Higher Education Level Research Articles

Psychological, Informational, and Material Factors Impacting Girls’ Menstruation-related School Absenteeism in Rural Tanzania

Girls’ education remains a significant challenge in sub-Saharan Africa as it is estimated that 1 in 10 adolescent girls miss school during their menstrual cycle. In Tanzania, girls must attend school regularly to be sufficiently prepared for the National Examinations that serve as gatekeepers to higher education levels and advanced careers. Our current study focuses on contextual factors that limit Tanzanian girls’ school attendance during menstruation (ADM). Using descriptive and inferential statistical techniques and survey data from post-menarche adolescent girls (N = 610) in the Mara region of Tanzania, the findings revealed that psychological, physiological, informational, and material factors increase the likelihood of girls’ school absenteeism during menstruation. The results from this study indicate that generalized anxiety, depression, worry about menstruation, menstruation preparation, and menstrual pad material have a direct impact on ADM. The findings from this study have implications for educational policy and school leadership

Determining food intake, the requirement, and weighing the relative risk between food secure and insecure households in rural areas of Ethiopia: The case of West Hararghe zone

The severity of food insecurity in Ethiopia is among the worst globally, with record-breaking food assistance needs by various factors. This study tries to uncover various aspects of food security related to food availability, food access, food utilization and food stability dimensions of food security. The study was executed in the west Hararghe zone of the Oromia region of Ethiopia. Its main objective was to determine the food security status of households, with specific objectives aiming at computing individual daily kilo calorie intake, determining the average food requirement, comparing the relative risk between food secure and insecure households and identifying factors that affect household food security status. A multi-stage sampling procedure, involving the purposive selection of; the Zone and Woreda, and a simple random selection of households, to draw the required number of representative sample respondents, was adopted. Hence, from 4163 total households, 134 were selected for collecting primary data. Data were analyzed using descriptive statistics, relative risk analysis using Cohorts and independent tests using ANOVA. Food security status was measured using the Household Food Balance Model (HFBM). Using this model, the study obtained 1973 kilo calories per individual per day intake and 2108 kilo calorie as their requirement, which indicated households were energy deficient by 135 kilo calorie with 2-sided-value < 0.1 critical level (t= -1.747, df =133 & sig2-sided. 0.083). Independent test results showed that farm income (at p-value < 0.1), gross product (at p-value < 0.05), age of household head (at p-value < 0.1), years of owning land (at p < 0.1) and family size (at p-value < 0.1) contributed significantly to food security status. Cross-tabulation showed a linear relationship between food security and higher education level (at p-value < 0.05), which urges a concern in improving farming societies’ literacy to the desired level. In the study areas, about 91.8% of the population produces crops depending on the seasonal rainfall and their daily kilo calorie consumed depends on it; this is statistically correlated with the food insecurity problem at p-value < 0.1 critical level (lambada = 1.75 & sig. = 0.08). Therefore, to tackle the food insecurity problem, alternative method of crop production should be devised such as the establishment of irrigation schemes, water harvesting structures, and water conservation practices, among others. Key words: food security, calorie requirement, food availability, relative risk

The Association between Moderate Physical Activity and Stress in Thai Older Adults with Hypertension

Background: Hypertension is a serious health concern for Thailand’s aging population. Although moderate physical activity is beneficial to physical and mental health, there are limited studies to specifically examine the relationship between physical activity and stress among older adults with hypertension in Thailand. Methods: This cross-sectional study was conducted from December 2022 to June 2023 through face-to-face interviews by questionnaires. Multiple logistic regression was employed to investigate the associations between moderate physical activity and stress. Results: The study included203 older adults with hypertension. The majority of the participants were female (78.82%) and aged over 69 years (69.46%). Moderate physical activity was reported by 36.45%, while 10.34% experienced stress. Older adults with hypertension who engaged in moderate physical activity were 93% less likely to experience stress compared to those who did not (AOR=0.07, 95% CI: 0.01 - 0.98, p=0.048). Additionally, those who graduated higher education levelwere less likely to experience stress. Conclusion: Moderate physical activity and a higher education level were associated with a lower experience of stress among older adults with hypertension. Healthcare professionals should incorporate physical activity and stress management strategies into their care plans for older adults with hypertension.Encouraging and promoting physical activity and educational opportunities are important to reduce stress levels in seniors with hypertension.

Analysing the behaviour change techniques in an effective food literacy program to inform future program design.

Food literacy programs aim to improve food related skills and knowledge and are selected Governments as a strategy to address dietary intakes at a community level. The purpose of this research is to identify behaviour change techniques in a food literacy program, which were assessed by the achievement of participant goals related to food literacy and dietary behaviour changes. Consensus methods were applied to map behaviour change techniques to an adult food literacy program. A second phase investigation applied content analysis of participant process evaluation data (collected between 2016 and June 2021) to align target behaviours and behaviour change techniques. Chi-square and ANCOVA were used to assess the statistically significant demographic characteristics, food literacy, and dietary behaviour scores for participants who set goals and recorded changes. A total of 4697 program participants provided evaluation data from the 4-week food literacy program. Participants who set goals and made changes were statistically more likely to have higher food literacy factor scores (p < 0.001) and fruit serves (p = 0.004). Statistical analysis showed that participants were more likely to have set goals and recorded changes if they were female (p < 0.001), older (p < 0.001), higher education level (p < 0.001), had a higher socioeconomic status (p = 0.049), lived with children (p = 0.014), were born in Australia (p = 0.019), or did not identify as Indigenous (p < 0.001). The behaviour change technique mapping process identified nine techniques used weekly and a total of 22 techniques used over the entire 4 week program curriculum. This is the first Australian study to link the contribution of behaviour change techniques to food literacy and dietary behaviour change in an established effective food literacy program. Knowing the behaviour change techniques associated with effective programs will facilitate replication of effective interventions.

Changes in Alcohol Intake by Educational Level among Older Men and Women in Spain during the 21st Century

Abstract Background and objectives Despite alcohol use being very common in older adults, studies are scarce and suggest alcohol use may be increasing. Furthermore, despite the known relationship between education and alcohol consumption, there is limited evidence of educational differences in older adults. Our objective was to describe trends in alcohol consumption in individuals aged ≥65 by sex and educational level in Spain. Research design and methods 43,157 participants aged ≥65 years were drawn from Spain’s national health surveys between 2001-2020, representing the non-institutionalized population. The outcomes were various measures of self-reported past-year alcohol intake. Age-standardized rates and negative binomial regression models were used to examine trends and differences in alcohol intake by educational level, sex, and period (2001-2009 vs. 2011-2020). Results The average daily alcohol intake and prevalence of heavy average drinking (&amp;gt;20/10 g/day) decreased over time, especially among men, while moderate average drinking remained unchanged or even increased. Alcohol intake increased with increasing educational levels. All drinking measures showed educational inequalities, and these were greater in women than men. The mean amount of drinking showed the greatest inequality, with and adjusted prevalence ratio of 2.6 in women and 1.1 in men between university relative to primary education level. Discussion and implications Alcohol intake in older adults decreased over time in Spain for heavy average drinking and average drinking amount, although not for moderate average drinking. Consumption remains highest among the highest educational levels, which may negatively affect health. Programs addressing alcohol consumption among older adults are needed to minimize alcohol-related harm.

Factors Associated with Axial Spondyloarthritis Remission in a Cohort of Saudi Patients with Longstanding Disease: A Multicenter Prospective Cohort Study.

Earlier treatment in axial spondyloarthritis (axSpA) was proposed to alter disease prognosis in this often-challenging condition. We aimed to assess the proportion of patients and prognostic factors associated with axSpA remission. The aim was to determine the number of patients with Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS-CRP) of <2.1 (inactive/moderate disease activity). We also evaluated global functioning and health using the Assessment of Spondyloarthritis International Society-Health Index (ASAS-HI). Patients with axSpA who were receiving targeted synthetic/biological disease- modifying anti-rheumatic drug (ts/bDMARDs) treatments and visited the rheumatology units at two tertiary-care centers between December 2021 and December 2022 were prospectively interviewed. Data regarding patient demographics, disease features, active and previous ts/bDMARDs treatments, and disease activity scores were obtained. Patients were assessed using the ASDAS- CRP, ASDAS-erythrocyte sedimentation rate (ASDAS-ESR), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and ASAS-HI. Overall, 60 patients with axSpA were included in this study (women, n = 35); 25 (41.7%) and 36 (62.1%) achieved an ASDAS-CRP of <2.1 and an ASAS-HI of ≤5 (good health), respectively. Out of the 60 patients, 75% (n = 45) were treated with anti-tumor necrosis factor. Factors associated with achieving the target ASDAS-CRP included age (p = 0.019), sex (p = 0.015), employment status (p = 0.015), education level (p = 0.030), and the number of previous ts/bDMARDs treatments (p = 0.019). Additionally, the ASDAS-CRP strongly correlated with spinal pain and moderately correlated with the ASAS-HI, BASDAI, and the number of previous ts/bDMARDs treatments. Remission was observed in 41.7% of patients, indicating a challenge in achieving target disease activity. However, 62.1% attained good health. Achieving remission was associated with younger age, male sex, a higher level of education, lower level of spinal pain, better global function by ASAS-HI, employment, and receiving their first ts/bDMARDs treatment. Our findings may potentially improve disease prognosis with the earlier use of ts/bDMARDs in those without favorable features by implementing an early axSpA intervention strategy.

Design and Testing of a Web-Based Student Information Management System

Politeknik Piksi Ganesha is an institution of higher learning located in Bandung, Indonesia, specializing in engineering and technological curricula. The research's general objective is to describe the design and implementation of the web-based Student Information Management System (SIMS) to manage student data at Politeknik Piksi Ganesha Bandung. The functional and non-functional specifications are represented using Unified Modeling Language (UML) based on broad data collection through observation, interviews, and a literature review. It also entails black-box testing, which measures the system's performance against set criteria, focusing on the output without the details of its internal workings. The significant findings indicate that SIMS enhances highly administrative processes, accuracy in data, and good communication among stakeholders by applying clear UML diagrams of the system. This successful system development meets the institution's requirements and adds to the bar for other developments within the educational technology sector. The result has also emphasized the need for practical design methodologies and testing frameworks to develop reliable information systems to improve decision-making in academic institutions. The research has contributed significantly to the discipline because it has shown how different technological innovations can alleviate the problems surrounding managing student information at higher education levels.

Community members’ perspective on social accountability in the health system: a cross- sectional study from Tanzania

Introduction: Social accountability initiatives are considered a way to address inefficiencies and improve overall health system performance. Tanzania has introduced Health Facility Governing Committees (HFGCs) to improve social accountability of the health system. However, information on how communities perceive these committees is lacking. This study aimed to assess the prevalence and social determinants of the HFGCs accountability from the community perspective in Tanzania. Methods: The research employed a cross-sectional survey design in two Tanzanian districts (Handeni and Mbarali) selected for their contrasting health performance. Data collection took place from July to October 2022, involving 1184 households in 31 villages/mitaa. The study measured social accountability through a set of six questions, focusing on community support, sensitization, feedback, trust, engagement, and overall accountability of HFGCs. Socio-demographic data such as sex, age, education, occupation, type of health facility and district were also collected and analyzed using linear regression to identify factors influencing perceptions of accountability. Results: The findings revealed a low prevalence of social accountability as measured by the variables of community awareness and engagement with the HFGCs. Only a small percentage of respondents felt adequately informed or involved in the activities of these committees. Social determinants such as higher education levels and certain occupations, such as business and retirement and those living in Handeni district, correlated positively with a better perception of social accountability. Conclusion: The study highlights significant challenges in the operational effectiveness of HFGCs in Tanzania, with a notable disconnect between these bodies and the communities they serve. Despite the theoretical framework for social accountability, actual community engagement remains low, impacting the overall efficacy of health governance at the local level. Future research should focus on improving community awareness and participation in these committees to improve their functionality and accountability, thereby aligning with national health objectives and local needs.

Unraveling the causal association between lifestyle and metabolic factors with endometrial cancer: evidence from a Mendelian randomization study

BackgroundEndometrial carcinoma (EC) remain a malignancy with incompletely understood risk factors. To address this knowledge gap, we employed mendelian randomization study to investigate potential protective and risk elements associated with endometrial cancer.MethodsWe conducted a two-sample Mendelian randomization (MR) study using genetic association data for overall EC and its subtypes from a large-scale genome-wide association study (GWAS). This GWAS encompassed 12,906 EC patients and 108,979 healthy controls. The EC cases were further categorized into 8758 endometrioid and 1230 non-endometrioid subtypes. To serve as instrumental variables, we identified independent genetic variants strongly associated with 5 lifestyle factors and 14 metabolic factors from relevant GWASs. Subsequently, we conducted univariable Mendelian randomization (MR) analyses.ResultsOur study revealed the relationship among EC with lifetime smoking index (OR: 1.43; 95% CI 1.05–1.96), frequency of alcohol consumption (OR:1.23; 95% CI 1.04–1.45), body mass index (BMI) (OR:1.82; 95% CI 1.64–2.01), type 2 diabetes mellitus (T2DM) (OR:1.06; 95% CI 1.00–1.12), and fasting insulin (OR:1.97; 95% CI 1.30–2.98). Conversely, inverse associations with EC were observed for education level (OR:0.72, 95% CI 0.62–0.83), moderate-level physical exercise (OR 0.35, 95% CI 0.15–0.84), and low-density lipoproteins (LDL) (OR 0.91, 95% CI 0.84–0.99).ConclusionsOur findings underscore a causal association between genetically predicted lifetime smoking index, alcohol intake frequency, BMI, T2DM, and fasting insulin with EC risk. Furthermore, our study highlights the potential protective effects of a high education level, moderate-intensity physical exercise, and LDL reduction against EC risk. This MR analysis provided valuable insights into underlying EC risk mechanisms and paved new ways for EC prevention strategies.

Translation and Validation of the Diabetes Knowledge Questionnaire in Indonesian Patients With Type 2 Diabetes.

The purpose of the study was to translate and cross-culturally adapt the 24-item Diabetes Knowledge Questionnaire (DKQ) for Indonesian patients with type 2 diabetes (T2D) and evaluate its psychometric properties. Forward-backward translation, adaptation involving 7 experts, and pretesting to develop the Indonesian version of DKQ were conducted. Psychometric analysis was carried out among T2D patients from 40 primary health care centers in Indonesia. Known-group, convergent and discriminant validity, internal consistency and test-retest reliability were assessed. Additionally, a descriptive item analysis was conducted. In total, 39 patients participated in the pretesting and 304 patients in the validation process and descriptive analysis. Of the 24 items, 2 were adjusted during the adaptation process, and 1 item was deleted because it did not adequately reflect the original item. Known-group validity was demonstrated because patients with younger ages, higher educational levels, and longer diabetes duration had significantly higher DKQ scores. Convergent validity was demonstrated by a significant positive correlation of the DKQ scores with overall treatment satisfaction. The 23-item DKQ Bahasa Indonesia showed satisfactory internal consistency (Cronbach's α = 0.73; omega total = 0.72) and good test-retest reliability (intraclass correlation coefficient = 0.87 in a sample of 27 patients). No floor and ceiling effects were found in the item analysis. The study demonstrates adequate validity and reliability of the 23-item DKQ Bahasa Indonesia for assessing diabetes knowledge in Indonesian primary care patients with T2D. This instrument can be used to identify room for improvement and develop diabetes education programs.

Applying the Health Belief Model to cervical cancer screening uptake among women in Ethiopia: a systematic reviewand meta-analysis.

Cervical cancer is a leading cause of cancer mortality globally, especially in Africa, including Ethiopia. This review assesses predictors of cervical cancer screening uptake among Ethiopian-eligible women using the Health Belief Model. Higher education levels, perceived susceptibility, severity, and fewer barriers are associated with increased screening. Effective HBM-based interventions could enhance screening rates, potentially reducing cervical cancer incidence and mortality. The review aimed to synthesize the existing literature on the prevalence of Cervical Cancer Screening Service Uptake and Associated Factors among Eligible Women using the Health belief model in Ethiopia, 2024. This systematic review and meta-analysis searched Google Scholar, PubMed, and the Cochrane Library engine. Key terms such as "Cervical cancer screening", "uptake", "utilization", "factors", "barriers", and "Ethiopia" were used to identify relevant articles. Data extraction utilized a detailed form, and the methodological quality of each study was assessed using the JBI quality appraisal checklist for cross-sectional studies. Statistical analysis was conducted using STATA version 17, and the meta-analysis findings were presented using forest plots and tables. The result of seven studies revealed that the overall prevalence of Cervical Cancer Screening Service Uptake among eligible women in Ethiopia was 21% (95% CI: 15%-27%). Factors independently associated with Cancer Screening Service Uptake included: Knowledge (OR = 4.563, 95% CI: 1.012-4.188), age 30 up to 49 (OR = 4.106, 95% CI: 1.562-6.650), history of STD (OR = 2.59, 95% CI: 1.694-4.486), high perceived susceptibility (OR = 3.814, 95% CI: 2.312-5.316), high perceived severity (OR = 2.603, 95% CI: 2.203-3.003), low perceived barrier (OR = 4.390, 95% CI: 1.331-8.449), high perceived self-efficacy (OR = 4.77, 95% CI: 4.102-5.431), high perceived benefit (OR = 3.67, 95% CI: 1.851-5.489), and education level greater than primary level (OR = 4.497, 95% CI: 3.619-5.375). Cervical cancer is a major public health challenge in Ethiopia. Consequently, there is a pressing need for the governments to formulate comprehensive, multi-sectorial policies and strategies. These initiatives should be designed to address the problem influenced by interconnected factors, to reduce the prevalence of cervical cancer in Ethiopia.

Construction and verification of the prediction model for risk of sleep disturbance in elderly patients with hypertension: a cross-sectional survey based on NHANES database from 2005 to 2018

ObjectiveTo construct and verify a risk prediction model for sleep disturbance in elderly patients with hypertension, aiming to offer guidance for sleep management in this demographic.MethodsA cohort of 6,708 elderly hypertensive patients from the NHANES database, spanning 2005 to 2018, met the inclusion criteria and were selected for this study. Participants were randomly assigned to a development group (n = 4,696) and a verification group (n = 2,012) in a 7:3 ratio. The occurrence of sleep disturbance was assessed across the subjects. Independent risk factors for sleep disturbance were analyzed using weighted multivariate logistic regression within the development group. A predictive model for sleep disturbance risk in elderly hypertensive patients was developed and verified using Stata 17.0. The model's predictive accuracy and stability were evaluated using the verification group's data.ResultsOf the 6,708 subjects, 2,014 (30.02%) were identified with sleep disturbance, and the weighted prevalence of sleep disturbance among elderly hypertensive patients was 33.283%. Weighted multivariate logistic regression analysis in the development group revealed that six factors were independently associated with sleep disturbance: higher total depression scores, higher education level, asthma, overweight, arthritis, and work restriction (OR > 1 and P < 0.05). The area under the receiver operating characteristic (ROC) curve (AUC) for the nomogram prediction model was 0.709 in the development group and 0.707 in the verification group, indicating good discrimination ability. Brier scores for the nomogram model were 0.185 in the development group and 0.189 in the verification group, both below 0.25, suggesting good calibration. Decision Curve Analysis (DCA) determined that the nomogram's clinical net benefit was maximized when the threshold probability for sleep disturbance in elderly hypertensive patients was 0.13–0.67 in the development group and 0.14–0.61 in the verification group, highlighting the model's clinical utility.LimitationsThis study is not without its limitations, including issues with data collection, the absence of external validation, and the non-extrapolation of results.ConclusionThe prevalence of sleep disturbance among elderly hypertensive patients stands at 33.283%. The nomogram model, based on identified risk factors for sleep disturbance in this population, has demonstrated good predictive efficiency and clinical relevance. It serves as a valuable tool to assist healthcare providers in identifying elderly hypertensive patients at high risk for sleep disturbance.

Association between Social Demographic Factors and Health Literacy in Jordan

The study highlights that low health literacy is a serious global health threat, causing health problem denial, poor communication with healthcare providers, and widening disparities. It aims to investigate how income, education, and socio-economic status affect health literacy levels. The study conducted an occasional design using quantitative data. This study was conducted using a structured questionnaire to obtain information from 413 randomly selected Ammani residents The questions were designed to assess the impact of health literacy level. The study's quantitative results show that socio-economic factors are the reasons for the health literacy among Amman residents, based on the 413 sample. Although gender only shows little differences, age, income, and education greatly affect health literacy, with those aged 30-60, higher income earners, and people with higher education levels having better understanding. It is necessary to design health literacy interventions for different demographic groups so as to eliminate the disparities and to get the so desired health outcomes. This study assesses the association between social demographic factors and health literacy in Jordan and found the level of literacy affected by social and economic factors, but in varying proportions for each topic with some recommendations.

First-Generation College Students’ Intergenerational Narratives of Redemption and Upward Mobility

SYNOPSIS Objective. This study explored the role of intergenerational narratives in the motivations and goals of first-generation college students. Design. Reflexive thematic analysis examined narrative responses to open-ended questions regarding their motivations and goals for college enrollment. Results. Analyses generated a central theme: breaking the family cycle of poverty to achieve upward mobility. This theme included three subthemes: attaining financial stability, obtaining a higher level of education than their family, and challenging oppressive university and societal systems for a better future. The participants often approached their intergenerational narratives in two distinct ways: “self-initiated” and “parent-initiated.” In parent-initiated narratives, participants centered their parents in their intergenerational stories. They stated that their parents’ stories inspired them to attend college, break the cycle of poverty, and avoid the hardships their parents experienced. Conversely, in self-initiated narratives, participants centered themselves in the intergenerational stories. They expressed their aspirations to break the family cycle of poverty and avoid the challenges they and their families faced while growing up. Conclusions. These findings underscore how first-generation college students’ intergenerational redemption narratives shape their motivations for pursuing higher education and life goals.

Analysis of factors associated with tooth loss in older adults from 1995 to 2015: a population-based cross-sectional survey in Guangdong, China.

The aim of this study was to detect trends and related factors in the functional dentition (FD) in 65- to 74-year-olds in Guangdong, China, while also assessing trends in education and income inequality factors. Three large-scale cross-sectional National Oral Health Surveys (NOHS), specifically NOHS II in 1995, NOHS III in 2005, and NOHS IV in 2015, were included. Post hoc stratification was weighted for 1038 participants aged 65 to 74years. Retaining teeth ≥ 20 teeth and retaining < 20 teeth was defined as functional dentition (FD) and nonfunctional dentition (NFD), respectively. Logistic regression models were established to assess related factors. Slope index of inequality (SII) and relative index of inequality (RII) were used to analyze inequality. From NOHS II to IV, the FD proportion increased from 42.8 to 71.9%. Years of NOH, with caries, with periodontal pocket, high educational level, high income level, female, and those who had dental visits were associated with FD preservation. The education-related SII decreased from 0.44 to 0.20, and the income-related SII increased from 0.13 to 0.16. The FD proportion among 65- to 74-year-olds improved from 1995 to 2015. Years of NOHS, with caries, with periodontal pocket, high education level, and high income level were associated with higher FD proportion. Female and those who had dental visits were associated lower FD proportion. Social inequalities in FD persisted, especially economic-related inequalities. Public health policy support and respective interventions should be applied to increase FD retention.

Utilisation and associated socio-demographic factors related to the maternal continuum of care in sub-Saharan Africa: A systematic review and meta-analysis.

Maternal continuum of care (MCC) is the utilisation of maternal health care services, including 4+ antenatal care (ANC) visits, skilled birth attendants (SBAs), and postnatal care (PNC). This systematic review and meta-analysis assessed the pooled proportion of MCC utilisation among women in sub-Saharan Africa (SSA) and its association with selected sociodemographic factors. We identified keywords and MeSH terms related to the condition (MCC), the context (SSA), and population (women with history of childbirth) to search for published or unpublished observational studies. We used the Joanna Briggs Institute tool to extract data and the Newcastle Ottawa Scale for quality assessment. Meta-analysis was used to compute pooled estimates (MCC utilisation and odds ratio (OR) associates) with 95% confidence intervals (CI) using Stata 17. Of 45 402 studies identified, we included 23 involving 320 353 women. The pooled estimate of MCC utilisation across SSA was 18.72% (95% CI = 14.51, 22.93), showing a significant increase (P < 0.05) from 2015 to 2022. Southern Africa had the highest MCC utilisation (38%; 95% CI = 36.59, 39.41), while East Africa had the lowest (17.5%; 95% CI = 12.22, 22.75). Maternal continuum of care utilisation was associated with maternal age 25-34 years (pooled odds ratio (POR) = 1.27), urban residence (POR = 2.69), richer/richest wealth status (POR = 1.68), as well as higher level of education and employment (POR = 1.32). MCC utilisation in SSA remains low, with significant variation across the sub-regions and sociodemographic strata. Context-specific interventions targeting identified factors are essential to enhance MCC utilisation in SSA. PROSPERO: CRD42021272708.

Compliance and Determinants of Spectacle Wear Among Moroccan Adults Residing Beni-Mellal Khénifra Region.

Ensuring a high level of adherence to wearing spectacles is essential to preserve eye health and achieve optimal vision correction. Comprehending the factors influencing adherence to wearing spectacles can inform strategies to improve eye care outcomes. This study aimed to assess the prevalence and factors influencing adherence to wearing spectacles among Moroccan adults residing the Beni-Mellal Khenifra region. A cross-sectional interview survey was conducted involving 389 adult spectacle wearers. Participants were recruited through a multilevel random sampling technique and interviewed using a structured questionnaire. This questionnaire collected data on demographics, spectacle prescription, usage patterns, and barriers to compliance. Compliance was assessed based on self-reported frequency and duration of spectacle wear according to the prescription. Possible factors influencing the wearing of spectacles were investigated using both univariate and multivariate regression models. This study revealed that 57.6% of participants adhered to the recommended use of spectacles. Factors associated with compliance were higher education level, longer duration of spectacle use, awareness about the importance of spectacle wear, absence of a family history, specific refractive error types, and increased severity of refractive errors. Participants reported various reasons for not adhering to the recommended use of spectacles, with the most common being forgetfulness, perceiving improved vision without spectacle, discomfort while wearing spectacle, difficulty adapting to spectacle, and loss of spectacle. Given the high prevalence of non-compliance to spectacle wear among adults in the Beni-Mellal Khenifra region, it is evident that additional efforts are required to improve understanding and education regarding the advantages of consistent spectacle usage. Targeted educational and awareness initiatives have the potential to substantially enhance adherence rates and consequently improve visual health outcomes in the region.

Concordance between late effects reported by physicians and patients in a cohort of long-term Hodgkin lymphoma survivors: an analysis of data from nine consecutive EORTC-LYSA trials.

Studies looking into the concordance between late effects reported by physicians vs. those reported by Hodgkin lymphoma (HL) survivors are missing. A Life Situation Questionnaire focusing on late effects collected data from 1230 HL survivors (median follow-up 14.3years). Twenty-six disease- and treatment-related late effects from various organ systems were matched with physician-recorded data. The concordance between physicians and survivors was systematically evaluated using percentage agreement and kappa statistics. Potential non-responder biases and associations with patient and disease characteristics were also investigated. Agreement levels (indicated by kappa statistics) varied from none to moderate agreement, with the highest Kappa values observed for myocardial infarction (kappa = 0.55, 95% CI 0.43-0.66) and pulmonary embolism (kappa = 0.55, 95% CI 0.35-0.75). HL survivors consistently reported a higher prevalence of late effects compared with physicians. Notably, the prevalence of subjective symptoms such as persistent fatigue and xerostomia was repeatedly underreported by physicians. A trend towards higher concordance was observed in survivors with higher clinical stage, higher education level, and treatment initiated at younger ages. Additionally, findings indicated that survivors who did not respond to the questionnaire experienced fewer late effects compared to those who did respond. Substantial discrepancies were noted in the reported prevalence of late effects between survivors and physicians, especially for outcomes which are not easily quantified. It is therefore essential to integrate outcomes reported by both physicians and survivors to achieve a comprehensive assessment of the long-term consequences of HL treatment.

Tradeoffs between privacy and screening efficiency for air passengers – Implications for tourism supply chain management

ABSTRACT This study employs the stated preference method to explore airline passengers’ choices during security screening and examines their trade-offs between privacy and efficiency. We compare two Asian economic hub cities (i.e. Hong Kong and Shanghai), with 500 business and leisure travellers sampled from each city. A generalised mixed multinomial logit model is estimated. The results suggest that travellers display varied levels of privacy concerns, including biometrics, biographical data, identifiers, and behavioural information. The participants from Shanghai expressed a willingness to go through fingerprint scanning and to provide facial images. The travellers in Hong Kong displayed notable reluctance to receive iris scans and disclose political and religious affiliations, and they were particularly hesitant about sharing medication records. Despite some differences between the two markets, both groups strongly opposed smartphone tracking, including access to search history and GPS location. In general, business (vs. leisure) travellers, men (vs. women), individuals with higher education levels, and those with higher personal monthly incomes strongly preferred fast-track schemes that utilised personal data. Our findings highlight the possibility of making more effective transitions to high-tech screening methods that meet the changing expectations of travellers if total screening time can be significantly decreased.

The distribution of insufficient effort responses according to the methods of classifying and interpreting students’ evaluation of teaching effectiveness

PurposeThis study explores the distribution of insufficient effort responders according to methods of classifying students’ evaluation of teaching effectiveness in higher education. Five different methods were found in the literature to classify students’ evaluation of teaching effectiveness in higher education.Design/methodology/approachQuantitative research methodology was used to achieve the goals of this study. Data from a major public university was used through 20 five-point items that are designed to measure students’ evaluation of teaching effectiveness. The dataset that consisted of 26,679 surveys was analyzed. Detecting insufficient efforts responding was based on item response theory procedures.FindingsThe results show that insufficient effort responders are distributed differently to students’ evaluation of teaching effectiveness in higher education levels according to different methods of classifying these levels. The results of this study suggest using a percentage of students’ agreement of 4 or 5 for each item to classify SET levels and deleting IERs before interpreting SET results.Research limitations/implicationsAccording to the results of this study, it is recommended to research the relationships between IER and SET scores and students’ motivation to participate in evaluating teaching effectiveness.Practical implicationsAccording to the results of this study, it is recommended to:1– Exclude the IERs from the dataset before generating SET reports. 2– Use the percentage of 4 (agree) and 5 (strongly agree) satisfactions of SET items to classify and interpret SET results.Originality/valueReviewing the literature shows the absence of studies that explore the distribution of insufficient effort responders according to methods of classifying students’ evaluation of teaching effectiveness in higher education. The results suggest using a percentage of students’ agreement of 4 or 5 for each item to classify SET levels and deleting IERs before interpreting SET results.