Initial Education Research Articles

Adult Individuals Applicable to the Family Health Center Knowledge and Awareness About Osteoporosis

Abstract Background The aim of this study is to determine the knowledge and awareness of adult individuals applying to the Family Health Center (FHC) about osteoporosis. Methods A descriptive design study was conducted at a FHC in Turkey/Istanbul between January and May 2022. The sample of the research consisted of 320 adults selected by purposeful sampling method. Ethical approval and necessary permissions were obtained from the the conduct of the study. Data were collected through a socio-demographic characteristics form, a 20-item single-subscale Osteoporosis Knowledge Assessment Questionnaire (OKAQ), and a 27-item Osteoporosis Awareness Scale (OAS). Descriptive statistics, normality tests, analysis of variance, Kruskal-Wallis analysis of variance, t-test, and Mann-Whitney U test were used for data analysis. Statistical significance was accepted at p < 0.05. Results T The average age of adults is 60.47±13.17 and 55.9% are female and 44.1% are male. 34.7% had completed middle school. Participants’ highest correct response rate in the osteoporosis knowledge assessment questionnaire was for the item ‘Osteoporosis increases the risk of bone fracture’ (81.6%), while the lowest correct response rate was for the item ‘Osteoporosis generally causes symptoms (such as pain) before fractures occur’ (26.3%). According to the Osteoporosis Awareness Scale, adults’ awareness levels were above average. They scored the highest in the preventive behaviors subscale and the lowest in the risk factors subscale. Adults with university-level education scored significantly higher in all subscales of the OAS compared to other education levels (p < 0.05). Individuals with knowledge about osteoporosis and those who consumed milk regularly scored significantly higher in all subscales of the OAS (p < 0.05). Conclusions Although adults’ awareness of osteoporosis is above average, their correct knowledge about osteoporosis is inadequate. Key messages • An individual’s education level affects osteoporosis knowledge and awareness. • It is recommended to plan educational initiatives to increase osteoporosis knowledge and awareness.

Exploring PrEP awareness among addiction service professionals: an Italian cross-sectional study

Abstract Background Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy. Since 2023, in Italy, PrEP has been subject to reimbursement, making it freely available to individuals who meet specific criteria, including those who engage in substance use during sexual activity (chemsex). In this context, all healthcare professionals (HCPs) in Addiction Departments and Services (ADS) play a crucial role from the intake interview in identifying potential PrEP candidates, providing an essential gateway to services. Thus, this study primarily aimed to explore the knowledge of ADS professionals regarding PrEP. Methods In 2024, an ongoing nationwide cross-sectional study has been conducted in Italy, enrolling a convenience sample of HCPs employed in ADS. The online questionnaire comprised items assessing knowledge regarding PrEP, training on PrEP, and experiences related to daily practice. The primary outcome was the awareness of PrEP existence, while secondary outcomes included knowledge regarding reimbursement. Results Preliminary analyses were conducted based on 269 questionnaires. Participants had a median age of 52 years (IQR=45-59). Physicians represented 26.0% of the sample, followed by nurses (23.0%). Awareness of PrEP stood at 43.5%, while knowledge of the existence of reimbursement conditions was at 29.9%. A vast majority (93.7%) felt inadequately informed, while 97.0% believed HCPs in ADS should receive training. Physicians demonstrated significantly higher awareness of PrEP existence, whereas there were no significant differences in reimbursement knowledge compared with other HCPs. Conclusions Intermediate findings revealed substantial gaps in PrEP awareness and reimbursement knowledge. These results emphasize the critical importance of tailored education and training programs to bridge these gaps and facilitate effective PrEP implementation in diverse healthcare settings, ultimately advancing HIV prevention efforts and promoting equitable access to care. Key messages • Substantial knowledge gaps about PrEP among healthcare professionals working in Addiction Departments and Services in Italy were highlighted. • Effective PrEP implementation hinges on empowering professionals with the necessary expertise to identify and support PrEP candidates, underscoring the critical role of tailored education initiatives.

Statistical analysis of seroprevalence and risk factors of hepatitis C in Nowshera District, Pakistan

Hepatitis C virus (HCV) transmission remains a significant public health concern. It is well documented globally, however, Nowshera district, Pakistan, is lacking such profile. This study aims to explore the relationship between HCV infection and several risk factors, including socio-demographic, clinical and personal life-style factors. This study using a cross-sectional design, examined 606 randomly selected individuals visiting the Pathology department at Qazi Hussain Medical Complex and District Headquarter (DHQ) Hospital Nowshera between May 1, 2022 and Jun 30, 2023. This research investigation employed a methodical approach involving formal interviews in conjunction with structured questionnaires to gather comprehensive information related to socio-demographic characteristics, clinical history, and personal hygiene practices. We collected 10 ml of blood samples and tested the separated serum to identify markers using the Immuno-Chromatographic Test (ICT) and the Enzyme-Linked Immunosorbent Assay (ELISA). IBM SPSS Statistics version 27 was used for data analysis. To measure the association between dependent variable and independent variables, a chi-square and risk analysis was carried out; multiple logistic regression was employed for modeling the risk factors associated with independent variable. A statistical significance level was established at a P-value of less than 0.05. In present study, which included 606 participants, 12% were found to be infected with HCV. Importantly it revealed that facial shave at barber (adjusted odds ratio, aOR = 40.65, p = 0.000) represents the most prevalent mode of HCV transmission. Additionally, a strong association was observed between HCV infection and history of past surgery (RR = 2.98, p = 0.001), HCV infected family member (aOR = 4.28, p = 0.001), workplace injuries (aOR = 6.68, p = 0.000), history of hospital admission (RR = 2.09), practicing ear and nose piercing (aOR = 5.01, p = 0.001), dental treatment (RR = 2.31) and the frequency of injections (aOR = 8.607, p = 0.000). These findings underscore the pressing need for targeted interventions. This study highlights the paramount importance of understanding the modes of HCV transmission and their associated risk factors. The results emphasize the need for educational initiatives, both within the healthcare sector and among the general public, to combat HCV transmission effectively. By implementing sterilization procedures and increasing awareness, we can make significant strides in reducing the burden of HCV infection. Moreover, proactive measures within families can help contain the spread of the virus, ultimately contributing to improved public health.

Exploring the Impact of Employee Motivation on Investment Decisions: - A Study of Factors Influencing Mutual Fund Investment Among Corporate Employee

This study explores the impact of employee motivation on investment decisions, specifically focusing on the factors influencing mutual fund investments among corporate employees. As financial literacy and investment participation grow, understanding the underlying motivations that drive investment choices is crucial for both individuals and financial institutions. Utilizing a mixed-methods approach, we conducted surveys and in-depth interviews with corporate employees across various sectors. The findings reveal that intrinsic motivations, such as personal financial goals and career advancement, significantly influence mutual fund investment decisions. Additionally, extrinsic factors, including company-sponsored financial education programs and peer influence, play a critical role in shaping employees' investment behaviors. Our analysis indicates that motivated employees are more likely to engage in proactive financial planning and make informed investment choices. We also identified barriers such as risk aversion and lack of confidence in investment knowledge that hinder mutual fund participation. The implications of this study suggest that organizations should enhance employee motivation through targeted financial education initiatives and create a supportive investment culture. By doing so, companies can not only improve employee financial well-being but also foster a more engaged and motivated workforce. This research contributes to the existing literature on employee motivation and investment behavior, offering insights for corporate stakeholders and financial advisors aiming to enhance mutual fund investment strategies among employees.

The Influence of Prenatal Vitamin use and Community Health Programs on Reducing Teratogenic Medication Exposure and Improving Perinatal Nutrition among African American Adolescents with Limited Access to Healthcare

This review paper examines the critical influence of prenatal vitamin use and community health programs on reducing teratogenic medication exposure and improving perinatal nutrition among African American adolescents with limited access to healthcare. African American adolescents face disproportionate barriers to healthcare access, including socioeconomic challenges and systemic healthcare inequities, which contribute to heightened risks of teratogenic exposure and poor prenatal nutrition. The paper explores the role of prenatal vitamins such as folic acid, iron, and calcium in preventing congenital disabilities and enhancing maternal health. It also highlights the impact of community-based health programs and education initiatives that aim to bridge healthcare gaps for vulnerable populations. By focusing on adolescent pregnancy in African American communities, this review identifies key challenges such as limited healthcare access, inadequate educational resources, and socio-economic constraints. Furthermore, the paper assesses the effectiveness of current health interventions and policies, offering recommendations for improving healthcare access and expanding community programs. The review underscores the necessity for long-term research to address gaps in the intersection of race, adolescent health, and prenatal care, ultimately aiming to inform policy and program development that promotes equitable maternal and fetal health outcomes.

Driving Individual Taxpayer Compliance: How Information Technology Elevates Tax Service Quality, Social Engagement and Education

This study investigates the factors influencing Individual Taxpayer Compliance in Indonesia, focusing on Tax Service Quality, Social Engagement and Education, and the moderating role of Information Technology. The findings reveal that Tax Service Quality does not significantly impact taxpayer compliance, suggesting that improvements in service quality alone may not suffice to enhance compliance levels. In contrast, Social Engagement and Education are significant factors that positively influence taxpayer compliance, indicating the effectiveness of educational initiatives and community involvement in fostering compliance behavior. Furthermore, information technology has been found to have no significant moderating effect on the relationship between tax service quality or social engagement, education, or taxpayer compliance. These results underscore the importance of prioritizing social engagement and educational strategies while recognizing that technology should be integrated as a complementary tool to improve compliance outcomes. A balanced approach combining these elements is essential for fostering a more compliant taxpayer environment in Indonesia.

The Impact of Financial Literacy, Inclusion, and Access on Msme Growth and Welfare in North Sumatra: A Mediating Role of Business Growth

This study examines the impact of financial literacy, financial inclusion, and financial access on the growth and welfare of Micro, Small, and Medium Enterprises (MSMEs) in North Sumatra, Indonesia, with business growth acting as a mediating factor. Using a quantitative research design and Structural Equation Modeling (SEM) analysis, data were collected from 306 MSME operators selected via purposive sampling. The findings reveal that while financial literacy does not have a significant direct effect on MSME growth and welfare, both financial inclusion and financial access significantly enhance business growth and welfare. Furthermore, business growth serves as a mediating variable, amplifying the positive effects of financial inclusion and access on MSME welfare. The results indicate that MSMEs benefit from better access to formal financial services, such as credit and insurance, which facilitates business expansion and improves the overall welfare of business owners. However, the lack of significant impact from financial literacy suggests that practical financial education initiatives should be paired with improved access to capital and market opportunities. This study highlights the need for integrated policy efforts to enhance financial literacy, expand financial inclusion, and provide easier access to credit to foster MSME growth and welfare in North Sumatra.

A comprehensive survey of artificial intelligence adoption in European laboratory medicine: current utilization and prospects.

As the healthcare sector evolves, Artificial Intelligence's (AI's) potential to enhance laboratory medicine is increasingly recognized. However, the adoption rates and attitudes towards AI across European laboratories have not been comprehensively analyzed. This study aims to fill this gap by surveying European laboratory professionals to assess their current use of AI, the digital infrastructure available, and their attitudes towards future implementations. We conducted a methodical survey during October 2023, distributed via EFLM mailing lists. The survey explored six key areas: general characteristics, digital equipment, access to health data, data management, AI advancements, and personal perspectives. We analyzed responses to quantify AI integration and identify barriers to its adoption. From 426 initial responses, 195 were considered after excluding incomplete and non-European entries. The findings revealed limited AI engagement, with significant gaps in necessary digital infrastructure and training. Only 25.6 % of laboratories reported ongoing AI projects. Major barriers included inadequate digital tools, restricted access to comprehensive data, and a lack of AI-related skills among personnel. Notably, a substantial interest in AI training was expressed, indicating a demand for educational initiatives. Despite the recognized potential of AI to revolutionize laboratory medicine by enhancing diagnostic accuracy and efficiency, European laboratories face substantial challenges. This survey highlights a critical need for strategic investments in educational programs and infrastructure improvements to support AI integration in laboratory medicine across Europe. Future efforts should focus on enhancing data accessibility, upgrading technological tools, and expanding AI training and literacy among professionals. In response, our working group plans to develop and make available online training materials to meet this growing educational demand.

Infrastructure development, inequality, and employment in Sub-Saharan Africa from the professional perspectives of Kenya, Ghana, and Tanzania

This study investigates the challenges and opportunities in infrastructure development, inequality, and employment in Sub-Saharan Africa. There is a critical gap between infrastructure planning and execution, exacerbated by inadequate funding, bureaucratic hurdles, and a lack of technical expertise, leading to profound inequality in infrastructure and employment opportunities, particularly affecting rural and marginalized communities. The study aims to identify the mismatch between current job market needs and the workforce's skills, analyse the impact of rapid population growth and insufficient educational initiatives, and propose solutions for integrated infrastructure planning and equitable policy development. This research employs qualitative semi-structured interviews and thematic analysis using NVivo to gain in-depth insights into the institutional characteristics influencing infrastructure development, inequality, and employment. Findings reveal significant disparities in infrastructure and employment opportunities, with rural and marginalized communities being disproportionately affected. There is a notable mismatch between job market needs and the available workforce skills, further complicated by rapid population growth and inadequate educational initiatives. The study recommends an integrated approach to infrastructure planning that encompasses sustainability, accessibility, and equitable distribution. Policies should address inequality, ensure equitable access to infrastructure benefits, and align education and skill development with the evolving job market. Leveraging public–private partnerships is also suggested to accelerate infrastructure development efficiently. This paper contributes to the discourse on infrastructure, inequality, and employment in Sub-Saharan Africa, providing a roadmap for addressing these intertwined challenges through integrated policy initiatives.

Preparing Teachers for the ‘Ummah’: A Case Study of Hayat Foundation

This preliminary study initiates an exploration into a novel informal Islamic teacher education programme developed by a community organisation. The presented case study explores the Afghan Muslim inspired Hayat Foundation’s communal educational initiative, the Marefat programme. The programme, derived from Islamic educational theoriesis ‘imbued with notions of reflective, critical, and reflexive thinking’, which are designed to recognise the individual levels of development for every educator and simultaneously elevate their efficacy, agency, and person. Adopting an interpretivist-narrative methodology conveyed through a dialogical approach, this study focuses on the lived experiences of this social-welfare organisation by seeking to decipher the teleological nature of the programme. This examination is guided by three questions which seek to identify its intended audience, the specificity of the issue it attempts to address, and the approaches it has adapted to implement its programme. The findings suggest that the overarching purpose of this educational initiative is to foster empowering liberatory pedagogical responses to counter oppressive narratives in the reading of the Islamic tradition.

Medical learner perspectives on elements of an educational rural generalist pathway: survey outcomes

IntroductionThe Northern Ontario School of Medicine University (NOSM U) continues to be challenged in meeting its social accountability mandate of addressing the rural health human resource crises in its catchment of Northern Ontario. Its new educational initiative, the Rural Generalist Pathway (RGP) aims to graduate family physicians specifically prepared for rural practice. This study elicits the perspective of NOSM U learners on the various components being considered for this educational pathway.MethodsA mixed methods survey was created for each of two medical learner groups, undergraduate NOSM U students and its family medicine residents. Quantitative data was analyzed for frequencies and percentages and qualitative data underwent thematic analysis.ResultsWith a response rate of 24.6% for undergraduates and 37.9% for residents, the survey discovered undergraduates consider rural clinical rotations as the most valuable experiences in rural medicine. Among the findings, both the majority of medical students and residents (87.3% and 87.9% respectively) agreed that support for a resident’s family well-being and community integration was the element of the pathway most likely to influence them in pursuing the RGP. Mentorship by a practicing rural physician was an element highly supported by 81% of undergraduate and 81.8% of postgraduate learners as likely to influence them to take the RGP.DiscussionIncorporating learner perceptions into the development of the RGP could help focus institutional resources and enhance learner participation in this pathway, producing more rural family doctors to serve Northern Ontario.

A pedagogical evaluation of an institution's digital assessment platform (DAP): Integrating pedagogical, technical and contextual factors

An assessment for learning approach is foundational for student learning. The necessity to shift teaching and learning online as a response to COVID-19 has propelled digital assessment into the mainstream within higher education institutions. User experience is a common indicator of effectiveness of technologically enhanced initiatives; however, measuring the pedagogical impact of digital assessment initiatives has not been straightforward. This paper presents a pedagogical evaluation, incorporating staff and student perspectives, of a digital assessment platform (DAP) at a large Australian metropolitan university. Data were collected using surveys, interviews, focus groups and case studies and incorporated findings from student evaluations of courses and a student-staff partnership project. Results highlight strong pedagogical reasons for continuing the digital assessment initiative, while also identifying constraints and opportunities for improvement. The insights generated through this evaluation emphasise the importance of considering technical, pedagogical and contextual factors and the interplay between the factors. In a quality assurance climate, where the demand for this type of institution-wide evaluation is increasing, this study contributes an approach that addresses some of the complexities and challenges of evaluating digital assessment initiatives in higher education. Future research is needed to understand more fully the relationships between pedagogical and contextual factors when undertaking an evaluation. Implications for practice or policy: The DAP enabled the (re)design of authentic, inclusive, engaging and secure assessment tasks. Educator support is critical in learning the system and creating assessment with high pedagogical merit. Student familiarisation opportunities with using the DAP are beneficial. The DAP’s longevity within the institution is crucial considering the significant effort required of educators and students. Contextual influences blur understanding of pedagogical factors.

82 Assessing the usage of and barriers to using language interpretation services in a Canadian tertiary paediatric center

Abstract Background Canada has one of the highest immigration rates worldwide per population with roughly 447,180 permanent residents welcomed in 2022. Limited-English proficiency (LEP) populations face barriers in accessing health care with implications including delayed presentation, misdiagnosis, poor compliance, decreased patient comprehension, and adverse events. Adequate health care provider training in using language interpretation services (LIS) is crucial to improve the quality of patient care and reduce miscommunication. There is a lack of research in this area in Canadian paediatric populations. Objectives To identify attitudes towards and usage of LIS among health care providers in a tertiary paediatric center, as well as levels of LIS training received. Design/Methods An online survey was developed and distributed to paediatric health care professionals including physicians, residents/fellows, nursing staff, and allied health providers. Survey completion was anonymous and voluntary; data collection occurred from October 2022–February 2023. Descriptive statistics were used for quantitative data and thematic analysis for free text responses. Results 345 respondents accessed the survey and 281(81%) completed it. Multiple paediatric professions were surveyed with most responses stemming from nursing staff, residents and physicians, and other allied health. 52.8% of respondents encountered a paediatric patient and/or their caregivers with a language barrier in English once per week or more. LIS were used by 53.1% of respondents once per week or more. 51.5% of respondents reported no previous training in using LIS in patient care, and 3.6% reported previous formal training. 57.9% of respondents felt LIS training was very beneficial to their role and 53.7% reported this increased their LIS usage. Overall, in-person interpreters were perceived as the most effective LIS modality followed by video and telephone interpreters. Barriers to using LIS included: inability to access desired modality and/or language; insufficient time; and lack of comfort in effective usage. Conclusion It was evident respondents felt LIS was integral to patient care, especially with an increasingly diverse population. Multiple barriers to using LIS were identified with likely applicability to other Canadian paediatric facilities. Suggested improvements were themed around improving LIS accessibility, improving LIS education and awareness, and increasing access to rare languages. This study has important implications for LIS and paediatric care, including informing educational and advocacy initiatives, policy change, and LIS resource allocation.

Impact of the EduIntegrity Suite on Academic Integrity: A Qualitative Study

The EduIntegrity Suite, a collection of tools designed to promote academic integrity, has garnered significant interest within educational institutions. This study explores the Suite's perceived effectiveness and its influence on various stakeholders through a mixed-methods approach. Semi-structured focus group interviews were conducted with students, educators, and administrators at institutions utilizing the Suite. Student discussions explored their perceptions of the Suite's impact on their learning environment and potential concerns. Educators discussed how the Suite influenced their teaching practices and addressed suspected misconduct. Administrator focus groups provided insights into the decision-making process for implementing the Suite, its effectiveness, and its broader cultural influence. An online component complemented the focus groups, involving a comprehensive review of documents and websites related to the Suite. Company websites and product information for the Suite's individual tools were examined. Academic resources discussing the Suite's functionalities and potential applications were reviewed. News articles and blog posts offering insights from educators, administrators, and students regarding their experiences were explored. The findings highlight the Suite's multifaceted functionalities, including plagiarism detection, grammar and citation checking, originality reports, and remote proctoring services. While students acknowledged the Suite's potential deterrent effect, concerns about workarounds and a shift in focus from learning to detecting cheaters were also voiced. Administrators, however, emphasized the Suite's potential as a tool for promoting a culture of academic integrity, not just detecting plagiarism. Transparency and clear communication emerged as crucial for fostering trust and student acceptance. The EduIntegrity Suite appears to offer a promising approach to academic integrity when implemented strategically and combined with effective pedagogical practices. However, the success hinges on a multi-pronged approach that addresses student concerns, utilizes the Suite's functionalities effectively, and fosters a culture of ethical learning within the institution. To achieve this, institutions can prioritize clear communication about the Suite's purpose and limitations, support and develop staff with the Suites functionality and ethical consideration. Moreover, encourage educational initiatives that promote critical thinking, responsible research practices, and proper citation skills. Collaboration between educators and administrators can leverage the Suite's capabilities to create a more supportive and ethically sound learning environment.

The Effectiveness of an Educational Intervention on Countering Disinformation Moderated by Intellectual Humility

<span lang="EN-US">There is an ongoing debate among scholars on how to tackle disinformation. Media education initiatives to increase literacy are effective ways to counter disinformation. Hence, the European Commission (2022) published <em>Guidelines for Teachers and Educators on Tackling Disinformation and Promoting Digital Literacy Through Education and Training</em>. The present research looked at the role of social media literacy in increasing awareness of the role of social media in spreading disinformation. We developed an educational intervention based on the European Commission guidelines. We investigated its impact on perceived social media literacy, the intention to share fake news on social media, and general conspiracy beliefs. We conducted a within-subject (two times measurement: before the educational intervention and one week after) +1 experiment with <em>N</em> = 127 young adults (aged 18 to 23). After filling in an initial survey, the experimental group received a 15-minute educational intervention on the role of social media for disinformation dissemination in complex digital information environments. One week later, all participants completed the second survey to assess perceived social media literacy and general conspiracy beliefs. In both surveys, participants saw three Instagram posts from a fictitious media outlet to express potential intentions to share on social media. Among the three posts, two showed false information. Findings showed that educational intervention produces a significant increase in perceived social media literacy and a decrease in general conspiracy beliefs. Intellectual humility moderates the impact of educational intervention on algorithmic awareness.</span>

Incentivizing Youth and Family SNAP-Ed Participation With Fruit and Vegetable Rewards

Poor diet quality in the United States impacts millions of individuals, particularly in low-income communities. The Federal Government’s primary safety-net program, the Supplemental Nutrition Assistance Program (SNAP), and its associated nutrition education initiative, SNAP-Ed, aim to improve food security and diet quality. A number of Food as Medicine interventions have demonstrated that tying nutrition education to healthy food incentives improves diet quality and metabolic disease markers. There have been recent efforts to provide fruits and vegetables to SNAP participants via GusNIP (Gus Schumacher Nutrition Incentive Program) and related programs. However, these incentives have not been tied to nutrition education opportunities. We argue that SNAP-Ed can have a greater impact on diet quality and food security by increasing its reach to a larger number of SNAP participants with the benefits of food incentives. Thus, we propose pilot studies to assess the efficacy of combining SNAP-Ed and healthy food incentives, targeting both adults and youth for a comprehensive impact.

Implementation of Digital Initiatives in Higher Education in India: Problems and Solutions

The education system is gradually becoming technology-oriented. The Ministry of Education of India has initiatives numerous digital platforms, tools, and devices like (SWAYAM, SWAYAM Prabha, Shodhganga, Shodhshuddhi, NDL, NAD, e-PG Pathshala, e-Yantra, FOSSE, SAMARTH, IRINS, spoken tutorials and Virtual Labs and so on) to ensure that everyone can access advance and quality education. The study explores problems and solutions regarding implementing digital initiatives in higher educational institutions. This study adopted secondary data from different papers published in journals, newspaper pieces, and various government policies and reports with the help of content analysis. Due to a lack of knowledge and awareness, many problems are faced in successfully implementing digital initiatives in India's higher Education. The problems encountered include limited digital resources and tools, poor internet connectivity in rural institutions, and a lack of proper policy guidelines and rules and regulations when implementing digital initiatives. This paper explores solutions to the problems regarding implementing digital initiatives, such as regular training and workshop programme arrangements that help to increase knowledge and awareness among academics, researchers, and students. Provide adequate internet infrastructure, especially in rural areas, and require sustainable funding to implement digital initiatives in higher Education successfully. The outcome will be highly beneficial if the students can learn digitally. It is valuable for faculty members to develop professional skills.

Improving quantitative neuromuscular monitoring: an education initiative on stimulating electrode placement.

Quantitative neuromuscular monitoring reduces the incidence of residual neuromuscular block, but broad acceptance of monitoring has been elusive despite recommendations for quantitative monitoring for decades. Acceptance of quantitative monitoring may, in part, be related to the quality of the data from monitoring systems. This evaluation explored proper stimulating electrode positioning for electromyographic (EMG) monitoring, the impact of an educational intervention on electrode positioning and anesthesia provider (anesthesiologist, resident, anesthetist) confidence in the monitoring data from the device. In a single-center, observations of EMG electrode placement by anesthesia technicians, in 55 adult elective surgery patients were made by an independent observer. Separately, the anesthesia provider satisfaction with EMG derived data was recorded after reversal of neuromuscular block. An educational intervention then occurred on proper electrode positioning, including prior observations of electrode positioning, and prior anesthesia provider satisfaction with the EMG derived data. After the intervention, stimulating electrode position was observed with an additional 60 patients and anesthesia provider satisfaction with the data was again ascertained. The educational intervention significantly increased the proportion of ideal ulnar nerve groove electrode positioning from 74.5% to 95% (P < 0.003) and ideal wrist crease positioning (distal electrode within 2cm of crease) from 61.8% to 96.7% (P < 0.001). Anesthesia provider confidence with EMG derived information during anesthesia delivery, increased from 67 to 90% after the education (P = 0.005). There was a significant relationship between correct stimulating electrode placement and anesthesia provider confidence in the EMG derived data on neuromuscular block status. An educational intervention to improve EMG electrode positioning proved meaningful. It increased anesthesia provider confidence in the EMG derived data during anesthesia case management.

Engaging stakeholders in cultural tourism Living Labs: A pathway to innovation, sustainability, and resilience

This study explores the motivations and benefits driving stakeholder engagement in Living Labs (LLs) for sustainable cultural tourism, with a focus on a case study in Split, Croatia. LLs, which foster innovation through collaboration between stakeholders, are increasingly recognized as essential for addressing sustainability challenges in tourism. Using a combination of exploratory and confirmatory factor analysis (EFA/CFA), we identify key motivations for stakeholder participation, including the desire to shift attitudes toward tourism development, enhance educational initiatives, and improve heritage interpretation. The results reveal that stakeholder engagement not only enriches tourism offerings—such as joint marketing efforts and innovative visitor experiences—but also strengthens resilience in heritage destinations. Our findings emphasize the critical role of ambidextrous management, which balances innovation and resource efficiency, in enhancing stakeholder collaboration. The study provides practical recommendations for smart governance and advocates for stakeholder-centric, bottom-up approaches in the design and management of LLs. These insights contribute to both the theoretical framework and practical implementation of sustainable cultural tourism, offering actionable strategies for policymakers and practitioners to foster local ownership and co-creation in heritage tourism development.

MARRIAGE EDUCATION PRACTICES AT RECONCILIATION SCHOOLS

This paper aims to explore community-based marriage/family education practices conducted by the Reconciliation School. The Reconciliation School is an effort to help individuals achieve a better, happier, and more peaceful life by addressing emotional wounds caused by dysfunctional families. In its training sessions, the Reconciliation School adopts therapeutic methods developed by John Bradshaw and Virginia Satir. Interviews conducted by the author with several participants reveal positive impacts on their relationships with their spouses, children, parents, and themselves after undergoing therapy and training. As a conclusion, this paper suggests that community-based family education initiatives like the Reconciliation School should be expanded and potentially adopted to strengthen the family system in Indonesia, where the divorce rate currently hovers around 12-15 percent.