Low Educational Background Research Articles

Obesity is linked to disease severity in moderate to severe atopic dermatitis-Data from the prospective observational TREATgermany registry.

There are conflicting data on a potential association between obesity and atopic dermatitis (AD). The purpose of this study was to investigate the relationship between obesity and AD disease severity. Patients from the TREATgermany registry cohort were divided into three groups according to their body mass index (BMI). Due to low numbers, underweight patients (BMI <18.5 kg/m2) were excluded from the analysis. Physician- and patient-reported disease severity scores as well as additional phenotypic characteristics were evaluated for association with BMI. Generalized linear mixed models and multinomial logit models, respectively, were applied to investigate the association of BMI, age, sex and current systemic AD treatment with disease severity. This study encompassed 1416 patients, of which 234 (16.5%) were obese (BMI ≥30 kg/m2). Obesity was associated with lower educational background and smoking. Otherwise, obese and non-obese AD patients had similar baseline characteristics. Increased BMI was associated with higher oSCORAD (adjusted β: 1.24, 95% CI: 1.05-1.46, p = 0.013) and Patient-oriented eczema measure (POEM) (adjusted β: 1.09, 95% CI: 1.01-1.17, p = 0.038). However, the absolute difference in the overall oSCORAD was small between obese and non-obese AD patients (Δ oSCORAD = 2.5). Allergic comorbidity was comparable between all three groups, with the exception of asthma which was more pronounced in obese patients (p < 0.001). In this large and well-characterized AD patient cohort, obesity is significantly associated with physician- and patient-assessed measures of AD disease severity. However, the corresponding effect sizes were low and of questionable clinical relevance. The overall prevalence of obesity among the German AD patients was lower than in studies on other AD cohorts from different countries, which confirms previous research on the German population and suggests regional differences in the interdependence of AD and obesity prevalence.

Prevalence and Risk Factors Associated with the Psychological Maltreatment and Neglect of Child Laborers in Rural Bangladesh

Globally, child labor and maltreatment are considered serious public health concerns. Many child laborers in the informal sector are subjected to psychological abuse and neglect that is often akin to slavery. Our study examined the prevalence of these two forms of maltreatment among child laborers in rural Bangladesh, as well as the associated risk factors. Based on the snowball sampling technique, this study surveyed 100 child laborers employed in agricultural and domestic work in rural areas of the Sunamganj district, Bangladesh. The structured questionnaire utilizes the ICAST-CH instrument. To analyze the data, both simple and multiple linear regression analyses were conducted using two statistical software packages, SPSS and STATA. The study concluded that more than half of the child laborers have experienced psychological maltreatment “sometimes” in the form of being screamed at and insulted over the past year. In the past year, over 40% of respondents indicated they were “sometimes” deprived of food and drink and were not well cared for when they became ill. Multivariate analysis demonstrated that parents of psychologically maltreated child laborers had low educational backgrounds. A higher risk of neglect was observed among child laborers who worked for extended hours for their employers and whose families possessed limited land. In spite of the high prevalence of psychological maltreatment and neglect of child laborers in Bangladesh, the issue appears to be ignored. More comprehensive and rigorous scientific studies are required to bring about policy change.

Exploring predictors of Treatment Attendance in Patients with PTSD and Comorbid Personality Disorders: Secondary Analysis of a Randomized Controlled Trial

IntroductionPosttraumatic stress disorder (PTSD) and personality disorders (PD) often co-occur and treatment dropout remains a challenging problem for both disorders. The literature on predictors of treatment dropout is highly mixed and few reliable predictors have been identified for both PTSD and PD treatments separately, let alone for concurrent PTSD and PD treatment.ObjectivesThe aim of the present study was to identify predictors of treatment attendance among a wide range of variables in patients with PTSD and comorbid PD who received trauma-focused treatment with and without concurrent PD treatment.MethodsData were used from the prediction and outcome study in comorbid PTSD and personality disorders (PROSPER), a study consisting of two randomized clinical trials (RCT) testing the effectiveness of trauma-focused treatment (eye movement desensitization and reprocessing or imagery rescripting) with versus without concurrent PD treatment (dialectical behavior therapy or group schema therapy). 256 patients with PTSD and comorbid personality disorder participated in the study. The potential predictors included demographic (e.g. work status), patient severity (e.g. PTSD severity), patient-therapist (e.g. working alliance) and therapist (e.g. therapist experience) variables. The ordinal outcome variable was treatment attendance (0, 1-7, 8-11, 12+ trauma-focused treatment sessions). Relevant predictors were identified by a series of ordinal regression analyses (threshold for inclusion p &lt; .10). Relevant predictors were then entered together in a final ordinal regression model. Multiple imputation was used to handle missing data.ResultsThe final model included ten predictor variables and provided a good fit for the data (pooled R2Nagelkerke = .29). Higher education level (OR = 1.22, p = .009), self-rated PTSD severity (OR = 1.04, p = .036) and working alliance (OR = 1.72, p = .047) were associated with a larger number of attended sessions. Higher levels of inadequate social support from a friend (OR = 0.90, p = .042) and being randomized in the concurrent treatment condition (OR = 0.52, p = .022) were associated with a smaller number of attended sessions.ConclusionsIn terms of treatment attendance rates, the results suggest that trauma-focused treatment is preferred over concurrent trauma-focused and personality disorder treatment for patients presenting with PTSD and PD. Clinicians should further be aware of the risk of lower treatment attendance for patients with a lower educational background and those reporting inadequate social support. Enhancing working alliance may protect against early treatment termination. Finally, patients with higher levels of PTSD severity at baseline may need a larger number of treatment sessions.Disclosure of InterestNone Declared

Comparative Study of Cultural Landscape Perception in Historic Districts from the Perspectives of Tourists and Residents

From a human-centric perspective, improving the spatial quality of historical districts is a key focus in achieving their refined governance. Based on a public survey performed in Zhangzhou Ancient City, we explored the differences in the perception of cultural landscape genes (CLGs) between residents and tourists with different individual characteristics, utilizing non-parametric tests and box-plot analysis methods. The findings indicate the following: Tourists have a stronger perception of CLGs related to site layout and architectural features than residents, while residents have a stronger perception of cultural customs. Gender-related differences in the perception of CLG are only significant among tourists, with females showing a higher level of CLG perception than males. Residents of different age groups show a “U-shaped” distribution in their perception of CLGs related to site layout, whereas senior tourists have a lower cognitive perception level. People with lower educational backgrounds among residents tend to perceive cultural customs more significantly, whereas tourists with diverse educational backgrounds do not perceive them as having a significant impact. Residence location, visit frequency, duration of residence, and residence nature are key positive factors affecting the perception of CLGs. Our study highlights the significance of considering the users’ characteristics in enhancing the refined governance of historical districts.

Psychological status of residents at the onset of nationwide COVID-19 lockdown in low- and medium-risk areas of China.

The coronavirus disease 2019 (COVID-19), a dual threat to public physical and mental health, prompted an investigation into the psychological well-being of residents in low- to medium-risk areas of China during the initial stages of the pandemic. We administered WeChat-based questionnaire surveys and employed chi-square tests and multiple logistic regression to analyze correlations between residents' age, gender, education, symptoms, COVID-19 close contact history, information sources, and anxiety, depression, and attitudes toward lockdown measures. We received 10,433 valid questionnaires, revealing 26% anxiety and 19.5% depression. Support for lockdown measures reached 98.2%. Factors such as female gender, self-diagnosed pneumonia symptoms, close contact history, and higher education levels increased anxiety risk. Having a doctorate posed a severe anxiety risk, at 4.5 times (P = .019, 95% CI 1.29-15.73). Older age acted as a protective factor, reducing severe anxiety risk to 0.98 and 0.22 times (P < .001, 95% CI 0.14-0.34). Females with a master degree or below and those receiving COVID-19 information from multiple channels faced higher depression risk. Pneumonia symptoms were a risk for all anxiety and depression degrees. Attitudes toward lockdown measures had no significant impact on psychological status, nor did any of the analyzed factors affect residents' overall attitude toward lockdown. Our findings underscore the need for increased psychological counseling, particularly for young females with lower educational backgrounds or self-suspected infection symptoms, to mitigate mild to moderate anxiety and depression in future epidemics or pandemics. The public, especially those of working age with doctorates or higher education, bears the highest risk of severe anxiety. Lockdown measures enjoy strong support in low- to medium-risk areas of China.

Nursing institutions' professors' perception and distant education experience during COVID-19 pandemic lockdown.

The nursing profession represents a demanding and challenging profession with a purpose to keep up with the evolving health-care demands of the population. The purpose of this study is to assess nursing institutions' professors' previous experience about information and communication technologies (ICTs) and their perception of distant education during the pandemic lockdown. This present is a cross-sectional study among participants n = 249 recruited from all academic staff (N = 694) of 23 higher institutes of nursing professions and health techniques in Morocco. The Chi-square test for independence (χ2) and adjusted Z scores were used as a data analysis method to assess the association between the professors' education levels and ICT experience. A significant association [χ2 (1, n = 249) = 19.510, P < 0.001] was revealed between professors' education level and taken training related to ICT in education; significant few professors (16; 9.3%) reported that taken training session [χ2 (1, n = 249) = 8.940, P = 0.003] belonged to the bachelor degree group. In matters of perception, a few proportion (10%) reported that using technology effectively belonged to the bachelor and low education background group. The findings showed that having previous experience in teaching remotely and training related to the ICT was significantly associated with a higher education background. Moreover, professors with higher degrees agreed that distant education could be an alternative to face-to-face course during quarantine.

미디어 리터러시 역량이 가짜뉴스 대응에 미치는 영향에 관한 연구

This study examined how individual media literacy competencies affect response behavior towards fake news, which is causing damage to individuals and society. Media literacy competencies are being emphasized as a means to minimize this damage. Therefore, the study investigated the relationship between individual demographic characteristics and media literacy competencies (critical competency, use production competency, social communication competency) concerning information distrust, information confirmation, and active response. This investigation utilized secondary data from the Korea Communications Commission's 2021 ‘Media Literacy Measurement Study to Support Media Education.’ The results of the study revealed a positive relationship between information distrust and critical competency, as well as a positive relationship between information confirmation and critical competency, social communication competency, use, and production competency. Additionally, active response exhibited a positive relationship with male participants, those with lower educational backgrounds, individuals with lower media usage times, critical competency, and social communication competency. Conversely, there was a negative relationship with use and production competency. This study found that media literacy competences which are emphasized as countermeasures against fake news, are related to fake news response behavior. Accordingly, as a countermeasure against fake news, it is proposed to strengthen individual media literacy competences through media education.

Illiterate Addenbrooke's Cognitive Examination-III in Three Indian Languages: An Adaptation and Validation Study.

Literacy is an important factor that predicts cognitive performance. Existing cognitive screening tools are validated only in educated populations and are not appropriate for older adults with little or no education leading to poor performance on these tests and eventually leading to misdiagnosis. This challenge for clinicians necessitates a screening tool suitable for illiterate or low-literate older individuals. The objective was to adapt and validate Addenbrooke's Cognitive Examination-III (ACE-III) for screening general cognitive functions in illiterate and low-literate older populations in the Indian context in three languages. The Indian illiterate ACE-III was systematically adapted by modifying the original items of the Indian literate ACE-III to assess the cognitive functions of illiterates and low-literates with the consensus of an expert panel of professionals working in the area of dementia and related disorders. A total of 180 illiterate or low-literate participants (84 healthy-controls, 50 with dementia, and 46 with mild cognitive impairment [MCI]) were recruited from three different centers speaking Bengali, Hindi, and Kannada to validate the adapted version. The optimal cut-off score for illiterate ACE-III to distinguish controls from dementia in all 3 languages was 75. The optimal cut-off scores in distinguishing between controls and MCI ranged from 79 to 82, with a sensitivity ranging from 93% to 99% and a specificity ranging from 72% to 99%. The test is found to have good psychometric properties and is a reliable cognitive screening tool for identifying dementia and MCI in older adults with low educational backgrounds in the Indian context.

Picture this: Evaluating the efficacy of genetic counseling visual aids.

Visual aids have been validated as effective tools for educating patients in a variety of medical settings. However, research exploring the efficacy and potential benefit of genetic counseling visual aids is lacking. To begin to address this gap, this study assessed participant knowledge of genetic counseling concepts after viewing either visual or non-visual educational content. Participants were recruited from the general population using the crowdsourcing platform Mechanical Turk. Wilcoxon rank-sum tests were carried out to evaluate differences in knowledge survey scores between the visual and non-visual groups, and Poisson regression models were fitted to evaluate these differences across a variety of demographic backgrounds. The visual group had equal or higher scores than the non-visual group across all analyses. The difference in group scores was statistically significant for autosomal recessive inheritance knowledge scores (p < 0.05). In addition, this difference was approaching significance for higher-level knowledge scores (p = 0.05) and total knowledge scores in individuals who have not completed post-secondary education (p = 0.05). These results indicate that visual aids improve knowledge of specific genetic counseling concepts such as inheritance patterns; the education of which is often integral to genetic counseling. These results also indicate that visual aids may facilitate a deeper understanding of genetic counseling concepts and may be particularly valuable for individuals with lower educational backgrounds. Together, the results of this study support the inclusion of visual aids in genetic counseling education to help improve patient understanding and the accessibility of genetic healthcare information.

Inequities in primary liver cancer in Europe: The state of play

The liver cancer burden in Europe is increasing and to improve health outcomes equitably, it is crucial to investigate how social determinants of health (SDoH) affect liver cancer risk factors and access to care. This paper summarises the available evidence on the differential distribution of liver cancer risk factors, incidence, and health outcomes in the European Economic Area and the United Kingdom from an SDoH perspective. Vulnerable and marginalised populations have low socio-economic and educational backgrounds and are the most affected by liver cancer risk factors. Reasons for this include that access to hepatitis B virus vaccination varies, while viral hepatitis screening, harm reduction, and treatment access are limited. Additionally, alcohol-related liver disease remains prevalent among individuals with low education, insecure employment, economic instability, migrants, and deprived populations. Moreover, significant variation exists across Europe in the proportion of adults with steatotic liver disease, overweight/obesity, and diabetes, based on geographical area, gender, socio-economic, educational background, and density of ultra-processed foods outlets. Inequities in cirrhosis mortality rates have been reported, with the highest death rates among individuals living in socio-economically disadvantaged areas and those with lower educational levels. Furthermore, insufficient healthcare access for key populations with primary liver cancer is influenced by complex healthcare systems, stigmatisation, discrimination, low education, language barriers, and fear of disclosure. These challenges contribute to the liver cancer care pathway inequities. Future studies are needed to explore the different SDoH-interlinked effects on liver cancer incidence and outcomes in European countries. The ultimate goal is to develop evidence-based multilevel public health interventions that reduce the SDoH impact in precipitating and perpetuating a disproportionate liver cancer level among specific populations.

Beyond correlates: the social gradient in childhood overweight

BackgroundHealth (in)equity has a high priority on research and policy agendas. Even though it is known that inequalities in overweight prevalence accumulate with age and are already existent among children below the age of six, research on this topic is scarce. In this young age group, parents play an important role in preventing overweight and associated adverse consequences. This study examines the magnitude of parental misclassification of child weight status and its correlates, focussing on the factors that determine social status and equity.MethodsPreschool children’s weight and height was measured objectively. Parents gave information on their socioeconomic background. Family education was dichotomised into tertiary and non-tertiary educational level, according to CASMIN. Binary logistic regression, adjusted for parental BMI, was applied to detect odds of childhood overweight.ResultsData on family educational level and anthropometrics were available from 643 children (4.5 ± 0.82 years, 52.7% male) and their parents of which 46.5% (n = 299) had a tertiary educational background. The groups (tertiary vs. non-tertiary educational level) differ significantly in overweight prevalence (3.7% vs. 11.9%, p ≤ 0.001). Odds of overweight were two times higher in children with non-tertiary educational background (OR: 2.123, CI: 1.010–4.461, p < 0.05), adjusted for parental BMI.ConclusionChildren from families with low educational background have an elevated risk of overweight, already at a very young age. Education in general (not explicitly health education) seems to play a tremendous role in the prevention of overweight and obesity and should therefore be implied in policies enhancing health equity.Trial registrationDRKS-ID: DRKS00010089.

Challenges of Rural Teachers' Development in Remote Areas of Western China

This paper discusses the challenges of rural teachers' development in Western China. Rural teachers are the backbone of China's basic education as well as the key and future of rural basic education development. How to inject and retain rural teachers as well as stabilize the ranks of rural teachers is fundamental to improving the quality of rural basic education, including promoting rural revitalization. Via the investigation of rural schools in Western China, this paper discovered that there are still several challenges in the development of rural teachers, for instance, teacher structure deviation, low overall educational background, serious substitute teachers, few training times, simple training methods, poor training effect, and serious teacher loss. According to the interview results, the existing challenges among rural teachers are analyzed, and recommendations are given, which include obtaining a rational allocation of teacher resources, optimizing the teacher structure, strengthening teacher training, enhancing the overall quality of teachers, and improving the incentive system in detail.

Short-Term Postoperative Depression and Anxiety in Patients with Differentiated Thyroid Carcinoma: Assessment of Potential Oncologic-Psycho Relevance.

Objective: To understand whether TSH suppressive therapy affect short-term postoperative cancer-related depression and anxiety among DTC patients. To evaluate short-term postoperative psychological problems and its relationship with baseline parameters, fatigue, sleep quality, illness perception, and patients' quality of life. Study Design and Methods: This was a prospective, observational, single center study. This study involved 831 TC patients who consecutively admitted to the inpatient department of hospital between 1st June 2020 and 31th February 2021. Results: Mean scores of the self-rated anxiety scale (SAS) (49.04 vs. 40.69) and self-rated depression scale (SDS) (44.61 vs. 39.86), as well as the incidence of anxiety (41.5% vs. 22.1%) and depression (22.5% vs. 2.4%) significantly decreased 3 months after surgery. For personal and clinical characteristics, low educational background (SAS, β = 1.392; SDS, β = 1.622; and p < 0.05), without children (SAS, β = 4.068; SDS, β = 1.873, and p < 0.01), FNAC (SAS, β = -0.981; SDS, β = -2.583; and p < 0.05), and multifocal tumor (SAS, β = -1.287; SDS, β = -2.681; and p < 0.05) were the main effects for both short-term postoperative anxiety and depression. Multiple linear regression analysis identified the serum TSH level as a significant variable associated with worse SAS (Beta = -0.695 and p=0.043) and SDS (Beta = -3.133 and p < 0.001) scores 3 months after surgery. FT4 was independently associated with SAS scores (Beta = -0.202 and p < 0.001). Patients with middle ATA risk had a significantly higher level of SDS scores (p=0.033). Conclusion: We confirmed that cancer-related anxiety and depression among DTC patients significantly alleviated 3 months after surgery. TSH suppression therapy has profound effects on cancer-related anxiety and depression, and the degree of anxiety and depression significantly deteriorated with the decrease of TSH level.

Plasma ADAM10 Levels and Their Association with Alzheimer's Disease Diagnosis in Older Adults with Fewer Years of Formal Education.

Low educational attainment is a potential risk factor for Alzheimer's disease (AD) development. Alpha-secretase ADAM10 plays a central role in AD pathology, attenuating the formation of beta-amyloid peptides and, therefore, their aggregation into senile plaques. This study seeks to investigate ADAM10 as a blood-based biomarker in mild cognitive impairment (MCI) and AD in a diverse group of community-dwelling older adults, focusing on those with limited educational attainment. Participants were recruited from public health services. Cognition was evaluated using Mini-Mental State Examination (MMSE) and Addenbrooke's Cognitive Examination - Revised (ACE-R) batteries. Blood samples were collected to analyze plasma ADAM10 levels. A logistic regression was conducted to verify the influence of plasma ADAM10 on the AD diagnosis. Significant differences in age, years of education, prescribed medications, and cognitive test scores were found between the MCI and AD groups. Regarding cognitive performance, both ACE-R and MMSE scores displayed significant differences between groups, with post hoc analyses highlighting these distinctions, particularly between AD and cognitively unimpaired individuals. Elevated plasma ADAM10 levels were associated with a 4.5-fold increase in the likelihood of a diagnosis of MCI and a 5.9-fold increase in the likelihood of a diagnosis of AD. These findings suggest ADAM10 levels in plasma as a valuable biomarker for assessing cognitive status in older individuals with low education attainment. This study underscores the potential utility of plasma ADAM10 levels as a blood-based biomarker for cognitive status, especially in individuals with low educational backgrounds, shedding light on their relevance in AD development and diagnosis.

Conflict between cattle ranching and the conservation of jaguar (Panthera onca) and puma (Puma concolor) in the Amazon arc of deforestation.

Livestock predation constitutes the primary source of conflict between humans and large carnivores. Moreover, human factors, such as attitudes and emotions, can affect people's tolerance towards carnivores, exacerbating the conflict. Such conflicts often lead to retaliatory killing of carnivores, which not only poses significant threats to species conservation but also to ecosystem functioning and services. Therefore, mitigating human-carnivore conflicts is essential to promote both species conservation and human well-being. Here, we studied the conflict between extensive cattle ranching and the conservation of jaguars (Panthera onca) and pumas (Puma concolor) in 129 ranches located in the Amazon arc of deforestation. We interviewed ranchers about livestock management procedures, livestock mortality, approaches to reduce predation in the area, and attitudes regarding carnivores and conservation. Our results revealed that ranchers did not perceive carnivore attacks as the primary cause of cattle mortality. However, they exhibited a significant lack of tolerance towards these incidents, partially explained by economic reasons. They also showed negative attitudes towards big cats, which were mainly associated with social factors, such as low educational background. As a consequence, jaguar and puma were frequently killed in retaliation. Ranches showed different vulnerability to attacks depending on cattle management (cattle density, calves) and landscape (forest cover inside the ranch, distance to national parks). Our findings suggest that the conflict between cattle ranching and big cats conservation in the Amazon deforestation frontier is trigger by livestock predation, but perpetuated by limited knowledge about carnivores, the lack of support from the government to mitigate livestock losses, and the perception that conservation laws conditioned the viability of cattle ranching. Forthcoming mitigation strategies should focus on interventions designed to increase people's tolerance towards jaguars and pumas (e.g. improving knowledge about ecosystem services provided by large carnivores).

Factors affecting functional disability in patients with non-specific chronic low back pain: a cross-sectional study.

Knowledge about factors affecting functional disability in patients with non-specific chronic low back pain (NSCLBP) is helpful in guiding treatment, but there has been little systematic research on this topic. This study aimed to identify independent factors contributing to functional disability in NSCLBP patients especially the impact of sagittal parameters and body postures in work, learning, and daily life. Sociodemographic data, sagittal parameters, Oswestry Disability Index (ODI), Numeric Rating Scale (NRS), and 36-item Short Form Health Survey (SF-36) of NSCLBP patients were collected. Patients were divided into a low-functional disability group (ODI ≤ 20) and a high-functional disability group (ODI > 20), and the ODI was converted to ranked ODI (RODI) accordingly. Sociodemographic data, sagittal parameters, NRS, and SF-36 were compared by univariate analysis between both groups. A correlation analysis of the aforementioned factors with the RODI was conducted. The sociodemographic data and sagittal parameters related to the RODI were analyzed by logistic regression to select potential RODI-associated factors. The level of significance was set at P < 0.05. Age, educational background, daily main posture while working or learning (DMPWL), daily standing time while working or learning (DSTTWL), daily sitting time while resting (DSITR), sacral slope-pelvic tilt (SS-PT), spinosacral angle (SSA), NRS, and SF-36 (except mental health, MH) were different between the two groups (P < 0.05). Correlation analysis showed that they were related to the RODI (P < 0.05). The logistic regression analysis indicated that the regression coefficients of a college degree, postgraduate diploma, DSITR, and SSA were (B = -0.197; P = 0.003), (B = -0.211; P = 0.006), (B = -0.139; P = 0.039), and (B = -0.207; P = 0.001), respectively, and the odds ratio (OR) and 95% confidence interval (CI) were 0.489 (0.308; 0.778), 0.299 (0.125; 0.711), 0.875 (0.772; 0.993), and 0.953 (0.925; 0.981), respectively. Educational background, DSITR, and SSA are independent factors affecting functional disability in NSCLBP patients. NSCLBP patients with a lower educational background, shorter DSITR, or smaller SSA should be taken into account in clinical practice and therapeutic choices. Extending sitting time for rest and the avoidance of a forward-leaning standing position are beneficial for reducing functional disability in NSCLBP.

Behavioral intentions and perceived stress under isolated environment.

Isolation is a special environment that will affect the mental health and behavior of individuals. The current study was to explore the relationship between behavior intention (BI) and perceived stress in isolated environment during Shanghai Omicron pandemic. A cross-sectional study was conducted between April 8 and 14, 2022. Three self-reported questionnaires were used to evaluate quarantine duration, stress perception, and BI. A total of 1042 participants in Shanghai under quarantine at home were included by random sampling. Logistic regression and one-way variance analysis were used to determine the risk factors related to BI. The finding implicated negative BI was more reported by the population of males, with lower educational background, with jobs, and youngers. A negative association existed between perceived stress and BI (B=-1.004, p=.003, OR=0.367, 95% CI=.191-.703). The proportion of positive BI decreased with quarantined duration, whereas the negative BI seemed vibrate upward then downward. There existed a significant effect of quarantined days on perceived stress with different BIs. High perceived stress was a risk factor of positive BI. This preliminary study has significance to understand the effect of compulsory measures on BI and for policies makers to take a psychosocial perspective to consider the effective pandemic intervention strategies.

Impact of Education on Non-Compliance and MDR TB Risk: Specialized Hospital Study

Background: Multidrug-resistant tuberculosis (MDR-TB) poses a significant global health threat, with treatment challenges linked to patient non-compliance. Education has been proposed as a potential strategy to improve adherence and reduce the risk of MDR-TB. This study aims to assess the impact of education on non-compliance and MDR-TB risk among patients receiving treatment at a specialized hospital. Objective: The primary objective of this retrospective cross-sectional study was to determine whether education provided to MDR-TB patients could reduce non-compliance rates and subsequently mitigate the risk of MDR-TB. Methods: The study included 50 MDR-TB patients who had received at least three months of treatment. Data were collected from the MDR-TB wards at the National Institute of Disease of the Chest and Hospital in Dhaka, spanning from October 2011 to March 2012. Patient education interventions focused on treatment adherence and MDR-TB prevention. Results: The study's findings demonstrate a substantial decrease in non-compliance rates Among MDR-TB patients, 64% had a history of non-compliance, with 72% being male and primarily having lower educational backgrounds. Conversely, 70% of drug-compliant patients had attained at least a secondary education level. Educational interventions led to a significant 20% reduction in non-compliance, from an initial 28% to a final 8%, emphasizing their potential to reduce MDR-TB risk. Conclusion: This study demonstrates the positive impact of education on reducing non-compliance among MDR-TB patients. A 20% reduction in non-compliance rates indicates that educational interventions can effectively contribute to decreasing the risk of MDR-TB. Future efforts should prioritize integrating education into MDR-TB treatment programs to enhance patient adherence and reduce the burden of MDR-TB.

Tailoring community preventive care to personal health needs: a data-driven and participatory approach

A digital platform with tools for health promotion was developed as a proof of concept in co-creation with all relevant stakeholders involved: citizens, caregivers, and local policy makers, aiming to optimize community preventive care.&#x0D; The platform, referred to as BIBOPP, was developed as a proof of concept focusing on prevention and health promotion for citizens, local policy makers but also for primary care givers wanting to offer personalized follow up. To this end, we set up multiple co-creation sessions with different target groups of end users, including those with expected limited digital literacy skills, eg. older adults and people with no or low formal educational background. Based on this input, the functionalities of the tools were designed and developed and afterwards tested with a new group of end-users.&#x0D; The online prevention platform offered citizens from 5 Flemish municipalities a digital screening, allowing them to evaluate their health and lifestyle. This screening is the Domus Medica Health Guide (GGDM), an evidence-based tool predicting personal risk for chronic diseases. The outcome of the screening is linked to the electronic medical health record hosted by the general practitioner, notifying the latter in case of excessive risk and involving him in the process of disease prevention and health promotion.&#x0D; Based on the personalized lifestyle advice resulting from the survey responses, end users then received an overview of activities and primary care providers in their community, tailored to their personal risk profile and preferences.&#x0D; The data collected with consent from the end users, yielded insights on the self-reported lifestyle and health of these participants. On an aggregated level, this tool has the potential to provide data for population health management.&#x0D; First lessons learned indicate that the platform did require significant digital literacy skills from end-users, as indicated by the participants younger age and relatively healthy lifestyle (eg. less than 10% smokers, +50% daily physical activity, …). However, in a co-creation session group with older adults, they indicated that digital skills were not a threshold when peer support was available. Furthermore, they recognized that the tool helped them in the self-management of their health and that they trusted the data governance. People with low to no formal educational background on the other hand were more suspicious about the tool and data governance unless this was offered to them through their trusted care providers. Also, older adults indicated that support with the interpretation of the advices by a health professional could be of added value.&#x0D; Next steps for BIBOPP now are involving these health professionals, and more specifically primary care actors in onboarding and guiding people to and through the platform.&#x0D; To conclude, this data-driven proof of concept co-designed with end-users, has promise to deliver personalized services, strengthen community preventive care, and optimize the local health policy.&#x0D; &#x0D;

Management of Snake Bites in the Agricultural Sector

Snake bites are the one that causes high rates of morbidity and mortality among workers in the agricultural sector. Snake bites can be a medical emergency that can endanger human life, and snake venom can damage local tissues, resulting in permanent disability and amputation. This study aims to identify farmers' knowledge related to snakebite management. A literature review searched three databases, Google Scholar, ScienceDirect, and PubMed, for all study designs between 2019 and 2023. The researcher found ten studies that met the inclusion criteria in the review. The high risk of snake bites for farmers makes it essential for farmers to know the most critical things in snakebite management. When bitten by a snake, the most important thing to do is first aid treatment in a threatening situation. Some factors that can affect the management of snake bites on farmers are the characteristics of farmers who are usually male with a low educational background and level of knowledge. In addition, low experience will affect the ability to handle first aid. Nurses can be present as extension workers to increase farmers' knowledge about first aid for snake bites to farmers.