Academic Programs Research Articles

Effectiveness of immune checkpoint inhibitors and other treatment modalities in patients with advanced mucosal melanomas: a systematic review and individual patient data meta-analysis

Mucosal melanomas (MM) are an aggressive subtype of melanoma. Given the rarity of this disease, the conduct of clinical trials is challenging and has been limited. Current treatment options have been extrapolated from the more common cutaneous melanoma even though MM is distinct in pathogenesis, etiology and prognosis. This is the first meta-analysis to comprehensively assess the efficacy of immune checkpoint inhibitors (anti-PD1 and anti-CTLA4) and other treatment modalities (targeted therapy such as KIT inhibitors and VEGF inhibitors, as well as radiotherapy) on survival outcomes in MM to develop clinical guidelines for evidence-based management. The protocol was prospectively registered on PROSPERO (PROSPERO ID: CRD42023411195). PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science and Google Scholar were searched from inception until 25 July 2024, for all cohort and observational studies. Eligible studies included those with five or more participants with locally advanced or metastatic MM treated with anti-PD1, anti-CTLA4, VEGF inhibitors and/or KIT inhibitors. Titles and abstracts of potential articles were screened and full texts of all potentially eligible studies were retrieved and reviewed by two independent reviewers. Individual patient data (IPD) from published Kaplan-Meier curves were reconstructed using a graphical reconstruction method and pooled as a one-stage meta-analysis. A sensitivity analysis using a two-stage meta-analysis approach was conducted. Extracted outcomes included overall survival (OS) and progression-free survival (PFS). For each treatment arm, median survival time and 12-month survival proportion were estimated. Data from double-arm trials was pooled to estimate hazard ratios (HRs), ratios of restricted mean time lost (RMTL) and restricted mean survival time (RMST). From a total of 7402 studies, 35 eligible studies comprising a total of 2833 participants were included. Combined anti-PD1 and anti-CTLA4 therapy had the highest 12-month OS and 12-month PFS at 71.8% (95% CI: 67.6%, 76.2%, n=476) and 35.1% (95% CI: 30.5%, 40.4%, n=401) respectively, followed by anti-PD1 therapy alone (OS: 64.0% (95% CI: 61.4%, 66.7%, n=1399); PFS: was 28.3% (95% CI: 25.8%, 31.2%, n=1142), anti-PD1 and VEGF inhibitor combination therapy (OS: 57.1% (95% CI: 51.0%, 63.9%)), KIT inhibitors (OS: 48.2% (95% CI: 37.6%, 61.8%); PFS: 8.3% (95% CI: 3.7%, 18.7%)) and anti-CTLA4 therapy alone (OS: 33.3% (95% CI: 28.4%, 39.1%); PFS: 9.8% (95% CI: 5.9%, 16.5%)). In the double-arm studies, combination therapy with anti-PD1 and anti-CTLA4 had similar OS and PFS with anti-PD1 alone (OS: HR 0.856 (95% CI: 0.704, 1.04); RMTL ratio 0.932 (95% CI: 0.832, 1.044, P=0.225); RMST ratio 1.102 (95% CI: 0.948, 1.281, P=0.204); PFS: HR 0.919 (95% CI: 0.788, 1.07); RMTL ratio 0.936 (95% CI: 0.866, 1.013, P=0.100); RMST ratio 1.21 (95% CI: 0.979, 1.496, P=0.078)), however, anti-PD1 therapy alone had significantly better PFS than anti-CTLA4 alone (HR 0.548 (95% CI: 0.376, 0.799); RMTL ratio 0.715 (95% CI: 0.606, 0.844, P<0.001); RMST ratio 1.659 (95% CI: 1.316, 2.092, P<0.001)). Anti-PD1 therapy with radiotherapy versus anti-PD1 alone showed no significant difference (OS: HR 0.854 (95% CI: 0.567, 1.29); RMTL ratio 0.855 (95% CI: 0.675, 1.083, P=0.193); RMST ratio 1.194 (95% CI: 0.928, 1.536, P=0.168; PFS: HR 0.994 (95% CI: 0.710, 1.39); RMTL ratio 1.006 (95% CI: 0.87, 1.162, P=0.939); RMST ratio 0.984 (95% CI: 0.658, 1.472, P=0.939)). For the systemic treatment of MM, anti-PD1 is the best monotherapy. While combining anti-PD1 with other treatment options such as anti-CTLA4, VEGF inhibitors or radiotherapy might achieve better outcomes, these improvements did not reach statistical significance when evaluated by HR, RMTL and RMST ratios. This work was supported by theNational Medical Research CouncilTransition Award (TA20nov-0020),SingHealthDuke-NUSOncology Academic Clinical Programme (08/FY2020/EX/67-A143 and 08/FY2021/EX/17-A47), the Khoo Pilot Collaborative Award (Duke-NUS-KP(Coll)/2022/0020A), theNational Medical Research CouncilClinician Scientist-Individual Research Grant-New Investigator Grant (CNIGnov-0025), the Terry Fox Grant (I1056) and the Khoo Bridge Funding Award (Duke-NUS-KBrFA/2024/0083I).

Sport students’ experiences of teaching and learning in the United Kingdom: A comparison between further and higher education settings

Few studies have investigated teaching and learning experiences of university sports students which is surprising considering the high annual numbers recruited to sport degree programmes and consequent non-completion rates. This study compared teaching and learning experiences of 350 first-year sport students at a post-92 English University with how they were taught at their further education institutions. Key findings showed the teaching and learning methods at university were less structured and tutor-led but with more teaching staff involved. Practical implications for developing rich modes of university provision that best support the needs and expectations of newly arrived sports students are provided.

Impact of the Usage of Cell Phones and Social Media Among the Rural College Girl Students

The main problems of the study deal with prevalent in Government Colleges, every year 25% of college girls drop out of their higher education, and 10% of the girls are coerced into marriage by parents and continuing education. The study was conducted at the Government Arts and Science College for Women, Alangulam of Tenkasi District. It was purely an empirical study. This College offers 5 Degree Courses in Arts and Science, comprising 896 girls. One-eighth of the samples were taken for the present study. The main objectives of the study include studying how many hours cell phones are spent per day by female students on social media. ii, to examine whether it has been used for either academic purpose or personal purpose. iii.To provide effective supportive mechanisms to solve socialmedia addiction. The present study covers 100 college girlsstudents in art science. 80% of students have said that daily onehour using 2GP (Rs.250/- per month) for online courses incollege and more than one and a half hours using houses forpersonal uses. 60% of the of girl's students have reported thatapart from studying, they cell phones for chatting with friends,WhatsApp status, and reels. 25% of the girls students haveescaped from college education and eloped with lovers throughcell phone chatting.15% of the cell phones were snatched byparents and stopped their education.

The integration of Artificial Intelligence (AI) into undergraduate education

The incorporation of AI as a tool in educating undergraduates is a promising concept held with a great potential of positively influencing the learning process, learners’ experiences and institutional management systems. At the same time, it lifts essential moral issues that ought to be adequately addressed into new stages. The aim of this paper is to review literature on the subject of ethics in the application of AI in the context of an undergraduate degree program. Algorithmic choices for instructional design are another relevant ethical concern along with privacy and data protection, practitioners’ responsibilities, and the requisite levels of transparency, as well as the depersonalized and mechanized nature of learning management systems. The analysis reveals how the use of AI technology might deepen the social and economic inequities the students have described and how difficult it is to keep the students’ trust in cases when AI technology is not transparent. Also, the paper raises concerns related to several ethical issues and their consequences to students, teachers, and institutions on how strong ethical principles and policies to apply AI in the educational sectors. It is established that the use of AI in the delivery of undergraduate education has the potential of enhancing the effectiveness of learning(). Nonetheless, it is recommended that the integration of AI in the classroom must be done with reference to several ethical concerns so as to prevent further negative ramifications of the technology.

Multivariate analysis of academic and sport performance among Indonesian university student-athletes

Research on student-athletes' academic performance reveals a complex interplay of factors. Interestingly, few studies have investigated the achievement of student-athletes in both academics and athletics, the two areas in which they are usually evaluated. In this study, we investigated the association between factors that may affect student athlete academic performance with their sports achievement. In this study, 166 students from 20 sport faculties universities within faculty of sports who had at least a provincial sports accomplishment were involved. The factors that were strongly connected with student-athletes' academic achievement were analyzed using a logistic regression analysis. According to this study, there is a considerable correlation between the academic achievement of student athletes, their gender and internet access. It has been found that academic achievement is strongly influenced by students' proficiency in establishing an internet connection significantly impacts their academic performance. In addition, gender makes a major contribution to the prediction of academic grades in student athletes in Indonesia. Athletes may be eligible for specialized academic programs that are intended to help them continue to improve in both their academic and athletic endeavors. As a result, Indonesian universities mandate the establishment of a mentorship center development organization to assist student-athletes. Curriculum modifications may also be implemented in response to the time allotted to students for academic and sports performance.

Race/Ethnicity, Education, and All-Cause Mortality in US Adults: Mediation by Telomere Length

Abstract Background Racial/ethnic inequities in mortality risk are pervasive in the United States even after controlling for socioeconomic status indicators such as educational attainment. Although the mechanisms underlying these inequities remain unclear, telomere length (TL) has emerged as a potential mediator. We aimed to investigate the joint association of race/ethnicity and education with all-cause mortality risk, and the contribution of TL to this relationship. Methods We used data from the U.S. National Health and Nutrition Examination Survey, 1999 to 2002, and 2019 Linked Mortality File (n = 6,526 non-institutionalized adults aged 25 years or older, including 2,166 deaths), a retrospective cohort study with a follow-up period to December 31, 2019. Cox proportional hazards regression and causal mediation analysis were used to address these aims. We reported hazard ratios (HR) and 95 % confidence intervals (CI). Furthermore, for the mediation analysis, we reported the total, direct, and indirect effects measured as HR and 95 % CI. Results After adjusting for age and sex, among White individuals, those with less than a high school education had a 2.26 times higher (95% CI: 1.93, 2.65) rate of all-cause mortality compared to those with some college or higher education. When compared with White adults with at least a college degree, Black adults with at least a college degree had a 1.38 higher rate of dying (95% CI: 1.04, 1.84). There was no significant joint association of race/ethnicity and education on all-cause mortality in Mexican Americans. In the mediation analysis, TL did not significantly contribute to the joint association of race/ethnicity and education with all-cause mortality risk. Discussion These findings underscore the need for a better understanding of the joint relationship of race/ethnicity and education on mortality risk inequities and their potential mechanisms to improve population health ultimately. Key messages • Lower educational attainment was associated with higher mortality rates among White individuals, disparities persisted among the Black population, despite higher education levels. • Our analysis did not find a significant mediation effect of telomere length on the joint effect of race/ethnicity and education-mortality relationship.

Pitfalls in the assessment of higher education learning gains in Brazil through multilevel regression: handling the ceiling effect.

This work assesses the validity of the Brazilian Indicator of the Difference between Observed and Expected Performances (IDD), which applies a multilevel regression model to rank university courses. It proposes a methodology to test for inconsistencies and research for the causes. With this objective, we develop an experimental methodology, applied to a database with 4,432 production engineering students distributed over 329 undergraduate courses, from the government’s National Institute for Educational Studies and Research. We display a graphical analysis of the expected and achieved grades in final graduation exams, the gap in which determines the learning gains for every course. Then we apply the multilevel linear regression model of the IDD in a particular scenario, to test for consistency in value-added learning measurements using the technique reductio ad absurdum. The result reveals that the present methodology for the calculation of the IDD is inadequate and inconsistent, and that this can be explained by the ceiling effect. It needs to be radically revised to prevent unfair judgements. Finally, we propose and implement a production frontier technique to correct for the ensuing ceiling effect, namely a variable returns to scale data envelopment analysis model for adjusting the measurements using evidence based benchmarks.

How much digital public health is taught in German public health programs? A qualitative analysis

Abstract Background Digital public health (DiPH) professionals are crucial for a successful digital transformation in social and health care. However, the extent to which academic professionals are taught DiPH-related content in their public health studies in Germany remains unclear. Methods We used a systematic module handbook analysis to assess accredited full-time public health-oriented degree programs at German Universities for DiPH-related modules. Programs were identified through the Hochschulkompass platform and among the German Public Health Association member programs. We used MAXQDA for the content analysis of the included module handbooks. Results We identified 79 public health programs. Of these, 10 Bachelor’s and 6 Master’s offered at least one DiPH module, all being highly heterogeneous in their overall addressed public health subfields. Regarding DiPH, 6 programs lectured on the ethics of digitalizing health and data protection, 5 programs each offered modules on DiPH in health policy, on data science in healthcare and software used for eHealth, or on the digital determinants of health. 4 programs each included modules on digital health promotion and alternative evaluation methods. 3 programs each addressed digital science communication and health technology assessment. Finally, 2 programs had modules on digital epidemiology. We found differences between the common understanding of DiPH in academia and the content in the module handbooks. The content identified in the analysis focused mainly on technical areas. Social and health science content was only marginally present. Conclusions The diverse DiPH study programs allow academic public health specialists in Germany to develop specific profiles. There is a need for further development of modules with relevance to the respective degree program to achieve comprehensive competencies in DiPH. We encourage the uptake of our analysis to develop a core curriculum in DiPH among European public health programs. Key messages • Digitalization affects all areas of life, including healthcare systems and public health. Preparing the future workforce already during their training is crucial to enable them to lead the change. • German public health programs are not fit to prepare students for their professions. Developing DiPH curricula with pre-defined and updated competencies will strengthen programs in Germany and beyond.

Ready to act? Factors associated with nurses’ desire to work in Primary Health Care in Italy

Abstract Background The rapid increase in demand for primary healthcare (PHC) services after the pandemic requires reconsidering nursing staff planning and availability. The objectives of the study were to i) identify knowledge, attitudes, practices and work expectations of future nurses in primary care; ii) estimate the prevalence of nursing students who desire to be employed in PHC and Family and Community Health Nursing (FCHN) services after graduation. Methods A cross-sectional study is being conducted on a sample of nursing students enrolled in universities in the Lazio Region. A structured instrument was built based on the literature and national regulations and validated (Cronbach’s alpha=0.81). Results In this first phase, 163 nursing students were enrolled. The majority of the sample was female (N = 125, 76.7%), with a mean age of 22 (SD ± 5) years and were enrolled in the last year of degree program (N = 85, 52.1%). A total of 49 students (30%) reported adequate knowledge of PHC service reorganization policies and nursing practice in this setting. While 74% (N = 122) of the sample intended to undertake a PHC curricular internship during their degree program, only seven students (4%) participated in one. 52 individuals (30%) expressed their intention to be employed in PHCs after graduation, and 29 (17.8%) indicated their desire to work as FCHN practitioners. The main factors contributing to the undesirability of employment in PHC reported by students were: i) preferring the hospital settings (N = 53, 48%); ii) not having adequate skills to be employed in the PHC (N = 21, 19%); and iii) believing that the PHC does not offer attractive services for nursing practice (N = 14, 13%). Conclusions A multivariable analysis will be conducted to identify predictors of nursing students’ desire to work in PHCs after graduation. Preliminary results of the study showed that only one-third of nursing students indicated a desire to work in PHCs. Key messages • Only one-third of nursing students express a desire to work in PHC and in Family and Community Health Nursing (FCHN) services post-graduation. • Collaboration between the PHC workforce, academics, stakeholders, and policymakers is needed to create tailored initiatives that increase the attractiveness of PHC.

Sociodemographic disparities in depression and anxiety symptom severity among young adults in Sweden

Abstract Background Young adults are disproportionately affected by mental health problems such as depression and anxiety. While previous studies have identified sociodemographic predictors using the four-item Patient Health Questionnaire (PHQ-4), differences in symptom severity remain less explored. This study aimed to evaluate the sociodemographic predictors of different levels of depression and anxiety symptoms among young adults in Sweden. Methods Survey data from a population-based sample of Swedish adults aged 20-21 (n = 3,226) was used. Symptom severity was categorized into three levels: normal/mild, moderate, and severe, based on established cutoff scores on the PHQ-4. Gender, parental education and birth country, and upper secondary education were assessed through linked registry information. Multinomial logistic regression was used. Results Females had a higher risk of moderate (RR = 1.8, 95% CI 1.5, 2.2) and severe (RR = 2.3, 95% CI 1.8, 3.1) symptoms (compared to no or mild symptoms) relative to males. Among males, the risk of moderate symptoms was higher without a secondary degree (RR = 1.9, 95% CI 1.0, 3.4) compared to an academic degree. Males with parents born abroad faced elevated risks of moderate (RR = 1.9, 95% CI 1.3, 2.9) and severe (RR = 2.2, 95% CI 1.3, 3.7) symptoms relative to males with Swedish-born parents. Among females, parental tertiary education was associated with a lower risk of moderate symptoms (RR = 0.7, 95% CI 0.5, 0.9) compared to lower education. Further, females having a vocational (RR = 1.5, 95% CI 1.1, 2.1) or no secondary degree (RR = 3.6, 95% CI 2.1, 6.1) had an increased risk of severe symptoms compared to females with an academic degree. Conclusions This study identified sociodemographic predictors for moderate and severe symptoms of depression and anxiety among young men and women in Sweden. Mental health promotion and prevention should specifically target young adults at elevated risk of experiencing moderate to severe symptoms. Key messages • Understanding sociodemographic predictors of depression and anxiety symptoms in young adulthood is essential for public health work. • Mental health promotion and prevention needs to include appropriate interventions for young men and women from diverse socioeconomic and cultural backgrounds.

Assessment of the level of health literacy in students with specific learning disorders

Abstract Background Specific Learning Disorders (SLDs) include dyslexia, dysorthography, dysgraphia, and dyscalculia and are referred to as specific educational learning disabilities. For students with SLDs, the issue of health literacy (HL) arises because understanding, evaluating and utilising health information are critical to making informed decisions about one’s health. This study aims to determine the level of HL in students with a certified SLD. Methods From November 2023 to April 2024, students with an SLD studying at the University of Udine (Italy) who agreed to participate, were surveyed using an online questionnaire on the EUSurvey platform. This consisted of the HLS-EU-Q47 to measure HL, followed by a socio-demographic section. The HLS-EU-Q47 classified HL into 4 levels: inadequate, problematic, sufficient and excellent; descriptive analysis was performed and the correlation with the sociodemographic data was examined using χ² test. Results 38 students participated (mean age 24 years, 60.5% female), 60% of whom are in an undergraduate degree program. 42% of the sample had a single SLD (26% dyslexia, 13% dysgraphia), while 58% of them have multiple SLDs. Overall, 42% of students were found to have a problematic HL level, 24% inadequate, only 24% sufficient and 11% excellent. No statistically significant association was found between) HL level and gender, number of SLDs, school attended at the time of SLD certification, and use of supports (all p-values&amp;gt;0.05). Conclusions The level of HL in students with SLDs appears to be consistent with data from the Italian population (58% inadequate or problematic) from the 2019-HLS19 Health Literacy Survey. This suggests that the presence of an SLD does not affect the level of HL and that it is likely that the university degree is able compensate for HL difficulties that could be related to the presence of an SLD. A larger sample is needed to see if it is confirmed that there is no association between the investigated variables. Key messages • Despite the presence of SLDs, the HL of academic students follows the same trend compared to the general Italian population. • The structural use of supportive measures by these students probably bridges the gap in access to and correct use of health information.

"I don't want hear about that": Treatment wishes/preferences of elderly patients regarding possible treatment goals in acute life-threatening illness or acute organ failure

Abstract Background In many people with acutely life-threatening illnesses, the will to undergo treatment is not known with sufficient precision. It is often unclear whether the person concerned would have consented to life-sustaining measures or would have preferred to die with palliative care. This applies in particular to the vulnerable group of elderly, chronically ill/fragile people. It is not uncommon for people to reject the risks/burdens of medical treatment, even if there is a chance of success. On the other hand, there are many people who fight to continue living, even if this can be associated with great burdens and the outcome is rather uncertain. Aim of the study is to determine the characteristics of cardiologic patients who refuse to discuss treatment wishes/preferences in case of acute emergencies, temporary (e.g. in the context of intensive care unit (ICU) treatment), or permanent (vegetative state) inability to consent. Methods Prospective, questionnaire-based cross-sectional study including Hospital Anxiety and Depression Scale (HADS) and assessment of quality of life using the 12-item Short Form Health Survey (SF-12) on normal cardiology wards. Results 455 cardiologic patients were interviewed (mean age 71.2 ± 12.9 years, 39.6% female), 76.1% had moderate-severe concomitant diseases according to the Carlsson Comorbidity Index (4.3 ± 2.4 points) (see Table I). 23.5 % of respondents did not wish to address the above-mentioned question, they were significantly older (74.6 ± 13.1 vs. 69.9 ± 12.8 years; p=0.0009), had more comorbidities, were less likely to have a high level of education (university degree: 13.0 % vs. 30.6 %; p=0.0021) and were less likely to be employed (11.7 % vs. 25.8 %; p=0.0026). Furthermore, these patients live alone more frequently (45.8% vs. 30.6%; p=0.0048) and are less likely to live in a partnership (52.0% vs. 68.0%; p=0.0043). Refusal of an advance directive was also more common (22.5% vs. 10.7%; p=0.05), quality of life was impaired (42.4 ± 9.8 vs. 45.9 ± 10.5 points; p=0.0022), and the HADS-score levels were higher (15.6 ± 7.3 vs. 12.7 ± 7.8 points; p=0.0007). Conclusions A relevant proportion of our patients refuse to discuss treatment wishes/preferences in case of acute emergencies, temporary or permanent inability to consent. Paradoxically, these were patients for whom it would make particular sense (older, sicker, and more socially isolated patients). Those patients are also prone to anxiety and depression, and have a reduced quality of life.

Knowledge and attitudes of the Italian population on sharing health data: a cross-sectional study

Abstract Background Healthcare digitization enhances data accessibility but faces data management and privacy challenges. The study sought to explore the Italian public’s understanding and views on storing and sharing health data for treatment and research purposes, as well as factors influencing their attitudes toward health data management and sharing. Methods A cross-sectional questionnaire assessed socio-demographic information, knowledge about health data sharing, and attitudes toward sharing data for treatment and scientific purposes. Descriptive analyses and multivariable logistic regressions were performed to examine the associations between sociodemographic factors and knowledge/attitudes about data storage and sharing. Results A total of 1,389 citizens participated. Most respondents (65.4%) thought that healthcare providers could access personal health data nationwide, while 94% expressed willingness to share personal health data nationwide. A high percentage of respondents (73%) fully agreed that storing and sharing personal health-related data could improve research and quality of care. Males and younger individuals (&amp;lt;41 years) were likelier to have higher data-sharing knowledge (adjusted Odds Ratio [adjOR] 1.50, 95% Confidence Interval (CI) 1.03 - 2.18, and adjOR 1.99, 95% CI 1.29 - 3.08 respectively). Lower educational-level respondents exhibited lower positive attitudes towards sharing health data for treatment and research purposes (adjOR 0.18, 95% CI 0.05-0.58 for high school, and adjOR 0.11, 95% CI 0.03-0.41 for middle school or lower, compared to those with a university degree). Conclusions The findings offer valuable perspectives for European policymakers, healthcare practitioners, and researchers who aim to enhance data handling, foster cooperation, and maximize the benefits of health data for tailored care and scientific progress. Key messages • Italian citizens show strong willingness to share health data nationwide for treatment and research, suggesting a favorable environment for collaborative healthcare initiatives. • Sociodemographic factors such as age and education level influence attitudes towards health data sharing, stressing interventions to ensure equitable access and participation in data-driven healthcare.

Honors Track in Global and Occupational Health: a students’ perspective from Humanitas University

Abstract Background To meet an increasing interest in global health, more opportunities for medical students should be created. Humanitas University (Milan, Italy) has debuted a new extracurricular activity called “Honors Track in Global and Occupational Health” (HT-GOH), to allow students critical insights into the field at the beginning of their career. Objectives HT-GOH is a two-year programme, led by expert professors in the field. The main aim is to circumvent limitations of global health education at individual institutions, achieved through a combined presence and online approach that allows for international collaboration with experts and attendance of online lectures and travel abroad for practical experiences. Complemented by monthly meetings, participation to workshops, seminars, conferences, and the discussion and literature review of crucial global health topics. Results The six participating students are actively promoting discussions, exchange of ideas, and literature findings on many global health issues. They audited courses in other universities and are building connections within the field. The active involvement of the students and their increasing interest in the global health debate can be seen by their participation in this abstract and the conference. The effectiveness of the programme is being evaluated through monthly feedback by students. Conclusions The programme allows for an initiation to research work, promoting collaboration between students and exploration of a variety of topics under the guidance of experts. The nature of a specific programme allows for a more individualized approach and greater development of skills unique to each student. This HT represent a valid approach to global health education, especially in settings in which this field is only taught in the context of a public health course. Key messages • A new programme at Humanitas University offering an innovative approach to the field of global health to interested students. • The students’ perspective towards an integrated approach to global health in medical schools.

Teaching the Professional Dimension of Translation in Academic Translation Programmes

Reform policies in higher education have brought about changes in attitudes regarding the education of translators. One of the latest challenges concerns the concept of professionalization of translation and the need for a type of training that would provide students with the specific skills required for the translator’s profession. Indeed, most translation programmes today aim at educating highly qualified translators on a competence-based training. Μore particularly, the emphasis is on metacognitive competence acquisition and the reflexive capacity development taking into account students’ motivation and expectations, their general background knowledge as well as individual learning styles. The present paper proposes a didactic approach on a professionally-oriented basis that would help students enter most effectively the translation industry by realizing at the same time the importance of acquiring a strong theoretical background on translation. Among the main issues to be addressed are the contribution of translation theory to the practice of translation, the role of the translator as cultural mediator, his social responsibilities as well as the translator’s psychological traits and their effect on translation quality. Finally, it proposes a variety of learning activities that are closely related to the act of translating together with a number of student assessment methods bearing a strong professional orientation.

1.X.1. Achieving universal health coverage: international lessons from Irish policy implementation

Abstract Health systems all over the world are struggling to meet population health needs and provide timely access to universal healthcare in the context of the COVID-19 pandemic. COVID-19 occurred in Ireland in the early years of implementation of a national plan for universal healthcare, called Sláintecare. While many health systems are experiencing a retrenchment on universalism in the context of COVID-19, in Ireland despite tediously slow Sláintecare implementation, the pandemic provided a boost to reform implementation and universalism. The reason for this workshop is to draw on a publicly funded Health Research Board Applied Partnership Award, entitled ‘Foundations’, harnessing lessons from the Irish COVID-19 health system response to inform Sláintecare’s implementation https://hrbopenresearch.org/articles/3-70/v1 The objectives of the workshop are to 1) provide academic research evidence from the Irish experience of universal health system reform during and since COVID-19; 2) to give participants space to reflect on the implications of the Irish universal health system reform on international health systems and policy; 3) to actively involve workshop participants in an engaged discussion on implementing universal health coverage in the context of COVID-19. The added value of the workshop is to share learnings from an academic research programme, which is coproducing evidence in partnership with the Irish health system, in a worldwide context, providing relevant and thought-provoking discussion and analysis for an international audience. Four separate inter-related presentations will draw on aspects of the Foundations’ research project. Presentation 1, Prof Sara Burke will outline recent academic literature on universalism and the politics of reform implementation in the context of COVID-19 and present a timeline of universal healthcare reform implementation since 2018 when Sláintecare was adopted by the Irish government (14 mins). Presentation 2, Dr Sarah Parker will detail a specific study which set out to advance understanding of how and to what extent COVID-19 has highlighted opportunities for change that enabled better access to universal, integrated care in Ireland, with a view to informing universal health system reform and implementation (10 mins). Presentation 3, Dr Katharine Schulmann and Carlos Bruen will present findings on the governance of reform implementation and implications for all health systems (10 mins). Presentation 4, Dr Philip Crowley, Health Service Executive (HSE) National Director of Strategy and Research and Chair of the Foundations’ research steering group will reflect how research findings can inform implementing reform and their implications for all health systems (6 mins). There will be four presentations totalling 40 mins, followed by questions and discussion chaired by an international expert/academic on universal health systems. Key messages • COVID-10 has highlighted how universal health coverage is more important than ever, however the pandemic has resulted in some retrenchment on universalism. • While data and research drove health system decision making during the pandemic, embedding research evidence into health system and policy reform remains challenging and can be politically opposed.

Malnutrition in infants aged 6-23 months in China's poorest rural counties from 2016 to 2021: cross sectional study.

To assess trends and differences in child malnutrition by population subgroups among infants aged 6-23 months in China's poorest rural counties. Six consecutive cross sectional surveys were conducted annually. The study was conducted in 116 counties in 19 provinces from 2016 to 2021, representing China's 832 poorest counties. A total of 210 088 participants were selected through a multistage cluster sampling procedure; all participants were infants aged 6-23 months. Prevalence of anaemia, stunting, wasting, overweight, and growth status in children (measured by length-for-age and weight-for-length z scores). Four main malnutrition forms were prevalent in 2016: anaemia (prevalence 18.3%), stunting (7.5%), wasting (4.7%), and overweight (3.1%). The prevalence of any two coexisting malnutrition forms was low. All four forms of malnutrition decreased from 2016 to 2021. Anaemia decreased by more than half, with an annual reduction rate of 9.11% (95% confidence interval (CI) 4.83% to 13.20%). Stunting was reduced by over a third, with an annual reduction rate of 10.44% (7.56% to 13.22%), which is faster than the World Health Organization's target of 3.9%. Differences in child growth by county gross domestic product quarters were small and decreased over time, but growth differences related to education persisted. Infants whose mothers completed education up to primary school level had approximately twice the risk of stunting (adjusted rate ratio 2.29 (95% CI 1.87 to 2.81)) and wasting (1.73 (1.40 to 2.13)) compared with children whose mothers had an education level of a college degree or above. Boys had poorer growth and higher anaemia than did girls. For all outcomes, differences related to sex and education were greatest at 6 months of age. Education related inequalities in growth of infants persists, with these differences particularly affecting children whose mothers completed education only up to primary school level.

Assessing Academic Perspectives on Infodemic Management and Health Security: A Needs-Based Approach

Abstract Background The information environment significantly impacts public health decisions, behaviors, and health security. Misinformation and disinformation can compromise health interventions and undermine public trust, and this phenomenon, known as the infodemic, is increasingly challenging to address and requires innovation and transformation of public health and education of the health workforce. This study aimed to assess the relevance of infodemic management (IM) to different academic fields and training needs to create a competent workforce. Methods As part of the US Federal Assistance Award within the University Partnership Program between Emory University and the University of Belgrade, a mixed-methods study was conducted to evaluate the curricula of all 31 faculties at the University of Belgrade. An online survey was distributed to faculty deans to assess the current educational framework and opinions on IM in various academic fields. This approach provided a multidimensional view of how IM is perceived and integrated across diverse disciplines. Results The survey received 33 responses from different departments at the University of Belgrade. Over 75% of participants identified misinformation as prevalent in their respective fields. More than half of the respondents believe that students are not sufficiently familiar with the concept of the infodemic and its potential consequences, only 9% believe these topics are well covered in the current curriculum, and over 90% agree that additional content on IM is required to update study programs, indicating a gap in our current educational approach. Conclusions Academic circles have acknowledged the issue of misinformation and its negative impact on public health. Current gaps in academic curricula indicate the critical necessity of integrating IM into educational programs. This innovative approach will provide future specialists with the necessary skills to navigate the complexities of the modern information ecosystem. Key messages • Over 75% of surveyed professors identify misinformation and disinformation as prevalent in their professional fields, indicating a widespread impact. • Over half of professors feel academic programs do not sufficiently equip students to navigate the information ecosystem, with over 90% calling for additional infodemiology content.

Creating a safe space: medical students’ perspectives on using actor simulations for learning communication skills

BackgroundCommunication skills are an essential part of clinical competence that need to be acquired during health professions education. Simulations are extensively used for learning communication skills and have long been integral to medical degree programmes. In this research we use qualitative methodology to explore fourth-year medical students’ experiences in simulations aimed at improving versatile doctor-patient communication, focusing on their learning with trained actors.MethodsThe data comprises reflective writings from 208 fourth-year medical students, gathered after a communication skills course. These students provided informed consent for their writings to be included in the research. We performed an inductive qualitative content analysis on the textual data, with findings presented as themes, supported by categories, codes, and excerpts from raw data to enhance the trustworthiness of the analysis.ResultsWe identified eight key themes capturing students’ learning experiences through simulations: practising in a safe learning environment, valuing feedback, gaining new perspectives, finding simulations valuable and enjoyable, boosting confidence and self-knowledge, and viewing simulations as authentic and engaging learning opportunities. Some students offered critical perspectives on simulations. Throughout the course, students learned diverse aspects of patient care, emotional and behavioural communication dynamics, and lessons from medical errors. Some students offered critical perspectives on simulations, and a few indicated they did not learn anything new.ConclusionsA safe learning environment is vital for encouraging learners to explore, make errors, and absorb feedback to improve their communication with patients. Students predominantly valued the communication skills training with actors and the constructive feedback received and given in the debriefing discussions. However, some students expressed critical views toward simulations. Simulations are not static; they evolve and require continual improvements. Hence, we advocate for the ongoing exploration and enhancement of communication skills learning methods, including simulations, with careful consideration for students’ vulnerability and the importance of psychological safety. Additionally, it is critical to address students’ perceptions that certain clinical teachers prioritise biomedical knowledge over communication skills. Providing tailored training for teachers regarding the learning methods and the desired outcomes of communication courses is essential.

Patients’ trust in health information sources as an antecedent of novel healthcare technology usage

Abstract Background As professional health information sources, healthcare maintenance organizations (HMOs) need to convince patients of the necessity, efficiency, and reliability of technology-based services to increase and optimize their usage. It raises the question of whether patients’ trust in health information sources shapes the use of technology-based services and, in return, increases their willingness to use novel healthcare services in the future. Methods Data were collected through an online close-ended survey among 668 adult Israeli citizens insured with Israeli health insurance (85% of them Jewish, 52.5% female, and in their early 40s, with half holding an academic degree). The survey explored actual use and willingness to use innovative healthcare technologies and the trust respondents attributed to various sources of health information. Data were analyzed by SPSS 28. Results Participants generally use healthcare technology primarily to schedule appointments, search for medical information, and make health-related requests. To quite an extent, they are willing to be treated with innovative healthcare technologies (e.g., for radiological purposes and personally tailored medication). Preliminary results suggest that trust in the measured formal health information sources (i.e., formal health providers, HMO, HMO online services) was positively associated with technology-based healthcare services usage (r=.14 - .20, p&amp;lt;.001). A positive association also emerged between the current use of healthcare technology and the willingness to use innovative medical technologies in the future (r=.23, p&amp;lt;.001). Conclusions HMOs, as key players, have the power to maximize the usage of advanced health services by establishing trusting relationships with their patients. This will increase the usage of healthcare technology-based services and generate positive patient experiences, which will result in the willingness to experience novel types of health services in the future. Key messages • Encouraging patients to use technology-based health services will maximize the potential inherent in the use of innovative health services and treatments in the future. • Nurturing trusting relationships with patients at any level in the health system will increase their compliance with health providers’ recommendations to use advanced health services.