Context Of Health Research Articles

Antimicrobial Resistance in Aquaculture: Risk Mitigation within the One Health Context.

The application of antimicrobials in aquaculture primarily aims to prevent and treat bacterial infections in fish, but their inappropriate use may result in the emergence of zoonotic antibiotic-resistant bacteria and the subsequent transmission of resistant strains to humans via food consumption. The aquatic environment serves as a potential reservoir for resistant bacteria, providing an ideal breeding ground for development of antimicrobial resistance (AMR). The mutual inter-connection of intensive fish-farming systems with terrestrial environments, the food processing industry and human population creates pathways for the transmission of resistant bacteria, exacerbating the problem further. The aim of this study was to provide an overview of the most effective and available risk mitigation strategies to tackle AMR in aquaculture, based on the One Health (OH) concept. The stringent antimicrobial use guidelines, promoting disease control methods like enhanced farm biosecurity measures and vaccinations, alternatives to antibiotics (ABs) (prebiotics, probiotics, immunostimulants, essential oils (EOs), peptides and phage therapy), feeding practices, genetics, monitoring water quality, and improving wastewater treatment, rather than applying excessive use of antimicrobials, can effectively prevent the development of AMR and release of resistant bacteria into the environment and food. The contribution of the environment to AMR development traditionally receives less attention, and, therefore, environmental aspects should be included more prominently in OH efforts to predict, detect and prevent the risks to health. This is of particular importance for low and middle-income countries with a lack of integration of the national AMR action plans (NAPs) with the aquaculture-producing environment. Integrated control of AMR in fisheries based on the OH approach can contribute to substantial decrease in resistance, and such is the case in Asia, where in aquaculture, the percentage of antimicrobial compounds with resistance exceeding 50% (P50) decreased from 52% to 22% within the period of the previous two decades.

“My Mom Is a Fighter”: A Qualitative Analysis of the Use of Combat Metaphors in ICU Clinician Notes

BackgroundA metaphor conceptualizes one, typically abstract, experience in terms of another, more concrete, experience with the goal of making it easier to understand. Even though combat metaphors have been well-described in some health contexts, they have not been well-characterized in the setting of critical illness. Research QuestionHow do clinicians use combat metaphors when describing critically ill patients and families in the electronic health record? Study Design and MethodsWe included notes written about patients >=18 years admitted to ICUs within a large hospital system from 2012-2020. We developed a lexicon of combat words, and isolated note segments that contained any combat mentions. Combat mentions were systematically defined as a metaphor or not across two coders. Among combat metaphors, we used a grounded theory approach to construct a conceptual framework around their use. ResultsAcross 6,404 combat-related mentions, 5,970 were defined as metaphors (Cohen’s kappa 0.84). The most common metaphors were “bout” (26.2% of isolated segments), “combat” (18.5%), “confront” (17.8%) and “struggle” (17.5%). We present a conceptual framework highlighting how combat metaphors can present as identity (“mom is a fighter”) and process constructs (“struggling to breathe”). Identity constructs were usually framed around: (1) hope, (2) internal strength, and/or (3) contextualization of current illness based on prior experiences. Process constructs were used to describe: (1) “fighting for” (e.g. working toward) a goal, (2) “fighting against” an unwanted force, or (3) experiencing internal turmoil. InterpretationWe provide a novel conceptual framework around the use of combat metaphors in the ICU. Further studies are needed to understand intentionality behind their use and how they impact clinician behaviors and patient/caregiver emotional responses.

How the Global Burden of Animal Diseases links to the Global Burden of Crop Loss: a food systems perspective.

Food systems comprise interconnected webs of processes that together transform inputs (land, labour, water, nutrients and genetics, to mention just a few) into outputs such as nutrition and revenue for human societies. Perfect systems do not exist; rather, global food systems operate in the presence of hazards, biotic and abiotic alike, and under the constraint of limited resources to mitigate these hazards. There are, therefore, inefficiencies in these systems, which lead to losses in terms of monetary, nutritional, health and environmental values and create additional negative externalities in the health, social and environmental spaces. Health hazards in the food system do not respect arbitrary distinctions between the crop and livestock sectors, which are highly interconnected. These linkages exist where one sector provides inputs to another or through substitution effects where supply in one sector influences demand in another. The One Health approach advocates investigating the intersectoral hazards in a highly interdisciplinary manner. This article provides a conceptual framework for integrating the methodologies developed by the Global Burden of Crop Loss and Global Burden of Animal Diseases initiatives to generate burden estimates for hazards in food systems that better account for interconnectivity and foster an improved understanding of food systems that is aligned with the interdisciplinary nature of the One Health approach. A case study related to maize and poultry sector linkages in the wider context of public and environmental health is presented.

Dimensions of clinical leadership among pre-registration nursing students: a cross-sectional study between two countries

To explore a) pre-registration students' self-perceptions of clinical leadership behaviours and b) differences in students' self-perceptions of leadership behaviours between two countries (UK and Israel). Effective leadership has been associated with high-quality and compassionate care provision in health and social care contexts. This has led to a common acceptance that teaching leadership in nursing education is essential if students are to develop competencies in this area. Worldwide, there is limited research on nursing students' perception of clinical leadership behaviours as well as on the development of leadership behaviours during the study years. A cross-sectional survey design was used among two convenience samples of UK and Israeli pre-registration nursing students. Closed questionnaires were uploaded in the format of a commercial internet survey provider (Qualtrics.com) and distributed through the virtual learning platforms in the two participating universities. In total 656 students were invited to participate and the response rates were 28.1 % (Israel) and 17.9 % (England). Overall, 140 students completed the questionnaires. Significant differences were found between the two sites in the leadership dimensions "Emotional Intelligence" and "Impact and Influence" (p < .05), with UK students scoring higher than Israeli students. Among the Israeli sample, significant differences were found in leadership dimensions according to years of study, with higher scores reported in the 3rd and 4th year students compared with the 1st and 2nd Year students in the referred dimensions (p < .05). Differences in students' clinical leadership perception exist between the two cohorts examined. Nurse educators should expand international research on this subject to identify possible antecedents in developing clinical leadership behaviours. At the same time, there is a need to continue efforts to enhance the development of clinical leadership behaviours during all study years through curriculum updating to prepare future nurses better to provide quality, safe and person-centered care.

Competencies Relevant to Physical Activity Specialists in Navigating Mental Health Contexts: A Scoping Review

To inform future learning opportunities, we performed a scoping review to identify competencies relevant to physical activity (PA) specialists in supporting the PA and mental health of people experiencing mental health concerns. CINAHL, PsycINFO, and SPORTDiscus databases were searched up to June 22, 2022, for research studies and commentaries. Pertinent text was extracted and subject to content analysis using an inductive approach. Sixty-two competencies from 62 publications were organized into four domains: (a) interacting with mental health care services/systems, (b) responding to mental health concerns, (c) employing PA counseling/coaching to promote mental health among people with diverse mental health needs, and (d) building relationships that are responsive to diverse mental health needs. These findings may serve as a road map for stakeholders interested in developing PA specialists’ confidence to meet the challenges of navigating mental health contexts. Despite consistency across sources, points of divergence warrant consideration from learning institutions and professional bodies.

A Review of the Latest Guidelines for Diagnosing and Managing Asthma in Children in the United States and Canada.

Globally, asthma remains the most widespread chronic respiratory condition in children, with a larger proportion of children being affected by the condition. Regardless of the higher prevalence rates, the outcomes of pediatric asthma have remained inadequate, even as there are numerous preventable deaths (approximately 300 children in the United States and 250 children in Canada, annually). The characteristic symptoms of pediatric asthma include wheezing, cough, and shortness of breath that are characteristically triggered by several potential stimuli. However, several diagnostic challenges exist and have resulted in either overdiagnosis or underdiagnosis, making pediatric asthma diagnosis and management problematic. Effective management of asthma in children entails a holistic approach that encompasses non-pharmacological and pharmacological management, alongside self-management and educational aspects. Working with pediatric asthma patients and their families/caregivers is vital to promoting and realizing better asthma diagnosis and management outcomes. Educational guidelines regarding the best ways for effective treatment, avoidance of triggers, modifiable risk factors, and the actions that should be taken during chronic asthma attacks through individualized action plans are vital. Thus, the objective of this systematic review is to provide an overview of the latest guidelines on pediatric asthma diagnosis and management. In this regard, this review presents several similarities in existing pediatric asthma diagnosis and management guidelines in the United States and Canada. For instance, most guidelines and studies reviewed have proposed the use of objective tests for confirmation of asthma diagnosis, particularly in symptomatic individuals. The peak flow variability measurement, bronchodilator reversibility testing, and spirometry have also been proposed by the guidelines and studies, even as the recommendations regarding the timing and hierarchy of the objective test substantially vary between the guidelines and studies. We hope that the present review will be helpful to physicians and healthcare service providers working within pediatric health contexts.

Shape-shifting versions of class in Australia and the pursuit of equity in public health.

The COVID-19 pandemic and current cost of living crisis have highlighted socioeconomically patterned health disparities, bringing renewed focus on equity in public health. Despite political rhetoric invoking cultural narratives of egalitarianism and opportunities for class mobility, social class remains a significant factor in health outcomes in the Australian context. For social scientists, class (despite robust critiques) is a key analytical concept that has been theoretically broadened to encompass social and cultural practices (habitus). In public health, however, concepts of social disadvantage have expanded toward frames such as health equity and socioeconomic status in ways that can obscure 'class' and habitus. Understandings and operationalization of concepts of class and equity not only impact collaborative and interdisciplinary relationships, but also the framing of public health problems and health promotion interventions and policies. In this article, we draw on our experiences as anthropologists conducting ethnography in and of Australian health promotion programs to map and re-evaluate the intersection of concepts of social class and equity. We trace how representations of class emerged in these programs, and the versions of class and equity that materialized across different public health contexts. We argue for a conceptual repositioning of class that recognizes its shape-shifting qualities and of its materializations in different politics, disciplines and everyday contexts. In doing so, we highlight 'class' as a salient dimension of the design, implementation and evaluation of health promotion programs.

Building and Maintaining a Whole Community Initiative: Health Communication in Practice with Be Well Communities™

ABSTRACT The most effective health communication builds from evidence-based best practices and theory. In practice, health campaigns rely on considerations often under-discussed in health communication, such as consistent agency-style client service, image management, and community coalition-building. Health outcome progress often requires change at multiple levels, from individual cognition and behavior to policy creation. These multi-level needs further highlight the importance of effective practical health communication supporting a range of outcomes and building toward replication. This article covers the complexities of building and implementing a theory-informed health communication structure for a multifaceted, place-based cancer prevention initiative. Part of the overall process includes detailing the internal communications of a health communication group, interorganizational communication, engaging community partner support, the message creation process, and longitudinal efforts on program maintenance and assessment. Furthermore, this article seeks to offer an example of the client service role a health communication team can play to combine theory, empirical message development, and community goals in whole community efforts. Ultimately, the goal is to share experiences from seven years of program work to help guide future community-based efforts in other health contexts and foster progress in theoretical and practical understandings of health communication.

Hybrid learning environments: It’s all about ecology

Technology-enhanced learning has been part of higher education health contexts for nearly three decades, but since the recent Covid-19 pandemic specific challenges emerged, requiring learning design reconfigurations to facilitate continuity of student learning. The pandemic calls for a deeper understanding of how technology can promote connections, active participation and knowledge building in higher education health contexts. Identifying what is currently occurring and considering potential innovations requires a move towards a nuanced understanding of the ecology of complex elements contributing to productive networked learning in these contexts. This multiple-case study doctoral research project includes four undergraduate health courses at a New Zealand university, in the disciplines of nursing, social work, and bioscience. Drawing on the Activity Centred Analysis and Design (ACAD) framework, the research explores the influence of course design elements, such as social arrangements, learning space formats, learning tasks, on learning activity, taking a systematic approach to the analysis. In this paper, we report on initial observations and interviews with students involved in diverse hybrid learning environments, in order to identify how innovative learning designs are supporting students' agency and active engagement.

When Needs Don’t Translate into Wants: Choosing the Right Tone to Communicate About Healthy Behaviors

ABSTRACT Although individuals should benefit from adhering to communication that promotes healthier behaviors, such communication often encounters mixed success. To understand this incongruity, we identify a misconception about the roles of two distinct drivers of health behavior: needs (which are more objective) and wants (which are more subjective). While needs generally translate into wants in ordinary consumption contexts, they sometimes clash with wants in the context of health behaviors. We propose that communicators’ failure to anticipate this misalignment leads them to choose an inadequate communication tone (more or less assertive). Across three studies conducted in the field and online, adopting the perspectives of both communicators and receivers, we examine how the misalignment of needs and wants in health contexts affects the selection of communication tone and reactions to this communication. We find that communicators (and study participants taking the role of communicators) frequently select the tone (more or less assertive) of their communication based on the receivers’ (objective) needs. Still, conversely, receivers’ responses depend on how the tone of communication matches their (subjective) wants. This gap tends to disappear for more severe health issues, where wants align better with needs. The frequent misalignment of needs and wants in the health domain challenges health communication effectiveness. Communicators should seek ways to address this misalignment, for example, by increasing the perceived severity of the health issue or the perceived authority of the source.

An interdisciplinary examination of a gunshot detection system: The public health context of a policing technology

An interdisciplinary examination of a gunshot detection system: The public health context of a policing technology

The Role of Artificial Intelligence in the Primary Prevention of Common Musculoskeletal Diseases.

Musculoskeletal disorders (MSDs) are a leading cause of disability worldwide, with a growing burden across all demographics. With advancements in technology, conversational artificial intelligence (AI) platforms such as ChatGPT (OpenAI, San Francisco, CA)have become instrumental in disseminating health information.This study evaluated the effectiveness of ChatGPT versions 3.5 and 4 in delivering primary prevention information for common MSDs, emphasizing that the study is focused on prevention and not on diagnosis. This mixed-methods study employed the CLEAR tool to assess the quality of responses from ChatGPT versions in terms of completeness, lack of false information, evidence support, appropriateness, and relevance. Responses were evaluated independently by two expert raters in a blinded manner. Statistical analyses included Wilcoxon signed-rank tests and paired samples t-tests to compare the performance across versions. ChatGPT-3.5 and ChatGPT-4 effectively provided primary prevention information, with overall performance ranging from satisfactory to excellent. Responses for low back pain, fractures, knee osteoarthritis, neck pain, and gout received excellent scores from both versions. Additionally, ChatGPT-4 was better than ChatGPT-3.5 in terms of completeness (p = 0.015), appropriateness (p = 0.007), and relevance (p = 0.036), and ChatGPT-4 performed better across most medical conditions (p = 0.010). ChatGPT versions 3.5 and 4 are effective tools for disseminating primary prevention information for common MSDs, with ChatGPT-4 showing superior performance. This study underscores the potential of AI in enhancing public health strategies through reliable and accessible health communication. Advanced models such as ChatGPT-4 can effectively contribute to the primary prevention of MSDs by delivering high-quality health information, highlighting the role of AIs in addressing the global burden of chronic diseases. It is important to note that these AI tools are intended for preventive education purposes only and not for diagnostic use. Continuous improvements are necessary to fully harness the potential of AI in preventive medicine. Future studies should explore other AI platforms, languages, and secondary and tertiary prevention measures to maximize the utility of AIs in global health contexts.

Adopting OurNotes in Canadian Mental Health Settings: Implementation Recommendations.

The OurNotes movement aims to support patient collaboration and engagement in care through the implementation of pre-visit notes. By contributing to a pre-visit history or agenda, the patient voice is incorporated into the visit. While OurNotes has been successfully piloted in primary and acute care settings, its implementation in Canadian mental healthcare settings has been limited. In this study, we conducted semi-structured interviews with patients, care partners and mental health clinicians to identify implementation recommendations for OurNotes in Canadian mental health contexts. Six recommendations were identified. These recommendations can be adopted by organizations considering the implementation of OurNotes in mental health clinical settings.

Extended Reality for Mental Health Evaluation: Scoping Review.

Mental health disorders are the leading cause of health-related problems worldwide. It is projected that mental health disorders will be the leading cause of morbidity among adults as the incidence rates of anxiety and depression grow worldwide. Recently, "extended reality" (XR), a general term covering virtual reality (VR), augmented reality (AR), and mixed reality (MR), is paving the way for the delivery of mental health care. We aimed to investigate the adoption and implementation of XR technology used in interventions for mental disorders and to provide statistical analyses of the design, usage, and effectiveness of XR technology for mental health interventions with a worldwide demographic focus. In this paper, we conducted a scoping review of the development and application of XR in the area of mental disorders. We performed a database search to identify relevant studies indexed in Google Scholar, PubMed, and the ACM Digital Library. A search period between August 2016 and December 2023 was defined to select papers related to the usage of VR, AR, and MR in a mental health context. The database search was performed with predefined queries, and a total of 831 papers were identified. Ten papers were identified through professional recommendation. Inclusion and exclusion criteria were designed and applied to ensure that only relevant studies were included in the literature review. We identified a total of 85 studies from 27 countries worldwide that used different types of VR, AR, and MR techniques for managing 14 types of mental disorders. By performing data analysis, we found that most of the studies focused on high-income countries, such as the United States (n=14, 16.47%) and Germany (n=12, 14.12%). None of the studies were for African countries. The majority of papers reported that XR techniques lead to a significant reduction in symptoms of anxiety or depression. The majority of studies were published in 2021 (n=26, 30.59%). This could indicate that mental disorder intervention received higher attention when COVID-19 emerged. Most studies (n=65, 76.47%) focused on a population in the age range of 18-65 years, while few studies (n=2, 3.35%) focused on teenagers (ie, subjects in the age range of 10-19 years). In addition, more studies were conducted experimentally (n=67, 78.82%) rather than by using analytical and modeling approaches (n=8, 9.41%). This shows that there is a rapid development of XR technology for mental health care. Furthermore, these studies showed that XR technology can effectively be used for evaluating mental disorders in a similar or better way that conventional approaches. In this scoping review, we studied the adoption and implementation of XR technology for mental disorder care. Our review shows that XR treatment yields high patient satisfaction, and follow-up assessments show significant improvement with large effect sizes. Moreover, the studies adopted unique designs that were set up to record and analyze the symptoms reported by their participants. This review may aid future research and development of various XR mechanisms for differentiated mental disorder procedures.

Hydrogen as an innovative nootropic in health and disease.

Molecular hydrogen (H2, dihydrogen) is an antioxidant and signaling molecule with potent antioxidative, antiapoptotic, and anti-inflammatory properties. Despite the growing interest in H2 as a potential therapeutic agent, the evidence regarding its potential as a nootropic remains limited. Only a handful of studies on the human population have evaluated its effects, although there are suggestive indications of its efficacy. The present paper overviews H2's potential as a novel agent for improving cognitive functions in health and disease contexts, highlighting its mechanisms of action and areas for further investigation. Current evidence suggests that H2 improves executive function, alertness and memory in several clinical trials, from healthy young and elderly individuals to individuals with altered circadian rhythms, neurodegenerative disorders, and cancer. Further investigations are needed to confirm the potential positive effects of dihydrogen as a nootropic agent in both health and disease.

Structural and Evolutionary Relationships of Melanin Cascade Proteins in Cnidarian Innate Immunity.

Melanin is an essential product that plays an important role in innate immunity in a variety of organisms across the animal kingdom. Melanin synthesis is performed by many organisms using the tyrosine metabolism pathway, a general pathway that utilizes a type-three copper oxidase protein, called PO-candidates (phenoloxidase candidates). While melanin synthesis is well characterized in organisms like arthropods and humans, it is not as well understood in non-model organisms such as cnidarians. With the rising anthropomorphic climate change influence on marine ecosystems, cnidarians, specifically corals, are under an increased threat of bleaching and disease. Understanding innate immune pathways, such as melanin synthesis, is vital to gaining insights into how corals may be able to fight these threats. In this study, we use comparative bioinformatic approaches to provide a comprehensive analysis of genes involved in tyrosine-mediated melanin synthesis in cnidarians. Eighteen PO-candidates representing five phyla were studied to identify their evolutionary relationship. Cnidarian species were most similar to chordates due to domain presents in the amino acid sequences. From there, functionally conserved domains in coral proteins were identified in a coral disease dataset. Five stony corals exposed to stony coral tissue loss disease were leveraged to identify eighteen putative tyrosine metabolism genes, genes with functionally conserved domains to their Homo sapiens counterpart. To put this pathway the context of coral health, putative genes were correlated to melanin concentration from tissues of stony coral species in the disease exposure dataset. In this study, tyrosinase was identified in stony corals as correlated to melanin concentrations and likely plays a key role in immunity as a resistance trait. In addition, stony coral genes were assigned to all modules within the tyrosine metabolism pathway, indicating an evolutionary conservation of this pathway across phyla. Overall, this study provides a comprehensive analysis of the genes involved in tyrosine-mediated melanin synthesis in cnidarians.

Multidrug-resistant Acinetobacter baumannii: An underestimated pathogen in veterinary medicine in Italy

The increasing drug resistance of Acinetobacter (A.) baumannii is a growing concern globally. This bacterium, prevalent in hospitals, is responsible for multi-resistant infections and has been identified by the WHO as a priority pathogen for new antibiotic development. While there is extensive information on human isolates, data on animal isolates are scarce and fragmented based on limited clinical cases and genomic analyses. The impact of resistant strains on public and veterinary health is challenging to assess due to a lack of data. However, the potential impact on public health cannot be underestimated. Therefore, it is imperative to strengthen surveillance of A. baumannii in domestic animals, livestock, and wildlife. The growing presence of this pathogen in veterinary clinical samples is alarming, especially given the increasing interaction between animals and humans. Recognizing animals as potential reservoirs is crucial for understanding pathogen transmission dynamics, given their capacity for zoonotic transmission. With the rise in the number of animals testing positive for multi-resistant bacteria, monitoring A. baumannii in the animal population is vital to prevent the pathogen's spread and protect public health. A review of studies conducted in Italy on the topic underscores the role of pets, livestock, and foods of animal origin in the transmission of A. baumannii and Acinetobacter spp. Further animal research is urgently needed to gain a better understanding of the mechanisms of spread and resistance. This review underscores the need to explore this area, providing crucial insights for public health and infectious disease management within a One Health context.

A correlational study on the experiences of family members of trans and gender diverse people in Portugal

Introduction : Research on the experiences of family members of transgender and gender diverse (TGD) people remains limited, despite their crucial impact on the well-being of TGD individuals. This study aimed to fill this gap, by investigating their experiences within the wider ecological context that influences them. Method : A sample of 87 parents, siblings, partners, children, and extended family members of TGD people (M age = 39.9) were surveyed through questionnaires about their reactions and concerns regarding the disclosure of their TGD relatives, experiences in education and health contexts, and perceptions of the Portuguese legal framework. Results: The results revealed largely positive reactions to disclosure, favorable experiences with healthcare services, and optimistic views of the Portuguese legal framework. Average scores were reported regarding distress and concerns at the time of disclosure and experiences with the education system. Additionally, results revealed a significant correlation between greater concerns and more negative reactions to disclosure. Discussion: These findings highlight the need for support and resources for family members of TGD people and wider dissemination of information on gender identity issues.

Positive Play

This book results from an initiative by the European university consortium EUGLOH - European University Alliance for Global Health - between the University of Porto, Portugal (U.P.), and the University of the Arctic, Norway (UiT). To support the activity consisting of a three-day masterclass and workshop at UiT, designated as “Tromsø Idea Camp 2024 - Developing ideas through co-creation using human-centred design,” which had as its motto: . “Identify the needs and expectations of Vardesenteret’s patients before, during, and after treatment, considering their and volunteers’ points of view and creating projectual answers that foster empathy and communication”, a handbook was created, which later formed the basis of this book. It has three sections dedicated to Person-Centred Design in the Context of Health and Well-being. The first section— ”Reported Experience”, — Relates to the doctoral project “Ludic Activities in Health Context: An Anorexia Nervosa Case in the Hospital Environment,” which systematizes Ludic methods and tools created in and for a clinical context to support the treatment and monitoring of Anorexia Nervosa. Part of the project stems from collaborative work with São João Central Hospital, Portugal, in a group dedicated to treating eating disorders. The second section - “Documented Experience” — Explores the concept of Positive Play, coined by Giesteira, B., Cardoso, P., and Peçaibes, V. in various papers and book chapters from 2021 onwards. It presents a group of methods and tools created by the authors in recent years, such as the SEED Toolkit - “SomaEsthetics for Enabling Designers” (Giesteira, B. 2023) and the ANgame Collab (Cardoso, P., Peçaibes, V., Giesteira, B. 2022). The first tool aims to work on the concept of Somaesthetics, promoting empathy and contributing to identifying feelings and sensations interdependent on body activities and movements. The second tool aims to mediate playful sessions of Participatory Design, especially in the ‘user research’ phase. Other tools and methods were selected because, based on the aforementioned authors’ experience, they are most suitable for applied research in Health Technology Design. The third section - “Lived Experience” — Records the three days of the workshop dedicated to the themes: “Emotional Design and Somaesthetics”; “Human-Centered and Participatory Design”; “Ideation, Lateral Thinking, and Prototype.” In addition to the aforementioned themes, the different phases of development of the participants' projects from the various universities of the EUGLOH university consortium are recorded, which, in a Participatory Design approach, involved the collaboration of volunteers and oncology patients from Vardesenteret. This section shares the tools used to support each phase of product or service design and the final results of the low-fidelity prototypes.

Effect of self-efficacy among persons who inject drugs treated with direct-acting antivirals on Hepatitis C treatment initiation, duration, completion, adherence, and cure

BackgroundSelf-efficacy, a patient-level factor, has been shown to facilitate patient engagement in treatment and optimize treatment-related outcomes in various health contexts. Research on interventions supporting hepatitis C virus (HCV) direct-acting antiviral (DAA) treatment uptake and adherence among persons who inject drugs (PWID) is needed, but whether self-efficacy factors influence DAA treatment cascade outcomes in this population has been less studied. MethodsUsing the HERO study data, we analyzed a subset of participants with any general health self-efficacy data (n=708) measured at baseline and end-of-treatment time points using a 5-items instrument (facets: ‘goal setting', ‘goal attainment', ‘having a positive effect', ‘being in control', and ‘working to improve’). The cascade outcomes included DAA treatment initiation, duration, adherence, completion, and sustained virologic response (SVR). The effect of baseline and change (Δ) scores for composite and item-level self-efficacy on the cascade outcomes was assessed using logistic regression and generalized linear models. ResultsHigher baseline composite self-efficacy [adjusted odds ratio (95 % confidence interval) =1.57 (1.07, 2.29)], ‘goal attainment’ [1.31 (1.03, 1.67)] and ‘having a positive effect’ [1.33 (1.03, 1.74)] were associated with greater likelihood of treatment initiation. ‘Δ Goal attainment’ was significantly associated with SVR [1.63 (1.04, 2.53)]. ‘Δ Being in control’ and ‘Δ working to improve’ were associated with treatment adherence and duration, respectively. ConclusionsGeneral health self-efficacy positively influences DAA treatment initiation among PWID. ‘Goal attainment’ facilitates the achievement of DAA treatment-related outcomes. Further studies should assess the effect of self-efficacy related to performing healthcare tasks specific to DAAs on the treatment-related outcomes.