Educational Support Research Articles

Emergency Physicians’ and Nurses’ Perspectives on Transgender, Intersexual, and Non-Binary Patients

Introduction: Providing appropriate healthcare for transgender, intersexual and non-binary (TIN) individuals remains a significant challenge, as this group experiences higher rates of health inequalities, discrimination, and barriers to accessing care. Emergency physicians (EP) often lack formal training and knowledge about caring for TIN patients, while comparatively less evidence is available for other healthcare professionals, including emergency nurses (EN). Therefore, our goal in this study was to explore the experiences, knowledge, and attitudes as well as education/training needs of both ENs and EPs in Germany regarding the care of TIN patients. Methods: In February 2023, we electronically surveyed EPs and ENs from emergency departments (ED) across Germany. The survey, developed through literature review and collaboration with experts and members of the TIN community, consisted of 15 closed-ended items divided into three sections: experiences and knowledge; attitudes; and education/training needs. We used standard descriptive statistics and tested for group differences using the chi-square test. Results: Of the approximately 1,665 EPs and ENs contacted, 502 completed the survey and were eligible for further analysis (30% response rate). Of the respondents, 233 (46%) were EPs and 269 (54%) were ENs, with ENs being significantly younger and with fewer years in practice. More than half reported experience caring for TIN patients (71% of ENs vs 61% of EPs; P = 0.002), but there were significant gaps in medical and non-medical knowledge. Attitudes toward TIN patients were generally positive, but differences in communication approaches were noted, with ENs significantly more likely than EPs to limit their communication with TIN patients to what was necessary (25% of ENs vs 17% of EPs; P = 0.006). Most respondents (55% of ENs and 58% of EPs) had no training in the management of TIN patients, with only 8% of EPs and 17% of ENs having received such training during their medical/nursing school education (P = 0.01). Both groups agreed that there is an urgent need to increase awareness of emergency medical care for TIN patients among ED staff. Conclusion: Both emergency physicians and nurses in Germany demonstrated deficits in knowledge of and clinical preparedness to care for patients in the ED who identify as transgender, intersexual and non-binary, indicating a clear need for enhanced education, training, and institutional support to improve emergency care for this vulnerable patient population. [West J Emerg Med. 2024;25(6)1–9.]

Knowledge and attitudes on anemia and menstrual health among Malaysian female university students

Anemia is a significant public health concern, particularly among young female adults due to its potential impact on reproductive health. This study investigated the association between anemia-related knowledge, attitudes, menstrual health, and anemia status among Malaysian university students. This was a cross-sectional study named “SCARF” - Study to Combat Anemia - Research for Female Students, involving 674 university students in Malaysia. Anemia status was determined based on haemoglobin level, while knowledge, attitude and menstrual health were measured using validated questionnaires. The mean menarche age of students in this study was 12.1 ± 1.21 years. Students who were anemic had significantly longer menstrual cycle duration (P = 0.034) and more days with heavy flow (P = 0.038). Most students had poor knowledge (44.5%) and attitudes (84.1%) towards anemia. Students with good knowledge were 1.1 times more likely to have better anemia status compared to those with poor knowledge (95% CI: 1.0–1.2, P = 0.049). This study highlighted a lack of practical application of the knowledge to dietary habits. Collaborative efforts between educators and healthcare providers are crucial in developing a comprehensive strategy, such as interventions to prioritise educational initiatives and practical support to enhance overall menstrual health among female students.

Identification and optimisation of a risk stratified cohort of patients with type 2 diabetes through the delivery of a enhanced pharmacist-led service

Abstract Introduction Cardio-renal metabolic (CRM) diseases are each associated with significant morbidity and mortality, and due to their shared pathology, the benefit of managing these diseases holistically is becoming increasingly evident. The East Belfast Federation practices have sought to review patients living with type 2 diabetes (T2D), prioritising those not meeting their 3 Treatment Targets (3TT, HbA1c, blood pressure [BP] and cholesterol) to optimise treatment through a pharmacist-led model of care. Aims and Objectives 1. Improve adherence to latest update of NICE T2D [NG28, 2022], with a focus on patients with Cardiovascular Disease (CVD) & Chronic Kidney Disease (CKD). 2. Upskill diabetes teams, to create a legacy effect and ensure improved holistic management will continue beyond the project period. 3. Use a clinical audit tool to identify, stratify and optimise T2D patients not meeting their 3TTs. 4. Improve identification, coding and recall of patients with non-diabetic hyperglycaemia (NDH) as per QOF Indicator NDH001NI [QOF 2022/23]. 5. Enhanced focus on review of sulphonylureas (SU) in relation to frailty and risk of hypoglycaemia [Strain, 2021]. Method Patients not meeting their 3TTs (HbA1c>58 mmol/mol, BP>140/80mmHg, total cholesterol>5mmol/L) were identified from October 2022 to July 2023. Primary care based clinics created which we tailored to the specific needs of the practices with a focus on optimising patients with CVD & CKD co-morbidities. Dedicated specialist education and clinical support was provided to existing diabetes teams in CRM patient management. Additional searches were created and patients identified to review patients experiencing NDH and on a SU. Results At 9 months from baseline, there was a statistically significant improvement of 8.9% in patients achieving all 3TTs (n=373, P=0.013). This was accompanied by an increase in the number of patients optimised for CV risk reduction, with a 39% and 42% increase in patient receiving sodium glucose co-transporter-2 (SGLT2) inhibitors (n=542) and Glucagon-like peptide-1 receptor agonists (GLP1RA) (n=190), respectively. A 5.5% (n=28) reduction in the number of patients on a SU was observed, as well as a 44% (n=76) increase in the number of referrals into the Diabetes Prevention Programme (DPP). 151 statins and 51 BP medications were started/optimised. Discussion and Conclusion The project further exemplifies the feasibility of a pharmacist-led T2D service in a primary care setting. In addition to improvement in established T2D markers, the role promoted collaboration and facilitated best-practice sharing across multiple diabetes teams. This approach allows for more co-ordinated care for patients who may otherwise be referred to multiple specialists, which often results in fragmented care. Future work should focus on promoting CRM protection as early as possible to reduce disease progression and improve outcomes.Number of patients on antidiabetic meds% attainment of 3TT

The determinants of oral health in Turkish elderly: an analysis of Turkey Health Survey (THS) 2022

Abstract Background Oral health is an integral part of health and wellbeing; however, the use of dental care by the elderly is lower compared to other services. Considering the relationship between oral health and chronic diseases, along with healthcare use patterns, evaluating oral health in the elderly is crucial. This study aims to assess the oral health status and individual, socioeconomic and healthcare related factors in people aged 65 and over in Turkey. Methods This cross-sectional study was based on THS 2022 micro dataset. Participants aged 65 and over constituted the population of this study, with 3144 participants included. Data analysis was performed using SPSS 28.0 and included descriptive statistics, Pearson’s chi-square and logistic regression. Results The mean age of participants was 72.57 with 54% being women.Self-reported poor oral health was noted in 25.8%, and 75.2% did not receive dental care in the past year. Individual factors such as older age, obesity, and multimorbidity, as well as social factors like female gender, being single, and language barrier, were associated with worse oral health. Education and social support were also associated with oral health. Among economic factors, employment showed a significant association. Concerning healthcare-related factors, not using oral care in the past year, unmet dental care needs due to financial constraints, appointments, and transportation were associated with worse oral health. Logistic regression revealed significant associations between oral health and age, multimorbidity, gender, language, education, social support, employment, dental care use, unmet dental care needs due to financial constraints and transportation. Conclusions Addressing barriers and risk factors is needed to improve oral health among Turkey’s elderly. Efforts should focus on enhancing access to dental care and addressing socioeconomic determinants of oral health. Key messages • Identifying and addressing barriers and individual, socioeconomic and health-care related risk factors associated with poor oral health among the elderly in Turkey is important. • It is needed to prioritize efforts aimed at enhancing access to oral care for the elderly in Turkey by both improving physical access and addressing social determinants to ensure better oral health.

Interventions’ transferability assessment to strengthen Vaccination Uptake Among Migrants in Greece

Abstract Background Migrant children in Greece face significantly lower vaccination coverage rates for MMR and HPV compared to their counterparts. To address this disparity, our research focuses on selecting and adapting evidence-based interventions tailored to the specific needs of different migrant communities staying in Greece, guided by the PIET-T framework. Methods Using a stakeholder-engaged approach, we involved 26 key stakeholders to select evidence-based interventions relevant to the Greek context. These interventions underwent detailed analysis, considering their effectiveness, cultural appropriateness, and potential for transferability within the PIET-T framework. Key stakeholders provided input on intervention feasibility and country- and context-specific adaptation. Results Three interventions were identified as promising for MMR and HPV vaccination uptake: two health promoter interventions and a school-based vaccination one. The health promoter intervention was adapted so to involve health professionals and trusted community members delivering culturally sensitive education and navigation support, addressing barriers such as language and lack of information. The original school-based program implements education sessions and on-site vaccinations, leveraging the trusted environment of schools to reach parents and children. On-site vaccinations were omitted since they were not relevant to the Greek context due to legal barriers. Conclusions Our stakeholder-engaged approach, guided by the PIET-T framework, ensures interventions are tailored to the specific needs and contexts of different migrant communities in Greece. By prioritizing cultural sensitivity and community involvement, we aim to enhance MMR and HPV vaccination uptake and improve health outcomes among migrant populations.

Empowering People Experiencing Homelessness for cancer prevention using the Health Navigator Model

Abstract Cancer poses a significant public health concern. Reports highlight that cancer-related mortality rates are double among people experiencing homelessness (PEH). CANCERLESS project delivered an innovative solution based on the Health Navigator Model (HNM). The HNM is an evidence-based patient-centred intervention that develops patient empowerment through health education and social support, promoting timely access to cancer prevention services. A pre-post design study conducted across four pilot sites in Europe (Austria, Greece, Spain, UK) involved 652 PEHs. Pilot interventions based on the HNM were implemented, with effectiveness evaluated at baseline and post-intervention. The study assessed the impact of the HNM on various factors including risk behaviors, lifestyles, quality of life, empowerment, health literacy, psychological distress and utilization of health and care services. Preliminary findings from CANCERLESS HNM intervention showed significant improvements (p= .000) in participants’ quality of life (55.82 (27.65) vs. 66.18 (22.27)) and sense of empowerment (25.58 (19.95) vs. 59.94 (43.10)). However, there were no observable impacts in health literacy (p= .509) or psychological distress (p= .140), which remained within acceptable ranges both pre- and post-intervention. Similarly, there were no significant changes observed in lifestyle or risk behaviours among PEHs. Nonetheless, the evaluation of effectiveness suggested that the HNM increase in the uptake of cancer prevention care, such as cancer screening (p= .000). The CANCERLESS HNM intervention significantly improved the quality of life and empowerment of PEHs. Additionally, it successfully promoted their involvement in cancer prevention efforts, addressing disparities in access to preventive healthcare services. Increased engagement in such initiatives can lead to early detection and treatment, ultimately reducing cancer morbidity and mortality rates, thereby positively impacting public health. Key messages • By promoting health equity and social justice, interventions like CANCERLESS HNM contribute to building healthier and more resilient public health systems. • CANCERLESS boosts cancer prevention awareness, tackles healthcare disparities, enhances cancer early detection, benefiting public health.

Health as predictor of unemployment. A population based study in Belgium

Abstract Background Health and employment are interrelated, but this can be both the result of social causation and health selection. Insights in the association between health and employment should be explored in different settings and countries because contextual factors may differ. In this study we investigate if at the Belgian population level, ill health leads to a higher risk of unemployment. Methods We used data from the Belgian health interview survey 2018 linked with administrative data from the compulsory health insurance including information on employment status in 2018 and 2019. The sample for this study consisted of people with a paid job, aged 18-64 year, with no record of having being unemployed in 2018 (n = 3769). Multivariate logistic regression was used to assess if the risk of becoming unemployed in 2019 varied in function of the health status assessed in the 2018 survey. Results After adjustment for age, sex, education and social support, the risk of becoming unemployed was significantly higher for people with moderate to very bad self-rated health compared to those in good health (OR 2.76; 95% CI 1.34-5.67). Similarly, unemployment in the year following participation in the survey was significantly higher among people with activity limitations because of health problems (OR 2.32; 95% CI 1.14-4.72). The higher the number of chronic diseases and conditions, the higher the risk of unemployment (OR 1.37; 95% CI 1.13-1.53). Specific predictors of unemployment were a history of serious depression in the past 12 months (OR 4.47; 95% CI 1.85-10.80) and hypertension (OR 2.54; 95% CI 1.08-6.00). Conclusions In Belgium, health problems are a risk factor of getting unemployed. Especially people with a history of serious depression in the past year have a higher risk to lose their job. The findings confirm the health selection of unemployment and the need for the labour market to invest in interventions to support people with health problems to keep or find a job. Key messages • As employment is a fundamental right, also for people with health problems, further efforts are needed to create an inclusive labour market, with also job opportunities for more vulnerable people. • To be able to understand better the link between health and unemployment at population level, longitudinal population data are needed including both dimensions.

Strategies to advancing digital health equity: perspectives from underserved groups

Abstract Digital Health Technologies (DHTs) are revolutionizing healthcare. However, there is a lack of demonstrable health benefits across all populations. To advance digital health equity, we explored the perspectives of underserved groups on strategies to support digital inclusivity. Participants belonged to two or more CLEARS (Culture (ethnicity, language, religion), Limiting conditions (visual or hearing), low Educational attainment, older Age, Residence (rural, deprived or no fixed address), low Socioeconomic status) groups. This framework encompassed sociodemographic factors associated with digital exclusion and recognizes the role of intersectionality.(1) Twenty-nine individuals participated in focus groups (n = 4) or interviews (n = 11) and shared their perspectives on the barriers to DHTs, innovative ideas to improve inclusivity, and perceived feasibility of implementing changes. An inductive reflective thematic analysis was used to analyze the transcripts, assisted by N-Vivo. Participants experienced fragmented communication with healthcare providers when using DHTs, explaining how they received a no-reply SMS message asking them to confirm an appointment via a link but were unable to access the link. Current solutions to overcoming such barriers included using non-digital routes (e.g., visiting a pharmacy) or calling non-emergency healthcare services. Many participants expressed the need for DHT support services to be implemented to provide educational support and access to devices. However, some participants raised concerns about the financial strain this might place on healthcare systems. Future research should evaluate the feasibility of implementing different DHTs support services across different settings to advance digital health equity. (1)Wilson et al. (2023). Strategies to develop, design, implement and support digital health equity in key underserved groups: protocol for a systematic review. Alzheimer’s & Dementia. Key messages • Strategies to mitigating digital exclusion within healthcare should be designed with underserved groups. • Future research should evaluate the feasibility of implementing different DHTs support services across different settings to advance digital health equity.

Social Media Influence on Factors Affecting Quality of Life among Breast Cancer Survivors: A Conceptual Study

Breast cancer disease remains a significant burden in global public health, affecting women with new cases and mortality. In 2018, Malaysian women of different races, like Malays, Chinese, and Indians, were diagnosed with breast cancer, approximately 17,000 in total. The consequence is that their quality of life was affected, especially in physical and emotional health. Nowadays, the use of social media among users is increasing, and in healthcare, it examines the role of social media in patient education and social support, which highlights the importance of modern digital technology. This conceptual study examines the factors affecting quality of life, moderated by the role of social media influence. Sociodemographic, psychological state, self-care behaviors, social support, and healthcare support systems were among the factors identified. The study relies on the integration of the quality-of-life model and social cognitive theory in conducting the literature review. Furthermore, this study has implications for improving the quality of life through social media, promoting patient-doctor engagement with social media, supporting policymakers in improving public health outcomes, and identifying potential future research topics. Theoretical contributions with integrated frameworks and an innovative approach to breast cancer survivorship were also identified. Policymakers and healthcare professionals have an opportunity to make practical contributions through the use of social media. The study's limitations were a narrow focus on cancer research, limited generalisability, and a broad range of social media investigations

Performance Assessment of GPT 4.0 on the Japanese Medical Licensing Examination.

To evaluate the accuracy and parsing ability of GPT 4.0 for Japanese medical practitioner qualification examinations in a multidimensional way to investigate its response accuracy and comprehensiveness to medical knowledge. We evaluated the performance of the GPT 4.0 on Japanese Medical Licensing Examination (JMLE) questions (2021-2023). Questions are categorized by difficulty and type, with distinctions between general and clinical parts, as well as between single-choice (MCQ1) and multiple-choice (MCQ2) questions. Difficulty levels were determined on the basis of correct rates provided by the JMLE Preparatory School. The accuracy and quality of the GPT 4.0 responses were analyzed via an improved Global Qualily Scale (GQS) scores, considering both the chosen options and the accompanying analysis. Descriptive statistics and Pearson Chi-square tests were used to examine performance across exam years, question difficulty, type, and choice. GPT 4.0 ability was evaluated via the GQS, with comparisons made via the Mann-Whitney U or Kruskal-Wallis test. The correct response rate and parsing ability of the GPT4.0 to the JMLE questions reached the qualification level (80.4%). In terms of the accuracy of the GPT4.0 response to the JMLE, we found significant differences in accuracy across both difficulty levels and option types. According to the GQS scores for the GPT 4.0 responses to all the JMLE questions, the performance of the questionnaire varied according to year and choice type. GTP4.0 performs well in providing basic support in medical education and medical research, but it also needs to input a large amount of medical-related data to train its model and improve the accuracy of its medical knowledge output. Further integration of ChatGPT with the medical field could open new opportunities for medicine.

Clinical and Sociodemographic Profile, Self-Care, Adherence and Motivation for Treatment, and Satisfaction with Social Support in Portuguese Patients with Type 2 Diabetes.

Objective: This study aimed to characterize the sociodemographic and clinical profiles of Portuguese patients with type 2 diabetes mellitus (T2DM) and to assess their self-care practices, treatment adherence, motivation, and satisfaction with social support. Methods: A cross-sectional observational study was conducted at an endocrinology unit in northern Portugal from January 2021 to December 2022. The sample included 303 adult patients with T2DM who provided informed consent. Data were collected using a structured questionnaire addressing sociodemographic, clinical, and self-care aspects. Validated scales were used to assess diabetes knowledge, self-care activities, treatment adherence, motivation, and social support. Results: Of the 303 patients enrolled, with a median age of 67 years, 51.2% were female and 68.2% retired. Clinical measures showed a median systolic blood pressure of 135 mmHg, abdominal circumference of 104.6 cm, and BMI of 29.3 kg/m2. Self-care practices were suboptimal, with only 25.1% of patients consistently following a healthy diet, and 31% engaged in weekly physical activity. Although treatment adherence was generally high, issues like forgetfulness were reported. Satisfaction with social support varied, with 30% of patients feeling isolated. Conclusions: The study identifies significant gaps in diet and physical activity adherence among T2DM patients. There is a need for targeted educational interventions and enhanced support systems to improve self-care and treatment outcomes. Personalized care strategies addressing educational, motivational, and social support factors are crucial to better managing T2DM and improving patient well-being.

Artificial intelligence in rheumatology: perspectives and insights from a nationwide survey of U.S. rheumatology fellows.

Artificial Intelligence (AI) is poised to revolutionize healthcare by enhancing clinical practice, diagnostics, and patient care. Although AI offers potential benefits through data-driven insights and personalized treatments, challenges related to implementation, barriers, and ethical considerations necessitate further investigation. We conducted a cross-sectional survey using Qualtrics from October to December 2023 to evaluate U.S. rheumatology fellows' perspectives on AI in healthcare. The survey was disseminated via email to program directors, who forwarded it to their fellows. It included multiple-choice, Likert scale, and open-ended questions covering demographics, AI awareness, usage, and perceptions. Statistical analyses were performed using Spearman correlation and Chi-Square tests. The study received IRB approval and adhered to STROBE guidelines. The survey aimed to reach 528 U.S. rheumatology fellows. 95 fellows accessed the survey with response rate to each question varying between 85 and 95 participants. 57.6% were females, 66.3% aged 30-35, and 60.2% in their first fellowship year. There was a positive correlation between AI familiarity and confidence (Spearman's rho = 0.216, p = 0.044). Furthermore, 67.9% supported incorporating AI education into fellowship programs, with a significant relationship (p < 0.005) between AI confidence and support for AI education. Fellows recognized AI's benefits in reducing chart time (86.05%) and automating tasks (73.26%), but expressed concerns about charting errors (67.86%) and over-reliance (61.90%). Most (84.52%) disagreed with the notion of AI replacing them. Rheumatology fellows exhibit enthusiasm for AI integration yet have reservations about its implementation and ethical implications. Addressing these challenges through collaborative efforts can ensure responsible AI integration, prioritizing patient safety and ethical standards in rheumatology and beyond.

A Critical Comparison of the Learning and Teaching Strategy of the University of Glasgow and the University of Manchester

Abstract: The two broad currents of changes in formal higher education this study focuses on are: the shift from teacher-centred to learner-centred educational approaches, and integration of information and communication technologies. The policy documents that are chosen to analyse in this essay are those of the University of Glasgow and the University of Manchester. This study found three claims that supported Learner centre Education, and the development of technology expanded students' access to education and challenging traditional teaching ways. UOG's policies reflect more first current of changes than UOM's, while UOM's policies reflect more second current of changes than UOG's. The first current of change is more explicitly reflected in UOG's education policy and is only implicit in UOM's policy. UOG regards technologies as flexibility to education, while UOM regards technologies as the fundamental support for new education. However, both the policies of UOG and UOM need to take more into account the challenges and response strategies brought about by these educational changes, and further refine their educational strategies to improve feasibility.

Amplifying School Mental Health Literacy Through Neuroscience Education

Children and adolescents face a wide variety of developmental changes and environmental challenges, and it is estimated that at least one in five children aged 3–17 will experience behavioral or mental health issues. This period of life coincides with major changes in brain structure and function that have profound long-term consequences for learning, decision-making (including risk taking), and emotional processing. For example, continued development of the prefrontal cortex in adolescence is a sensitive period during which individuals are particularly susceptible to risky behaviors, environmental stressors, and substance use. While recent advances in mental health literacy programs have paved the way for increased awareness of the benefits of mental health curricula in schools, these efforts could be greatly bolstered with support in basic neuroscience education in developmentally appropriate and area-specific content. Here, we provide a discussion on the basic structural and functional changes occurring in the brain throughout childhood, how this contributes to changes in cognitive function, and the risk factors posed by early life adversity, stress, and drug use. Finally, we provide a perspective on the benefits of integrating findings from the field of neuroscience and suggestions for tools to better equip students, teachers, administrators, and school mental health staff to provide new directions for addressing the mental health crises faced by millions of children and youth each year.

Leveraging Islamic Social Finance for Fair and Sustainable Tertiary Education Funding for Orphans in Malaysia: Insights from Sri Lanka

The primary objective of this paper is to draw lessons from Sri Lanka's experience with OrphanCare utilizing Islamic social finance, while also identifying avenues through which Malaysia could establish a sustainable model for achieving a similar purpose. This study uses a qualitative, exploratory approach to investigate the operational framework of OrphanCare in Sri Lanka and its potential lessons for Malaysia. Due to limited secondary sources, an unstructured interview with OrphanCare representatives was conducted to gather in-depth insights. The research unfolds in two phases: first, data collection from both primary (interviews) and secondary (reports, literature) sources to identify gaps and challenges; and second, the analysis of this data using content analysis. The OrphanCare interview from Sri Lanka offers crucial insights for Malaysia's mission in enabling orphan access to higher education. Challenges, like financial constraints and limited support networks, align with Malaysia's inequality reduction goals. Tertiary education benefits, including employability and personal growth, are highlighted. Islamic social finance lessons stress its transformative potential, while collaboration and long-term commitment are its strengths. Recommendations include education funds, support networks, career guidance, awareness campaigns, and sustainable collaborations. A regulatory framework featuring the Orphans Education Fund with a 2% annual contribution from listed companies, managed by National Higher Education Fund Corporation (PTPTN), is proposed. This paper demonstrates originality by uniquely proposing the utilization of Islamic Social Finance to enhance orphan access to tertiary education. It draws insights from Sri Lanka's OrphanCare model and presents innovative strategies for Malaysia to tackle inequalities through collaborative efforts and a robust regulatory framework.

Farmers’ perceptions and awareness of cattle feedlots as a climate-smart approach to enteric methane emissions

The perceptions of farmers regarding communal feedlots and their role in reducing enteric methane emissions have received limited attention in research. This study aims to examine farmers’ perceptions, assess awareness, and identify barriers to adopting feedlots as a climate-smart practice to enteric methane emissions in rural communities in the Eastern Cape Province, South Africa. 161 structured, paper-based questionnaires were distributed among smallholder cattle farmers around three feedlot locations. Most farmers had heard about feedlots (67.7 %); however, only a few (19.9 %) participated. The lack of knowledge about feedlot operations was the main factor influencing farmers’ participation in feedlots. Most farmers did not perceive feedlots as a climate-smart approach to reducing enteric methane output (53.8 %), with few sure (9.6 %) and others unsure (36.5 %). When asked about the reasons for their perceptions of feedlots as a climate-smart approach to mitigating methane, many farmers were unsure of the reasons (86.5 %), with the least believing it could be related to poor feed quality (1.9 %). The availability of financial resources and level of education were the key factors influencing farmers’ willingness to adopt feedlots as a climate-smart practice. These findings emphasise the importance of targeted educational workshops and support systems to enhance farmers’ awareness and promote the adoption of cattle feedlots as a climate-smart approach. The findings can also inform policy and practice to address perceived feedlot drawbacks, such as feed provision and technical assistance, and improve their successful implementation. However, further research is needed to explore farmers’ perceptions of cattle feedlots as a climate-smart practice.

The Structural Model of Influential Interplay among Cultural Practices, Social Support, Economic Factors, and the Suku Anak Dalam Community’ Perceptions of Religious Education

The Suku Anak Dalam (SAD) community in Sumatra, Indonesia, faced unique educational challenges influenced by cultural, social, and economic factors. This study aimed to explore and confirm the influential relationships among cultural practices, social support, economic factors, and SAD’s perceptions of religious education. A total of 356 literate SAD from some regions in Sumatra were sampled. Utilizing Partial Least Squares Structural Equation Modeling (PLS-SEM), data were collected through a structured questionnaire translated into the local language. The results revealed that cultural practices positively impacted SAD’s perceptions of religious education (H1, t=7.550, p=0.000) and significantly enhanced social support (H4, t=3.870, p=0.000). Social support positively influenced perceptions of religious education (H2, t=4.880, p=0.000), while economic factors had a strong positive effect on both perceptions of religious education (H3, t=9.119, p=0.000) and social support (H5, t=31.108, p=0.000). These findings highlight the necessity of integrating cultural, social, and economic aspects in educational policies for the SAD community. The study's novelty lies in its structural model, offering deep insights into religious education perceptions. Future research should explore similar dynamics in other indigenous communities using longitudinal and qualitative methods.

Exploring the Stressors and Coping Mechanisms of Chinese University Instructors Amidst the COVID-19 Pandemic

This study explores the pressures and challenges Chinese university instructors face during the rapid shift to online teaching due to the COVID-19 pandemic. Using a quantitative research methodology, the study employed a questionnaire distributed via the Qualtrics platform to gather data from instructors at over 20 top-tier Chinese universities. The results of the correlation analysis of the data show that personal factors significantly influence instructors’ stress levels and coping strategies. The study underscores the need for enhanced technical training, psychological support, and improved online teaching resources. These insights inform educational reforms and support measures to enhance instructors’ well-being and teaching quality in an evolving educational landscape.

To Emerge or Not to Emerge? A Qualitative Inquiry on Basic Needs of Emerging Adults During the COVID-19 Pandemic

Purpose: This study explores the experiences of Turkish emerging adults during the early months of the COVID-19 pandemic as regards their needs. Design/Methodology/Approach: In this context, 20 participants (10 males and 10 females) were recruited (March to April, 2020) using purposive snowball sampling in a phenomenological design. Data were collected via semi-structured online interviews and analyzed using interpretative phenomenological analysis. Findings: We have explored several of the needs experienced by the participants (self-allocation, relational, physiological, career and physical). We also discovered some barriers (relational, physiological, educational, environmental, personal and financial) and facilitators (social support, technological support, physical facilities, educational support and personal traits) to address their needs. We finally asked what they do in order to fulfill their needs (behaviors for building relationships, behaviors for self-allocation, behaviors for career development, behaviors for physical health) Highlights: In light of the findings, It is important to design intervention studies regarding mental health problems that may arise due to emerging adults not being able to meet their needs during the Covid-19 period. In addition, it is recommended that steps be taken in line with the needs of emerging adults by taking into account the findings of this study in the face of possible situations that may be encountered similar to the Covid-19 period.

“Livonia is just all racism”: locating black families’ racial and spatial experiences, school choices, and educational agency in metropolitan Detroit

ABSTRACT Focusing on the metropolitan Detroit region, this paper examines how seven Black families’ racial and spatial subjectivities influenced their suburban school and community choices, and more broadly their acts of educational agency. Using a critical phenomenological approach, key findings show that families’ lived experiences of race and racism in the region, along with the increased presence and support of Black students, families, and educators in select suburban schools influenced their choices and efforts to make suburban schools aligned with their educational and communal priorities, revealing the dual nature in which Black families navigate unjust U.S. education landscapes. Implications address the ongoing challenges Black families encounter in U.S. regional education landscapes and the need for more just approaches that honor Black families’ educational agency and placemaking in local contexts.