Initial Education Research Articles

Beyond Verification: The Evolving Role of Fact-Checking Organisations in Media Beyond Verification: The Evolving Role of Fact-Checking Organisations in Media Literacy Education for YouthEducation for Youth

This research investigates the crucial role of fact-checking organisations in promoting media and information literacy (MIL) amid the challenges of widespread misinformation. By educating and empowering individuals, these organisations and their educational branches are identified as emerging components within MIL ecosystems, particularly focusing on engaging youth. Using qualitative research methods, our study analyses the activities of seven prominent fact-checking organisations and two university-affiliated projects across Spain, Catalonia, Poland, Hong Kong, the Philippines, Argentina, and Brazil. Thus, our study aims to understand why fact-checking organisations have become involved in MIL education and training for youth and what types of MIL, approaches, and subjects fact-checking organisations employ in their MIL education and training initiatives for this audience. Our findings reveal a shift in these organisations toward actively promoting MIL education through dedicated divisions and teams driven by mission-oriented action and peer collaboration. Various institutions and political and educational policies support or hinder this transformation. A significant issue observed is the limited availability of open-access materials and general opacity regarding their pedagogical approaches. Although these organisations have integrated educational components into their models, achieving financial sustainability remains challenging.

Advanced Detection Techniques to neutralize Supply Chain Cyber-attacks on small and medium businesses in the United States: The Machine Learning and AI Approach.

Cyber-attacks targeting supply chains represent a significant and increasing risk for small and medium-sized businesses (SMBs) in the United States. This paper examines the role of machine learning (ML) and artificial intelligence (AI) in detecting and mitigating these cybersecurity threats. Key challenges faced by SMBs include high implementation costs, a shortage of skilled personnel, inadequate data quality, and the complexity of integrating advanced technologies into existing systems. Despite these hurdles, the paper identifies strategic approaches that can empower SMBs to effectively leverage ML and AI, including affordable solutions, targeted training, and improved data management practices. It emphasizes the importance of addressing privacy and usability concerns to facilitate successful technology adoption. Recommendations include pursuing cost-effective, subscription-based AI and ML models, utilizing government incentives, and enhancing workforce skills through training and partnerships. Additionally, collaboration with larger organizations can improve data management and system efficacy. By implementing robust protective measures and increasing awareness through educational initiatives, SMBs can strengthen their cybersecurity posture and better navigate the evolving landscape of cyber threats.

Privacy, confidentiality and ethical concerns in audio ai assistants: A comparative study of North American, European, and Asian Markets

This study examines the ethical, privacy, and confidentiality issues with audio AI assistants in the markets of North America, Europe, and Asia. Understanding the ramifications of data collecting, storage, and usage is crucial as the use of technologies like Google Assistant and Amazon Alexa grows. The study highlights significant regulatory differences between the areas; North America offers a fragmented landscape, and many Asian nations are still developing their data protection legislation, while Europe leads with strong frameworks like the General Data Protection Regulation (GDPR). Key challenges identified include a lack of user awareness regarding privacy rights, extensive data collection practices, unauthorized listening, data breaches, and cultural differences influencing attitudes toward data protection. The findings reveal that these challenges impact user trust and hinder the responsible innovation of AI technologies. Recommendations for improvement include establishing global regulations to promote consistency in data protection, adopting best practices such as privacy-by-design principles, and enhancing user education initiatives. Additionally, the study identifies critical areas for future research, particularly the role of AI assistants in sensitive sectors like healthcare and education, where privacy concerns may differ significantly. Overall, this comparative analysis provides a foundational understanding of audio AI assistants' ethical landscape and underscores the importance of addressing these issues to foster a secure and trustworthy digital environment.

Sexual harassment among higher education students: a worldwide review

Abstract Introduction Sexual harassment is an uprising problem in higher education systems worldwide with major impacts on students. The aim of this study was to describe and meta-analyze quantitative data on sexual harassment prevalence among higher education students. Methods We searched in seven databases and included studies published in English and French from 2000 until 2023 if they measured sexual harassment prevalence on students attending higher education, and they were quantitative cross-sectional studies. Prevalence estimates disaggregated by gender identity, and world region were meta-analyzed using a random-effects model and reported following PRISMA guidance. Results We identified 53 articles, from 6 different regions of the world, with highly variable sample sizes, ranging from 164 to 779,170. 45% of the samples were from the United States. 32% of studies used convenience or purposive sampling and 39% random sampling. The meta-analyzed prevalence of sexual harassment was globally 36.9% (95% CI [30.6, 43.6], 43.7% for women, 16.8% for men, 33.4% for non-binary. In additional, variations in prevalence were observed across the different world regions. In particular, the Eastern Mediterranean region presented the highest prevalence estimates for sexual harassment among women, reaching 67.5%, while the Americas region presented the highest prevalence estimates for sexual harassment among men, at 18.8%. Discussions Higher education institutions, especially in low- and middle-income countries, should commit to the conduct of surveys to monitor the prevalence of sexual harassment, and policymakers should allocate specific funds and resources to support the implementation of sexual harassment prevention and intervention initiatives in higher education, prioritizing the safety and well-being of students. Key messages • High prevalence of sexual harassment in higher education underscores urgent need for proactive measures to ensure student safety and well-being. • Policymakers should allocate specific funds and resources to support the implementation of SH prevention and intervention initiatives in higher education.

Health literacy in the evolving era of personalised medicine and digital health

Abstract Health literacy is pivotal for advancing public health, empowering individuals to grasp health information and make informed decisions. However, health literacy levels are often influenced by social and economic factors, with lower levels correlating with reduced disease-specific knowledge and underutilization of preventive health services. As healthcare technology rapidly evolves, particularly with the advent of personalised medicine (PM) and novel genetic testing methods, there’s an increasing demand for heightened health literacy to effectively navigate these transformative innovations and optimize health outcomes. The European ExACT project aims to assess the understanding of PM and related technologies across the EU. In this context, through a survey conducted in several European countries, including Italy, France, Spain, Poland, the Netherlands, Romania, Hungary, and Germany, demographic data and attitudes towards PM, genetic testing, health portals, and big data were gathered. Logistic regression analysis identified factors influencing knowledge and attitudes. Among 6581 respondents, the results highlight a broad awareness of genetic testing (81%) and health portals (54%) yet a lesser familiarity with PM (48%) and big data (37%). Education level, age, and gender influenced awareness, with Hungary showing significant awareness across all topics (OR 2.09 95%CI 1.46-2.98), Spain excelling in big data (OR 1.88 95%CI 1.55-2.27), and Poland leading in genetic testing knowledge (OR 2.68 95%CI 1.82-3.96). Differences between countries may indicate successful policies and factors that can be replicated. Overall, the study emphasizes the importance of enhancing health literacy and sheds light on the predicting role of sociodemographic factors. It underscores the significance of bolstering health literacy to effectively navigate the advancements in PM and digital health, improving health outcomes in light of these evolving healthcare landscapes. Key messages • In Europe, awareness of personalised medicine, health portals and big data is lacking. Educational initiatives are crucial for effective navigation of innovations, considering regional differences. • Social and economic factors affect health literacy levels, impacting disease-specific knowledge and healthcare utilization.

Naloxone Coprescribing and the Prevention of Opioid Overdoses: Quasi-Experimental Metacognitive Assessment of a Novel Education Initiative.

Critical evaluation of naloxone coprescription academic detailing programs has been positive, but little research has focused on how participant thinking changes during academic detailing. The dual purposes of this study were to (1) present a metacognitive evaluation of a naloxone coprescription academic detailing intervention and (2) describe the application of a metacognitive evaluation for future medical education interventions. Data were obtained from a pre-post knowledge assessment of a web-based, self-paced intervention designed to increase knowledge of clinical and organizational best practices for the coprescription of naloxone. To assess metacognition, items were designed with confidence-weighted true-false scoring. Multiple metacognitive scores were calculated: 3 content knowledge scores and 5 confidence-weighted true-false scores. Statistical analysis examined whether there were significant differences in scores before and after intervention. Analysis of overall content knowledge showed significant improvement at posttest. There was a significant positive increase in absolute accuracy of participant confidence judgments, confidence in correct probability, and confidence in incorrect probability (all P values were <.05). Overall, results suggest an improvement in content knowledge scores after intervention and, metacognitively, suggest that individuals were more confident in their answer choices, regardless of correctness. Implications include the potential application of metacognitive evaluations to assess nuances in learner performance during academic detailing interventions and as a feedback mechanism to reinforce learning and guide curricular design.

Educational and communication strategies to promote HPV vaccination: A Systematic Review

Abstract Background Despite the evidence supporting the value of vaccination, Cervical Cancer (CC) and HPV-related diseases still represents a public health challenge, requiring international efforts to address all barriers that can reduce vaccine acceptance and equitable uptake. In this context, implementing interventions aimed at enhancing knowledge levels within target populations emerges as a crucial approach to improve vaccination coverage. Thus, this study conducted within the PERCH project (PartnERship to Contrast HPV), aimed to explore all educational interventions/communication strategies adopted at the international level to improve HPV vaccine uptake. Methods A systematic literature review was conducted by querying three databases from July 1, 2006 (the time of the first HPV vaccine licensure) to January 30, 2024. It included studies focused on educational interventions/communication strategies adopted by healthcare providers (HCPs) targeting the World Health Organization (WHO)-recommended population for HPV vaccination, as well as parents, caregivers, teachers, and other influential individuals involved in vaccination decision-making. Results Overall, 16 studies were considered, with 68.7% (11/16) focusing on educational initiatives and 50% (8/16) on communication strategies. Regarding the target population, 19% (3/16) involved parents/caregivers, 25% (4/16) included both parents and adolescents, and the remaining 56% (9/16) targeted adolescents/young adults. Videos were the most commonly used channel for both types of interventions (54%), followed by informative materials (31%), person-to-person solicitation (17%), social media (15%) and slide presentations (23%). Conclusions Understanding the strengths and weaknesses in HPV knowledge and communication is crucial for developing effective, tailored strategies to disseminate reliable information and promote evidence-based knowledge, thereby implementing high-value healthcare. Key messages • Effective communication of vaccination’s value to stakeholders is essential for informing health policies, guiding best practices, and countering misinformation. • Further research is needed to develop interventions that effectively increase HPV vaccine acceptance, aligning with the WHO’s goals to eliminate CC and HPV-related diseases.

2.I. Scientific session: Addressing vaccine hesitancy: from understanding determinants to implementing targeted strategies

Abstract Supported by NextGenerationEU (no. PE00000007) and EU4Health (VAXaction), the workshop will present a pan-European perspective on vaccine hesitancy and the effectiveness of counteracting interventions, especially when facing potentially pandemic infectious threats. Analysing human responses to epidemics is crucial to improve mathematical disease modelling and develop strategies to monitor behaviours during outbreaks, including assessing levels of vaccine hesitancy. This session will explore the multifaceted issue of vaccine hesitancy, which remains a significant barrier to achieving optimal vaccination coverage and is identified as one of the top threats to global health. By integrating theoretical frameworks with practical applications, the workshop aims to present a comprehensive overview of strategies employed to mitigate hesitancy across various demographics and regions. The first presentation will cover a thorough overview of the strategies employed to counteract vaccine hesitancy, leveraging existing infrastructure, health promotion policies, and educational initiatives. It will also explore the role of digital health tools and regulatory measures, such as health passes and nudging techniques, in enhancing vaccination uptake. Furthermore, the session will cover a systematic review of immunisation information systems (IISs) and the proposal of an innovative unvaccinated registry. This part of the workshop will delve into technological advancements and the integration of behavioural insights, which are essential for enhancing vaccine coverage and informing public health strategies. Another significant aspect of the discussion will be the evolution of vaccine mandates, from their historical roots to their contemporary applications. This discussion will reflect on policy shifts necessitated by emerging public health challenges and the need for adaptable strategies that can respond effectively to fluctuating vaccine coverage and acceptance rates. Panel discussions will feature notable experts such as Prof. Carlo Signorelli, President of the Italian NITAG, and Prof. Maria Ganczak, Vice President of the EUPHA Infectious Diseases Control section. These discussions will provide a comparative analysis of vaccination policies across different European countries, highlighting diverse approaches to mandates and the implementation of public health interventions aimed at combating vaccine hesitancy. By providing a unified approach to understanding and combating vaccine hesitancy, we aim to facilitate a critical exchange of ideas and strategies among experts in the field. It will serve as a dynamic platform for discussing evidence-based interventions tailored to specific population needs, enhancing public health outcomes across Europe. This engaging session promises to offer valuable insights into the complexities of vaccine hesitancy and the collaborative efforts required to address this global health challenge effectively. Key messages • Enhanced data collection and analysis are essential to combat vaccine hesitancy, allowing for tailored interventions that address specific community needs and barriers to vaccination. • Effective strategies against vaccine hesitancy require historical understanding and flexibility to adapt to new challenges, ensuring public health policies are responsive and culturally sensitive.

Nduga Human Development Index 35.19 / 0.35: PENA as an Alternative to Human Resource Development in Mountainous Papua

This study examines alternative strategies for human resource development in Nduga Regency, Mountainous Papua, where the Human Development Index (HDI) is still very low. The region faces significant challenges, including economic underdevelopment, low access to education, and ongoing conflict. This research focuses on the efforts of the Tunas Harapan Papua Care Foundation (Pena Papua) in improving access to education for students from underprivileged backgrounds. Through qualitative descriptive methods, data are collected through interviews, observations, and document reviews involving stakeholders from foundations, students, and local communities. The findings show that Pena Papua has contributed significantly to improving access to quality education and character development among students. However, cultural erosion, particularly the loss of mother tongues, was identified as a critical problem. The study concludes that although foundations have made significant progress in developing human resources, the preservation of cultural identity remains a challenge that must be addressed along with educational initiatives.

Navigating the infodemic through digital health literacy education in schools

Abstract Background High digital health literacy (DHL) can help to navigate the internet’s vast information landscape. This research explores the impact of learning DHL in schools on students’ DHL, and how it might mitigates confusion surrounding health-related information. Moreover, this research sheds light on how learning DHL in schools influences students’ inclinations towards specific sources of health information. Methods 1448 secondary school students aged 9-18 years participated in face-to-face interviews. Associations between learning digital health literacy (DHL) and students’ DHL, comprehension of health information, sense of being informed on health topics, and utilization of diverse health information sources were evaluated using the chi-squared test. Results The learning of DHL within school settings demonstrated a significant correlation with students’ overall DHL (X2 (6) = 120.99, p &amp;lt; .001). Those reporting high levels of DHL learning exhibited reduced confusion regarding health information (X2 (4) = 16.65, p = .002) and felt notably more informed (X2 (4) = 231.06, p &amp;lt; .001). Contrasted with peers who reported insufficient learning of DHL, students with high learning reported learning more about health from parents (X2 (2) = 55.28, p &amp;lt; .001), peer interactions (X2 (2) = 214.51, p &amp;lt; .001), online sources (X2 (2) = 78.54, p &amp;lt; .001), influencer content (X2 (2) = 68.46, p &amp;lt; .001), offline literature (X2 (2) = 24.32, p &amp;lt; .001), television (X2 (2) = 140.36, p &amp;lt; .001), and in school (X2 (2) = 205.53, p &amp;lt; .001). However, they were less reliant on physicians for health information (X2 (2) = 53.62, p &amp;lt; .001). Conclusions Integrating DHL into school curricula holds promise for enhancing students’ DHL and alleviating apprehensions regarding health-related information. Moreover, such educational initiatives have the potential to expand students’ repertoire of resources for accessing health information, encompassing both digital and non-digital sources.

Strengthening Equity, Diversity, and Inclusion in medical education via an intersectional approach

Abstract Background In the wake of COVID-19, equity, diversity, and inclusion (EDI) policies have been taken up in the health field, yet the actual impact of these initiatives, particularly for multiply marginalized individuals, is debated. Despite progress in areas such as diversity promotion, EDI has been critiqued as superficial and as failing to challenge the drivers of health inequity. This presentation discusses how an intersectionality-informed approach can help harness the transformative potential of EDI. Methods This research is informed by a literature review of EDI initiatives in the health field, and is an offshoot of a 4.5 year international project funded by the Canadian Institutes for Health Research focused on evaluating and strengthening intersectionality-informed policy guidance. Results There is a disconnect between EDI commitments and substantive action on health inequities and an intersectional approach can help bridge this divide. We demonstrate this with a case example which brings an intersectional approach to EDI initiatives in medical education - including bias trainings, courses on the social determinants of health, and the engagement of community groups. Drawing on promising equity promoting work across these areas, we show how intersectionality can harness the potential of EDI by bringing to the fore what has often been missing, including the promotion of health stakeholder reflexivity, attention to interacting systems and structures shaping health, and meaningful engagement with underrepresented communities. Conclusions An intersectionality-informed approach to EDI has the potential to enhance the health equity impacts of initiatives within medical education and the broader health field. Key messages • EDI initiatives in health often have limited impact on health inequities. • An intersectionality-informed approach to EDI can help health stakeholders drive transformative action on health inequities.

Exploring knowledge, attitudes and practices towards sustainable food aid programmes across Europe

Abstract Background Food insecurity has increased following the COVID-19 pandemic and the Ukraine conflict. In some EU high-income countries, more than 70% of food aid users experience food insecurity, highlighting the need for food aid programmes to provide good quality and sustainable services and maximise the social inclusion of food aid users. The aim of this study was to identify areas that can promote sustainability in food aid programmes. Methods Knowledge, attitudes and practices towards sustainable food aid were assessed via a quantitative questionnaire. Socio-demographic data were also collected. The survey was translated and disseminated online across 5 EU countries (Austria, Cyprus, Greece, Poland, Portugal), targeting staff and volunteers involved in food aid programmes (20 per country, total N = 100). Descriptive statistics were used for data analysis. Results Most participants were female (68%), 18-49 years old (87%) and occupied in a NGO (89%) as employee (55%). The mean total knowledge score was 11.8 out of 19 (SD 3.2) with low knowledge (% of correct answers) on household food waste (18%) and environmental impact of cooking appliances (29%). In all countries (except Austria) more than 70% of participants agreed that they can apply sustainability through their work; however, more than 50% agreed that sustainability is not always feasible in food aid programmes. Food loss/waste, access to local food and the economic crisis were the main parameters reported to impact sustainability in food aid (≥70% of N). The most frequently applied practices were storing food according to expiration date, monitoring quantities in food distribution, considering beneficiaries’ needs and reading food labels. The least frequently applied practices were composting food leftovers and using energy-efficient methods to distribute food. Conclusions Sustainability is considered important; however, more effort is needed to promote and embed sustainability parameters in food aid programmes. Key messages • Sustainability is considered important in food aid programmes; however, more effort is needed to promote and embed sustainability parameters in practice. • Identifying sustainability areas in food aid programmes can lead to successful educational and training initiatives.

Parent perspectives on sports betting and its effects on children

Abstract Background Gambling-related harm is a global challenge. Sports betting is a rapidly growing form of gambling, facilitated by access to online wagering platforms and increased advertising. Most public health initiatives target ‘problem’ gamblers, ignoring socio-cultural influences. Within this context, we examine what parents think about sports betting, the potential impacts on their children, and whether they participate in sports betting around their children. Methods Using a survey of 3,481 Australian adult sports fans with dependent children, we analyse parental attitudes to sports betting and their concerns about possible effects on children. ANOVA and regression methods are used to test for differences in attitudes to sports betting between parents who are gamblers (sports and non-sports) and non-gamblers. Results Compared to non-gambling parents, sports-betting parents are much more permissive (by up to 0.9 standard deviations) of sports betting around and by children, and less concerned (by up to 0.6 standard deviations) about any harmful effects of sports betting on children. Sports betting parents place less importance on discussing the risks of sports betting with their children, and the more often a parent bets on sports, the less confident they are about having these discussions. Parents who bet on sports are 5.8 percentage points less likely than non-gambling parents to have had such conversations. Conclusions The strong influence of parent modelling and normalisation, combined with policy initiatives that recommend parents discuss potential sports betting risks with their children, implies that having a better understanding of attitudes will facilitate improved educational and harm minimisation policy initiatives. The findings of our study are important for public health policy and should inform interventions aimed at gambling harm reduction. Targeting sports betting parents with better tailored educational campaigns is warranted. Key messages • Children of parents who bet on sports are less likely to receive messages about the risks of sports betting, in addition to being exposed to role modelling that reinforces sports betting. • Compared to non-gambling parents, those who bet on sports have more permissive attitudes towards sports betting, suggesting targeted messaging and interventions are warranted.

Energy Citizenship: Revealing the Intrinsic Motivational Factors Suggested by Self-Determination Theory

This study investigated the motivational factors driving energy citizenship through the lens of self-determination theory. Utilizing data from a survey of 749 respondents, we examined the role of intrinsic and extrinsic motivations in predicting energy citizenship. Our findings reveal that intrinsic motivations, such as personal responsibility for climate change, community involvement, and the desire to reduce one’s carbon footprint, significantly predict engagement in energy citizenship. Conversely, extrinsic motivations, including financial incentives and external pressures, were not significant predictors. The study underscores the importance of intrinsic motivations in fostering sustained pro-environmental behaviours, particularly as the complexity of these behaviours increases. These insights suggest that policymakers should focus on enhancing intrinsic motivations through education, community engagement, and autonomy-supportive initiatives to promote active participation in sustainable energy practices.

Combating antimicrobial resistance: A framework for educational tool innovation

Abstract Issue The World Health Organization (WHO) stresses the need for educational and training initiatives to address antimicrobial resistance (AMR) across human, animal, and agricultural sectors. AMR, a growing public health threat, was responsible for approximately 4.95 million deaths in 2019. Traditional educational frameworks tackling AMR are often applied in isolated sectors, failing to incorporate a holistic or collaborative approach. Description of the Policy The Holistic Engagement and Adaptive Response Theoretical framework (HEARTf) proposes a comprehensive, innovative approach combining behavioral theories, and persuasive technology, including the Theory of Planned Behavior, Persuasive Technology, and Diffusion of Innovation. The framework is designed to integrate stakeholders in developing and accessing educational tools, specifically a game designed to teach students about AMR. HEARTf emphasizes a multidisciplinary methodology, beginning with Phase 1 (exploratory phase) to gather baseline information from potential prescribers in Norway and Zambia. Results Initial application of HEARTf is leading the development of an educational game on AMR. This game uniquely combines behavioral theories and digital design, focusing on high-impact areas of AMR. Preliminary feedback indicates enhanced stakeholder engagement and a heightened willingness to adopt AMR best practices across different sectors. Lessons The HEARTf approach demonstrates the potential for enhancing AMR education through innovative, theory-based game design and development. It advocates for the continued integration of comprehensive educational strategies into global health initiatives to combat AMR effectively. These actions, being tailored to diverse sectors, suggest that similar holistic, theory-driven approaches may be beneficial in other public health crises. Key messages • HEARTf fosters innovative, multidisciplinary AMR education, enhancing stakeholder engagement and adoption of best practices. • Theory-based educational tools in AMR developed using HEARTf can significantly impact global health strategies and should be integrated into broader public health efforts.

The association between the mental health disorders, substance abuse, and tobacco use with head & neck cancer stage at diagnosis.

Mental health disorders, substance abuse, and tobacco use are prevalent in the US population. However, the association between these conditions and head and neck cancer (HNC) stage is poorly understood. This research aims to uncover the relationship between pre-existing mental health disorders, substance abuse, and tobacco use and HNC stage at diagnosis in patients receiving care in an integrated, public safety-net healthcare system. This study was a secondary data analysis of linked hospital tumor registries and electronic health record (EHR) data. The study's primary independent variables were the comorbidities of mental health disorders, substance abuse, and tobacco use. The dependent variable was HNC stage at diagnosis, operationalized as early stage (i.e., stages I, II, and III) and advanced stage (stage IV, IVA, IVB, or IVC). The analysis included multivariable logistic regression adjusted for covariates of demographic variables, tumor anato RESULTS: The study population consisted of 357 patients with median age of 59years, and was primarily male (77%), diverse (Black or African American 41%; Hispanic 22%), and from neighborhoods with low income (median average annual household income $39,785). Patients with a history of mental health disorders with or without tobacco use had significantly lower odds of advanced stage HNC at diagnosis (adjusted OR = 0.35, 95% Confidence Interval [CI]: 0.17-0.72.) while patients with a history of substance abuse with or without tobacco use had significantly higher odds of advanced stage HNC at diagnosis (adjusted OR 1.41, 95% CI: 1.01-1.98) than patients with no history of mental health disorders, substance abuse, or tobacco use. The relationship between HNC stage at diagnosis and the comorbidities of mental health disorders, substance abuse, or tobacco differs depending on the type and co-occurrence of these comorbidities. These findings demonstrate the need for innovative care delivery models and education initiatives tailored to meet the needs of patients with mental health disorders, substance abuse, and tobacco use that facilitate early detection of HNC.

Association between mental and physical health with poly-substance use among adults in 33 U.S. states

Abstract Leveraging national data from 33 states in the U.S. for adults 18 and over (N = 347,060), from the 2020-2022 Behavioral Risk Factor Surveillance System (BRFSS), we investigated the association between current self-reported physical and mental health outcomes and substance use, focusing on alcohol, nicotine, cannabis, and all combinations of poly-substance use. Specifically, we conducted multiple weighted linear regression analyses using self-reported outcomes for poor mental and physical health in the last 30 days to examine seven mutually exclusive combinations: alcohol (A) only, nicotine (N) only, cannabis (C) only, A+N, A+C, N+C, and A+N+C. We adjusted for race, sex, age group, education level, and marital status in our analyses. For poor mental health, mean number of days ranged from 3.49 (SD = 7.07) for A-only to 10.39 (SD = 11.54) for N+C and for poor physical health, means ranged from 2.38 (SD = 6.24) to 7.17 (10.61) for N+C. All adjusted β coefficients were significant for poor mental health days, notably with the three highest being 4.36 (95%CI: 3.72-5.00) for C-only, 5.68 (95%CI: 5.06-6.30) for N+C, and 5.27 (95%CI: 4.76-5.79) for A+N+C. For poor physical health, all adjusted β coefficients were significant except for A+N, with the two highest being 2.88 (95%CI: 2.31-3.45) for C-only, 3.16 (95%CI: 2.62-3.69) for N+C, and 1.83 (95%CI: 1.54-2.11) for N-only. Recent poly-substance use containing nicotine and cannabis was both associated with 5+ days of poorer mental health and 3+ days of poorer physical health. Overall, our findings hold implications for informing future policy discourse, shaping public health campaigns, and designing educational initiatives aimed at the link between mental health and substance use. Understanding the dynamics of poly-substance use involving the three most commonly utilized substances globally among adults is critical for crafting targeted interventions. Key messages • Recent poly-substance use (alcohol, nicotine, and cannabis) is related to poorer mental and physical health in the past 30-days. • Recent nicotine and cannabis co-use is associated with 5+ days of self-reported poorer mental health and 3+ days of physical health.

Patient Readiness for Surgery: A Quality Improvement Initiative

ABSTRACTThe use of a surgical safety checklist can help prevent sentinel events; however, a lack of adherence to the checklist can result in inadequate preoperative patient readiness and negative outcomes. The purpose of this quality improvement project was to address preoperative concerns that prevent patient readiness in a military hospital. To change practice, the project involved the use of an evidence‐based practice model and Kurt Lewin's change theory. The primary investigator provided an educational initiative on the required checklist for perioperative personnel and collected data on key elements (ie, consent completion, laboratory test results, antibiotic availability, checklist completion) for 30 days after the initiative. Consent completion rates were 100% both before and after the intervention. Statistical analysis (chi‐square [χ2]) showed significant improvement for the remaining three elements. The results were the most significant for laboratory test results (χ21 = 33.496, P &lt; .00001).

Rheumatic heart disease: an ongoing public health concern in vulnerable communities

Abstract Background Acute rheumatic fever (ARF) results from an autoimmune response triggered by group A streptococcus (GAS) infection (1). Severe or recurrent ARF episodes can cause permanent heart valve damage, leading to complications including heart failure, stroke, arrhythmias, carditis, and decompensation during pregnancy (2). Purpose Rheumatic fever (RF) remains a public health concern in Australia, particularly among Indigenous, migrant populations and socioeconomically disadvantaged communities. Europe and various regions worldwide have experienced significant migration from areas with a high prevalence of RHD (3). Amongst the more than 1 million asylum seekers who arrived in Europe in 2015, an estimated 1% could potentially be affected by RHD (3). This migration influx underscores the pressing need for the implementation of strategies in health policy and practice. We aimed to outline the attributes of our RF-RHD cohort to aid in the formulation of a Model of Care (MoC). Methods Cases were identified on a quarterly basis either through the NSW Public Health Rapid, Emergency, Disease, and Syndromic Surveillance (PHREDSS) system or via clinical diagnoses reported to the Public Health Unit (PHU) from January 2015 to June 2023. Demographic profiles, clinical particulars, and patient outcomes were collected from patients in the South Western Sydney Local Health District (SWSLHD), NSW, Australia. Results A total of 45 cases were reported (Table 1). This consisted predominantly of females with an average age at diagnosis of 14 years. A majority were obese (69%). Most were in the Maori and Pacific Islander populations (62%), while a smaller portion of patients were of Aboriginal or Torres Strait Islander descent (9%) (Australian Indigenous community). Notably, 84% of patients diagnosed with ARF subsequently progressed to RHD. Among the reported cases, 16 patients underwent valvular surgery, 2 patients progressed to end-stage heart failure, and there was 1 mortality. 39% (11) of female patients were pregnant during the study period, with 6 (55%) of these patients decompensating during their pregnancy (Table 2). Conclusion Rheumatic fever persists as a public health concern on a global scale. Our findings emphasize the need for a high index of clinical awareness in considering RF/RHD in socioeconomically disadvantaged communities. In our setting, there is a disproportionate burden of disease among the Pacific Islander population. The high occurrence of cardiac decompensation during pregnancy, underscores the need for close monitoring in this demographic. Despite the prevalence of rheumatic fever predominantly affecting young patients in vulnerable groups, we found a significant proportion of individuals lost to follow-up or not connected with Cardiology services. Addressing rheumatic fever requires a comprehensive approach that encompasses improved healthcare accessibility, targeted health education initiatives, and socioeconomic interventions.

Adult Individuals Applicable to the Family Health Center Knowledge and Awareness About Osteoporosis

Abstract Background The aim of this study is to determine the knowledge and awareness of adult individuals applying to the Family Health Center (FHC) about osteoporosis. Methods A descriptive design study was conducted at a FHC in Turkey/Istanbul between January and May 2022. The sample of the research consisted of 320 adults selected by purposeful sampling method. Ethical approval and necessary permissions were obtained from the the conduct of the study. Data were collected through a socio-demographic characteristics form, a 20-item single-subscale Osteoporosis Knowledge Assessment Questionnaire (OKAQ), and a 27-item Osteoporosis Awareness Scale (OAS). Descriptive statistics, normality tests, analysis of variance, Kruskal-Wallis analysis of variance, t-test, and Mann-Whitney U test were used for data analysis. Statistical significance was accepted at p &amp;lt; 0.05. Results T The average age of adults is 60.47±13.17 and 55.9% are female and 44.1% are male. 34.7% had completed middle school. Participants’ highest correct response rate in the osteoporosis knowledge assessment questionnaire was for the item ‘Osteoporosis increases the risk of bone fracture’ (81.6%), while the lowest correct response rate was for the item ‘Osteoporosis generally causes symptoms (such as pain) before fractures occur’ (26.3%). According to the Osteoporosis Awareness Scale, adults’ awareness levels were above average. They scored the highest in the preventive behaviors subscale and the lowest in the risk factors subscale. Adults with university-level education scored significantly higher in all subscales of the OAS compared to other education levels (p &amp;lt; 0.05). Individuals with knowledge about osteoporosis and those who consumed milk regularly scored significantly higher in all subscales of the OAS (p &amp;lt; 0.05). Conclusions Although adults’ awareness of osteoporosis is above average, their correct knowledge about osteoporosis is inadequate. Key messages • An individual’s education level affects osteoporosis knowledge and awareness. • It is recommended to plan educational initiatives to increase osteoporosis knowledge and awareness.