Infertility is a major public health issue with a 17.5% estimated lifetime prevalence. Despite advances in assisted reproductive technology (ART), almost half of those seeking ART end all treatment cycles without a child. Around 93% of patients want to be prepared and supported when facing unsuccessful treatment. Healthcare professionals perceive a high demand for such support, yet evidence-based interventions remain limited. This mixed-methods study evaluated the acceptability and feasibility of implementing and evaluating Beyond Fertility: a brief psychosocial intervention to promote patients' adjustment to the end of unsuccessful fertility treatment. Results will inform the design of a definitive randomised controlled trial (RCT) of Beyond Fertility. This is a prospective, mixed-methods, single-arm pilot study. The Beyond Fertility intervention offers preventive care (one individual/couple session before patients start their last treatment cycle) and early interventive care (one individual/couple and five group sessions if treatment is unsuccessful) to promote patients' emotional and social adjustment to the end of unsuccessful treatment. Beyond Fertility's development integrated feedback from patients and healthcare professionals. Adults scheduled to start their last NHS-reimbursed in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) cycle, including the last transfer with own or donated gametes/embryos or preimplantation genetic testing (PGT)-at a large NHS hospital in Portugal were consecutively recruited. Participants completed online questionnaires at baseline (T1, pre-intervention), post-individual/couple sessions (T2), and post-intervention (T3). A post-intervention focus group (T3) gathered feedback on the intervention and the study protocol. Participants also completed online open-ended feasibility questions after each intervention session. Feasibility outcomes focused on demand, acceptability, implementation, practicality, and promise of efficacy. Exploratory analysis of efficacy was change in quality of life (FertiQoL, T1-T3). Thirty-two participants consented to participate, completed T1, and were allocated to Beyond Fertility (62.1% acceptance rate). Participants reported that preventive care was acceptable, feasible, and beneficial. After a negative cycle outcome, 30.0% (n = 9) of participants ended treatment, and most (n = 21, 70.0%) continued. Of those who ended treatment, most (n = 6, 66.7%) accepted the interventive care, reporting it helped them accept their unmet desire for children and pursue alternative life goals. One-third (n = 3, 33.3%) received all sessions. Reasons for non-acceptance or withdrawal from the intervention in the immediate aftermath of treatment were the emotional burden of unsuccessful treatment (33.3%) and the sessions' group format (22.2%). Facilitators of session uptake were flexible online/in-person scheduling and delivery. Individual quality-of-life trajectories suggested a possible recovery after unsuccessful treatment. Beyond Fertility was seen as adequate and valued, and it showed promise in improving patients' quality of life after unsuccessful treatment. Before efficacy testing, feasibility issues require changes to Beyond Fertility's logic model, including activity design and revisions to its evaluation to target a larger, more representative sample of participants.

The government of Ethiopia has invested over 20 million dollars to improve the quality of education through digital technology. However, the effectiveness of such huge investment on education is overlooked. The purpose of this study was to assess the effectiveness of School Network (SN) in promoting students’ English Language performance. The researcher deployed a descriptive research design and a mixed research approach to collect data on the implementation processes and other contextual factors potentially influencing the process. The researcher also utilized UNESCO’s input, process, and output logic model to set standards of effectiveness. The research was conducted in the City Government Administration of Addis Ababa, specifically in four selected sub-cities, based on their achievement in SN implementation. The participants of the study included one English language expert, four school principals, 20 male and 10 female English Language teachers (a total of 30 teachers), six ICT/plasma technicians, and 160 pre-college students (80 males and 80 females). Five instruments were used to collect data from primary and secondary sources. Classroom observations were conducted to assess the delivery of School Network instruction in teaching English. Moreover, focus group discussions were held, and questionnaire was administered to examine the role of the School Network on students’ English language performance. Additionally, these instruments were used to identify challenges related to School Network usage in ELT. Furthermore, explorative interview was conducted and documents were analyzed to prove whether there was difference in effectiveness of the School Net instruction in teaching English language based on sex and stream(natural and social science students) or not. Besides, these instruments were utilized to identify challenges related to School Net usage in ELT. Both quantitative and qualitative approaches were employed to analyze and interpret the data gathered through these tools. The findings of the study indicated that SN has the potential to be accessed through platforms like plasma, e-learning, and cloud computing, and it provides video on demand (VOD). This enabled interactive blended language learning (IBLL), mobile-assisted language learning (MALL), and computer-assisted language learning (CALL) and Technology Assisted Language Learning (TALL). However, factors such as minimal teacher’s involvement, low level of students’ participation, lack of support services and facilities, frequent network disconnections, electric power fluctuations causing damage and theft of accessories such as set-top boxes, adapters, batteries and remotes; and school rules restricting students from using electronic devices in school, hindered its effectiveness. Hence, concerned authorities should evaluate the program's effectiveness and address the identified problems to help students benefit from the potential of School Network platforms to learn the target language (English).

PRESENTATION AND PURPOSE OF THE STUDY. The modern hotel and restaurant business increasingly relies on event-management as a tool that shapes the perception of service quality and strengthens competitiveness. Events allow hospitality enterprises to diversify services, increase customer loyalty, attract new audiences and build recognizable brands. In the context of digitalization, changing consumer preferences, strong competition and unstable socio-economic conditions, event management becomes an important element of strategic development. The demand for flexible management systems and the ability to organize events of various formats has grown, especially considering global challenges that have influenced tourism and hospitality. The purpose of this research is to identify the main characteristics of building an effective event-management system in the hospitality industry and define its role in improving quality, communication and competitiveness. RESEARCH METHODS. The study applies methods of abstraction, systematization, situational and comparative analysis, project approach, logical and analytical evaluation and modeling of organizational processes. This methodological base enabled the formation of substantiated conclusions regarding the structure and functioning of the event-management system. THE RESULTS. Event-management in the hotel and restaurant business is understood as a multifunctional activity aimed at planning, organizing and implementing events that meet client expectations and increase the value of the hospitality product. A key feature is strong customer orientation: events must be emotional, personalized and aligned with the goals of the target audience. Unlike standard operational services, event services involve complex coordination of many components – from scenario development and creative solutions to logistics, budgeting and communication. An important component is the integration of digital technologies. Hotels and restaurants increasingly use event CRM systems, cloud planning platforms, automated registration tools, hybrid formats and online communication systems. For many hotels and restaurants, event activity becomes a source of additional revenue and a tool for attracting new customers through conferences, cultural programs, celebrations, presentations and gastronomic events. CONCLUSIONS. Event-management is a key element of the modern strategy of hotel and restaurant enterprises. Its effective implementation helps improve service quality, optimize internal processes, attract new audiences and strengthen competitiveness. A well-structured event-management system integrates creative, technological, organizational and communication components, ensuring flexibility and adaptability in unstable market conditions. The ability of hospitality enterprises to develop professional event strategies becomes an important factor in resilience and long-term development, shaping the innovative potential of the entire industry. KEYWORDS: event-management; hotel and restaurant business; management system; event technologies; hospitality industry; customer experience; innovations; project management.

ABSTRACTBackgroundA limited number of physical activity programmes exist for Chinese people with young‐onset (18–40 years) type 2 diabetes amid its rising global prevalence. This study aims to develop a multimodal intervention for improving physical activity levels for individuals with young‐onset type 2 diabetes using co‐design.MethodsThe development process included three stages. Stage 1 involved synthesising the findings of a review of existing physical activity interventions and a qualitative study of exercise experiences of young adults with type 2 diabetes. This generated a list of candidate intervention elements and behaviour change techniques to inform the co‐design process. Stage 2 involved the development of animated trigger films, using findings from stage 1, to present the physical activity experiences of people with young‐onset type 2 diabetes. In stage 3, a series of co‐design workshops engaging relevant stakeholders were conducted, utilising the outputs from the previous two stages and aligning with the Design Thinking theory.ResultsTwenty‐five participants (12 young adults with type 2 diabetes, 12 healthcare professionals, and one family member) attended co‐design workshops to develop the intervention. The co‐design process resulted in a logic model for a tailored programme–IPAYD (Improving Physical Activity in people with Young‐onset type 2 Diabetes). This programme integrates behaviour change techniques across four elements: individualised goal setting and planning, exercise monitoring, a peer support forum, and educational resources. An eHealth platform was preferred to deliver the programme, incorporating one‐to‐one consultations and optional group sessions to enhance social support and social interaction.ConclusionsThrough stakeholder engagement in a co‐design process, this study makes a novel and much‐needed contribution to developing a physical activity intervention for Chinese people with young‐onset type 2 diabetes.Patient and Public ContributionAn advisory group of six Chinese young people with type 2 diabetes met online and communicated through a project‐focused WeChat group. They contributed to the animated film scripts, the topic guide of the workshops, the design of the intervention materials, and how to conduct the workshops to align with Chinese culture.

Evaluation of the Aged Care On-site Pharmacist (ACOP) program in Australian residential aged care homes: Key considerations and next steps.

Applicability of quantitatively predictive logical models at subnational level of governance: Testing the Seat Product Model on Polish, Czech, Hungarian and Slovak regional elections

Amid the deep integration of global "dual carbon" goals (carbon peaking by 2030 and carbon neutrality by 2060) with China’s ecological civilization drive, the modern value of traditional Chinese ecological culture—centered on the notion of "harmony between humans and nature" — has been reawakened. The profound fusion of emerging technologies such as the digital economy and artificial intelligence with the real economy not only offers opportunities for technological empowerment and efficiency gains in regional low-carbon transitions but also gives rise to new challenges, including labor market restructuring, skill mismatches, and inadequate adaptability of the built environment. As a form of "cultural capital" endowed with both value-leading capacity and practical resilience, the synergistic empowerment of traditional Chinese ecological culture with emerging economic factors has emerged as a pivotal pathway to resolving contradictions in regional low-carbon development.Drawing on core literatures spanning philosophy, economics, geography, digital economy, and sustainable development, this study employs a literature review approach and logical deduction to construct a comprehensive analytical framework: "Cultural Connotations → Modern Transformation → Synergistic Empowerment → Regional Practice → Optimization Pathways." It systematically dissects the intrinsic logic, core mechanisms, and implementation models through which traditional Chinese ecological culture empowers regional low-carbon economies.Key findings are as follows: First, traditional Chinese ecological culture evolves into a form of cultural capital compatible with modern low-carbon development via a three-stage transformation — encompassing value ethics, institutional rules, and practical behaviors. Second, at the mechanism level, this cultural capital forms a "four-dimensional synergy" with digital technology, small and medium-sized enterprises (SMEs), and sustainable built environments. It propels regional low-carbon transitions through four pathways — "value constraint, technological drive, subject adaptation, and spatial guarantee" —across three tiers: micro-level enterprise transformation, meso-level industrial upgrading, and macro-level regional governance. Third, in regional practice, diverse implementation models have taken shape, namely "culture + education and communication," "culture + spatial governance," and "culture + policy integration." However, challenges persist, such as fragmented cultural cognition, insufficient regional coordination, and superficial integration between technology and culture.By clarifying the inherent links between culture, technology, economy, and space, this study provides a theoretically grounded and practically feasible framework for regional low-carbon economic development. It also offers an innovative "Chinese culture + technology synergy" solution to contribute to global sustainable development.

This policy paper analyzes strategies to maximize the utilization of Indonesia's geothermal potential to support energy security and the green transition, with a focus on addressing the root cause of the low exploration success rate due to the lack of integrated geoscience data. Through a comprehensive policy analysis method involving regulatory inventory, data tabulation, and expert assessment, this study identifies the Establishment of a Geoscience Survey Institute and a Geothermal Endowment Fund as the most strategic solution with a priority score of 4.4. This policy is designed to provide integrated baseline data that can reduce exploration risks by up to 50%, cut costs by up to 40%, and accelerate project development by 2-3 years. Its implementation requires a comprehensive regulatory framework that includes an institutional legal umbrella, endowment fund management, data integration, and a robust monitoring and evaluation system. Using a logic model approach, this policy is projected to support the achievement of the 6.4 GW geothermal capacity target by 2030, contribute to a reduction in GHG emissions of 35 million tons CO2e/year, while strengthening national energy security based on domestic resources.

BackgroundStigma may negatively impact individuals throughout the continuum of cancer care and survivorship. Multitheory and multilevel intervention programs are necessary to reduce stigma but remain globally limited.ObjectiveThis tutorial aims to illustrate the development of a web-based experiential learning intervention, “Friend Supporter,” designed for the public, which simulates scenarios to foster empathy and helping intentions. We applied the intervention mapping (IM) approach, which is rooted in the socioecological model, using the first four steps.MethodsIn step 1, key issues faced by cancer survivors and influential factors were identified through empirical evidence and literature reviews on cancer stigmas and psychological theories. A multidisciplinary planning team assessed issue-related logic. In step 2, a logic model of change was created based on step 1 findings. In step 3, we designed program themes and a structure using systematic reviews and needs surveys among the public (n=1076) and cancer survivors (n=473), while applying theoretical change methods and practical strategies. Step 4 integrated prior findings. Inputs from an expert panel (n=5) and the public (n=13) using the think-aloud approach were used to refine the materials and functions, with educational resources for program providers also developed.ResultsStep 1 revealed that public misconceptions and attitudes worsened the quality of life of cancer survivors. Step 2 identified 3 long-term outcomes: reduced public bias, improved responses to disclosure via acquired skills, and support aligned with survivors’ aspirations. The short-term primary outcome was helping intention. Personal factors (knowledge, skills, and self-efficacy) were also expected to improve helping intention as mediators. In step 3, the literature review showed that multicomponent online interventions effectively reduced stigma. The survey indicated the public most needed information on “how to interact with friends diagnosed with cancer” (317/1076, 29.5%), regardless of whether they had a friend diagnosed with cancer (χ21=0.98; P=.32). Participants with no friends diagnosed with cancer were more likely to require information concerning “survival rates of all types of cancer” (χ21=7.3; P=.007). Preferred delivery modes were booklets or leaflets (529/1076, 49.2%) and the internet (texts and figures: 460/1076, 42.8%). Cancer survivors wanted their friends to understand “the possibility of a cure as a result of early detection and treatment” (193/473, 40.8%). To produce program materials, we applied stigma and discrimination, protection motivation, social cognitive, and learning theories. The 5-module program included self-learning, role-plays, worksheets, and written feedback from clinical psychologists. Step 4 confirmed the feasibility of the program with minor refinement. We then developed a practical guide for program providers’ future implementation.ConclusionsIM is useful for systematically developing web-based multitheory and multilevel interventions. “Friend Supporter” offers a promising approach to enhance supportive behaviors and reduce cancer stigma. Quantitative evaluation is underway using the final 2 IM steps (implementation and evaluation) to determine real-world effectiveness.

Development of fuzzy logic algorithm for predicting heavy metal content in poultry product.

ABSTRACT Microservice bad smells (MBSs) affect system quality. However, the lack of comprehensive and detailed explanations of MBSs and current classification methods does not comprehensively encompass the microservice characteristics, making it challenging to study and address MBSs. Existing studies have focused on MBS detection methods, but identifying and quantifying the effects of different smells and properly assessing system health remain challenging. This review aims to provide an exhaustive list of the MBSs and formulate a reasonable classification based on microservice characteristics. By reasonably assessing the harmfulness of smells, we would comprehensively explain different MBSs. We would explore microservice system evaluation methods and propose a microservice system health assessment model (MSHAM) based on MBSs. We conducted a systematic literature review (SLR) of the catalog and evaluation literature in the field of MBSs. We also combined the open questionnaire form to answer the research questions qualitatively and quantitatively. This paper presents a comprehensive list of 69 types of MBSs, incorporating a highly scalable classification. Following the quality characteristics in ISO/IEC 25010:2023, we determined the sets of characteristics affected by different smells, and provided detailed explanations of smells in the form of MBSs knowledge base. Furthermore, we introduced the MSHAM, revealing the quantification process of harmfulness. The formulated smells list and classification method capture MBS characteristics comprehensively, ensuring scalability. We have exposed the impact of MBSs, enhancing researcher and practitioner understanding. MSHAM provides a logical model to quantify MBSs harm and system health, supporting the development of real‐time health monitoring.

In the context of sanctions restrictions, rising capital costs, and a shortage of qualified IT resources, Russian food retailers are moving from “total digitalization” programs to a limited set of targeted initiatives in individual business domains. In these circumstances, the key management issue is not the achievement of an abstract level of digital maturity, but the choice of initiatives that maximize the contribution to operational and financial results under given resource constraints. The aim of the article is to develop a conceptual model for selecting and prioritizing digital transformation initiatives in food retail based on the company profile and domain as-sessment of digital maturity. The methodological framework includes structuring the company’s profile, a do-main-specific approach to maturity assessment, the formation of a catalog of types of initiatives with minimal requirements and expected effects, as well as structural and logical modeling of the selection procedure. The result is a model of four interrelated components, the application of which allows us to abandon “showcase” projects and focus resources on initiatives with the greatest impact on key performance indicators.

Purpose To build and design a simulation model to mimic customer behaviour using discrete event simulation. The model will incorporate a multi-channel queueing system. Thus, multi-servers will attend to customers in line. This improves service quality and avoids queues. Also, the simulation model will help identify gaps in the restaurant. Design/methodology/approach The research utilizes Arena simulation software to develop a model that simulates a typical South African restaurant. The model focuses on customer behaviour, operational flow and resource management, including staff and equipment. The simulation logic models customer flow through the restaurant. Upon arrival, customers are either seated immediately or wait in a queue if no seats are available. Once seated, customers place orders, which are passed to the kitchen for preparation. The time taken for each process (e.g. seating, ordering and food preparation) is recorded and analyzed for potential bottlenecks. Findings The use of discrete event simulation (DES) in conjunction with Arena simulation software offers a practical method for improving restaurant operations in South Africa. By modelling customer behaviour and operational processes, restaurant managers can identify critical bottlenecks and implement changes to improve efficiency, especially during peak periods. This study demonstrates that careful attention to staff scheduling, resource allocation and the layout of restaurant processes can greatly enhance customer satisfaction and operational effectiveness. The simulation results can serve as a decision-support tool for restaurant owners to test various strategies without disrupting actual operations. Research limitations/implications Further research could expand on this work by incorporating machine learning to predict customer behaviour trends or develop more detailed models that account for external factors such as load shedding, economic variability, or seasonal changes in customer patterns. Moreover, more optimization algorithms will be explored to identify an optimal solution to improve service quality to customers. Also, the Monte Carlo simulation will be included and embedded within a discrete event simulation. Furthermore, the future of DES in restaurant simulations lies in improving the realism of human behaviour models and integrating new technologies such as integration with artificial intelligence, real-time simulation and decision support and hybrid simulation models. Practical implications The application of DES in modelling human behaviour in restaurants offers significant advantages in operational management. As the restaurant industry continues to evolve, leveraging such simulation techniques will be crucial for maintaining competitiveness and improving customer experiences. The interaction of people at a restaurant, from when a customer arrives and places an order until they receive their food, was modelled using discrete event simulation. The simulation can be used to assess the restaurant’s performance, better comprehend the situation, and assess any new enhancements. The simulation’s overall effectiveness can be predicted using the model, along with the potential duration of an order and the impact of system changes. Social implications The baseline scenario revealed that customer wait times were acceptable during off-peak hours but significantly increased during peak times. In the peak hour scenario, customer abandonment rates (customers leaving without service due to long wait times) rose, suggesting that restaurants should implement dynamic staffing strategies to manage busy periods. The staff shortage scenario highlighted the critical role of adequate staffing in maintaining service quality, as both wait times and staff utilization were adversely impacted. Originality/value To the best of our knowledge, this is the first research on modelling human behaviour using discrete event simulation for South African restaurants.

Reliable assessment of bridge technical condition is a key challenge in infrastructure management due to uncertainty, subjectivity, and heterogeneity inherent in inspection-based data. Traditional deterministic evaluation methods often fail to capture the gradual nature of structural deterioration and the complex interactions between bridge components. This study proposes a hybrid methodology that integrates fuzzy logic and artificial neural networks (ANNs) to quantify the overall technical condition of bridge structures using long-term inspection data. A comprehensive dataset, derived from real bridge inspection reports collected over more than 15 years across various regions of Ukraine, served as the basis for model development. Five key input parameters—substructure condition, superstructure condition, deck condition, overall structural condition, and channel and channel protection condition—were employed to compute an integrated Bridge Condition Assessment indicator using a Mamdani-type fuzzy inference system. The resulting fuzzy-based indicator was subsequently used as the target variable for training ANN models. To ensure optimal predictive performance and training stability, Bayesian Optimization was applied for systematic hyperparameter tuning. Model performance was evaluated using standard regression metrics, including MSE, MAE, MAPE, and the coefficient of determination (R2). The results demonstrate that the proposed approach enables accurate approximation of the fuzzy-based Bridge Condition Assessment indicator, with MAPE values as low as 0.2% and R2 exceeding 0.982 for the best-performing model. The hybrid framework effectively combines interpretability and scalability, providing a decision-support framework based on fuzzy logic and surrogate modeling for automated fuzzy-based bridge condition assessment, maintenance prioritization, and integration into digital asset management systems.

Background: Self-harm is a growing public health concern and the strongest predictor of suicide in young people (YP). The “Supporting Adolescents with Self-Harm” (SASH) intervention was developed with YP with lived experience and expert clinicians. It involves rapid follow-up after ED attendance and up to six intervention sessions. The intervention has three components: Therapeutic Assessment (TA) of self-harm; an enhanced safety plan (SP); and Solution-Focused Brief Therapy (SFBT). Depending on the YP’s preference, carers can join sessions. Carers can also receive two individual sessions. The clinical and cost-effectiveness of SASH is being evaluated in a randomised controlled trial across nine emergency departments in three NHS Trusts in London, England. A total of 154 YP were recruited between May 2023 and March 2025 and randomised on a 1:1 ratio to SASH alongside Treatment As Usual (TAU) or TAU. A logic model describes the SASH inputs, activities, mechanisms, outcomes and longer-term impacts. The aim of this paper is to (1) illustrate how TA, SP, and SFBT were implemented in practice by presenting intervention materials and session recordings for four YP cases and one carer case and (2) explore how the case study materials/recordings reflect the intervention mechanisms in the SASH logic model. Methods: Each case focused on a different component of the intervention. Intervention materials (TA self-harm diagram and completed SP) and recorded SFBT sessions with four YP and one carer were analysed using a descriptive case study approach. The TA diagram and SP were extracted from medical records. Audio/video recordings of intervention sessions were identified. Recordings of intervention sessions and qualitative interviews were transcribed. Quotes from qualitative interviews with the same participants were included where relevant. Results: Across the four YP cases, some core themes emerged. The role of friendships for young people, particularly at school, was important in both negative and positive ways. Experiencing difficulties with friends at school led to feelings of sadness and stress, which could become overwhelming, leading to thoughts of self-harm (“I just need to hurt myself”), triggering self-harm behaviour. YP described mood changes and signs that they were becoming stressed, which improved their self-awareness and understanding of the link between their feelings and self-harm behaviour. They reflected on what kept them feeling calm and overcoming their fear of burdening others by sharing how they were feeling, as this helped them not to self-harm. They also described difficult feelings stemming from a need to please everyone or needing validation from others. Overcoming these feelings led to less social anxiety and more confidence. This made it easier to go to school and to be more social with friends/student peers, which in turn improved their mood. Conclusions: These case studies demonstrate how YP improved their self-awareness and understanding of the link between feelings and self-harm behaviour and identified personal strategies for managing difficult feelings and situations. The carer case study demonstrates how sessions with carers can facilitate carers better supporting their YP’s mental health. Supporting YP and carers in this way has the potential to reduce the risk of future self-harm.

Abstract Background and objectives One Paleopathology is a novel concept in Paleopathology that extends the One Health paradigm into the past. A workshop at the University of Durham, UK, was held prior to the 2024 International Society for Evolution, Medicine, and Public Health (ISEMPH) meeting, firstly to define and expand the concept of One Paleopathology and secondly to generate transdisciplinary research and outreach under this framework. This article presents a logic model to evaluate how effectively the workshop met its goals. Methodology Two surveys were conducted, one immediately following the workshop and at the one-year mark. These surveys assess the direct outputs from the workshop—tangible research and outreach products— as well as changes in participants’ attitudes toward One Paleopathology and the degree to which transdisciplinarity was incorporated into resulting projects. Results Both the outputs (direct products of the workshop activities) and outcomes (changes in knowledge or attitude because of the activities) of the workshop suggest that the goals are being met. The first goal, to define and expand the concept of One Paleopathology, was met, with participants expressing strong acceptance of the framework. The second goal—generating transdisciplinary research—is reflected in eight ongoing projects initiated at the workshop. Conclusions and implications The workshop structure and outcomes assessment presented here evaluate an initial effort in effecting conceptual change in the social sciences. Participants were enthusiastic about One Paleopathology, and over the following year new collaborations and research agendas aligned with the concept emerged. Importantly, participants reported integrating transdisciplinarity into their long-term research, indicating that the workshop had a sustained impact.

IntroductionDrug overdose remains a leading cause of preventable death in the United States, with persistent inequities among populations that often face stigma and barriers to care. Traditional evaluation models often exclude people with lived and living experience (PWLE) of substance use from meaningful decision-making.MethodsTo address this, the Arizona Department of Health Services (ADHS) implemented a community-based participatory evaluation model within its Overdose Data to Action in States (OD2A-S) program by establishing a Community Advisory Board (CAB). The CAB was designed to integrate lived experience into evaluation planning and interpretation, identify community-driven priorities, and guide program improvement. Members were recruited statewide through a nomination process and compensated. A licensed clinical social worker facilitated meetings using trauma-informed and healing-centered approaches. Participatory methods such as journey mapping and logic model development enabled members to translate personal and community experiences into actionable evaluation questions.ResultsBetween August 2024 and August 2025, the CAB met quarterly to prioritize evaluation of naloxone vending machines and peer navigation models. Members identified key barriers, including stigma, rural access, transportation, and lack of culturally responsive care, and provided input on equitable evaluation tools and communication strategies. A composition survey confirmed strong representation of individuals in recovery (86%) and people of color (88%), though rural and tribal, medically assisted treatment, and veteran perspectives remain limited or not represented.DiscussionEarly lessons demonstrate that compensated, trauma-informed engagement fosters trust, accountability, and practical insights that strengthen evaluation quality and relevance. Challenges include administrative delays in payment, limited generalizability due to small membership, and the need for sustainable funding to expand representation.ConclusionArizona’s OD2A-S CAB provides a replicable model for integrating lived experience into state-level overdose prevention. By positioning PWLE as co-evaluators rather than participants, this model advances equity, builds system trust, and strengthens the translation of data into action.

Non-communicable diseases (NCDs) are the leading cause of premature deaths globally, largely driven by modifiable behavioural risk factors such as unhealthy diet, physical inactivity, tobacco use, and alcohol consumption. Health literacy (HL) plays a vital role in modifying these behaviours. Evidence shows that Healthcare Assistants (HCAs) in Sri Lanka despite working in hospitals often demonstrate limited HL and high rates of risk behaviours. Enhancing HL among HCAs is therefore essential both for their own health and for enabling them to serve as credible health advocates in NCD prevention. This study aimed to develop and validate a Behaviour Change Intervention Package (BCIP) to improve HL related to NCD behavioural risk factors among HCAs in government hospitals in Sri Lanka. A Behaviour Change Intervention Package (BCIP) was developed using the Intervention Mapping (IM) approach, informed by the Calgary Charter HL framework. Steps included assessment of the logic model of the problem, setting objectives, intervention design, expert content validation, pilot testing, and planning for implementation and evaluation. The BCIP comprised a curriculum, facilitator guide, participant handbook, and PowerPoint presentations, for 16 two-hour sessions across eight weeks. Sessions employed lectures, role-play, group discussions, brainstorming, and m-health tools. Content validity was assessed by a 10-member expert panel, while pilot testing in selected hospitals evaluated feasibility and acceptability. Findings revealed that HL among HCAs was limited by factors at individual, family, organizational, community, and policy levels. The BCIP addressed these determinants by focusing on HL's four domains- finding, understanding, comparing, and applying health information. Expert review confirmed high relevance and appropriateness (mean scores > 3.0), while pilot testing showed feasibility and participant satisfaction with content, delivery methods, and session duration. The validated BCIP provides a structured, theory-driven approach to improving HL and reducing NCD risk behaviours among HCAs. Pilot findings support its feasibility for integration into routine induction or in-service training. Future studies will evaluate its effectiveness, with potential adaptation for broader workplace health promotion in Sri Lanka.

ABSTRACT Background Children and young people with long-term physical health conditions (LTPHCs), such as Juvenile Idiopathic Arthritis (JIA), are at increased risk of mental health difficulties, including anxiety and depression. Despite this, access to psychological support in paediatric healthcare settings remains limited. Group Art Psychotherapy Intervention for communicating the Needs of children with long-term health conditions (GAIN) was developed as an online, manualised group intervention to support the psychological well-being of children with LTPHCs and their families. Aims This service evaluation aimed to assess the acceptability of the GAIN intervention as an online, home-based treatment, explore the suitability of standardised outcome measures, and develop a logic model to inform future implementation. Methods Twelve young people with JIA participated in two age-stratified, six-session online art psychotherapy groups, facilitated by an HCPC-registered art psychotherapist. Data were collected via focus groups with therapists, patient and parent questionnaires (PedsQL, RCADS, SDQ), therapist session notes, and supervision reflections. Results The intervention was well-received, with participants reporting increased social connectedness, emotional expression, and empowerment. Four themes were identified from the thematic analysis: Peer support and discussion, Youth centred empowerment, Barriers and revisions, Age group differences. A logic model for the GAIN intervention is presented, and the acceptability of the questionnaires is reported. Conclusions The GAIN intervention demonstrated strong acceptability and potential benefits for children with LTPHCs, particularly in promoting peer support and emotional expression. Implications for practice/policy/future research The evaluation informs future adaptations and the development of the evidence base for art psychotherapy in paediatric healthcare settings. Plain-language summary Children and young people with long-term physical health conditions, like Juvenile Idiopathic Arthritis (JIA), can sometimes feel worried, sad, or lonely. Getting mental health support is not always easy. The GAIN programme (Group Art Psychotherapy Intervention for communicating the Needs of children with long-term health conditions) is an online group art therapy designed to help children and their families. In this study, twelve young people with JIA joined online art therapy sessions led by a trained art therapist. They made art, talked, and shared their experiences. Feedback came from children, parents, therapists, and group discussions. The results showed that most children enjoyed the sessions and found them helpful. They felt less alone, more confident, and better able to express their feelings. The sessions also helped them connect with others going through similar challenges. Overall, GAIN seems to be a helpful and supportive programme for children with long-term conditions. The feedback will be used to make the programme even better and to guide future research on art therapy in children’s healthcare.

The modern economic environment is characterized by a high level of institutional uncertainty, which significantly affects the behavior of entrepreneurs and consumers and the results of economic activity. In conditions of military, political and regulatory upheavals, the problem of adaptation of economic agents to unstable rules becomes particularly relevant. The purpose of the study is to identify and scientifically substantiate the patterns of behavioral reactions of economic agents to institutional restrictions and instability of rules in the process of adopting economic levels. The study is based on a combination of institutional and behavioral approaches, which allowed us to consider economic behavior not only as the result of rational choice, but also as a reaction to restrictions, risks and uncertainty of the environment. A comparative analysis of behavioral patterns of entrepreneurs and consumers in stable and unstable institutional conditions was applied. A generalization of the results of modern theoretical and empirical research was used, as well as an analysis of the current Ukrainian context. The main hypothesis of the study is the assumption that institutional instability systematically determines protective and short-term oriented behavioral reactions of economic agents. The novelty lies in the simultaneous analysis of the reactions of entrepreneurs and consumers and the identification of mechanisms of their mutual reinforcement. The methodological basis is the methods of scientific generalization, system analysis, comparison and logical modeling. Elements of scenario analysis and identification of typical institutional challenges and corresponding behavioral responses were used. Qualitative analysis of survey results, analytical reports and statistical observations was applied. As a result of the study, the behavioral models of entrepreneurs and consumers in different institutional conditions were systematized. It was established that stable rules contribute to long-term planning, investment activity and compliance with norms, while instability stimulates caution, investment postponement, savings growth and behavioral toning. The role of informal institutions as a compensatory mechanism and the weakness of formal rules is characterized. The presence of negative feedback loops between business and consumer behavior is revealed, which can lead to economic stagnation. Typical scenarios of institutional challenges and the corresponding reactions of economic agents are summarized. Recommendations are proposed to increase the stability of the institutional environment and take into account behavioral factors in economic policy. The theoretical significance of the study lies in the possibility of applying the conclusions in the formation of economic and regulatory policy, as well as in strategic business planning in conditions of uncertainty. The originality of the study lies in the comprehensive analysis of behavioral reactions of different types of economic agents to institutional instability and in identifying mechanisms of their interaction. The main conclusions emphasize the critical role of stable rules for the formation of productive economic behavior. Prospects for further research are related to the quantitative verification of the formulated hypotheses and the analysis of the dynamics of behavioral changes over time. The limitation of the study is the predominantly conceptual and analytical nature of the results obtained. Type of article – theoretical.