Educational Deficits Research Articles

A Review on Knowledge of Diabetes, Medication Adherence, and Factors associated with Non- adherence among Diabetes Mellitus Type 2 Patients

Background: This review paper addresses the critical issue of medication adherence among patients with Type 2 Diabetes Mellitus (T2DM). This review paper aims to evaluates the current literature on prevalence of medication adherence among patients with Type 2 Diabetes Mellitus, assesses the level of knowledge regarding diabetes mellitus and its association with medication adherence. In addition, to identify and analyse the factors contributing to non-adherence to medication among individuals with Type 2 Diabetes Mellitus. Methods: The authors conducted a thorough literature review using databases such as ProQuest, PubMed, ScienceDirect, and Google Scholar. They focused on peer-reviewed articles published between 2019 and 2024, employing keywords related to medication adherence, knowledge, and sociodemographic factors. A total 25 studies selected for inclusion, utilizing various methodologies including quantitative, qualitative, and interventional approaches. Results: The findings revealed significant variability in medication adherence rates among T2DM patients, ranging from 35.8% to 67.5%. Key factors influencing adherence included sociodemographic characteristics such as age, gender, ethnicity, education level, and economic status. Higher levels of diabetes knowledge were associated with better adherence, although the relationship was not universally significant, indicating that other factors also play a role. Conclusion: The review concludes that enhancing medication adherence among T2DM patients requires targeted interventions that address identified barriers, including educational deficits and socioeconomic challenges. Further research is recommended to develop effective educational strategies tailored to diverse patient populations, ultimately aiming to improve health outcomes and adherence rates in this critical area of public health.

Youth Unemployment in Bhutan: A Meta- Analysis of the Lessons and Perspectives

Unemployment is an economic issue worldwide. Bhutan is no exception; particularly during and after the Covid-19 pandemic the unemployment figures, particularly, youth unemployment rates in Bhutan were surprising. Despite efforts, the issue still looks elusive and wavering with no major reduction in national unemployment figures. To this end, a comprehension of the underlying issue, the nature of the Bhutanese labour market and an understanding contributing factors are essential. In addition, evaluating the government plans and policies is key. Thus, this study has attempted to analyse the data over the past 10 years, of relevant sources such as labour force surveys, policy documents of the Royal Government of Bhutan, and other related studies. The findings are presented as tables, graphs and descriptive statistics and discussed and concluded accordingly. The study identifies three critical elements referred to as the ‘employment triangle’ that significantly influence labour market dynamics in Bhutan. Moreover, they are demographic transformation, work attitudes and educational deficits. Precisely, youth unemployment in Bhutan is influenced by factors, such as demographic transformation (job security, employee protection, absence of employment-rich economy), work attitude (conventional job choice and preference patterns, negative role of society) and educational deficit (skills mismatch, inadequate national HRD planning and support, lack of skills development or school to work transition initiatives).

Radiation Therapist Education and Training: An International Survey.

This study reports on the current status of Radiation Therapist (RTT) education and training globally. RTTs are the health professionals responsible for the preparation and delivery of courses of radiation therapy, the latter being indicated in the management of 50%-60% of patients with cancer globally. Therefore, high standards of education of these professionals are paramount to safe and high-quality cancer care. In total, 195 responses were received to a survey sent via the International Atomic Energy Agency International Research Integration System to all member states. This represented 90 countries across all regions. The survey indicated a significant deficit in RTT education globally. Many regions report that limited radiation therapy-specific education is available and there is a paucity of assessed practice education. Radiation therapy-specific professional issues are the major barriers to curricula implementation globally. This survey highlights the considerable issues that prevail in the provision of high-quality education for RTTs globally. A collaborative global effort is required by the oncology community and other stakeholders to overcome this significant deficit.

Mental Health in Education for Crisis-affected Preschool Children: Multilevel Monitoring

Introduction: The crisis in Ukraine, related to military actions, poses a significant threat to the mental health of preschool children due to their vulnerability, limited self-awareness, and perception of their surroundings, as well as the critical developmental phase characterized by the establishment of foundational personality structures. Chronic stress and trauma can disrupt normal brain development, potentially leading to delays in cognitive and emotional development in the long term. Therefore, it is essential to systematically identify and analyze the negative factors affecting the mental development of preschool children across key domains, contributing to educational deficits and developmental gaps, and to design targeted interventions to solve those emerging issues. Purpose: The study is focused on the development and implementation of strategies for supporting, preserving, and enhancing the mental well-being of preschool children residing in areas proximate to armed conflict. The research underscores the importance of early and systematic monitoring across various levels (including children, families, educators, professional associations, and early childhood education institutions, including those with alternative forms of preschool education designed to accommodate crisis conditions). Methodology: Multilevel monitoring has encompassed 3,843 children situated in conditions detrimental to their mental health and development across seven frontline regions of Ukraine (Dnipropetrovsk, Donetsk, Zaporizhzhia, Mykolaiv, Odesa, Sumy, Kharkiv). This initiative is a part of a project by "All-Ukrainian Public Organization 'Association of Early Childhood Education Professionals'", with informational support from the Ministry of Education and Science of Ukraine and is being implemented in collaboration with the United Nations (UNICEF) project "Improving Access to Early Childhood Education Services in Emergencies and Early Recovery in Ukraine." Level 1 - initial, intermediate, and summative monitoring involved establishing the baseline developmental level of senior preschool children and identifying gaps across key areas, with subsequent measurement of progress and its correlation with interventions aimed at supporting and maintaining children’s mental health. Measurement of indicators was expressed through their manifestation at the minimum and maximum points for each child, with the establishment of an average score (average score = sum of all individual scores divided by the number of children). The average score reflects the overall performance between the lowest and highest indicators across children, educators, regions, and nationally. This analysis was conducted using a web-based spreadsheet program, Google Sheets, which is part of the Google Drive office suite." Level 2 - organizational and methodological monitoring focused on evaluating the methodological and organizational aspects of the educational process as fundamental factors in preventing negative impacts on children’s mental health. This was conducted using an electronic form developed in Google Forms, utilizing the Google Sheets web-based spreadsheet program, which is part of the Google Drive office suite. Level 3 - monitoring the quality of the educational process in early childhood education institutions using the ECERS-3 methodology, which allows for the analysis of comfort levels, developmental conditions, safety, and support for the mental health of preschool children. This involves an electronic Google Form equivalent to the paper-based ECERS-3 assessment; automatic calculations are performed according to the formulas specified by the international ECERS-3 methodology (Harms et al., 2020). Results: The study of the development of senior preschool children, based on the analysis of key domains through regular psychological and pedagogical observations and the use of diagnostic tools over a period of five months, enabled the identification of early signs of stress, anxiety, and other emotional manifestations. This assessment facilitated the evaluation of children's mental health and the development of a system of effective interventions to address the identified issues. Conclusion: The study underscores the importance of identifying personal characteristics of senior preschool children and developmental gaps across key domains to organize interventions and support measures aimed at preserving mental health, ensuring comprehensive development, and mitigating negative factors in crisis conditions. The results of the multilevel monitoring are valuable for updating educational practices and adapting them to crisis situations. Addressing the identified educational losses and gaps, including those related to social-emotional development and stress resilience, allows for the development of structured programs to counteract negative impacts and facilitate the recovery of preschool children

Never-Ending Chain of Crime: Defining the Vicious Cycle from Parental Incarceration on Children in Liangshan

Liangshan Yi Autonomous Prefecture is located between latitude 26°03′–29°18′ N and longitude 100°03′–103°52′ in Sichuan, China. It is a region entangled by deep-rooted poverty, elevated crime rates, and educational deficit. This environment has precipitated a severe dilemma wherein a substantial number of Liangshan’s children are at risk of being left behind. Sichuan’s Provincial People’s Court reported that from 2012 to 2016, Sichuan holds a drug-related crime of 29,747 cases, ranked fourth nationally (Chuguang). This critical factor of parental incarceration, predominantly due to drug trafficking offenses, exacerbated the issue of children being left behind in Liangshan. Parental incarceration is an on-going issue across the world. Multiple researchers have consequences of economic hardship, children’s criminal involvement, parent-child detachment, educational deficits, and psychological challenges, profoundly impacting the children (Murray et al.; Luk et al.; Herreros-Fraile et al.). On top of the single effects, several researchers have referred the vicious cycle of parental incarceration as the inter-generational effects of parental incarceration, driving teen-theft, drug use, and other crime involvements (Dobbie et al.; Herreros-Fraile et al.). However, there is a noticeable gap in defining the vicious cycle of incarceration on children in the context of Liangshan. This paper, therefore, analyzes preceding studies, analyzes the intergenerational impact of each single effects of parental incarceration on children in Liangshan, and defines a Liangshan-based cyclical impact of parental incarceration on Liangshan’s children.

Social Risk Factor Domains and Preventive Care Services in US Adults

Growing evidence suggests that social determinants of health are associated with low uptake of preventive care services. To examine the independent associations of social risk factor domains with preventive care services among US adults. This cross-sectional study used National Health Interview Survey data on 82 432 unweighted individuals (239 055 950 weighted) from 2016 to 2018. Subpopulations were created for each of the primary outcomes: routine mammography (women aged 40-74 years), Papanicolaou test (women aged 21-65 years), colonoscopy (adults aged 45-75 years), influenza vaccine (adults aged ≥18 years), and pneumococcal vaccine (adults aged ≥65 years). Statistical analysis was performed from July to December 2023. Six social risk domains (economic instability, lack of community, education deficit, food insecurity, social isolation, and lack of access to care) and a count of domains. Logistic regression models were used to examine the independent association between each primary outcome (mammography, Papanicolaou test, colonoscopy, influenza vaccine, and pneumococcal vaccine) and social risk factor domains, while controlling for covariates (age, sex, race and ethnicity, health insurance, and comorbidities). A total of 82 432 unweighted US individuals (239 055 950 weighted individuals) were analyzed. A total of 54.3% were younger than 50 years, and 51.7% were female. All 5 screening outcomes were associated with educational deficit (mammography: odds ratio [OR], 0.73 [95% CI, 0.67-0.80]; Papanicolaou test: OR, 0.78 [95% CI, 0.72-0.85]; influenza vaccine: OR, 0.71 [95% CI, 0.67-0.74]; pneumococcal vaccine: OR, 0.68 [95% CI, 0.63-0.75]; colonoscopy: OR, 0.82 [95% CI, 0.77-0.87]) and a lack of access to care (mammography: OR, 0.32 [95% CI, 0.27-0.38]; Papanicolaou test: OR, 0.49 [95% CI, 0.44-0.54]; influenza vaccine: OR, 0.44 [95% CI, 0.41-0.47]; pneumococcal vaccine: OR, 0.30 [95% CI, 0.25-0.38]; colonoscopy: OR, 0.35 [95% CI, 0.30-0.41]). Fully adjusted models showed that every unit increase in social risk count was significantly associated with decreased odds of receiving a mammography (OR, 0.74 [95% CI, 0.71-0.77]), Papanicolaou test (OR, 0.84 [95% CI, 0.81-0.87]), influenza vaccine (OR, 0.81 [95% CI, 0.80-0.83]), pneumococcal vaccine (OR, 0.80 [95% CI, 0.77-0.83]), and colonoscopy (OR, 0.88 [95% CI, 0.86-0.90]). This cross-sectional study of US adults suggests that social risk factor domains were associated with decreased odds of receiving preventive services; this association was cumulative. There is a need to address social risk factors to optimize receipt of recommended preventive services.

The Burden of Malaria in East Africa: Epidemiology and Health Impact

Malaria remains a significant public health challenge in East Africa, disproportionately affecting the region due to diverse ecological conditions, socioeconomic factors, and variable healthcare infrastructure. This review provides an overview of the epidemiological landscape and health impact of malaria in East African countries, including Kenya, Tanzania, Uganda, Rwanda, Burundi, and Ethiopia. The prevalence and distribution of malaria vary widely, with high transmission rates in specific regions and vulnerable groups, particularly children under five and pregnant women. The disease’s health impacts are profound, contributing to high morbidity and mortality, economic loss, and educational deficits, while placing a substantial burden on healthcare systems. Despite progress in malaria control efforts, challenges such as drug resistance, inadequate healthcare infrastructure, and the need for sustained funding persist. The methodology for this review involved a comprehensive analysis of existing literature and epidemiological data on malaria in East Africa. Addressing these challenges requires a multifaceted approach that includes improved surveillance, targeted interventions, and community engagement to reduce the burden of malaria and improve health outcomes in the region. Keywords: Malaria Epidemiology, East Africa, Health Impact, Socioeconomic Burden, Malaria Control Strategies.

An investigation into General Practitioners' experience with Long Covid.

Long Covid (LC) is the continuation or development of new symptoms after initial COVID-19 infection. Little is known about General Practitioners' (GP) experience of managing patients with LC. The aim of this study is to establish GP experiences with LC. A survey was designed and piloted in three training practices prior to distribution. The survey was completed by doctors working in GP training scheme practices in Cork, Ireland. Fifty-three of one hundred and sixty invited GPs completed the survey, indicating a 33% response rate. 8% (4/53) of participants agreed and 0% (0/53) strongly agreed with the statement they were "confident in diagnosing Long Covid". 81% (43/53) were not confident in treating patients with LC. 70% (37/53) were unaware of indications for referral to secondary care. 38% (20/53) were aware of the referral pathways to local LC clinics. 93% (49/53) agreed there were educational deficits regarding LC. There was a lack of confidence in the diagnosis and management of LC, and in the interface with secondary care. There is demand for educational interventions to assist GPs with their care of patients with this emerging condition.

Degenerative Cervical Myelopathy Awareness in Primary Care: UK National Cross-Sectional Survey of General Practitioners.

Degenerative cervical myelopathy (DCM) is a progressive neurological condition, characterized by spinal cord injury secondary to degenerative changes in the spine. Misdiagnosis in primary care forms part of a complex picture leading to an average diagnostic delay of 2 years. This leads to potentially preventable and permanent disability. A lack of awareness secondary to deficits in postgraduate education may contribute to these delays. This study aims to assess the awareness of DCM in the setting of general practice. General practitioners completed a quantitative web-based cross-sectional questionnaire. The 17-item questionnaire captured data regarding demographics, subjective awareness, and objective knowledge. The questionnaire was disseminated via professional networks, including via practice managers and senior practice partners. Incentivization was provided via a bespoke DCM fact sheet for those that completed the survey. A total of 54 general practitioners representing all 4 UK nations responded to the survey. General practitioners most commonly self-assessed that they had "limited awareness" of DCM (n=24, 51%). General practitioners felt most commonly "moderately able" to recognize a case of DCM (n=21, 46%). In total, 13% (n=6) of respondents reported that they would not be at all able to recognize a patient with DCM. Respondents most commonly reported that they were "moderately confident" in their ability to triage a patient with DCM (n=19, 41%). A quarter of respondents reported no prior introduction to DCM throughout their medical training (n=13, 25%). The mean score for knowledge-based questions was 42.6% (SD 3.96%) with the lowest performance observed in patient demographic and clinical recognition items. General practitioners lack confidence in the recognition and management of DCM. These findings are consistent with the diagnostic delays previously described in the literature at the primary care level. Further work to develop and implement educational interventions to general practitioner practices is a crucial step to improving patient outcomes in DCM.

Inclusion Goals: What Sex Education for LGBTQIA+ Adolescents?

According to the World Health Organization and the World Association for Sexual Health (WAS) Declaration of Sexual Rights, sex education aims to provide children and adolescents with comprehensive knowledge, skills, attitudes, and values, promoting equality and nondiscrimination while upholding freedom of thought and expression. However, current school curricula often focus on dichotomous sexual identity and hetero-cis-normative prevention strategies, neglecting the needs of gender minority (GM) and sexual minority (SM) youths. In family settings, discussions typically revolve around sexual risk reduction and basic contraception, omitting relational aspects and components of sexual identity such as orientations and gender expressions. This discrepancy highlights a gap between the official goals of sex education and its practical implementation, reflecting a cultural deficit in familial sex education. This study reviews the scientific literature on sexual health promotion interventions from 2015 to 2024 to identify inclusive approaches that enhance the participation of all youths, not just hetero-cis-normative individuals. The hypothesis is that most interventions primarily serve heterosexual and cisgender youths, indicating a need for more inclusive strategies to achieve better sexual health and educational outcomes. The study also suggests expanding curricula to align with recognized guidelines and the diverse needs of youth.

Continuous Recognition of Teachers’ Hand Signals for Students with Attention Deficits

In the era of inclusive education, students with attention deficits are integrated into the general classroom. To ensure a seamless transition of students’ focus towards the teacher’s instruction throughout the course and to align with the teaching pace, this paper proposes a continuous recognition algorithm for capturing teachers’ dynamic gesture signals. This algorithm aims to offer instructional attention cues for students with attention deficits. According to the body landmarks of the teacher’s skeleton by using vision and machine learning-based MediaPipe BlazePose, the proposed method uses simple rules to detect the teacher’s hand signals dynamically and provides three kinds of attention cues (Pointing to left, Pointing to right, and Non-pointing) during the class. Experimental results show the average accuracy, sensitivity, specificity, precision, and F1 score achieved 88.31%, 91.03%, 93.99%, 86.32%, and 88.03%, respectively. By analyzing non-verbal behavior, our method of competent performance can replace verbal reminders from the teacher and be helpful for students with attention deficits in inclusive education.

The Echo Report Understood: Improving Education in Echocardiography for Junior Doctors.

With echocardiography standing as the most widely used cardiac imaging modality, echocardiography report interpretation is a core responsibility of junior doctors. The literature, however, reveals a deficit in echocardiography education. The implications of this for patient care should not be ignored. To address this need, a hybrid teaching session was developed for junior (intern and resident grade) doctors, with the aim to increase understanding of echocardiography and increase confidence in report interpretation. Pre- and post-session data were analysed. Results revealed that the vast majority of respondents received less than an hour of echocardiography teaching at medical school, with over two-thirds receiving less than an hour in the postgraduate setting. A total of 80% of doctors interpreted echocardiography reports weekly, with almost all doctors perceiving this skill as important. Despite this, an overwhelming majority of doctors did not feel confident interpreting reports.The educational intervention achieved significant increases in perceived understanding of echocardiography and confidence with report interpretation. Participants were better able to identify cardiac pathology and understand report terminology. This intervention has the scope to improve patient safety through better management of cardiac patients and recognition of pathology from echocardiography. This work also identifies a need for more echocardiography education, having uncovered a concerning lack of confidence amongst junior doctors and an appetite for further teaching on this important topic.

(131) EFFECTIVENESS OF AN INTERACTIVE PATIENT LEARNING MODULE: INTIMACY IN PREGNANCY

Abstract Introduction Two-thirds of women experience negative sexual symptoms during their pregnancy. Women suffer with dyspareunia, arousal issues, decreased libido, and anorgasmia frequently throughout pregnancy, with a significant worsening of symptoms during the third trimester. Also, many women restrict their sexual activity due to fear and misconceptions of inducing preterm labor or harming the fetus and social parameters of sexual conduct during pregnancy. Due to the lack of readily available medical education regarding sexual function in pregnancy, many women of various religious backgrounds may feel lack of trusting asking family members or medical professionals regarding sexual wellness. Objective Patient education given during pregnancy will increase patient knowledge of intimacy during pregnancy as well as improve sexual satisfaction and relationship quality and mental health in pregnancy. Moreover, this module will address gaps in common misconceptions by introducing supportive literature findings regarding benefits of intercourse during pregnancy dispensing the social stigma. Methods This prospective study is a single group before and after pilot study. This study recruited 25 patients beyond 12 weeks’ gestation. We approached 34 of patients and 25 agreed to participate in review an educational module titled “Sexual Intimacy and Pregnancy” build from ACOG guidelines. This module was created at an 8th grade reading level. Patients completed a presurvey, used the module on an electronic device and then completed a post-module assessment. Results 68% of women currently experience sexual dysfunction as either one of more of the following: pain with sex, decreased libido, anorgasmia, or vaginal dryness. Compared to their pre-module response, more women correctly answered the items “What percentage of pregnant women experience sexual dysfunction?” (28.0% versus 76.0%; p = .001) and “Having sex will cause labor” (28.0% versus 4.0%; p = .03). Additionally, women were more comfortable asking their doctor about sex while pregnant following the module (OR = 2.26, 95% CI: 1.06 – 4.83; p = .04). Through the recruitment process, we noticed that patients more likely to participate based on age, level of education received and most significant gravidity. The key for this recruitment was to create an environment in the exam room where both parents were able to see and engage with the module. During the module, partners spoke about current sexual dysfunction initially followed by confirmation by the pregnant patient. Prior to viewing this module, most participants predicted a much smaller percentage of women would be afflicted by sexual dysfunction in pregnancy which illustrating the broad deficits in sexual health education. Conclusions All participants would recommend this educational module to fellow pregnant women and all participants rated the completion and content of this module at easy or very easy to follow. This education module demonstrates baseline improvement in knowledge of sexual function in pregnancy and increases comfort level of discussing sexual function during prenatal care. Future direction of this study aims to target education in various socioeconomic cultures where intimacy education is not discussed in the clinical setting. Disclosure No.

Queensland Trauma Education (QTE): an innovative simulation program that addresses the needs and barriers of interprofessional trauma care education across a complex landscape.

Effective trauma care requires the rapid management of injuries. Rural and remote areas face inequity in trauma care due to time, distance and resource constraints, and experience higher morbidity and mortality rates than urban settings. A training needs analysis (TNA) conducted with stakeholders across Queensland, Australia, revealed a lack of contextual, accessible and interprofessional trauma education for clinicians. The Clinical Skills Development Service and Jamieson Trauma Institute developed the Queensland Trauma Education (QTE) program to address these concerns. QTE comprises a face-to-face training course and open access to online training resources created and reviewed by trauma experts. QTE also supports local training through a statewide simulation network and free access to simulation training equipment. The aim of this article is to review the QTE program and assess the benefits to clinicians in both the delivery of education and the provision of trauma care. To evaluate the QTE program, a desktop review was conducted. This included analyses of website data, course and website content, and facilitator, stakeholder, participant and user feedback. The data were evaluated using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, and the program's alignment with the original TNA outcomes was assessed. The results showed that QTE aligns with the identified training needs. Specifically, QTE provides trauma education that is relevant, sustainable, employs best practice, is locally delivered, provides continuous support, is multidisciplinary, multi-platformed, physically accessible and accredited by the Australasian College for Emergency Medicine. The review also highlights how QTE has effectively been reaching its target population, improves knowledge and skills, has become widely adopted, and been implemented and maintained with relative success. The innovative QTE program addresses the previous deficits in trauma education and meets the needs identified in the TNA. The review also reveals further opportunities for continuous improvement and program sustainability.

Assessing the Effectiveness of a Unique Visual Aid in Improving Women's Knowledge of the Hysterectomy Procedure [ID 2683416

INTRODUCTION: This study aims to determine the efficacy of a visual aid in improving women's knowledge of the hysterectomy procedure. Currently, there is a lack of literature that examines evidence-based hysterectomy patient education, and a recent literature review stated that there is a deficit in education surrounding the different hysterectomy treatment options. METHODS: This is IRB study #Pro2021000882. Patients were recruited from the Department of Obstetrics, Gynecology & Reproductive Health at the Ambulatory Care Center at University Hospital in Newark, New Jersey. Participants consented and patient information was de-identified. Participants completed a 28-question pre-test, watched the visual aid in either English or Spanish, and then completed the same 28-question post-test. For both English- and Spanish-speaking participants, the percentage of participants who answered each pre- and post-test question correctly was calculated. Finally, average pre-test scores were compared to average post-test scores for each language. RESULTS: After watching the video, average test scores of English-speaking (N=30) participants increased by 19.76 (95% CI: 10.9, 28.6) percentage points, whereas Spanish-speaking (N=20) participants increased by 28.93 (95% CI: 19.7, 38.1) percentage points. From the 28-question knowledge test, there were 15 questions in the English version and 23 questions in the Spanish version where the percent of respondents who answered that question correctly after watching the video improved by 20 percentage points or greater compared to before watching the video. CONCLUSION: Our preliminary data provide evidence that the hysterectomy visual aid/video we created significantly improves knowledge of the hysterectomy procedure as measured by a validated hysterectomy knowledge quiz.

The public's considerations about implementing non-pharmaceutical interventions to manage a novel COVID-19 epidemic

In the future, new variants of the SARS-CoV-2 virus might emerge and cause outbreaks. If this occurs, the implementation of non-pharmaceutical interventions (NPIs) can be reconsidered. Consideration of the potential benefits and harms of implementing NPIs, and ultimately deciding about implementing NPIs, is currently mainly executed by experts and governments. However, general literature on public engagement suggests that integrating public perspectives into decision-making can enhance the quality of decisions and foster greater public understanding of them. In this study, a deliberative mini-public was conducted to integrate this public perspective. The aim was to elicit public considerations regarding non-pharmaceutical interventions by asking a diverse group of citizens to participate as decision-makers and convene, learn and deliberate about implementing non-pharmaceutical interventions during a hypothetical outbreak of a new SARS-CoV-2 variant. Participants emphasized the importance of early implementation during the outbreak, to prevent exceeding healthcare capacity, long-term mental health issues, educational deficits, and bankruptcies. Additionally, participants stressed taking public support into account, and shared ideas on maintaining support. Furthermore, participants wanted to give citizens personal responsibility and freedom in making their own assessment regarding adherence to interventions and how much risk of infection they would be willing to accept. Participants also expressed the need for the government to adopt a learning attitude towards improvements in pandemic response, and to generate more focus on long-term strategies. The deliberative mini-public, revealed public considerations that reflected public values and needs. These considerations might be helpful in better aligning epidemic management policies with public perspectives. Regarding the deliberative mini-public, uncertainties remain about the design and impact on a bigger scale.

Persistent negative symptoms in young people at clinical high risk of psychosis treated with an Italian early intervention program: a longitudinal study

Negative symptoms in CHR-P people are generally not responsive to treatments and commonly related to poorer functional outcome. However, less research attention has been dedicated to Persistent Negative Symptoms (PNS), defined as clinically stable negative symptoms of moderate severity evident for at least 6 months. This study aims to (a) determine the prevalence of PNS in a sample of young people at CHR-P; (b) investigate any association of PNS with functioning and clinical features; (c) examine longitudinal course of PNS across 2 years of follow-up and changes in PNS severity levels with specialized treatments. One Hundred Eighty CHR-P participants were recruited and were divided into CHR-P/PNS + and CHR-P/PNS− subgroups. The clinical assessments were based on the PANSS and the GAF and were conducted at baseline and every 12 months during the follow-up. Twenty four participants showed PNS at entry. Of them, 21 concluded the 2-year follow-up period. At baseline, the CHR-P/PNS + participants showed more educational and employment deficits, and more social and functioning impairment. During the follow-up, the CHR-P/PNS + subgroup had a significant longitudinal decrease in negative symptoms, which was specifically related to antidepressant treatment. CHR-P/PNS + subjects also showed a higher incidence of new hospitalization and a lower functional recovery over time. Our findings support that the persistence of negative symptoms in CHR-P people is longitudinally related to worse daily functioning and more severe clinical conditions that are at higher risk of hospitalization and are less responsive to specialized treatments.

A call for action to include psychosocial management into holistic, integrated care for patients with atrial fibrillation.

Contemporary management of atrial fibrillation (AF) has become increasingly complex. Therefore, strong efforts have been made during the past decade to develop models for structured, integrated care for patients with AF. These have also been incorporated in international guidelines for the management of patients with AF. However, implementation of integrated care approaches in daily clinical practice is scarce and far from optimal, and it may require a re-thinking of the structure of the healthcare system. The reasons for the poor implementation are many, from limited time and economic resources to deficits in postgraduate education of healthcare professionals, lack of involvement of patients in how integrated care should be designed, and fragmentation of the healthcare system. Moreover, patients' psychological challenges, which not only impact patients' adherence to treatment but, if untreated, increase their risk of morbidity, mortality, and poor quality of life, are not given sufficient attention. It is time to start a necessary discussion of what integrated care should be, what it should contain, and what is necessary to implement it in daily clinical practice.

In-depth analysis to develop a social marketing model to promote women's participation in waste segregation behaviour: A qualitative study

Waste separation is one of the key factors in managing solid waste and creating a healthy environment. Waste separation at source has always been associated with challenges. Therefore, this study was conducted to determine the perceptions of housewives and related parties regarding the factors that influence waste separation behaviour and to identify approaches to improve behaviour based on the social marketing framework. This study was conducted as a qualitative content analysis in Amol City in 2022. The data was collected through semi-structured individual interviews. A total of 25 housewives were selected as main participants and 5 stakeholders through purposive selection. The results of the study included lack of awareness of recyclable materials (product), personal, family and environmental barriers (price), lack of doorstep collection of dry waste (place), and lack of use of appropriate technology (promotion). The lack of financial resources, inappropriate political measures and the coronavirus pandemic were also the causes of this challenge. Most participants cited environmental and educational deficits as the main reason for not separating waste. It is possible to improve waste sorting behaviour at source through appropriate behavioural interventions at the individual, social and environmental levels. Researchers can use the results of this study to design, implement and evaluate waste segregation intervention programmes for housewives.

Exploring the Prevalence of Gender Inequality in the Nigerian Civil Service

The study explores how gender inequality exists in the Nigerian civil service. It adopts a convenience sampling technique where semi-structured interviews were administered to 27 civil servants in the Federal Territory of Abuja. Based on content- and consistency-based analysis, the researchers classified three emerging categories as exogenous, endogenous, and exo-endogenous factors. These factors further unravelled the emerging subcategories of each of the factors that included (1) the deficit in Education, (2) religion, (3) the civil service administration, (4) sex appeal as a criterion, (5) marriage and childbearing and (6) culture. With a consistency rate of 87.88%, the participants suggested that female education deficits constitute one factor that influences women’s employment. About 80.95% and 63.89% suggested that religion and civil service have negatively impacted female labour participation in the civil service. We concluded that women were not specifically employed in the civil service on the principle of gender equality or because the government intended to explore and benefit from their potential. The study recommended that there should be an enactment law that warrants fair practice in the civil service by removing any exclusions undermining women’s ability in decision-making and having equal access to various employment opportunities.