Experience Of Countries Research Articles

Informal Life Safety Education for Students in the Context of Globalisation: Insights From International Practices

Informal education is a process of self-organised acquisition of specific competencies. Although not necessarily goal-oriented and structured, it actively contributes to expanding professional knowledge and skills and is positioned as one of the critical competencies of an individual. Informal education has gained particular significance in the era of internationalisation. The article aims to analyse the specifics of organising informal education for students in the field of life safety against the backdrop of global internationalisation, based on the experience of foreign countries. The research identifies the primary forms of informal education, including single lectures, video lessons, online consultations, and communication tools. It has been established that informal education creates preconditions for self-realisation, acquisition of new knowledge, skills, and competencies, increased motivation, and professional competence. Mechanisms for crediting the results of informal learning to formal education have been provided. It has been found that the educational environment in the era of internationalisation involves academic mobility, active international relations, projects, research initiatives, and academic programs, as well as the integration of international, intercultural, and global dimensions into higher education goals. Policies and programs appropriate to implement in response to globalisation as a tool for maximising its opportunities have been identified. An analysis of the national internationalisation of informal education in life safety, consideration of its organisational strategies through the prism of target programs and personal motivation of higher education students has been conducted. It has been proven that informal education in life safety enhancement is flexible, not limited by time frames, and does not involve certain procedural formalities. It aims to improve students’ life activities, allowing them to actively socialise and enhance their socio-economic status.

State support for employment of rural population in Kazakhstan

Purpose - the problems of employment in rural areas are considered and the ways of their solution are proposed. Methods - economic and statistical method, monographic, systematic, sociological analysis - to determine the indicators and factors of providing jobs - were used in identifying the trends of employment of rural population. Results - the current situation in the labor market was studied, the state programs for the expansion of this segment and the results of their implementation were analyzed. The statistical data of unemployment rate by categories in dynamics are compared: age, gender composition, share of labor-sufficient urban and rural populations. The experience of foreign countries is shown, the approved norms of the number of employees employed in agriculture are presented. Conclusions - to improve the socio-economic infrastructure of rural areas and to improve the quality of life of rural residents it is important to improve the system of subsidizing economic entities. This, in turn, is achievable under the condition of investment of staff units in agricultural production and strengthening social protection of the population. Structural reorganization of the economy has affected the decrease of labor employment in the agrarian sphere, which is one of the criteria of economic development of the republic. Diversification in the agro-industrial complex, support of peasant (farmer) farms and alternative forms of labor relations in rural areas allow to smooth negative trends and receive additional income. The priority direction of labor mobility of rural residents is the expansion of small business. To this end, it is necessary to ease the tax burden on its enterprises, create regional centers for their support, which should direct the available financial and material resources primarily to the implementation of projects and employment programs in rural areas.

A MODERN APPROACH TO THE REGULATION OF CRIMINAL LIABILITY FOR ILLEGAL EXTRACTION OF AQUATIC BIOLOGICAL RESOURCES UNDER THE LEGISLATION OF THE CIS COUNTRIES

The scientific work examines some issues of legal regulation of the protection and use of aquatic biological resources. The work examines and analyzes the legislative experience of some CIS member states, including those belonging to the Caspian states. The presence of the latter is explained by the need for joint cooperation between States to combat illegal fishing of fish and other aquatic biological resources and preserve biological diversity. The article substantiates the question of the possibilities of developing the institution of legal responsibility for the illegal extraction of aquatic representatives of flora and fauna. In addition, the provisions of the articles of the criminal legislation of the CIS countries, which were influenced by the legislation of the Soviet Union, are considered. On this basis, the general distinctive features of the provisions on the application of criminal liability for non-compliance with legislation in relation to aquatic biological resources are identified. In addition, the peculiarities in the regulation of the studied legal relations by individual states are determined in terms of establishing the subject of the crime, qualifying signs of the corpus delicti, and the amount of damage to the environment. In addition, the paper raises the issue of international cooperation between countries regarding the protection and rational use of aquatic biological resources. In this regard, the most effective are the joint organizational actions of the States, which can be reflected in the Protocol on Cooperation currently under discussion in the Field of Combating Illegal Extraction (Poaching) of Biological Resources in the Caspian Sea. The authors propose recommendations on the development of this cooperation and the application of the experience of countries with a common history of criminal law development, but different approaches to the implementation of the goal of protecting aquatic biological resources.

북유럽 초·중 통합운영학교(Comprehensive School)의 특성 연구

Purpose: Due to the decline in school-age populations and urbanization, the discussion on integrated elementary and middle schools has begun in earnest. To effectively operate integrated schools, it is necessary to refer to the experiences of countries that have long implemented similar systems. Thus, this study aimed to explore the comprehensive school system in Northern Europe, where primary and lower-secondary schools are integrated, and analyze its characteristics to draw implications for the operation of integrated elementary and middle schools in the South Korean context. Methods: To achieve the research objectives, this study examined and analyzed the background and current status of the comprehensive school systems in Northern European countries—Finland, Norway, Sweden, and Estonia—that operate under a single structure integrating the primary and lower-secondary school education periods. The study also explored the teacher training systems, school evaluations, and student assessments in these countries. Results: The four countries aimed to achieve both social welfare for all citizens and educational effectiveness. The comprehensive school systems in each country share a common feature of striving to realize the values of social democracy. To link the two school levels, each country has developed its own teacher training and evaluation systems. Conclusion: These findings suggest that, in order to effectively operate integrated elementary and middle schools in the Korean context, it is essential to develop methods that link and integrate the two school levels while considering the specific characteristics of each level, promote collaboration among teachers, and clearly establish educational objectives in addition to administrative and economic goals.

Кримінальна відповідальність за злочини проти основ yаціональної безпеки: вітчизняний та зарубіжний досвід

The article deals with the issue of criminal liability for crimes against the foundations of national security on the example of domestic and foreign experience of certain countries. The author specifically analyzes the legislative regulation of criminal liability for crimes against national security in the Republic of Lithuania, the Republic of Latvia, the Republic of Estonia, Georgia, the Republic of Armenia, the Republic of Poland, Switzerland, the Federal Republic of Germany, and the French Republic. The author suggests that there is a need for more in-depth research and improvement of the legal regulations regarding criminal liability for crimes against the foundations of national security in Ukraine. The article proposes resolving any inconsistencies between the title of Section I of the Special Part of the Criminal Code of Ukraine, which is “Crimes against the Fundamentals of National Security of Ukraine”, and the content of the relevant articles included in it. This section should address criminal liability for all activities that threaten Ukraine’s national security. Therefore, the author recommends to include provisions for criminal liability related to the protection of state secrets, safeguarding critical infrastructure, expanding the scope of information security, imposing penalties for actions that aim to harm the state by an authorized person representing Ukraine in dealings with the leadership of a foreign state or organization, and establishing criminal liability for individuals who publicly insult the Ukrainian people or Ukraine.

До питання відновлення України після війни з Росією

This research article is devoted to the topical issues of restoration and modernization of Ukraine in the post-war period, the study of strategies for the restoration and reconstruction of economic and social structures in the regions of Ukraine that have been devastated by the war with russia. The research is based on the analysis of the experience of other countries that have experienced similar challenges, as well as on the study of successful practices and possible failures in the implementation of recovery measures. The paper emphasizes the importance of cooperation between different levels of government, civic initiatives, and international support to achieve effective and sustainable results. The article aims to make a practical contribution to solving the problems of recovery after a military conflict and to expand the theoretical understanding of the impact of military conflicts on society and the economy. The article is aimed at solving a number of problems related to the restoration of Ukrainian regions after the military conflict with Russia. One of the key problems is the destruction of economic and social structures in these regions, which requires careful analysis and strategic planning for their effective recovery. An important challenge is also the need to identify optimal recovery strategies that take into account the unique requirements of each region and promote rapid and sustainable recovery. It is also a challenge to ensure cooperation between different levels of government, community initiatives and international partnerships to achieve synergies and maximize results. The study should also take into account the importance of rebuilding infrastructure, adapting society to the new conditions, and consider the socio-economic consequences of the conflict and their impact on regional development. This formulation of the problem allows for a deeper understanding of the complex challenges and the search for effective strategies for recovery from military conflict.

Review of foreign experience of professional adaptation of war veterans

Problem setting. After the end of the war, most of the veterans will be an economically active stratum of the population, who will need active support from the state when reintegrating into civilian life, but in return will be able to benefit the country by remaining active subjects of the national economy. The preservation and development of this potential is critically important both for the post-war recovery of Ukraine and for the establishment of social justice in relation to defenders. The study of foreign experiences is an important step in order to learn effective practices that can be adapted and applied to the Ukrainian context. Despite the fact that the experience of other countries does not always fully correspond to Ukrainian realities, it contains useful lessons and methods that can be modified to solve the specific challenges that Ukraine faces. Analysis of recent researches and publications. Such domestic researchers as V.P. Kokhan, A.S. Kolisnyk, O.V. Shapovalova, V.I. Sheverdina, T. Zakharina, V.K. Malolitneva, R.A. Jabrailov. M. Bazaeva studied foreign experience using the example of the USA. At the same time, there is no comprehensive overview of foreign policy regarding the support of veterans and their reintegration into civilian life in domestic works. Purpose of research is to carry out a general review of foreign experience in issues of support for veterans using the example of the USA, EU, Germany, France and Great Britain. Article`s main body. The article examines the issue of professional adaptation of veterans as a key element in the successful reintegration of military personnel into civilian life. It outlines the experiences of the United States, the European Union, Germany, France, and the United Kingdom to identify effective veteran support practices that could be adapted to the Ukrainian context. The focus is on the legal and organizational aspects of veteran policies, including legislative support and the involvement of both governmental and non-governmental organizations in the outlined area. The article concludes that the United States has a well-developed system of veteran support, primarily driven by the Department of Veterans Affairs (VA). Special attention is given to the functioning of the U.S. Court of Appeals for Veterans Claims (CAVC). It is suggested that the establishment of a similar specialized judicial body could be an important step for Ukraine to effectively protect veterans’ rights in the post-war period. The article highlights the absence of unified legislation on veterans within the European Union. Nevertheless, it emphasizes the role of pan-European non-governmental organizations in this field, such as the European Confederation of Veterans. The legal and institutional framework for veteran policies in specific EU member states, particularly Germany and France, is also discussed. Special attention is given to the experience of the United Kingdom, which aspires to have the most advanced veteran support system. It is noted that the strategic approach to veteran policy, particularly through the Veterans’ Strategy Action Plan 2022-2024, provides long-term legal certainty for veterans and enhances the effectiveness of state policy. Conclusions and prospects for the development. The article underlines that professional adaptation of veterans is a critical precondition for successful post-war recovery in Ukraine and the preservation of veterans’ economic activity. The use of foreign experience, particularly the creation of specialized judicial bodies, the development of national veteran support strategies, and the active involvement of non-governmental organizations, could become a subject of further discussion aimed at finding the optimal path for building an effective veteran support system in Ukraine.

The Impact of Economic Policy Changes on International Trade and Relations

Economic policies continue to remain central in determining relations among nation states in the global economy that is progressively characterised by integrated globalisation. The newer changes in the course of economics; or due to the geopolitical conflicts, advancement in the field of technology, the impact of COVID-19, commerce worldwide has experience newer changes. A review of these policies is presented in this paper with a view of assessing their direct and indirect effect on international trade. Analyzing the experience of various countries, including both developed ones and the countries in the process of development, this paper aims to reveal how nations responded to these changes, as well as what strategies can work, and what difficulties can be encountered. Besides, the paper contains a prognosis of future developments of the international economy, having several scenarios and guidelines for practical implementation. These disconnects highlight the relevance of the critical philosophy in economic policy formulation since the globe economic policy should balance internal economic stable and international trade cooperation.

Digital Measures to Decipher Forest Fires a Comparative Study of the Moroccan and American Experiences

Objectives: The study analyzed the digital measures in forest fire management in Morocco and the United States, comparing of the fire management methods in each country. The goal was to enhance the policies and strategies used in Morocco and to further integrate the Moroccan approach with the American experience. Methods: The study relied on the descriptive-analytical approach to describe the digital measures adopted in both Morocco and the United States for extinguishing forest fires. The comparative approach was also used to compare the experiences of both countries in combating forest fires and explore how Morocco can benefit from American expertise. Results: The study results indicate that both Morocco and the United States use digital technology for early detection of forest fires. However, Morocco faces challenges such as funding shortages, inadequate technical infrastructure, and the need for firefighter training. Meanwhile, the U.S. employs advanced technologies, including satellites, drones, and ground-based thermal sensors, and benefits from integrated information management systems and artificial intelligence. Despite this, the U.S. also encounters challenges related to coordinating efforts among different agencies. In comparison, the U.S. has significantly higher levels of funding and technical support, allowing for the use of more advanced technologies. Therefore, Morocco could benefit from the American experience in several ways, including improving technical infrastructure, training firefighting teams, using integrated information management systems, and exchanging expertise and knowledge.. Conclusions: These results reflect the importance of digital technology in enhancing the effectiveness of forest fire response and highlight Morocco's potential to benefit from the United States' experience to address this environmental issue more effectively.

Contraceptive access and use among women with migratory experience living in high-income countries: a scoping review

BackgroundWomen who have migrated often encounter difficulties in accessing healthcare and experience inequitable sexual and reproductive health outcomes in destination countries. These health inequities include contraceptive access and use. To better understand what influences contraceptive access and use, this scoping review set out to synthesize the evidence on contraceptive access and use and on associated interventions among women with migratory experience in high-income countries (HICs) in Europe, North America and Australasia.MethodsThe scientific databases PubMed, Web of Science and CINAHL were searched for peer-reviewed quantitative, qualitative and mixed method articles published between January 2000 and June 2023. Articles were included if they reported on studies exploring contraceptive use to prevent pregnancies among women of reproductive age with migratory experience living in HICs. Two researchers independently screened and extracted data from the articles. Findings were categorized by patient and health system level factors according to Levesque et al.’s framework of access to health care.ResultsA total of 68 articles were included, about half (n = 32) from North America. The articles focused on the individual level rather than the health system level, including aspects such as women’s contraceptive knowledge, the influence of culture and religion on accessing and using contraception, partner involvement, and differing health insurance coverage. On the health system level, the articles highlighted lack of information on contraceptive services, cultural (in)adequacy of services and communication aspects, contraceptives’ side effects, as well as geographic availability and cost of services. The review further identified three articles reporting on interventions related to contraceptive counselling.ConclusionsThere is a lack of knowledge regarding how health systems impose obstacles to contraceptive services for women with migratory experience on an organizational level, as research has focused heavily on the individual level. This review’s findings may serve as a foundation for further research and advances in policy and practice, specifically recommending early provision of health system related information and contraceptive education, engagement of male partners in contraceptive discourses, cultural competency training for healthcare professionals, and strengthening of interpretation services for contraceptive counselling.

Strengthening China’s National Essential Public Health Services Package for hypertension and diabetes care: protocol for an interrupted time series study with mixed-methods process evaluation and health economic evaluation

BackgroundDespite major primary health care (PHC) reforms in China with the 2009 launch of the National Essential Public Health Service Package, the country experiences many challenges in improving the management of non-communicable diseases in PHC facilities. “EMERALD” is a multifaceted implementation strategy to strengthen the management of hypertension and type-2 diabetes mellitus (T2DM) in PHC facilities. The study aims to: (1) examine the effectiveness of EMERALD in improving hypertension and T2DM management; (2) evaluate the implementation of the interventions; and (3) use the study findings to model the long-term health economic impact of the interventions.MethodsThe EMERALD intervention components include: (1) empowerment for PHC providers through training and capacity building; (2) empowerment for patient communities through multi-media health education; and (3) empowerment for local health administrators through health data monitoring and strengthening governance of local PHC programs. An interrupted time series design will be used to determine the effectiveness of the interventions based on routinely collected health data extracted from local health information systems. The primary effectiveness outcome is the guideline-recommended treatment rates for people with hypertension and T2DM. Secondary effectiveness outcomes include hypertension and T2DM diagnosis and control rates, and enrolment and adherence rates to the recommended care processes in the National Essential Public Health Service Package. A mixed-methods process evaluation will be conducted to evaluate the implementation of the interventions, including the reach of the target population, adequacy of adoption, level of implementation fidelity, and maintenance. Qualitative interviews with policy makers, health administrators, PHC providers, and patients with hypertension and/or T2DM will be conducted to further identify factors influencing the implementation. In addition, health economic modelling will be performed to explore the long-term incremental costs and benefits of the interventions.DiscussionThis study is expected to generate important evidence on the effectiveness, implementation, and health economic impact of complex PHC interventions to strengthen the primary care sector’s contribution to addressing the growing burden of non-communicable diseases in China.Trial registrationThe study has been registered on Chinese Clinical Trial Registry at https://www.chictr.org.cn/ (Registration number ChiCTR2400082036, on March 19th 2024).

CURRENT STATE AND DIRECTIONS OF FINANCIAL ARCHITECTONICS DEVELOPMENT

The article presents an analysis of the evolution of financial architectonics in the context of globalisation, identifying the principal avenues for its advancement in order to guarantee the stability and efficacy of financial systems. The topic is of great relevance in light of the necessity to reform the extant financial system in the context of economic globalisation and the interdependence of countries. The global financial crisis of 2008 and the crisis caused by the pandemic of 2019-2021 have demonstrated the deficiencies of the extant financial architecture and the necessity of modernising it to guarantee the stability and resilience of financial systems. The research methodology employed a combination of monographic, comparative, and content analysis techniques to examine a substantial corpus of scientific literature. This approach facilitated an in-depth investigation of the predominant methodologies for interpreting financial architectonics and a comprehensive analysis of the diverse experiences of countries in developing financial systems. The findings of the study indicated that the efficacy of financial architectonics is contingent upon the presence of active and stable risk markets that facilitate access to essential financial data and investor protection mechanisms. It was determined that contemporary financial systems frequently fail to satisfy the requirements of a globalised economy, thereby necessitating their reform. The development of new regulatory mechanisms for financial markets and institutions, as well as the creation of international standards and codes of conduct, have become the primary avenues for achieving financial stability. The practical value of this article lies in its capacity to inform the development of novel approaches to the management of financial systems at both national and international levels. The proposed recommendations for the development of financial architectonics can assist governments and financial institutions in responding in a more effective manner to global financial crises and ensuring stable economic development.

Prevalence of obstetric violence in high-income countries: A systematic review of mixed studies and meta-analysis of quantitative studies.

Obstetric violence, or mistreatment of women in obstetric care, can have severe consequences such as fear of future childbirth, post-traumatic stress disorder, and depression. The primary objective was to estimate the prevalence of obstetric violence in high-income countries. The secondary objective was to extract the main domains of obstetric violence perceived by women from qualitative studies. Following prospective registration (PROSPERO CRD42023468570), PubMed, Web of Science, Scopus, CINAHL, Embase, and Cochrane Library were searched with no restrictions. Included studies were cross-sectional, cohort, mixed methods, and qualitative studies based on populations from high-income countries. The review was conducted by two independent reviewers. Risk of bias was assessed. Rates of obstetric violence were pooled using random effects model, computing 95% confidence intervals (CI) and assessing heterogeneity using I2 statistic. Funnel plots and Egger's test were used to detect potential reporting biases and small-study effects. Of the 1821 records screened, 25 studies were included: 14 quantitative and 2 mixed methods studies, comprising 60 987 women, and 9 qualitative studies were included, comprising an additional 4356 women. 81.25% of quantitative studies, including the quantitative component of the mixed methods studies, were considered satisfactory or better regarding risk of bias. The prevalence of obstetric violence was overall 45.3% (95% CI 27.5-63.0; I2 = 100.0%). The prevalence of specific forms of mistreatment was also estimated. Lack of access to analgesia was 17.3% (95% CI 6.9-27.7; I2 = 99.7%). Ignored requests for help was 19.2% (95% CI 11.7-26.6; I2 = 99.0%). Shouting and scolding 19.7% (95% CI 13.0-26.4; I2 = 98.7%). The use of fundal pressure during the second stage of labor (Kristeller maneuver) was 30.3% (95% CI 22.1-38.5; I2 = 97.6%). There was no funnel asymmetry. Lack of information and/or consent were the most frequent domains extracted from the qualitative articles and the qualitative component of the mixed methods studies. The results demonstrate that obstetric violence is a prevalent problem that women in high-income countries experience. Lack of information and/or consent were the domains most frequently described in the qualitative studies and the qualitative component of the mixed methods studies.

Police and civil society partnership: Peculiarities of implementation in modern conditions

The purpose of the article is to find out the peculiarities of the implementation of partnership relations between the police and civil society in modern conditions, based on the analysis of current Ukrainian and foreign legislation, as well as scientific literature. Partnership as a type of social interaction is characterized by the authors of the article. The essence of the term “partnership” in modern foreign science is analyzed. The main features of the partnership model of interaction of subjects are characterized, with an emphasis on the partnership between the police and civil society institutions. The main components of the mechanism of partnership interaction between the institutions of the State and civil society institutions in the field of law enforcement are considered. The experience of different countries related to the partnership of law enforcement agencies and civil society institutions is described, with the aim of promoting the formation of effective forms of partnership between the police and civil society institutions in modern Ukraine. The importance of building in Ukraine an effective partnership model of cooperation between the police and civil society institutions in modern Ukraine is emphasized. The importance of public participation in the implementation of state functions in the field of security in modern conditions is proved. The importance of trust for effective partnership is emphasized.

Fighting cyber crimes: the experience of certain foreign countries

Fighting cyber crimes: the experience of certain foreign countries

The Role of Artificial Intelligence in Criminal Justice - Reality and Perspective

Artificial intelligence has recently become one of the hot topics in scientific and professional circles of various fields. Current technological processes in the world have significantly increased the use of digital technologies in practically all fields. Over the past century, several researchers and mathematicians have been developing the idea that computing machines can not only perform typical technical tasks but also learn to think and perform individual tasks accordingly, like humans. This idea has developed over time, and nowadays, the main topic among scientists, researchers, and practitioners worldwide is artificial intelligence and the tasks it can perform. Artificial intelligence is already actively used in various fields of public activity and many professions, and there is still talk that many professions can be replaced by artificial intelligence in the future. In this regard, using artificial intelligence in jurisprudence is particularly important and controversial. Based on the relevance of the mentioned issue, this article is dedicated to the use of artificial intelligence in the field of criminal proceedings and investigations. The article discusses the origin and development of artificial intelligence and its primary role in criminal proceedings and investigations. In the work, special attention is paid to the experience of different countries. The paper also analyzes court decisions of precedent importance in this regard. The paper also contains the main challenges of using artificial intelligence in criminal justice and investigation.

SPATIAL DISTRIBUTION AND ASSESSMENT OF PUBLIC GREEN SPACES IN AN URBAN SETTLEMENT

The article examines the current land use of green spaces as an integral part of the urban economy through the example of a city in central Ukraine, Kropyvnytskyi. It analyses the regulatory framework for the functioning of green spaces. The study also includes an analysis of the geospatial distribution of public green spaces and their structure by number and area in the regional centre. The authors estimate the green areas covered with tree plantations based on vegetative indicators using remote sensing data. The Normalised Difference Vegetation Index (NDVI) allowed for clarifying the boundaries of green areas, their area, and the density of green mass of vegetation. This index helps to identify the spatial-temporal trends of vegetation, which are necessary to support scientific-grounded management decisions for city governance. The results of determining the NDVI are presented in the example of the park-monument of landscape art ‘Dendropark’. For vegetation in good condition, its value exceeds 0.7, corresponding to 58 % of the area. The Shannon Diversity Index has been used to assess the distribution of land use types in the green areas of general use. We identified six types of green area land use in Kropyvnytskyi city and performed the index calculations according to these types of land use. The calculation of the provision of public green spaces for city residents confirmed its low value compared to the standards. The research’s results determined that Kropyvnytskyi city needs to create new green zones, preserve existing ones, inventory, and develop a database of all green areas. Planting areas of new residential buildings and applying the experience of other countries to increase green areas due to alternative landscaping types (vertical landscaping, green roofs, and others) will allow for an expansion in the green areas of settlements, especially in large cities. The practical importance of the research results is their potential use for creating a strategy to develop and preserve green plantings in the city of Kropyvnytskyi for future years. Keywords: vegetation index, land use, diversity index, green areas, parks.

In-person versus remote (mHealth) delivery for a responsive parenting intervention in rural Kenya: a cluster randomized controlled trial

BackgroundAn estimated 43% of children under age 5 in low- and middle-income countries (LMICs) experience compromised development due to poverty, poor nutrition, and inadequate psychosocial stimulation. Numerous early childhood development (ECD) parenting interventions have been shown to be effective at improving ECD outcomes, at least in the short-term, but they are (a) still too expensive to implement at scale in low-resource and rural settings, and (b) their early impacts tend to fade over time. New approaches to deliver effective ECD parenting interventions that are low-cost, scalable, and sustainable are sorely needed.MethodsOur study will experimentally test a traditional in-person group-based delivery model for an evidence-based ECD parenting intervention against a hybrid-delivery model that increasingly substitutes in-person meetings with remote (mHealth) delivery via smartphones, featuring audiovisual content and WhatsApp social interactions and learning. We will assess the relative effectiveness and cost of this hybrid-delivery model compared to in-person delivery and will extend the interventions over two years to increase their ability to sustain changes in parenting behaviors and ECD outcomes longer-term. Our evaluation design is a cluster Randomized Controlled Trial (cRCT) across 90 villages and approximately 1200 households. Midline and endline surveys collected 12 and 24 months after the start of the interventions, respectively, will examine short- and sustained two-year intention-to-treat impacts on primary outcomes. We will also examine the mediating pathways using mediation analysis. We hypothesize that a hybrid-delivery ECD intervention will be lower in cost, but remote interactions among participants may be an inferior substitute for in-person visits, leaving open the question of the most cost-effective program.DiscussionOur goal is to determine the best model to maximize the intervention’s reach and sustained impacts to improve child outcomes. By integrating delivery into the ongoing operations of local Community Health Promoters (CHPs) within Kenya’s rural health care system, and utilizing new low-cost technology, our project has the potential to make important contributions towards discovering potentially scalable, sustainable solutions for resource-limited settings.Trial RegistrationNCT06140017 (02/08/2024) AEARCTR0012704.

How does the role of complementary and alternative medicine in general practice differ between countries? Interviews with doctors who have worked both in Germany and elsewhere in Europe

BackgroundAvailable data suggest that general practitioners (GPs) in Germany use complementary and alternative medicine (CAM) modalities more frequently than GPs in many other countries. We investigated the country differences perceived by general practitioners who have worked in Germany and in one of four other European countries with regard to the role of complementary and alternative treatments in primary care.MethodsIn this qualitative study we conducted semi-structured interviews with 12 GPs who had worked both in Germany and Italy, the Netherlands, Norway or the United Kingdom (UK; n = 3 for each of the four countries). Participants were asked how they perceived and experienced country differences regarding health system, relevance of CAM modalities, the role of evidence-based medicine (EBM) and science, and how they handle so-called indeterminate situations. For the analysis, we followed a thematic analysis approach according to Braun and Clarke with focus on themes that cover CAM.ResultsParticipants unanimously reported that they perceived CAM to be more relevant in general practice in Germany compared to the other countries. We identified four overarching themes in relation to the perceived reasons for these differences. Firstly, physicians with experiences in countries with a strong EBM and science orientation (Netherlands, Norway and the UK) considered the deeply ingrained view in national healthcare systems and GP communities that CAM modalities are not evidence-based as the main reason for the lower use of CAM by GPs. Secondly, extensive training of communication skills was cited as a reason that reduced the need for CAM in the Netherlands, Norway and the UK. Thirdly, differences in patient expectations and demands were perceived as a factor contributing to greater utilisation of CAM by German GPs compared to the other countries. Finally, country-specific reimbursement mechanisms were considered as a factor influencing the role of CAM in general practice.ConclusionsThe study results point to major differences between countries with regard to the role of CAM in GP care. Differences in basic attitudes in the discipline of general practice, patient expectations and system conditions appear to play an important role here.

The impact of COVID-19 on people with epilepsy: Global results from the coronavirus and epilepsy study.

To characterize the experience of people with epilepsy and aligned healthcare workers (HCWs) during the first 18 months of the COVID-19 pandemic and compare experiences in high-income countries (HICs) with non-HICs. Separate surveys for people with epilepsy and HCWs were distributed online in April 2020. Responses were collected to September 2021. Data were collected for COVID-19 infections, the effect of COVID-related restrictions, access to specialist help for epilepsy (people with epilepsy), and the impact of the pandemic on work productivity (HCWs). The frequency of responses for non-HICs and HICs were compared using non-parametric Chi-square tests. Two thousand one hundred and five individuals with epilepsy from 53 countries and 392 HCWs from 26 countries provided data. The same proportion of people with epilepsy in non-HICs and HICs reported COVID-19 infection (7%). Those in HICs were more likely to report that COVID-19 measures had affected their health (32% vs. 23%; p < 0.001). There was no difference between non-HICs and HICs in the proportion who reported difficulty in obtaining help for epilepsy. HCWs in non-HICs were more likely to report COVID-19 infection than those in HICs (18% vs 6%; p = 0.001) and that their clinical work had been affected by concerns about contracting COVID-19, lack of personal protective equipment, and the impact of the pandemic on mental health (all p < 0.001). Compared to pre-pandemic practices, there was a significant shift to remote consultations in both non-HICs and HICs (p < 0.001). While the frequency of COVID-19 infection was relatively low in these data from early in the pandemic, our findings suggest broader health consequences and an increased psychosocial burden, particularly among HCWs in non-HICs. Planning for future pandemics should prioritize mental healthcare alongside ensuring access to essential epilepsy services and expanding and enhancing access to remote consultations. We asked people with epilepsy about the effects of COVID-19 on their health and healthcare. We wanted to compare responses from people in high-income countries and other countries. We found that people in high-income countries and other countries had similar levels of difficulty in getting help for their epilepsy. People in high-income countries were more likely to say that their general health had been affected. Healthcare workers in non-high-income settings were more likely to have contracted COVID-19 and have the care they deliver affected by the pandemic. Across all settings, COVID-19 associated with a large shift to remote consultations.