. Ghana boasts a rich tapestry of oral traditions, comprising myths, legends, proverbs, and folktales that have been passed down through generations. However, in the face of modernization and globalization, these indigenous narratives face the risk of being marginalized or forgotten. Through qualitative analysis and literature review, this paper explores how storytelling serves as a vital mechanism for the transmission and preservation of Ghanaian folklore. It investigates the cultural, social, and educational implications of storytelling practices within Ghanaian communities, highlighting their capacity to instill values, foster intergenerational bonds, and reinforce cultural pride. Moreover, the study investigates contemporary initiatives aimed at revitalizing traditional storytelling methods, such as community storytelling events, educational programs, and digital media platforms. By recognizing the intrinsic value of storytelling in safeguarding Ghana's cultural heritage, this research underscores the importance of ongoing efforts to ensure the continued vitality and relevance of Ghanaian folklore in the modern era.