National Intervention Research Articles

National Paralympic sport policies influencing a country’s Paralympic success

ABSTRACT The Paralympics Games are increasing in competitiveness as more countries seek top medal outcomes. In response, governments are focusing on the development and implementation of effective national sport policies/systems to optimise Paralympic success. However, little is known about national sport policy influencing a country’s Paralympic success. Indeed, the literature on national elite sport policy has focused on Olympic sport and emerging Paralympic sport studies are limited to a country/sport. The aim of this research was to identify key national Paralympic sport policy interventions influencing a country’s Paralympic medal outcomes. This exploratory qualitative study was informed by a realist perspective, and by the social relational and human rights models of disability. Twenty-three semi-structured interviews were conducted with national Paralympic sport managers from the United Kingdom, Australia, France and Canada, and the data was analysed using qualitative descriptive analysis. Findings confirm that existing national Olympic sport policies are also important for Paralympic success, however, within these policies, parasport-specific processes were identified, and two policy interventions unique to Paralympic sports were found: integration of disability-specific and Paralympic sport knowledge in the sporting system, and a national framework for Paralympic athlete classification. This study advances knowledge on national Paralympic sport policies and suggests that researchers, evaluators, and practitioners need to account for Paralympic-specific policies and processes. Tailoring policies to the specificities of the Paralympic domain may provide competitive advantage in the Paralympic Games. This study argues for further research to understand how the identified policy interventions may be influenced by the country’s context.

Rethinking laïcité as a geopolitical concept

ABSTRACT Laïcité, France’s idiosyncratic religious neutrality, is a concept that governs significant aspects of daily life while being notoriously variable in its application. Alongside sociological, legal and historical understandings of laïcité, I propose an additional way to view laïcité: through a critical geopolitical perspective. I argue that laïcité has been made and unmade through geographic imaginaries and practices through which idealised modes of universal citizenship confront and negotiate with affiliations to faith and culture to produce hegemonic ideas about the place of religious identity in French society. In particular, this confrontation has occurred within the French public school system, the école républicaine. I argue that laïcité, as it is manifested through educational policies as well as geographic imaginaries, reflects a will to forge a nationally unified citizenry as well as ambivalence about the need to negotiate with locally rooted cultural identities. I illustrate this through the phenomenon of student infringements, or atteintes, against laïcité: while these are framed as a grave threat to republican unity requiring national interventions, there has nevertheless been a consistent lack of spatially specific official knowledge of where atteintes take place.

Exploring mental health challenges and coping strategies in university students during the COVID-19 pandemic: A case study in Dhaka city, Bangladesh.

Mental health challenges have emerged worldwide during the COVID-19 pandemic. University students experienced changes in their lifestyles, academic life, family relationships, earning capacity, and support systems. This study explores the common mental health challenges in university students and their coping strategies using social support in the first wave of lockdowns in Dhaka city in 2020. By learning from young people's impacts and coping responses, we can help build an improved strategy for future events of this magnitude. A qualitative study design was employed to conduct 20 in-depth interviews and two focus group discussions with students from purposively selected three public and three private universities in Dhaka city and five key informant interviews with different stakeholders. We used inductive reflexive thematic analysis and applied six phases of the thematic analysis. Codes retrieved from two differently prepared codebooks were merged and compared to identify themes for a fair interpretation of the underlying data. Data were manually indexed, summarized, and interpreted to categorize codes into sub-themes leading to themes. Financial constraints, academic pressure, learning resources shortages, losing confidence, relationship breakup, excessive internet dependency, and traumatic experiences challenged the mental health conditions of the students unevenly across universities during the COVID-19 pandemic. Expressed mental health well-being impacts ranged from anxiety, stress, and depression to self-harm and suicidal ideation. Family bonding and social networking appeared as robust social support mechanisms to allow students to cope with anxiety, stress, and depression. Partial financial subsidies, soft loans to purchase electronic resources, faculty members' counseling, and sessional health counseling contributed to minimizing the mental health impacts of COVID-19. Mental health is still not a resourced area of health and well-being in Bangladesh. Concentration on developing strong social support and improving increased financial subsidies, including learning resources, can be effective in assisting students in coping with the common mental health burdens during pandemic periods. A national intervention plan should be immediately designed and implemented by engaging different stakeholders including healthcare professionals and establishing effective mental healthcare support centers at universities to avoid immediate and prolonged negative mental health impacts.

Algının Çerçevelenmesi: İngiliz Basınında 1896 Osmanlı Bankası Baskını

This study aimed to explore how British newspapers framed the Ottoman Bank Raid in 1896 and how they might have functioned in the political and social reconstruction of Ottoman Empire within the international sphere. A qualitative inductive framing analysis was carried out. The results of textual analysis revealed two main frames: (i) human interest: internal unrest and fracture within the Ottoman Empire and (ii) emphasis on unification: isolation policy within international relations. While the former frame mainly included disinformation regarding the number of Armenians killed or wounded, combined with constant use of negative metaphors for Ottoman Empire and Muslim population, the latter frame focused on national, international support and forceful intervention of Europe rather than diplomatic pressure.

Reducing opioid use for chronic non-cancer pain in primary care using an evidence-based, theory-informed, multistrategic, multistakeholder approach: a single-arm time series with segmented regression

BackgroundMany countries have high opioid use among people with chronic non-cancer pain. Knowledge about effective interventions that could be implemented at scale is limited. We designed a national intervention that...

Application of mathematical modelling to inform national malaria intervention planning in Nigeria

BackgroundFor their 2021–2025 National Malaria Strategic Plan (NMSP), Nigeria’s National Malaria Elimination Programme (NMEP), in partnership with the World Health Organization (WHO), developed a targeted approach to intervention deployment at the local government area (LGA) level as part of the High Burden to High Impact response. Mathematical models of malaria transmission were used to predict the impact of proposed intervention strategies on malaria burden.MethodsAn agent-based model of Plasmodium falciparum transmission was used to simulate malaria morbidity and mortality in Nigeria’s 774 LGAs under four possible intervention strategies from 2020 to 2030. The scenarios represented the previously implemented plan (business-as-usual), the NMSP at an 80% or higher coverage level and two prioritized plans according to the resources available to Nigeria. LGAs were clustered into 22 epidemiological archetypes using monthly rainfall, temperature suitability index, vector abundance, pre-2010 parasite prevalence, and pre-2010 vector control coverage. Routine incidence data were used to parameterize seasonality in each archetype. Each LGA’s baseline malaria transmission intensity was calibrated to parasite prevalence in children under the age of five years measured in the 2010 Malaria Indicator Survey (MIS). Intervention coverage in the 2010–2019 period was obtained from the Demographic and Health Survey, MIS, the NMEP, and post-campaign surveys.ResultsPursuing a business-as-usual strategy was projected to result in a 5% and 9% increase in malaria incidence in 2025 and 2030 compared with 2020, while deaths were projected to remain unchanged by 2030. The greatest intervention impact was associated with the NMSP scenario with 80% or greater coverage of standard interventions coupled with intermittent preventive treatment in infants and extension of seasonal malaria chemoprevention (SMC) to 404 LGAs, compared to 80 LGAs in 2019. The budget-prioritized scenario with SMC expansion to 310 LGAs, high bed net coverage with new formulations, and increase in effective case management rate at the same pace as historical levels was adopted as an adequate alternative for the resources available.ConclusionsDynamical models can be applied for relative assessment of the impact of intervention scenarios but improved subnational data collection systems are required to allow increased confidence in predictions at sub-national level.

Adapting and Scaling a Digital Health Intervention to Improve Maternal and Child Health Among Ethnic Minority Women in Vietnam Amid the COVID-19 Context: Protocol for the dMOM Project.

Due to interconnected structural determinants including low maternal health knowledge, economic marginalization, and remoteness from low-capacity health centers, ethnic minority women in remote areas of Vietnam face severe maternal, newborn, and child health (MNCH) inequities. As ethnic minorities represent 15% of the Vietnamese population, these disparities are significant. mMOM-a pilot mobile health (mHealth) intervention using SMS text messaging to improve MNCH outcomes among ethnic minority women in northern Vietnam-was implemented from 2013-2016 with promising results. Despite mMOM's findings, exacerbated MNCH inequities, and digital health becoming more salient amid COVID-19, mHealth has not yet been scaled to address MNCH among ethnic minority women in Vietnam. We describe the protocol for adapting, expanding, and exponentially scaling the mMOM intervention qualitatively through adding COVID-19-related MNCH guidance and novel technological components (mobile app and artificial intelligence chatbots) and quantitatively through broadening the geographical area to reach exponentially more participants, within the evolving COVID-19 context. dMOM will be conducted in 4 phases. (1) Drawing on a review of international literature and government guidelines on MNCH amid COVID-19, mMOM project components will be updated to respond to COVID-19 and expanded to include a mobile app and artificial intelligence chatbots to more deeply engage participants. (2) Using an intersectionality lens and participatory action research approach, a scoping study and rapid ethnographic fieldwork will explore ethnic minority women's unmet MNCH needs; acceptability and accessibility of digital health; technical capacity of commune health centers; gendered power dynamics and cultural, geographical, and social determinants impacting health outcomes; and multilevel impacts of COVID-19. Findings will be applied to further refine the intervention. (3) dMOM will be implemented and incrementally scaled across 71 project communes. (4) dMOM will be evaluated to assess whether SMS text messaging or mobile app delivery engenders better MNCH outcomes among ethnic minority women. The documentation of lessons learned and dMOM models will be shared with Vietnam's Ministry of Health for adoption and further scaling up. The dMOM study was funded by the International Development Research Centre (IDRC) in November 2021, cofacilitated by the Ministry of Health, and is being coimplemented by provincial health departments in 2 mountainous provinces. Phase 1 was initiated in May 2022, and phase 2 is planned to begin in December 2022. The study is expected to be complete in June 2025. dMOM research outcomes will generate important empirical evidence on the effectiveness of leveraging digital health to address intractable MNCH inequities among ethnic minority women in low-resource settings in Vietnam and provide critical information on the processes of adapting mHealth interventions to respond to COVID-19 and future pandemics. Finally, dMOM activities, models, and findings will inform a national intervention led by the Ministry of Health. PRR1-10.2196/44720.

The relationship between sleep quality, snoring symptoms, night shift and risk of stroke in Chinese over 40 years old.

To analyze the relationship between sleep quality, snoring symptoms, night shift and risk of stroke in Chinese population over 40 years old. Based on the national screening and intervention program for high-risk population of stroke in 2016, 15,016 people completed the study of "the association between sleep and stroke," 58,696 people completed the snoring questionnaire, and 58,637 people completed the night shift questionnaire. The proportion of coronary heart disease, hypertension, hyperlipidemia, diabetes, snoring, atrial fibrillation, stroke and high-risk group of stroke risk rating were higher in the group with poor sleep quality (p < 0.05). The proportion of high blood pressure, hyperlipidemia, diabetes, atrial fibrillation, transient ischemic attack (TIA), or high-risk group of stroke risk rating was higher in snoring group (p < 0.05). The body mass index (BMI), waist circumference, neck circumference, fasting blood glucose, triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL) and homocysteine (Hcy) levels in snoring group were higher than the non-snoring group, and high density lipoprotein (HDL) levels were lower (p < 0.05). People with TIA, high risk for stroke, and high blood pressure were higher in night shift workers than non-night shift workers (p < 0.05). The levels of BMI, fasting blood glucose, 2 h postprandial blood glucose, glycated hemoglobin, TG, TC, LDL, HDL and Hcy in night shift group were lower than the non-night shift group (p < 0.05). Sleep quality, snoring and night shift might be related to the risk factors of stroke.

Trends in the Prevalence of Hepatitis B Virus, Hepatitis C Virus, and HIV Infections in Iranian Patients with Hereditary Bleeding Disorders.

Patients with hereditary bleeding disorders (HBDs) have always been vulnerable to transfusion-transmitted infections (TTIs) such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections due to being regular recipients of blood and blood products. This study aimed to detect the trends in the prevalence of HBV, HCV, and HIV infections by birthyear in Iranian patients with HBDs to show the efficacy of national interventions implemented to administrate control and to prevent these infections, i.e., blood safety, newborn HBV vaccination, and safe replacement treatments. In this retrospective study, the trends in the prevalence of hepatitis B core antibody (HBcAb), HCV antibody (HCV-Ab), and HIV antibody (HIV-Ab) in Iranian patients with HBDs born before 2012 were assessed using patients' clinical archives. The determinants of HBV, HCV, and HIV infections were investigated in bivariable and multivariable logistic regression analyses. Out of 1475 patients with HBDs, most were male (87.7%) and diagnosed with hemophilia A (52.1%) and severe bleeding disorder (63.7%). The prevalence of HBcAb, HCV-Ab, and confirmed HIV-Ab was 22.9%, 59.8%, and 1.2%, respectively. The trends in HBcAb, HCV-Ab, and HIV-Ab were all decreasing by birthyear and reached a stable level of 0% for patients with birthyears in 1999, 2000, and 1984, respectively. In multivariable analysis, birthyear was significantly associated with HBcAb prevalence. In the multivariable analysis, type of HBD; birthyear; bleeding severity; histories of receiving packed cells, fresh frozen plasma, and cryoprecipitate before 1996; and history of receiving factor concentrate before 1997 were highly associated with the prevalence of HCV-Ab. Moreover, in the bivariable analysis, birthyear and type of HBD were associated with HIV-Ab prevalence. This study demonstrated the decreasing trends in HBV, HCV, and HIV seroprevalence in Iranian patients with HBDs following preventive interventions such as HBV vaccination, blood safety measures, and the provision of safe replacement treatments.

Causes and contexts of childhood overweight and obesity in the Pacific region: a scoping review

Background: Non-communicable diseases (NCDs) are a major threat to health and development and account for 75% of deaths in the Pacific Islands Countries and Territories (PICTs). Childhood obesity has been identified as a main risk factor for NCDs later in life. This review compiled overweight and obesity (OWOB) prevalence (anthropometric data) for children aged six to 12 years old living in the Pacific region and identified possible related causes. Methods: We conducted a systematic search using PubMed, Google Scholar and ScienceDirect for articles published between January 1980 and August 2022. We also searched for technical reports from Ministries of Health. Guided by the eligibility criteria, two authors independently read the selected articles and reports to extract and summarise relevant information related to overweight and obesity. Results: We selected 25 articles, two worldwide analyses of population-based studies and four national reports. Information revealed that childhood OWOB prevalence reached 55% in some PICTs. This review also indicated that age, gender and ethnicity were linked to children’s weight status, while dietary practices, sleep time and level of physical activity played a role in OWOB development, as well as the living environment (socio-economic status and food availability), parenting practices and education level. Conclusion: This review highlighted that anthropometric data are limited and that comparisons are difficult due to the paucity of surveys and non-standardized methodology. Main causes of overweight and obesity are attributed to individual characteristics of children and behavioural patterns, children’s socio-economic environment, parenting practices and educational level. Reinforcement of surveillance with standardised tools and metrics adapted to the Pacific region is crucial and further research is warranted to better understand root causes of childhood OWOB in the Pacific islands. More robust and standardized anthropometric data would enable improvements in national strategies, multisectoral responses and innovative interventions to prevent and control NCDs.

Facility-Based Cross-Sectional Survey on Aedes-Borne Diseases and Associated Symptoms among Febrile Patients During the 2019 Dengue Outbreak in Moshi Rural District, Tanzania

Background: Diseases caused by Aedes-borne viruses, such as; dengue, chikungunya, and Zika are emerging and re- emerging in different parts of the world. Tanzania has experienced several dengue outbreaks since 2010. The present study aims to determine the seroprevalence and associated symptoms of dengue and chikungunya fever in the Moshi rural district during the 2019 dengue outbreak. Methodology: A facility-based cross-sectional survey was conducted in 15 health facilities in the Moshi Rural district. A total of 397 participants with malaria-like symptoms were enrolled. Participants were screened for seropositivity towards dengue and chikungunya Immunoglobulin G and M (IgG and IgM) using ELISA-based kits. Results: Out of 397 participants, 28 (7.1 %) and 8 (2.0%) were dengue IgM and IgG positive respectively. Chikungunya IgM positives were 34 (8.6%). The most commonly reported symptoms were; headache 189 (27.7%), joint pains 132 (19.4%) and muscle pain 106 (15.5%). Factors such as being a farmer and history of travelling to outside regions was associated with dengue IgM seropositivity (p&lt;.05). Conclusion: Aedes-borne illnesses appear to be endemic in the area, with IgG antibodies against the Chikungunya virus being more prevalent among study participants. These results provide an understanding of arboviral diseases as well as provide an early warning signal on the risk of transmission in north Tanzania. The results inform the allocation of local and national public health intervention to prevent future outbreaks.

Understanding factors associated with rural-urban disparities of stunting among under-five children in Rwanda: A decomposition analysis approach.

Childhood stunting in its moderate and severe forms is a major global problem and an important indicator of child health. Rwanda has made progress in reducing the prevalence of stunting. However, the burden of stunting and its geographical disparities have precipitated the need to investigate its spatial clusters and attributable factors. Here, we assessed the determinants of under-5 stunting and mapped its prevalence to identify areas where interventions can be directed. Using three combined rounds of the nationally representative Rwanda Demographic and Health Surveys of 2010, 2015and 2020, we employed the Blinder-Oaxaca decomposition analysis and the hotspot and cluster analyses to quantify the contributions of key determinants of stunting. Overall, there was a 7.9% and 10.3% points reduction in moderate stunting among urban and rural areas, respectively, and a 2.8% and 8.3% points reduction in severe stunting in urban and rural areas, respectively. Child age, wealth index, maternal educationand the number of antenatal care visits were key determinants for the reduction of moderate and severe stunting. Over time, persistent statistically significant hotspots for moderate and severe stunting were observed in Northern and Western parts of the country. There is a need for an adaptive scaling approach when implementing national nutritional interventions by targeting high-burden regions. Stunting hotspots in Western and Northern provinces underscore the need for coordinated subnational initiatives and strategies such as empowering the rural poor, enhancing antenatal health care, and improving maternal health and education levels to sustain the gains made in reducing childhood stunting.

Leptospirosis in Ecuador: Current Status and Future Prospects.

The location of Ecuador-an equatorial nation-favors the multiplication and dispersal of the Leptospira genus both on the Pacific Coast and in the Amazon tropical ecoregions. Nevertheless, leptospirosis epidemiology has not been fully addressed, even though the disease has been recognized as a significant public health problem in the country. The purpose of this literature review is to update knowledge on the epidemiology and geographical distribution of Leptospira spp. and leptospirosis in Ecuador to target future research and develop a national control strategy. A retrospective literature search using five international, regional, and national databases on Leptospira and leptospirosis including humans, animals, and environmental isolations of the bacteria and the disease incidence in Ecuador published between 1919 and 2022 (103 years) with no restriction on language or publication date was performed. We found and analyzed 47 publications including 22 of humans, 19 of animals, and two of the environments; three of these covered more than one of these topics, and one covered all three (i.e., One Health). Most (60%) of the studies were conducted in the Coastal ecoregion. Twenty-four (51%) were published in international journals, and 27 (57%) were in Spanish. A total of 7342 human and 6314 other animal cases were studied. Leptospirosis was a frequent cause of acute undifferentiated febrile illness in the Coast and Amazon and was associated with rainfall. All three major clusters of Leptospira-pathogenic, intermediate, and saprophytic-were identified from both healthy and febrile humans, the environment, and animals; moreover, nine species and 29 serovars were recorded over the three Ecuadorian ecoregions. Leptospira infections were diagnosed in livestock, companion, and wild animals from the Amazon and the Coast regions along with sea lions from the Galápagos Islands. Microscopic-agglutination test was the diagnostic tool most widely used. Three reviews covering national data on outpatients and inpatients determined the varied annual incidence and mortality rate, with males being more commonly affected. No human cases have been reported in the Galápagos Islands. Genomic sequences of three pathogenic Leptospira were reported. No studies on clinical ground, antibiotic resistance, or treatment were reported, nor were control programs or clinical-practice guidelines found. The published literature demonstrated that leptospirosis was and still is an endemic disease with active transmission in the four geoclimatic regions of Ecuador including the Galápagos Islands. Animal infections, distributed in mainland and insular Ecuador, pose a significant health risk for humans. Nationwide epidemiological surveys-encouraging more research on the fauna and environment with appropriate sampling design on risk factors for human and animal leptospirosis, Leptospira genotyping, increased laboratory capability, and readily available official data-are required to improve our understanding of transmission patterns and to develop effective national intervention strategies with the intention of applying One Health approaches.

Reassembling local-regional industrial networks towards sustainability: an evolving “eco-transformation arena” in a Chinese industrial district

This paper investigates a pathway for transforming small and medium enterprise-based industrial districts to eco-industrial development in newly industrialised countries. Our framework conceptualises the eco-transformation of industrial districts as a reassembling process of local-regional industrial networks toward sustainability from an ‘arenas of development’ perspective, highlighting how an emerging eco-transformation arena may challenge existing unsustainable industrial networks. We employ a case-study method to illuminate how such an eco-transformation arena has emerged in Shunde District in Southern China and evolved in the dimensions of continuity, scale and depth of transformation. The results show the pathway is driven by national policy intervention and local government responses. The subsequent development is likely to shift into a fluid, non-linear process unfolded through the continuing interaction of agenda setting, actors and their relationships, strategies and actions performed, translation projects and spaces of negotiation (i.e. the arena’s five components) while being influenced by context and place-specificity.

Prevalence and determinants of undiagnosed hypertension in the Western region of Saudi Arabia.

Recent data regarding the prevalence and determinants of undiagnosed hypertension in Saudi Arabia are particularly lacking. This study aimed to investigate the prevalence of undiagnosed hypertension and to identify potential associates of hypertension risk among adults in the Western region of Saudi Arabia. Cross-sectional data for 489 Saudi adults were collected from public places in the cities of Madinah and Jeddah. Demographic, anthropometric (height, weight, waist circumference), and blood pressure (assessed by a digital sphygmomanometer) data were collected from all participants during face-to-face interviews. The American College of Cardiology and American Heart Association guidelines were used to evaluate blood pressure status. Sodium intake was assessed using a semi-validated food frequency questionnaire. The prevalence of undiagnosed, elevated blood pressure, stage I, or stage II hypertension was 9.82%, 39.5%, and 17.2%, respectively. The proportions of individuals with undiagnosed hypertension were higher among men and smokers (p < .001 for both). Blood pressure status was positively associated with weight, body mass index, and waist circumference among participants (p < .001 for all). Higher body mass index and waist circumference were associated with increased odds of stage I and stage II hypertension. Sodium intake was not associated with blood pressure status. A strikingly high prevalence of undiagnosed hypertension was observed among the study sample. National intervention programs are necessary to encourage regular screening and follow-up for the early detection and management of hypertension.

All necessary measures? The United Nations and international intervention in Libya

In this slim book, Ian Martin, the first United Nations Special Representative of the Secretary-General (SRSG) to Libya, evaluates the international response to the 2011–2 conflict and the international community's responsibility for Libya's subsequent instability. All necessary measures? relies heavily on Martin's personal recollections, but the book is more than a memoir: it offers a thoughtful assessment of the short-term factors that led to Libya's current predicament. The book does not address intra-Libya dynamics in great depth, focusing instead on the positions and roles of key international players. It will therefore be of primary interest to scholars of International Relations, conflict mediation and state-building. The book is structured around a series of questions, which Martin is likely to have reflected on repeatedly over the last decade: Was a military intervention necessary? Did NATO exceed its mandate to protect civilians and seek regime change? Was a successful negotiated transition between Gaddafi and the rebels possible? Should there have been a peacekeeping mission after the conflict? Were the first post-conflict elections held too soon? The result is a highly illuminating account of the thinking and constraints of the period, though it is also somewhat defensive. For example, Martin rightly argues that the scattershot approach of Libya's transitional administration, the National Transitional Council (NTC), to funding in the informal security sector was highly destabilizing. He also notes that the unconditional unfreezing of Libyan assets facilitated this damaging spending. However, he largely absolves the international community of responsibility and concludes that ‘any attempt through the [UN] Security Council to control the use of the assets would have been hugely resented in the context of late 2011’ (p. 145).

Menstrual health and hygiene among young Palestinian female university students in the West Bank: a cross-sectional study

ObjectiveWe investigated some aspects of menstrual health and hygiene among young female students at Birzeit University in the West Bank of the occupied Palestinian territory.DesignCross-sectional study in a large central...

Cyberbullying: Study of a series of 96 Moroccan adolescents and young adults

IntroductionCyberbullying is a form of virtual harassment through the Internet, cell phones and social networks. Its psychopathological consequences are serious, including the risk of suicide.ObjectivesThe aim of this study is to determine the prevalence of cyberbullying in a sample of Moroccan adolescents, as well as the associated comorbidities.MethodsThis is a descriptive cross-sectional study of cyberbullying among Moroccan adolescents and young adults aged 12 to 20 years old. The data collection was done by a survey on Google Form sent on social networksResultsA number of 120 forms were completed by high school students, followed by secondary school and university students, of which 96 were valid. The average age was 16 years with a sex ratio of 0.25. Fifty-nine percent of the youth spent more than two hours daily on the Internet and 73% admitted having been bullied online at least once while 19% said it happened often. The profile of harassers included strangers, followed by acquaintances and schoolmates. The platforms where harassment was most present were Facebook, Instagram and WhatsApp. The most frequent types of cyberbullying were private hate messages, humiliating comments about physical appearance and messages with sexual connotations. After the harassment, 65% of victims did not tell anyone; 68% of victims felt angry, and one in five felt suicidal. Among the most common comorbidities were adjustment disorder, anxiety and depressive symptoms, aggressive behavior, and suicidal ideation. Half of the youth felt that cyberbullying had impacted their school or family life.ConclusionsParents, educators, and health professionals need to be aware of the risks of virtual communication, and the link between cyberbullying and mental health disorders, and to develop national intervention and prevention programs.Disclosure of InterestNone Declared

Type 2 Diabetes Prevention Programs-From Proof-of-Concept Trials to National Intervention and Beyond.

The prevention of type 2 diabetes (T2D) in high-risk people with lifestyle interventions has been demonstrated by several randomized controlled trials. The intervention effect has sustained up to 20 years in post-trial monitoring of T2D incidence. In 2000, Finland launched the national T2D prevention plan. For screening for high T2D risk, the non-laboratory Finnish Diabetes Risk Score was developed and widely used, also in other countries. The incidence of drug-treated T2D has decreased steadily since 2010. The US congress authorized public funding for a national diabetes prevention program (NDPP) in 2010. It was built around a 16-visit program that relies on referral from primary care and self-referral of persons with either prediabetes or by a diabetes risk test. The program uses a train-the-trainer program. In 2015 the program started the inclusion of online programs. There has been limited implementation of nationwide T2D prevention programs in other countries. Despite the convincing results from RCTs in China and India, no translation to the national level was introduced there. T2D prevention efforts in low-and middle-income countries are still limited, but results have been promising. Barriers to efficient interventions are greater in these countries than in high-income countries, where many barriers also exist. Health disparities by socioeconomic status exist for T2D and its risk factors and form a challenge for preventive interventions. It seems that a stronger commitment to T2D prevention is needed, such as the successful WHO Framework Convention on Tobacco Control, which legally binds the countries to act.

Linguistic Fingerprints and Ideological Fragmentation

The past decade of national security interventions designed to counter or offer alternatives to extremist narratives have had questionable efficacy. Too frequently, interventions have been overly concerned with ‘message dominance’, focusing on ‘what’ people think, at the expense of ‘how’ people think. Intervention strategies have fundamentally ignored the role of cognitive processing in extremist decision making. This is in spite of an increasing body of evidence which demonstrates that low cognitive complexity (black and white thinking) is a recurrent contributing factor to extremist decision making. In this article, Joshua Stewart introduces Integrative Complexity (IC), a psychological measure of cognitive complexity. Through a hypothetical futures scenario, he explores the wider potential of IC in meeting national security objectives and poses that even the most obdurate, black and white thinking can be leveraged towards positive behaviours.◼