Health Engagement Research Articles

59 An Examination of the Moderating Effect of Self-Efficacy on the Association Between Health Literacy and Healthy Activity Engagement in Older Adults

Objective:Engagement in activities that promote overall brain health and well-being is often a key step in reducing risks to cognitive health in older adults. Given that higher health literacy has been found to be associated with healthier lifestyles, it is unsurprising that it has been the focus of many studies and programs aimed at improving the health outcomes of older adults. An equally important factor to consider when it comes to such efforts is the role of moderating variables in the relationship between health literacy and engagement in healthy behaviors. The present study examined the moderating effect of self-efficacy, a variable that has been shown to be positively associated with both health literacy and health behaviors. We hypothesized that increased self-efficacy will strengthen the relationship between health literacy and healthy activity engagement in a sample of community-living older adults.Participants and Methods:Forty-nine older adults (age: M = 64.35, SD = 8.00; education: M = 16.39, SD = 2.37; 87.76% female) completed a health literacy measure (Newest Vital Sign; NVS), a self-efficacy questionnaire (General Self-Efficacy Scale; GSE), and a lifestyle behaviors questionnaire (Healthy Aging Activity Engagement Scale; HAAE). The NVS is a performance-based measure in which participants are asked to interpret the verbal and numerical information of a nutrition label to make health-related decisions. The GSE is a self-report measure that evaluates one’s belief in their ability to handle challenges, solve problems, and accomplish goals. The HAAE is a self-report measure that assesses one’s engagement in healthy activities across multiple health domains.Results:To examine whether self-efficacy moderates the relationship between health literacy and healthy activity engagement, a moderation analysis was conducted using Hayes’ PROCESS macro for SPSS with age and education included in the model as covariates. The results revealed no significant interaction between health literacy and self-efficacy, b = 0.23, p = .59, 95% CI [-0.60 to 1.05].Conclusions:Contrary to expectations, in the present sample, the degree of self-efficacy was not a condition under which level of health literacy exerted its influence on healthy activity engagement in older adults. Future studies with larger and more nationally representative samples are needed to explore self-efficacy and other potential moderating factors in order to identify individual characteristics that support older adults’ adoption and engagement in health-promoting behaviors.

Gender Reconstruction in Visual Form of Teaching Material

Background: 
 Gender has become a crucial area of research due to the unpleasant experience of gender disparity in the workplace, home, and other settings, including education, health, and civic engagement. The ideal way to promote gender equality early on is to guarantee everyone access to a high-quality education. The learning process is greatly aided by textbooks. Through language, visuals, stories, and illustrations, gender content is developed and represented in books. Given that the textbook serves as the primary means of instruction, it is crucial to examine how gender is constructed in Kontakte Deutsch 1, the widely used textbook in Indonesia.
 Methodology: 
 A descriptive qualitative methodology was used in this study's Critical Discourse Analysis (CDA) approach. The research data source was from illustrations, words, and stories in the textbook Kontakte Deutsch 1.
 Findings: 
 The results showed that male and female figures appeared visually at the same frequency. In categories like social roles, passions, and professional choices, gender equality was noted and portrayed. Inequalities such as stereotyping, gender subordination, and marginalization of gender were still present in a tiny proportion of phrases and narratives.
 Conclusion: 
 This study demonstrated how the authors of Kontakte Deutsch 1 made an effort to advance gender equality principles through linked topics. Gender discrimination only appeared in a minor portion of the story. 
 Originality: 
 There have been no studies on gender reconstruction in Kontakte Deutsch 1, commonly used in Indonesian high schools. This thorough investigation deepens our understanding of how gender is portrayed in instructional materials and emphasizes the significance of treating all genders equally and respectfully.

5.I. Round table: Governing private sector engagement: opportunities & challenges in public health policy & practice

Abstract Health systems all over the world rely on a mix of public and private inputs in the financing and provision of health services and products, with varying degrees of involvement of the private sector. The importance of private sector engagement was evident during the COVID-19 pandemic, when governments had to work with the private sector to meet the demand of health services and products. Private actors were engaged or worked in partnership with the public health system to supply rapid and often innovative solutions to strengthen some existing services and develop new ones. In tandem, various governance challenges such as the lack of transparency, inefficiencies, and potential corruption - undermining effective health system performance were also experienced. This workshop aims to shed light on the learnings from private sector engagement (both positive and negative) during the pandemic, discuss the relevant issues shaping the governance of private sector engagement in public health, and the policy and practice implications in the post-pandemic world. Session plan: Opening/welcome by Dr Natasha Azzopardi Muscat Director, Division of Health Systems and Public Policy, WHO Regional Office for Europe (5 mins) - Tentative Brief reflection on the Importance of governing private sector engagement - opportunities and challenges in public health policy and practice by Gabriele Pastorino Technical Officer, WHO Regional Office for Europe (5 mins) Technical overview: key messages from the joint WHO EURO/European Observatory policy brief on lessons learnt from private sector engagement during COVID-19 by Anna Maresso, European Observatory on Health Systems and Policies (5 mins) - Tentative Roundtable discussion with panelists on key learnings on private sector engagement during COVID-19. (40 minutes) Panelist representing Policy, Academia, and Practice would be engaged in a roundtable discussion, answering questions to shed more light on this topic. This would be followed by interactive Q& A with the audience. Proposed questions: -what we have learned from the COVID-19 pandemic on engaging with the private sector (common challenges and opportunities) -examples of successful engagements and innovative collaborations that were maintained after the pandemic or scaled up relevant issues shaping the governance of private sector engagement in public health, and the policy and practice implications in the post-pandemic world. Key take-home messages from the session by Dr Naomi Limaro Nathan, Consultant, WHO Regional Office for Europe. (5 mins) Closing remarks Key learning outcomes: • To enable an increased awareness of the opportunities and challenges of governing private sector engagement in public health policy and practice in the post-pandemic world. •To build momentum for public health stakeholders to engage in the discourse and contribute to strengthening the governance of private sector engagement. Key messages • The pandemic experience has provided an opportunity for learnings - both good and bad to enable strengthened governance for private sector engagement. • Engaging with the private sector in a post-pandemic world is vital to addressing health system needs and achieving UHC.

Seeking approval first: Mental health care utilization and engagements among MENA adolescents in the United States

Like most adolescents, those from the Middle East and North African (MENA) region face a host of stressors that threaten their mental health. However, evidence suggests that this population may encounter specific barriers to access that inhibit or preclude help-seeking and engagement with mental health services. To better understand how these barriers limit MENA adolescents’ engagement with mental health services, we conducted interviews with 27 school-based service providers for MENA students in three U.S. cities and analyzed four focus group discussions from a Photovoice project with seven Arab adolescents in Detroit, MI. Our findings identified four key themes around barriers to service access and utilization: (1) the importance of reputation and adhering to familial and societal expectations, (2) student-parent communication around mental health and psychological distress, (3) the role of gender in seeking and engaging with mental health services, and (4) the quality and cultural appropriateness of mental health services. Strategies and recommendations for future research, policy, and practice to overcome these barriers are discussed.

Health Smart City towards improving Public Health and Citizen Engagement

Abstract Climate change is modifying weather patterns, producing far-reaching effects on the environment, the economy and society as a whole, endangering global livelihoods, health, food and energy security, and water resources. Europe will not escape its effects, aggravating risks and threats to public health (PH). Today cities are leading the effort to tackle climate change. Cities are embracing digitalization and establishing smart cities (SC). SC should address people mobility, but also the impact of extreme weather phenomena. The degradation of the environment will foreseeably create security and health crisis that could benefit with digital technologies. The development of urban policies should be guided by evidence-based PH practices. The inclusion of PH into the pillars of the SC will contribute toward mitigating PH crises, such as the COVID-19 pandemic. Design Science Research Methodology was used to elicit a Smart Public Health City (SPHEC) framework. A set of PH and SC experts participated in the process, using diabetes as a case study. The European Green Deal served as a blueprint toward a healthier and more sustainable city. The SPHEC framework was defined by elucidating the PH functions within a SC, with the identification of a set of digital PH services that are required to support the SPHEC framework. This allows to assess the benefits obtained with the digital PH services, and provides evidence for guiding decision-making. The role of digital PH services emerges from the analysis of the framework, through the development of proper digital PH services, strengthening capacity and resilience in future climate emergencies, and motivating policy makers to endorse this challenge. Climate change is a serious threat with impact in PH and cities need to be prepared to tackle it. The use of the SPHEC framework enable to understand the role of both digitalization and the green deal in supporting public policies to tackle chronic diseases like diabetes.

Establishing best practices for E-commerce transport packaging waste management in Canada: A systematic review

The growth in online retail purchases has increased significantly, especially through the COVID-19 pandemic, yet causes more packaging waste than brick-and-mortar retail. Free and easy returns further exacerbate the problem. Current research addressing post-consumer packaging waste has focused on packaging design and material choices. Yet, effective guidelines, policies, strategies, and practices for e-commerce packaging waste management must be determined (Escursell et al., 2021). Therefore, this research identifies global best practices to address transport packaging waste in e-commerce, focusing on Canada. A systematic review of the extant literature (2011–2020) revealed five key objectives of packaging sustainability guidelines: Optimizing Resources, Responsible Sourcing, Resource Recovery, Material Health, and Consumer Engagement. The analysis showed that Responsible Sourcing and Resources Recovery were highlighted in 41% of publications, Optimizing Resources in 31%, and Consumer Engagement in 23% of the studies. The most popular waste reduction strategy was Design for Environment under the Optimizing Resources guideline. This work is the first to identify and articulate clear guidelines, policies, and practices to support industry and policy decision-makers in addressing the transport packaging waste problem in e-commerce.

Exploring the association of lifestyle behaviors and healthy ageing among the older adults in India: evidence from LASI survey

BackgroundUnderstanding health and developing trends among the older population is essential for countries to tackle the challenges of an ageing population and formulate relevant policies. Facilitating healthy ageing is an essential strategy to address the issues arising among the aged. The concept of healthy ageing is defined as “the process of developing and maintaining the functional ability that enables wellbeing in old age (WHO),“ where “functional ability comprises the health-related attributes that enable people to be and to do what they have reason to value.“ People have different ageing pathways depending on their genetic profile and different life course health risk exposures. Therefore, ageing, more specifically healthy ageing, largely depends on individual lifestyle choices. This study examines the association between lifestyle behaviours and healthy ageing among older adults in India.MethodsBased on the first round of LASI in 2017-18, we conceptualized healthy ageing within the WHO functional ability framework. We developed a Healthy Ageing Index (HAI), which incorporates physiological health, functional health, cognitive functions, psychological well-being, and social engagement. We used principal component analysis to generate a composite score for HAI. We then used multiple linear regression to demonstrate the association between lifestyle behaviours and HAI.ResultThe mean HAI was 82.8%, indicating that the study population is healthier. The study findings show that smoking and drinking are more prevalent among males, rural residents, illiterate individuals, those currently employed, and those belonging to the poorest wealth quintile. Engaging in physical activity is associated with better health outcomes (β = 2.36; 95% CI: 2.16–2.56).ConclusionThis study emphasizes the importance of adopting a healthier lifestyle to achieve healthy ageing. Health behaviours are modifiable, so our results highlight the need for policy interventions to promote a healthier lifestyle from an early age.

Impact of Basic Needs Fulfillment on the Health, Well-being, and Academic Engagement of Occupational Therapy Students

The basic needs of students may serve as unknown factors in academic engagement and well-being. Challenges in meeting these needs disproportionately impact underrepresented minority and first-generation students. The purpose of this pilot study was to explore the perceived presence and impact of basic needs on health, well-being, and academic engagement in occupational therapy students. A 43-item survey was distributed to 231 students and focused on questions addressing basic needs in physiology, safety, and belonging. Respondents reported worry over or the need to work to pay bills, no support from family/friends, and limited access to food in the past 30 days and related this to feeling stressed, not being able to do homework, not participating in class, and loss of leisure time. Ninety-four percent used student health services frequently. Recommendations to address gaps in basic needs include flexible policies, inclusive learning environments, supportive and intentional actions, and providing resources.

Assessing the governance environment for private sector engagement in health in Africa: Results from a multi-country survey.

The role of the private sector in health is clear in many countries but engagement can be improved. The World Health Organization (WHO) developed a global strategy in 2020 focused on engaging the private sector in health service delivery through governance in mixed health systems and detailed six governance behaviours to guide its Member States. To operationalise these global ideas into practice, the Regional Office for Africa conducted a multi-country study to understand perceptions around the six governance behaviours. This article examines the perceptions of respondents from 13 African countries on the governance environment for private sector engagement in health. Data were collected through an online survey that was distributed to individuals from ministries of health and their partner organisations, private sector institutions and initiatives in countries and development organisations (n = 81) across 13 countries. The survey was based on the following six governance behaviours: build understanding, enable stakeholders, nurture trust, foster relations, align structures and deliver strategy. Results showed that respondents had mixed perceptions of the governance environment for private sector engagement in health in their respective countries. Although 88% of respondents (n = 63/72) were familiar with the general inclusion of the private sector in national health sector plans, 63% of respondents (n = 45/71) noted there was limited or no integration of the private sector in the health system, and further, 28% of respondents noted there was no private sector reporting in health information systems (n = 19/69). Key opportunities presented in more than one governance behaviour include: (i) increasing private sector engagement in public sector activities, (ii) establishing clear roles and responsibilities through formal partnership agreements, (iii) improving data sharing through shared health information systems, (iv) incentives and subsidies, (v) capacity building, (vi) creating norms, guidelines, and regulations and (vii) conducting joint monitoring and evaluation. Many of these outlined overlapping concepts are not exclusive to one behaviour, thus, it is evident that when targeted, there is the potential to improve numerous governance behaviours. This further reiterates the view that the governance behaviours should be understood as connected and not unrelated areas. The study provides insight into the perceptions of respondents from select African countries on the governance environment for private sector engagement in health. These findings can inform the development of strategies and interventions to support and enhance private sector engagement in health in the region.

Application of Virtual Reality in a Super-Aging Society

Generally, when the proportion of the population aged ≥65 years exceeds 21% of the total population, it is referred to as a "super-aging society." In 2022, Japan surpassed this ratio, reaching 29%, presenting a significant challenge in sustaining the generous government support being provided. Maintaining connections with the community as individuals age, amid changes in their lives, bodies, and social relationships, is also considered crucial for the physical and mental well-being. Virtual reality may emerge as a potentially valuable tool aiding the promotion of health and social engagement of older people.

Did mpox knowledge, attitudes and beliefs affect intended behaviour in the general population and men who are gay, bisexual and who have sex with men? An online cross-sectional survey in the UK

ObjectivesTo investigate rates of mpox beliefs, knowledge and intended behaviours in the general population and in gay, bisexual or other men who have sex with men (GBMSM), and factors associated...

Adults' reading engagement and wellbeing in Aotearoa New Zealand.

Education and literacy have long been associated with a range of economic and social outcomes in industrialized societies. Recent research based on large-scale national and international surveys has examined effects of education and literacy on individuals' social and economic outcomes. This paper takes a further step in understanding the importance of literacy for individuals' economic and social outcomes by disentangling the effects of two different aspects of literacy, literacy proficiency as measured by standardized tests and reading engagement as measured by self-reports of everyday reading activities. Using recent nationally representative survey data from New Zealand, multivariate regression models estimate the effects of reading engagement on earnings, health, social trust, political efficacy and civic engagement. Reading engagement has statistical and substantial positive effects on each of these outcomes with the effects of literacy proficiency, education and other important variables held constant. Although these results do not imply a causal relationship between reading engagement and the outcomes, they have important implications for policy and practice in adult education as well as for future research about the role of reading engagement in wellbeing more generally.

Integrative Approaches in Acute Ischemic Stroke: From Symptom Recognition to Future Innovations.

Among the high prevalence of cerebrovascular diseases nowadays, acute ischemic stroke stands out, representing a significant worldwide health issue with important socio-economic implications. Prompt diagnosis and intervention are important milestones for the management of this multifaceted pathology, making understanding the various stroke-onset symptoms crucial. A key role in acute ischemic stroke management is emphasizing the essential role of a multi-disciplinary team, therefore, increasing the efficiency of recognition and treatment. Neuroimaging and neuroradiology have evolved dramatically over the years, with multiple approaches that provide a higher understanding of the morphological aspects as well as timely recognition of cerebral artery occlusions for effective therapy planning. Regarding the treatment matter, the pharmacological approach, particularly fibrinolytic therapy, has its merits and challenges. Endovascular thrombectomy, a game-changer in stroke management, has witnessed significant advances, with technologies like stent retrievers and aspiration catheters playing pivotal roles. For select patients, combining pharmacological and endovascular strategies offers evidence-backed benefits. The aim of our comprehensive study on acute ischemic stroke is to efficiently compare the current therapies, recognize novel possibilities from the literature, and describe the state of the art in the interdisciplinary approach to acute ischemic stroke. As we aspire for holistic patient management, the emphasis is not just on medical intervention but also on physical therapy, mental health, and community engagement. The future holds promising innovations, with artificial intelligence poised to reshape stroke diagnostics and treatments. Bridging the gap between groundbreaking research and clinical practice remains a challenge, urging continuous collaboration and research.

Trends in U.S. self-reported health and self-care behaviors during the COVID-19 pandemic.

The COVID-19 pandemic represents a unique stressor in Americans' daily lives and access to health services. However, it remains unclear how the pandemic impacted perceived health status and engagement in health-related behaviors. To assess changes in self-reported health outcomes during the COVID-19 pandemic, and to explore trends in health-related behaviors that may underlie the observed health changes. Interrupted time series stratified by age, gender, race/ethnicity, educational attainment, household income, and employment status. United States. All adult respondents to the 2016-2020 Behavioral Risk Factor Surveillance System (N = 2,146,384). Survey completion following the U.S. public health emergency declaration (March-December 2020). January 2019 to February 2020 served as our reference period. Self-reported health outcomes included the number of days per month that respondents spent in poor mental health, physical health, or when poor health prevented their usual activities of daily living. Self-reported health behaviors included the number of hours slept per day, number of days in the past month where alcohol was consumed, participation in any exercise, and current smoking status. The national rate of days spent in poor physical health decreased overall (-1.00 days, 95% CI: -1.10 to -0.90) and for all analyzed subgroups. The rate of poor mental health days or days when poor health prevented usual activities did not change overall but exhibited substantial heterogeneity by subgroup. We also observed overall increases in mean sleep hours per day (+0.09, 95% CI 0.05 to 0.13), the percentage of adults who report any exercise activity (+3.28%, 95% CI 2.48 to 4.09), increased alcohol consumption days (0.27, 95% CI 0.18 to 0.37), and decreased smoking prevalence (-1.11%, 95% CI -1.39 to -0.83). The COVID-19 pandemic had deleterious but heterogeneous effects on mental health, days when poor health prevented usual activities, and alcohol consumption. In contrast, the pandemic's onset was associated with improvements in physical health, mean hours of sleep per day, exercise participation, and smoking status. These findings highlight the need for targeted outreach and interventions to improve mental health in individuals who may be disproportionately affected by the pandemic.

Realising the potential of digital health communities: a study of the role of social factors in community engagement

ABSTRACT Health and fitness communities in the digital age are of strategic importance to global health and wellbeing. Despite this, information systems (IS) research on digital health and fitness communities has not kept pace with societal needs. Using partial least squares analysis, this study examines a number of social factors to predict members’ continuance intention (CI) in digital health and fitness communities. The findings confirm that the social presence (SP) of the community, as perceived by a member, influences their sense of belonging (SB) to it. SP and SB influence the member’s emotional engagement (EE) and appreciation of being recognised (AR) by the community. Subsequently, EE and AR are found to influence CI to stick with the community. In addition, the social influence (SI) of one’s social circles influences AR and CI. Departing from the dominant approaches, this study advances IS research on digital communities by conceptualising and testing a model to predict CI according to social relational theories. The study offers new theoretical foundations, which are appropriate to digital communities, upon which future studies can be based. Further, the findings offer practical insights for improving engagement in digital health and fitness communities.

A Family-Based Mental Health Navigator Intervention for Youth in the Child Welfare System: Protocol for a Randomized Controlled Trial.

Youth in the child welfare system (child welfare-involved [CWI] youth) have high documented rates of mental health symptoms and experience significant disparities in mental health care services access and engagement. Adolescence is a developmental stage that confers increased likelihood of experiencing mental health symptoms and the emergence of disorders that can persist into adulthood. Despite a high documented need for evidence-based mental health services for CWI youth, coordination between child welfare and mental health service systems to increase access to care remains inadequate, and engagement in mental health services is low. Navigator models developed in the health care field to address challenges of service access, fragmentation, and continuity that affect the quality of care provide a promising approach to increase linkage to, and engagement in, mental health services for CWI youth. However, at present, there is no empirically supported mental health navigator model to address the unique and complex mental health needs of CWI youth and their families. Using a randomized controlled trial, this study aims to develop and test a foster care family navigator (FCFN) model to improve mental health service outcomes for CWI adolescents (aged 12-17 years). The navigator model leverages an in-person navigator and use of adjunctive digital health technology to engage with, and improve, care coordination, tracking, and monitoring of mental health service needs for CWI youth and families. In total, 80 caregiver-youth dyads will be randomized to receive either the FCFN intervention or standard of care (clinical case management services): 40 (50%) to FCFN and 40 (50%) to control. Qualitative exit interviews will inform the feasibility and acceptability of the services received during the 6-month period. The primary trial outcomes are mental health treatment initiation and engagement. Other pre- and postservice outcomes, such as proportion screened and time to screening, will also be evaluated. We hypothesize that youth receiving the FCFN intervention will have higher rates of mental health treatment initiation and engagement than youth receiving standard of care. We propose enrollment of 80 dyads by March 2024, final data collection by September 2024, and the publication of main findings in March 2025. After final data analysis and writing of the results, the resulting manuscripts will be submitted to journals for dissemination. This study will be the first to produce empirically driven conclusions and recommendations for implementing a family mental health navigation model for CWI youth with long-standing and unaddressed disparities in behavioral health services access. The study findings have potential to have large-scale trial applicability and be feasible and acceptable for eventual system implementation and adoption. ClinicalTrials.gov NCT04506437; https://www.clinicaltrials.gov/study/NCT04506437. DERR1-10.2196/49999.

Cardiac rehabilitation engagement and associated factors among heart failure patients: a cross-sectional study

BackgroundChronic Heart Failure (CHF) still affects millions of people worldwide despite great advances in therapeutic approaches in the cardiovascular field. Cardiac rehabilitation (CR) is known to improve disease-related symptoms, quality of life and clinical outcomes, yet implementation is suboptimal, a frequently low engagement in rehabilitation programs has been found globally.ObjectiveTo quantify diverse CR-engaged processes and elucidate associated factors of the various levels of CR engagement in CHF patients.MethodsDischarged patients admitted from cardiology departments between May 2022 to July 2022 were enrolled by mobile phone text messaging, CHF patients from same department between August 2022 to December 2022 were enrolled by face-to-face. Individuals who met the inclusion criteria filled the questionnaires, including the generalized anxiety disorders scale, patient health questionnaire, cardiac rehabilitation inventory, patient activation measure, Tampa scale for kinesiophobia heart, social frailty, Patient Health Engagement Scale (PHE-s®). We obtained sociodemographic characteristics and clinical data from medical records. Chi-square tests and multivariable logistic regression analyses were performed to examine the factors associated with CR engagement phases.ResultsA total of 684 patients were included in the study. 52.49% patients were in the Adhesion phase. At the multivariate level, compared with the blackout phase process anxiety, monthly income (RMB yuan) equal to or more than 5,000 were the most important factor impacting CHF patients CR engagement. Compared with the Blackout phase, regular exercise or not, severe depression, previous cardiac-related hospitalizations 1 or 2 times, Age influenced patient CR engagement in the Arousal phase. Besides, compared with the Blackout phase, outcome anxiety and activation level were independent factors in the Eudaimonic Project phase.ConclusionThis study characterized CR engagement, and explored demographic, medical, and psychological factors—with the most important being process anxiety, monthly income, patient activation, severe depression, and previous cardiac-related hospitalizations. The associated factors of CR engagement were not identical among different phases. Our findings suggested that factors could potentially be targeted in clinical practice to identify low CR engagement patients, and strategies implemented to strengthen or overcome these associations to address low CR engagement in CHF patients.

Understanding the Strengths andLimitations ofCurrent Methods forSurveying Partner Nation Medical Facilities.

During exercises or operations, there may be times when U.S. medical capabilities are not available and the next best or only option may be to use partner nation (PN) or host nation capabilities. Joint Publication 4-02 Joint Health Services states that "medical planners should always consider the quality, suitability, and availability of multinational and host-nation support." It is normal practice for medical planners to survey PN medical capabilities as part of the pre-deployment planning process. Currently, medical capability surveys are not conducted in a consistent and systematic manner across the DoD global health engagement enterprise. The lack of a systematic approach undermines medical operations planners' ability to conduct efficient and adequate pre-deployment surveys. The article presents the results of a descriptive analysis of 62 unclassified medical capability surveys of PN or host nation facilities from the U.S. Africa Command (USAFRICOM) area of responsibility that were conducted by U.S. DoD personnel. The team characterized the content and formats of surveys with respect to what medical capabilities were described, how the capabilities were described, and how the information was presented. These analyses focused on determining if a surveyor obtained information about a capability, not whether or not the facility had a capability. Approximately 75-80% of surveys included information describing the presence or absence of five key capabilities: Emergency department/trauma care, surgical services, intensive care unit, laboratory, and imaging. Conversely, 30-50% of surveys did not include any information describing the presence or absence of five other key capabilities: Pharmacy, blood bank, mass casualty plans, land evacuation, or air evacuation. Information on key capabilities and administrative information was not consistently reported across the sample of surveys. There was substantial variation in how capabilities were characterized, including number of staff, staff training, and available equipment. Additionally, the order in which information was presented in surveys varied within and across components. There are significant inconsistencies in the types of capabilities and services documented and how the quality of the capabilities and services is characterized. These inconsistencies can be attributed, in part, to the absence of information that explicitly confirmed whether or not the facility had a capability. Such variation results in obscured or incomplete depictions of facility capabilities, thereby undermining the ability of medical planners to coordinate effective medical readiness for engagements, exercises, or real-life operations. Guidance and survey templates could support better-informed decision-making by including information about survey methods and documenting the lack of confirmatory information. The DoD enterprise should consider how guidance and a standard survey template could improve the relevance, accuracy, and efficiency of data collection and reporting.

Unique miRNome and transcriptome profiles underlie microvascular heterogeneity in mouse kidney.

Endothelial cells in blood vessels in the kidney exert different functions depending on the (micro)vascular bed they are located in. The present study aimed to investigate microRNA and mRNA transcription patterns that underlie these differences. We zoomed in on microvascular compartments in the mouse renal cortex by laser microdissecting the microvessels prior to small RNA- and RNA-sequencing analyses. By these means, we characterized microRNA and mRNA transcription profiles of arterioles, glomeruli, peritubular capillaries, and postcapillary venules. Quantitative RT-PCR, in situ hybridization, and immunohistochemistry were used to validate sequencing results. Unique microRNA and mRNA transcription profiles were found in all microvascular compartments, with dedicated marker microRNAs and mRNAs showing enriched transcription in a single microvascular compartment. In situ hybridization validated the localization of microRNAs mmu-miR-140-3p in arterioles, mmu-miR-322-3p in glomeruli, and mmu-miR-451a in postcapillary venules. Immunohistochemical staining showed that von Willebrand factor protein was mainly expressed in arterioles and postcapillary venules, whereas GABRB1 expression was enriched in glomeruli, and IGF1 was enriched in postcapillary venules. More than 550 compartment-specific microRNA-mRNA interaction pairs were identified that carry functional implications for microvascular behavior. In conclusion, our study identified unique microRNA and mRNA transcription patterns in microvascular compartments of the mouse kidney cortex that underlie microvascular heterogeneity. These patterns provide important molecular information for future studies into differential microvascular engagement in health and disease.NEW & NOTEWORTHY Renal endothelial cells display a high level of heterogeneity depending on the (micro)vascular bed they reside in. The molecular basis contributing to these differences is poorly understood yet of high importance to increase understanding of microvascular engagement in the kidney in health and disease. This report describes m(icro)RNA expression profiles of microvascular beds in the mouse renal cortex and uncovers microvascular compartment-specific m(icro)RNAs and miRNA-mRNA pairs, thereby revealing important molecular mechanisms underlying renal microvascular heterogeneity.

Pilot Study of the Intersection of COVID 19 and Activist Mental Health

Recent tensions in society have led to protests and demonstrations to raise awareness and consciousness ultimately for change. These efforts can be draining. Domestic increases in youth activism has illustrated transformative community action as well as the need to determine themes related to activist sustainability and mental health. Therefore, a phenomenological study was conducted to explore Millennial and Generation Z activist mental health perceptions and engagement during times of protest including COVID-19. The voice of seven youth activists regarding their experience with concurrent activism and mental health maintenance were explored. Themes derived from interviews with these young adult activists about their mental health behaviors, included: wellness maintenance, mindset, and technology. Intentions of youth activists to participate in integrated care were discussed. Implications and suggestions for counselors and helping professions are provided.