Effective Intervention Programs Research Articles

Determinants promoting and hindering physical activity in primary school children in Germany: a qualitative study with students, teachers and parents.

Determinants affecting children's physical activity (PA) at an early age are of particular interest to develop and strengthen strategies for increasing the levels of children's PA. A qualitative study was conducted to investigate the views of primary school-aged children, their teachers and parents regarding barriers and facilitators to engage in PA. Focus groups were conducted separately with primary school children, parents and teachers in a city in Northern Germany between October 2021 and January 2022. The semi- structured focus groups with children and teachers took part in person within school, whereas the focus groups with parents took place online. Data were transcribed verbatim and analysed using thematic analysis. During analysis, the socio-ecological model was identified as useful to map the determinants mentioned and was consequently applied to organize the data. Teachers (n = 10), parents (n = 18) and children (n = 46) of five primary schools in Germany participated in the focus groups. Participants of the three groups identified similar barriers and facilitators of PA in primary school-aged children, ranging across all four layers of the socio-ecological model. The barriers encountered were the preferences of children for sedentary activities (individual characteristics), the preference of parents to control their child's actions (microsystem), a lack of financial resources from parents and long sitting times in class (mesosystem), and barriers related to rainy weather and Covid-19 restrictions (exosystem). Facilitators mentioned were the childrens' natural tendency to be active (individual characteristics), involvement and co-participation of parents or peers in engaging in PA, support provided by teachers and the school (microsystem), living in rural areas, having sufficient facilities and favorable weather conditions (exosystem). A range of determinants promoting and hindering PA, ranging across all layers of the socio-ecological model were identified by children, parents and teachers in this study. These determinants need to be kept in mind when developing effective PA intervention programs for primary school-aged children. Future interventions should go beyond individual characteristics to also acknowledge the influence of childrens' social surrounding, including parents, peers and teachers, and the wider (school) environment.

Substance Use Disorders among Adolescents in the United States: 2000-2019.

Substance use disorders (SUDs) are characterized by impairment caused by the recurrent use of alcohol, illicit drugs, or both. SUDs are pervasive and endemic among US adolescents, with potentially negative health and social consequences. Although the term experimentation normalizes adolescent substance abuse, the long-term consequences of this behavior beginning in adolescence can be detrimental to not only the adolescent but also the adult into which he or she develops. Our objective was to examine the epidemiology of SUD among hospitalized US adolescents, 13 to 19 years of age, during the time period 2000-2019. A case-control study was conducted using 5,260,104 hospital discharge records (394,952 SUD and 4,865,152 non-SUD) from the 2000-2019 Kids' Inpatient Database. SUD and clinical outcomes variables were identified based on the International Classification of Diseases, Ninth/Tenth Revisions, Clinical Modification, coding. SUD rates (per 1000 discharges) were calculated and adjusted odds ratios (aORs) with their 95% confidence intervals (CIs) were computed using logistic regression models for predictors of SUDs among hospitalized adolescents. The prevalence of SUDs was estimated to be 75.10 cases per 1000 discharges (95% CI 74.86-75.31). Demographically, the highest crude rates (per 1000 discharges) were seen among Native American (139.58) and White (91.97) patients. Adolescent patients who experienced SUD were twice as likely as nonusers to be 16 to 19 years of age (aOR 2.2, 95% CI 2.13-2.19) or to be male (aOR 2.2, 95% CI 2.22-2.27). SUD was significantly associated with cooccurring conditions, including anxiety (aOR 2.5, 95% CI 2.48-2.53), depression (aOR 2.3, 95% CI 2.30-2.35), mood disorder (aOR 2.17, 95% CI 2.14-2.20), schizophrenia (aOR 2.6, 95% CI 2.52-2.64), sexually transmitted infections (aOR 2.3, 95% CI 2.23-2.45), hepatitis (aOR 3.0, 95% CI 2.87-3.15), and suicide (aOR 1.33, 95% CI 1.30-1.35). The study examined the epidemiology, risk factors, and common characteristics of hospitalized adolescent patients with SUDs. The high burden of psychiatric and medical comorbidities observed among this patient group warrants designing effective and comprehensive substance use prevention and treatment programs for youths.

Mental health disorders among Thai farmers: occupational and non-occupational stressors

This cross-sectional study aimed to identify occupational and non-occupational factors that impact levels of stress, depression, and anxiety among farmers located in the northern part of Thailand, including the potential psychological impacts of pesticide use. The participants (N = 270) were interviewed with a survey adopted and modified from peer-reviewed articles and questionnaires. The survey consists of four parts, including demographic information and pesticide exposure; perceived farm stressors employing Farm Stressor Survey (FSS); mental health disorder utilizing Srithanya Stress Scale (ST5), Nine-Questions Depression- Rating Scale (9Q), and Depression Anxiety Stress Scale 21 (DASS21); in addition to COVID-related stress utilizing COVID Stress Scale (CSS). The participants were categorized into two groups i.e., Spray and No Spray based on their self-reported occupational use of pesticide spraying within the past year. No significant associations were observed between occupational pesticide exposures and mental health disorder scores. Being female, having a second job besides a farmer, having applied pesticides for greater than 20 years, and having a higher farm stressor perception showed a significant positive association with self-reported mental health disorders; while having a good agricultural practice and PPE use showed a significant negative association with those outcomes. This pilot study scrutinized expanded sources of stress in farm work and provided information for the development of more effective mental disorder intervention programs for Thai farmers.

Relationship between addictions and obesity, physical activity and vascular aging in young adults (EVA-Adic study): a research protocol of a cross-sectional study.

Behavioral and substance addictions are prevalent health problems that, alongside obesity, are linked to reduced physical activity and increased sedentary time. Similarly, arterial stiffness and vascular aging are processes that begin gradually at an early age and are closely associated with morbidity and mortality from cardiovascular diseases. The main objective of this study is to analyze how addictions are related to obesity and body fat distribution, physical activity, sedentary time, arterial stiffness and vascular aging, as well as sleep quality, cognitive function and gender differences in young adults aged between 18 and 34 years. This cross-sectional descriptive observational study will analyze data from 500 subjects (250 men and 250 women) aged 18-34 without cardiovascular disease, selected by simple random sampling with replacement from the urban population of the city center of Salamanca (34,044 people aged 18-34, with 18,450 women and 15,594 men). Behavioral and substance addictions, as well as sleep quality and cognitive impairment will be assessed using questionnaires. The Pittisburg Sleep Quality Index (PSQI) will be used to measure sleep quality and the Ford questionnaire will be used to measure insomnia in response to stress. For obesity, weight, height, waist and hip circumference, body composition will be measured with the Inbody 230® impedance meter. For physical activity and sedentary time, we will use the Actigraph® accelerometer alongside the international physical activity questionnaire (IPAQ) and the Marshall questionnaire. The Sphygmocor System® will be used for pulse wave analysis and carotid-femoral pulse wave velocity (cfPWV), while the Vasera VS-2000® will measure cardio ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV). Vascular aging will be calculated with the 10th and 90th percentiles of cfPWV or baPWV. Demographic, analytical variables will be collected, as will data to assess vascular, cardiac, renal, and brain injury. Addictions are on the rise in today's society, affecting the mental health and well-being of those who suffer from them, generating important social problems such as job loss, family dysfunction, debt and social isolation. Together with obesity, they are prevalent health problems in young adults and are associated with lower physical activity and higher sedentary time. Meanwhile, arterial stiffness and vascular aging are processes that begin gradually at an early age and determine morbidity and mortality caused by cardiovascular diseases. The results of this project will allow us to understand the situation regarding behavioral and substance addictions in young adults. Better understanding of these addictions will in turn facilitate the development of more effective prevention strategies and intervention programs, which can then reduce the negative impact at both the individual and societal levels. [ClinicalTrials.gov], identifier [NCT05819840].

Epidemiological pattern of rape cases managed at a regional hospital in South Africa.

South Africa has one of the highest incidences of rape globally. Understanding the epidemiological pattern of rape is needed to inform the design of effective intervention programmes for rape prevention and management of alleged rape cases. To investigate important epidemiological patterns associated with rape in Kimberly, Northern Cape Province, South Africa. The Robert Mangaliso Sobukwe Hospital (RMSH) forensic unit. A descriptive, retrospective cross-sectional clinical audit of rape cases. The majority (93.3%) of the alleged rape victims were women, with a mean age (SD) of 21.6 years (11.3); the male population made up 6.7% of the cases, with a mean age (SD) of 10.5 years (6.9). The highest incidence of alleged rape in the male population was seen in the age group ≤ 16 years (81.8%) and for women 17-30 years (50.3%). Most of the incidents occurred at the perpetrators' homes (42.7%); on the days Fridays (14.6%), Saturdays (29.9%) and Sundays (23.2%); at night up to midnight 20:00-23:59 (32.9%) (p = 0.01) and involved threats of violence (55.5%). The majority (56.0%) of the perpetrators were known to the victims. Important information about the victims and circumstances in which rape occurs as reported herein can be used to inform the design of effective intervention programmes for sexual crime prevention and management in Kimberly, South Africa. This study helped to advance knowledge and understanding of the epidemiological pattern associated with rape in Kimberley, Northern Cape Province of South Africa.

The influence of eight cognitive training regimes upon cognitive screening tool performance in post-stroke survivors: a network meta-analysis.

Traditional meta-analysis offers only direct comparative evidence. The optimal cognitive training for poststroke cognitive impairment (PSCI) remains largely undetermined. This study aims to assess and compare the effectiveness of selected cognitive training methods for PSCI patients and to identify and rank the most effective intervention programs. Searches were conducted in PubMed, Embase, Cochrane Library, Web of science, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Database, and China Biomedical Database for randomized controlled trials up to September 30, 2023. Two researchers independently performed literature screening, data extraction, and quality assessment. Network meta-analysis was utilized to synthesize the main findings. The primary outcome focused on the intervention's impact on subjective cognitive function, with secondary outcomes including effects on activities of daily living, motor function, and functional independence. This study is registered with PROSPERO (CRD42023463282). Fifty eligible randomized controlled trials were identified, revealing eight distinct interventions. These interventions collectively demonstrate efficacy in enhancing cognition. Traditional cognitive training significantly improves overall cognitive function, daily living function, motor function, and functional independence. In Loewenstein Occupational Therapy Cognitive Assessment, Barthel Index, Fugl-Meyer Assessment, and Functional Independence Measure scales, a combination of computer-based and traditional cognitive training outperformed the conventional control group MD = 29.97 (95%CI: 16.3, 44.2), MD = 18.67 (95%CI: 9.78, 27.45), MD = 28.76 (95%CI: 5.46, 51.79) and MD = 42.2 (95%CI: 5.25, 78.99). In the MMSE scale, virtual reality cognitive training combined with traditional training was most effective MD = 8.01 (95%CI: 3.6, 12.4). On the MoCA scale, the combination of exercise and cognitive training showed superior results MD = 6.68 (95%CI: 2.55, 10.78). Only the combined computer-based and traditional cognitive training, as well as traditional cognitive training alone, significantly enhanced functional independence, with no notable differences in other pairwise interventions. The network meta-analysis suggests that augmenting traditional training with other modalities may enhance overall effectiveness. Specifically, interventions incorporating computer-based cognitive training appear to surpass other methods in improving cognition, daily living function, motor skills, and functional independence. The findings of this network meta-analysis provide evidence-based guidance for clinical decision-making. https://www.crd.york.ac.uk/PROSPERO/, identifier in PROSPERO (CRD42023463282).

The Nature of Victimization among Third Gender Individuals: An Empirical Study in Tangail Municipal Area

Understanding the nature and extent of third-gender victimization is crucial for effective addressing, influenced by various social, cultural, and political factors. This study aims to identify the victimization experienced by third genders in Tangail Municipal Area and to find out the causes, consequences, and preventive policies to overcome it. A quantitative approach was used, and data was collected through a survey questionnaire using snowball sampling. Results showed that 53% of the respondents were hijra, 14% were transgenders, and 33% were lady boys. The study found that 87.3% of respondents experienced physical assault, while 10.8% reported being raped, with 80.6% of cases perpetrated by neighbors. All respondents experienced psychological abuse, while 96.4% faced social stigmatization and 98.2% faced discrimination of violence and harassment. The consequences of victimization among third genders impact their mental and physical health, social life, and daily activities. Effective policies and intervention programs are needed to prevent the victimization of third genders.

Lived experiences with pre-exposure prophylaxis uptake and adherence among transgender women in Thailand: a qualitative study.

Transgender women (TGW) are disproportionately affected by HIV, and HIV prevalence among TGW in Thailand has been increasing. Although oral daily pre-exposure prophylaxis (PrEP) is effective for HIV prevention, PrEP uptake and persistence among TGW have been low. This study aimed to provide a deeper understanding of TGW's experiences with PrEP uptake and adherence, and to identify major barriers to PrEP use to inform intervention adaptation. We interviewed 20 young TGW (six non-PrEP users, eight adherent, six non-adherent) and 10 health care providers from two HIV clinics in Bangkok, Thailand, in 2022. We focused on understanding challenges to PrEP use in this population using an interview guide based on a theoretical model of behaviour change and thematic content analysis. Thematic analysis identified major barriers to and facilitators of PrEP uptake and adherence. Barriers to PrEP initiation included low self-perceived HIV risk, concern about potential side-effects, patient burdens such as frequent HIV testing for prescription refills and social stigma against PrEP. Barriers to adherence included side-effects, inconvenient access to health services (especially during COVID-19 lockdowns), forgetfulness resulting from busy schedules and low self-perceived HIV risk. TGW also reported health care providers' stigma against PrEP users deterred them from seeking further PrEP services. TGW identified major facilitators of PrEP initiation, including awareness about the benefits of PrEP, concern about risks of HIV and supportive social networks of PrEP users. As to PrEP regimens, most TGW participants reported a clear preference for long-lasting, injectable PrEP over daily oral PrEP. TGW and health care providers largely agreed on barriers and facilitators of PrEP use, but they differed in perceptions of HIV risk. The results highlighted challenges and opportunities to improve the delivery of PrEP, as well as other sexually transmissable infection and mental health services, especially among TGW. Thus, there is an urgent need for developing effective intervention programs that could raise PrEP awareness and knowledge, reduce PrEP stigma, and improve PrEP delivery systems among TGW in Thailand.

To assess knowledge, attitude, and practices among caretakers of adults with autism spectrum disorders and intellectual disabilities as regards causes, management methods, and rehabilitation of such children in Jalandhar District of Punjab

Background: Among the developmental disorders, autism spectrum disorder (ASD) and intellectual disability (ID) are the most common disorders present in human beings. Both of these account for 3–5% of the population. Early intervention with applied behavior analysis in natural surroundings may lead to improvements in I.Q. and change in ASD diagnosis. For young children, caretakers are the first source of instruction in social behavior and training of caretakers is considered very important for effective intervention programs for autistic children. Therefore, intervention strategies should be made through a joint approach between parents and professionals. Aims and Objectives: To assess the knowledge, attitude, and practice of caretakers of adults with ASD and ID regarding causes, management, and rehabilitation. Materials and Methods: Caretakers of 100 adults with ASD and ID were selected randomly from APAAR, an NGO based in PIMS; Chanan, an association of caretakers of adults with ID and ASD and from the records with District Education Officer, Jalandhar, were interviewed on a semi-structured pro forma. The data so obtained were analyzed statistically. It was a one-time study. Inclusion criteria – caretakers of adults with ID and ASD who were willing to participate. Exclusion criteria – caretakers of adults with ASD and ID who were not willing to participate. Results: 19 (18.45%) of caretakers of adults with ASD/ID believed that their condition was due to some medical condition whereas 77 (74.76%) believed that it was due to some old karma. 24 (23.3%) parents of children with ASD/ID undertook medical treatment including prevocational training and rehabilitation whereas 72 (69.9%) parents took treatment for traditional healers. 7 (6.8%) did not participate in the study. Conclusion: The majority of caretakers of adults with ASD/ID believed that the condition of their wards was due to old karma and possession by evil spirits as compared to medical causes and so they preferred traditional healing methods instead of medical treatment.

Investigating predictors of juvenile traditional and/or cyber offense using machine learning by constructing a decision support system

The present study aims to examine whether criminogenic risk factors can be applied to explain different types of juvenile offenses involving traditional and/or cyber offenses, and explore their common and unique patterns presented among juvenile offenders. To achieve the goals, this study employs machine learning (ML) techniques to construct a decision support system that predicts different types of juvenile offenses (i.e., non-offense, hacking only, traditional offense only, and both offenses) by risk factors rooted in a variety of criminological theories. This study is based on the data from the Second International Self-Report of Delinquency Study. The results demonstrate the generalizability of mainstream criminological theories to juvenile hacking and dual offenses involving both traditional offense and hacking. ML predictive models can successfully distinguish between different types of juvenile offenders and identify the most influential risk factors (e.g., gender, digital piracy, substance use, victimization, and parental supervision). The relative importance of risk factors provides valuable information to decision-makers and stakeholders in the juvenile justice system for developing more effective risk assessments and early intervention programs targeting different types of juvenile offenders.

Pathological and molecular study of kidneys in apparently healthy cattle and sheep with special reference to Leptospira species in central and northern Jordan.

Renal pathological conditions can cause significant economic losses for livestock owners. This study investigated and described the gross pathology and histopathology of lesions found in the kidneys of sheep and cattle, with particular attention to the presence of Leptospira spp. Three hundred and sixty kidneys from apparently healthy sheep and cattle (208 and 152, respectively) were collected from slaughterhouses in Jordan for gross and histopathological examinations, multiplex polymerase chain reaction (PCR) analysis, and gene sequencing of Leptospira spp. Histopathological analysis of the samples revealed the following conditions: interstitial nephritis (4.44%), glomerulonephritis (4.16%), acute tubular necrosis (17.22%), and renal congestion (4.72%). In addition, in 26.9% of the samples, hyaline material was observed in the interstitium of the cortex and medulla. The PCR results revealed that 83 (23.1%) of the 360 samples were positive for Leptospira spp. 16S rRNA, 42/152 (28%) of cattle, and 41/208 (20%) of sheep. Four samples (two sheep and two cattle) were sequenced and deposited in GenBank with accession numbers from OL701310 to OL701313. Basic Local Alignment Search Tool search and nucleotide similarities between OL701311 and OL701313 resulted in the highest similarities with different Leptospira borgpetersenii strains, whereas OL701310 showed the highest nucleotide similarity (99.2%) with the Leptospira interrogans strain. Similarly, phylogenetic analysis revealed that OL701311 to OL701313 clustered together with different serovars of L. borgpetersenii, whereas OL701310 clustered with the L. interrogans clade. This is the first study to reveal a close association between pathogenic Leptospira spp. and kidney disorders in Jordanian cattle and sheep. These findings may help expand the current understanding of the causes and mechanisms of renal disease in cattle and sheep and contribute to developing more effective prevention and treatment programs.

Automated control of the immune response to the causants of infectious disease

The problems that arose as a result of the rapid spread of the new coronavirus infection COVID-19 and the inability of health care institutions to provide the necessary medical care to a large number of patients in a timely manner showed the need to develop new approaches to diagnosis and the formation of an individual treatment program. Important in this direction is the development and implementation of specialized decision support systems based on the integration of expert systems for the analysis and interpretation of medical data and mathematical modeling tools. In order to form effective treatment programs, it is necessary to ensure the availability of reliable tools for predicting the dynamics of the disease in the conditions of external medical influences, various protection mechanisms, spatial effects, mixed infections etc. The purpose of this work is to generalize the basic model of viral infection to predict the complex controlled influence of adsorption and immune therapy on the development of the disease, taking into account diffusion disturbance and temperature response of the body, which is an important element of specialized decision-making systems for the formation of effective treatment programs. To find the solution of the original model singularly perturbed problem with delays, the procedure of stepwise numerical asymptotic approximation of the solutions of the corresponding specially constructed sequence of problems without delay has been modernized. Based on the obtained results of computer modeling, it was confirmed that the introduction of adsorbents during periods of intensive growth of the number of viral elements makes it possible to sufficiently effectively reduce the rate of their reproduction, and, therefore, provides an additional way of controlling the number of antigens in the body and preventing their supercritical growth. It is emphasized that taking into account the features of the action of adsorption drugs is important for making optimized decisions regarding the use of adsorption therapy

Stunting Analysis In Toddlers In West Java 2014-2021

Stunting in toddlers is a global health problem affecting children's physical andmental development. This study aims to analyze the prevalence, trends, causes, and impact of stunting on toddlers in West Java province from 2014-2021. It also provides poor nutrition, sanitation, and access and healthcare practices. The analysis results show that although preventive and intervention efforts have been undertaken by the government, stunting rates in children under 5 years of age in West Java still remain high during the study period. Bad nutrition, especially bad nutrition in the first 1,000 days of life, was identified as the main cause of stunting in this region. In addition, poor hygiene and lack of access to health care also played a big role in this problem. Stunting has a serious impact on the physical and cognitive development of toddlers and can affect their productivity and health in the future. Therefore, real steps need to be taken to improve good nutritional access, provide education on the importance of nutrition in pregnancy and childhood, as well as improving the health infrastructure and medical services facilities in West Java. This study provides an in-depth understanding of stunting dynamics in children under 5 years of age at the regional level, so that it can serve as a foundation for more effective intervention policies and programs to lower the malnutrition rate.

Achieving sustainable source reduction of marine litter for ocean conservation in West Africa: Insights from single-use plastic consumers in Liberia

Source reduction of marine litter is the most preferred approach to addressing the global problem of the entry of plastics into the environment, including the ocean. Policies to achieve this reduction within the African region have so far had limited success. Studying the behavioural dimension of the use of single-use plastics (SuPs) may provide the knowledge basis for developing sustainable plastic policies for desired impact. This study sought to determine the influence of socio-demographic factors and awareness of environmental impacts of plastics on the use of SuPs in West Africa using Liberia as a case study. The SuPs studied include carrier bags, drinking water sachets and bottles, drink/beverage bottles and expanded polystyrene packs. The results show that different prevailing socio-demographic factors influence the different uses of SuPs. Level of education and income levels of the respondents, for instance, had significantly positive influence on the patronage of bottled water, bottled drinks and expanded polystyrene packs. While on the other hand, rising income level had a significant negative influence on the use of sachet water alone. It also showed that awareness of environmental impacts of SuPs had no significant influence on the use of plastic carrier bags and sachet water but rather increased significantly the use of all other SuPs. The observed patterns of use of the SuPs imply underlying factors that need to be thoughtfully considered in developing SuP reduction policies and SuP management infrastructure as matters of priority. The study recommends that similar studies should be conducted in other parts of Liberia as well as across Africa to provide a basis for the development of effective behaviour intervention programmes. This study also provides a scientific context to apply recommendations of this study to other West African countries with similar issues and challenges with marine litter menace.

Development of a theory-based family resilience intervention program for parents of children with chronic diseases: A Delphi study

BackgroundLong-term illness exposes children with chronic diseases to a high risk of deterioration of physical and mental health. Developing an effective family resilience intervention program is a critical concern. ObjectiveTo develop a theory-based family resilience intervention program for parents of children with chronic diseases and provide a reference for clinical intervention. MethodsA two-phased research design, guided by the Walsh family resilience process model, was employed to develop the intervention program. In phase 1, a scoping literature review was conducted to identify the possible elements of family resilience interventions. In phase 2, a three-round Delphi survey was conducted with experts (n = 14) using an online electronic survey to obtain their consensus on the intervention content. ResultsThree main components were identified: (1) strengthening family beliefs, (2) adjusting the family organization pattern, and (3) improving the family communication process. And 8 modules were developed: “introducing adversity and family resilience”, “finding and strengthening positive family beliefs, and building confidence to live with the disease”, “analyzing and adjusting family structure”, “assisting families to increase and utilizing internal and external resources”, “optimizing communication skills”, “strengthening collaborative problem-solving capacity”, “enhancing the family narrative ability”, and “enhancing emotional expression”. After 3-round Delphi, the findings indicated that the intervention program is applicable and feasible for parents of children with chronic diseases in China. ConclusionThe principal merit of this study lies in the development of a family resilience intervention program for parents of children with chronic diseases. The intervention's usability and efficacy should be investigated in future studies. Implications to practiceDeveloping a family resilience intervention program is a critical first step toward providing effective care for parents of children with chronic diseases, and evaluating the program's feasibility and suitability in the target population is warranted.

Breast cancer survivors' experiences of barriers and facilitators to lymphedema self-management behaviors: a theory-based qualitative study.

Lifelong self-management plays a critical role in the prevention and management of lymphedema among breast cancer survivors. However, adherence to lymphedema self-management behaviors has remained suboptimal. Hence, we adopted a theory-informed method to elucidate the facilitators and barriers of lymphedema self-management for breast cancer survivors. In-depth semi-structured interviews were conducted between August and October 2022 in the lymphedema nursing clinic of a tertiary cancer hospital. The maximum variation sampling technique was used to ensure a diverse sample. The ITHBC (Integrated Theory of Health Behavior Change) framework was used to inform the interview outline and data analysis. Interview transcripts were coded line-by-line and mapped to domains in accordance with the ITHBC, using both deductive and inductive content analysis. A total of 16 participants were interviewed (aged 35 to 67). Twenty-three themes (12 facilitators and 11 barriers) were mapped onto the three domains (knowledge and belief, social facilitation, and self-regulation skill and ability) of ITHBC as facilitators and barriers to lymphedema self-management. Three additional themes including limited treatment resources for lymphedema, inconvenience of lymphedema management, boredom and tedium of lymphedema self-management were categorized under the domain of other barriers. Incorporating these findings into the ITHBC framework allows for a more systematic selection of theory-based strategies that may improve the design of effective lymphedema self-management interventions for breast cancer survivors. Elucidating impact factors, especially facilitators and barriers, for lymphedema self-management adherence is essential for developing effective intervention programs to enhance breast cancer survivors' lymphedema self-management behaviors.

Breast cancer screening attitudes, beliefs, and behaviors of Zuni Pueblo women: identifying cornerstones for building effective mammogram screening intervention programs

PurposeBreast cancer is the leading form of cancer and has the second highest mortality rate of cancers for American Indian/Alaska Native (AI/AN) women. Early screening is critical. This study examines the breast cancer-related knowledge, beliefs, and behaviors of Zuni women in the Southwest United States (U.S.).MethodsIn 2020 and 2021, a survey was administered to better understand cancer screening patterns in Zuni Pueblo; 110 women from 50 to 75 years of age were recruited to respond to the breast cancer screening portion. Inclusion criteria included self-identifying as AI, a member of the Zuni tribe, or married to a Zuni tribal member, and meeting the age and gender requirements. Descriptive statistics and bivariate analyses were conducted examining the associations between measures of breast cancer knowledge, beliefs, and behaviors and breast cancer screening status (never, ever/non-compliant, and ever/compliant).ResultsOf survey participants, 47.3% have had a breast cancer screening and are up-to-date, 39.1% have had a screening in the past but are not up-to-date, and 13.6% have never been screened. Age was the only statistically significant socioeconomic predictor of breast cancer screening; the median (interquartile range) ages of each group are 62 (54, 68) ever/compliant, 56 (54, 68) ever/non-compliant, and 53 (51, 55) never (p-value < 0.001). Significant differences by health status and access to medical care include having a regular health care provider and going to see a provider for routine check-ups. The survey also shows differences in knowledge about breast cancer risk factors, beliefs, and behaviors. Women across all three screening statuses reported that they would get screened if encouraged by a health care provider.ConclusionWhile survey respondents report a relatively high rate of ever having had a breast cancer screening, less than half are compliant with screening guidelines, which shows there is an opportunity to improve breast cancer screening rates. With culturally tailored interventions, providers have the potential to improve breast cancer screening for Zuni women.

Social determinants of alcohol-related traumatic injury in young adults: a scoping review protocol

IntroductionLimited research examines alcohol-related injury in the context of social determinants of health (SDoH) to guide effective intervention and prevention programmes. SDoH are non-medical factors that impact health such as...

Continuation of education after marriage and its associated factors among young adult women: findings from the Bangladesh Demographic and Health Survey 2017–2018

ObjectiveTo identify the individual and community-level variables associated with the continuation of education among currently married young adult women in Bangladesh.DesignCross-sectional data extracted from the Bangladesh Demographic and Health Survey...

Association between Serum 25-Hydroxyvitamin D Concentrations and Academic Performance among Adolescent Schoolchildren: A Cross-Sectional Study.

The level of association between 25-hydroxyvitamin D (25[OH]D) levels and students' academic performance has not yet been established. The current study aimed to investigate the association between serum 25(OH)D levels and academic performance among schoolchildren in Sudan. A cross-sectional study was conducted among schoolchildren during the 2021/2022 academic year from four randomly selected schools in Almatamah, River Nile State, northern Sudan. Sociodemographic data were collected using a questionnaire. Anthropometric measurements were performed in accordance with standard procedures. Academic performance was obtained from school records. Serum 25(OH)D levels were measured, and regression (multiple linear regression and multivariate logistic) analyses were performed. A total of 241 participants were enrolled in this study, of whom 129 (53.5%) were female. The mean standard deviation (SD) of the participants' ages was 15 ± 1.6 years. In multiple linear regression tests, being female, age, employment, and serum 25(OH)D level were positively associated with academic performance. The average overall academic score was 33.74%. Of the 241 participants, 95 (39.4%) and 149 (61.6%) had good and poor academic performances, respectively. In multivariable logistic regressions, age and 25(OH)D level were inversely associated with poor academic performance and vitamin D deficiency was associated with poor performance. The current study revealed a positive association between 25(OH)D levels and adolescents' academic performance. Effective interventional programs are needed to maintain sufficient vitamin D levels during childhood and adolescence and, as a consequence, to improve academic performance.