Outreach Program Research Articles

Giant spigelian hernia in an elderly woman: a case report

Introduction and importance Spigelian hernias are an uncommon type of abdominal hernia, constituting just 1-2% of all cases. These hernias develop through defects in the abdominal wall near the semilunar line. Their rarity and subtle presentation often complicate preoperative diagnosis. The case highlights the challenges of diagnosing and managing Spigelian hernias in low- and middleincome countries, where access to advanced diagnostic tools like imaging and specialized surgical care is limited, complicating patient management. Case presentation This case involves an elderly woman with no known chronic conditions, not on any medication, and no prior surgical history, who presented with a history of a prolonged, large, non-reducible swelling,Due to a lack of access to preoperative imaging, clinical evaluation was used to guide surgical management, leading to a successful repair. Clinical discussion Spigelian hernias often present without clear symptoms, making them difficult to diagnose, especially in settings with limited diagnostic resources like ultrasound or CT. In this case, the hernia involved multiple abdominal structures, which posed a significant risk for complications such as strangulation. Early surgical intervention is critical, particularly for elderly patients who are at higher risk. Conclusion This case demonstrates the importance of prompt surgical intervention in managing Spigelian hernias and the challenges faced in resource-limited settings. The Operation Hernia, A Global outreach program at no cost, provided crucial access to expert care in underserved regions, significantly improving patient outcomes.

A cross-sectional study of essential surgical, obstetric, and anaesthesia care capacity in the public sector in Fiji.

The Lancet Commission on Global Surgery indicator collection highlighted gaps in surgical, obstetric, and anaesthesia (SOA) care in Fiji. Our study is the first comprehensive assessment of essential SOA care capacity in Fiji to guide national surgical planning. In February 2021, we conducted a cross-sectional survey of public hospitals in Fiji using the World Health Organization-Program in Global Surgery and Social Change surgical assessment tool. We surveyed 18 facilities, including three divisional hospitals (DHs) and 15 subdivisional hospitals (SDHs). Twenty-two functional operating rooms (ORs) and 27 post-anaesthesia care beds served 884,887 people. Surgical care was concentrated in DHs and only delivered in select SDHs during outreaches. While SDHs had OR space, they lacked equipment, supplies, and human resources. From 2016 to 2021, surgical volume per 100,000 population increased by approximately 50% from 1,490 to 2,248; however, SOA specialists density per 100,000 population increased marginally from 5.8 to 7.1. There is significant variation across divisions. The Northern division has more ORs (4.55), SOA specialists (9.1), and surgical volume (3,731) per 100,000 population than the Central (2.40, 7.9, 2,367) and Western (1.78, 5.3, 1,519) divisions. This is due to more OR space and functioning, specialist post creation, and outreach services to SDHs. Policy recommendations include upgrading key SDHs with essential SOA care capacity, growing the SOA workforce, strengthening facility maintenance and climate resilience, and strengthening outreach programs. Investment in surgical care capacity must be urgently increased to meet the population's needs.

Mushroom Growing and Wealth Creation in Mbarara Municipality, A Case of Selected Mushroom Farmers.

The study was set out to explore whether mushroom growing create wealth among participating households in Mbarara Municipality. This study was guided by the following objectives: to explore whether the participating households generate income from the mushroom enterprise; to examine various investments created out of the income from the mushroom enterprise for diversified earning; and to investigate the saving capacity of the participating households for future investment and enterprise sustainability. A retrospective-prospective study design was used to investigate the aspects within the period that took place in the past so as to understand the present situation and use it to predict the future. The study population included group leaders and members. From this population the researcher sampled 50 respondents using purposive and simple random sampling techniques. The study used both questionnaire and interviews to gather field data; qualitative data was arranged according to themes and quantitative data was analyzed using Statistical package for social scientists (SPSS). From the study, it was found out that farmers generate income from mushroom growing; In addition, respondents mentioned that mushroom presents growers with high nutritional value as well as income. The study also revealed the distribution of income as positively skewed, implying that farmers ought to obtain skills and improve on the technology they use to produce more and earn much. The study concluded that mushroom growing can contribute to wealth creation in an urban setting context due to its low set-up cost, high price margin and quick returns. The study recommends that Higher Institutions of learning like Bishop Stuart University should develop outreach programmes to equip such enterprises with basic skills to enhance their efficiency and high returns leading to wealth creation and sustainable transformation.

Digital Health Technology Interventions for Improving Medication Safety: Systematic Review of Economic Evaluations

Background Medication-related harm, including adverse drug events (ADEs) and medication errors, represents a significant iatrogenic burden in clinical care. Digital health technology (DHT) interventions can significantly enhance medication safety outcomes. Although the clinical effectiveness of DHT for medication safety has been relatively well studied, much less is known about the cost-effectiveness of these interventions. Objective This study aimed to systematically review the economic impact of DHT interventions on medication safety and examine methodological challenges to inform future research directions. Methods A systematic search was conducted across 3 major electronic databases (ie, PubMed, Scopus, and EBSCOhost). The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed for this systematic review. Two independent investigators conducted a full-text review after screening preliminary titles and abstracts. We adopted recommendations from the Panel on Cost-Effectiveness in Health and Medicine for data extraction. A narrative analysis was conducted to synthesize clinical and economic outcomes. The quality of reporting for the included studies was assessed using the CHEERS (Consolidated Health Economic Evaluation Reporting Standards) guidelines. Results We included 13 studies that assessed the cost-effectiveness (n=9, 69.2%), cost-benefit (n=3, 23.1%), and cost-utility (n=1, 7.7%) of DHT for medication safety. Of the included studies, more than half (n=7, 53.9%) evaluated a clinical decision support system (CDSS)/computerized provider order entry (CPOE), 4 (30.8%) examined automated medication-dispensing systems, and 2 (15.4%) focused on pharmacist-led outreach programs targeting health care professionals. In 12 (92.3% ) studies, DHT was either cost-effective or cost beneficial compared to standard care. On average, DHT interventions reduced ADEs by 37.12% (range 8.2%-66.5%) and medication errors by 54.38% (range 24%-83%). The key drivers of cost-effectiveness included reductions in outcomes, the proportion of errors resulting in ADEs, and implementation costs. Despite a significant upfront cost, DHT showed a return on investment within 3-4.25 years due to lower cost related with ADE treatment and improved workflow efficiency. In terms of reporting quality, the studies were classified as good (n=10, 76.9%) and moderate (n=3, 23.1%). Key methodological challenges included short follow-up periods, the absence of alert compliance tracking, the lack of ADE and error severity categorization, and omission of indirect costs. Conclusions DHT interventions are economically viable to improve medication safety, with a substantial reduction in ADEs and medication errors. Future studies should prioritize incorporating alert compliance tracking, ADE and error severity classification, and evaluation of indirect costs, thereby increasing clinical benefits and economic viability.

Market Orientation in Universities: Bridging Academia and Stakeholder Expectations

This study explores the market orientation practices at Gulu University, Uganda, to understand how the institution aligns its academic programs with the needs of external stakeholders, such as employers, and enhances stakeholder satisfaction. Using a qualitative approach, data were gathered through semi-structured interviews, focus group discussions, and document analysis involving faculty, students, employers, and community leaders over a ten-year period (2013–2023). Findings reveal that Gulu University has made significant efforts to align its academic offerings with local job market demands, especially in fields like Information Technology and Business Administration. However, programs in areas such as the humanities were criticized for being less market-responsive, with graduates in these fields often lacking necessary practical skills. Both employers and students noted that while some programs were beneficial for job preparation, others felt outdated and disconnected from industry needs. The study also highlights that the university has engaged with external stakeholders through initiatives like internships and outreach programs, though these efforts were inconsistent and lacked coordination across departments. Students expressed frustration with the limited accessibility of these opportunities. Additionally, while some curriculum revisions have been made, the pace of change remains slow, particularly in non-technical disciplines, which hampers the university’s ability to meet evolving market demands. The study concludes that while Gulu University has made progress, barriers such as limited resources, fragmented stakeholder engagement, and slow curriculum updates hinder the full implementation of market orientation. Recommendations include adopting a more coordinated market orientation strategy, investing in faculty development, and integrating stakeholder feedback into the curriculum. Further research is recommended to assess the long-term impact of these strategies on graduate employability and institutional success

Assessing factors motivating female students to pursue agricultural higher education in India

ABSTRACT Purpose: To investigate the driving forces that inspire female students in India to enrol in higher education programmes related to Agriculture, as well as their career aspirations upon graduation. Design/Methodology/Approach: An online survey was undertaken to collect information and ultimately included a sample of 9914 female students representing 62 Agriculture universities across India. The data, comprising both primary and secondary sources, underwent thorough processing and analysis utilizing scaling techniques & statistical software. Findings: The field of Agriculture emerged as the most favoured choice, followed by Veterinary Science and Horticulture. The primary driving factors identified were gender empowerment and personal empowerment, closely followed by career aspirations and preferences. Students in disciplines such as Dairy Technology, Food Nutrition & Dietetics, and Food Technology exhibited higher preference scores for pursuing academic endeavours in Agriculture. The majority expressed a desire to work in the private sector while a significant portion expressed interest in preparing for competitive exams. Practical Implications: This study highlights the need for targeted policies that address the economic and social barriers faced by women in accessing agricultural education. Such policies could include providing scholarships specifically for women, improving institutional support, and enhancing outreach programmes to raise awareness about opportunities in agricultural education for women. Theoretical Implications: Agricultural Higher Education institutions attract a greater number of female students in agriculture as majors. Originality/Value: This pioneering study in India holds the primary objective of probing deeply into the factors behind the increasing preference of female students for agricultural education.

Emergency Medical Services-Led Outreach Following Opioid-Associated Overdose: Frequency, Modality, and Treatment Linkage

ABSTRACT OBJECTIVES Emergency medical services (EMS) post-overdose outreach programs expand beyond traditional 9-1-1 response to offer overdose survivors linkage to substance use treatment and other related harm-reducing interventions. Although intuitive and increasingly popular, evidence to define expected outcomes is exceedingly limited. We evaluated process and patient outcomes of one large Midwestern post-overdose outreach program to describe outreach characteristics and linkage to substance use treatment. METHODS This retrospective cohort study used clinical program records of individuals referred to a multidisciplinary post-overdose outreach program following a non-fatal presumed opioid overdose with emergency response. Measures included (i) number of outreach attempts, (ii) modalities of outreach attempts (in-person visit, text message, letter, phone call, or electronic mail), (iii) outcome of outreach (i.e., if the individual was contacted), (iv) interventions provided including linkage to substance use treatment with coordinated admission and transportation. We used descriptive statistics to report patient characteristics, outreach frequency, outreach modality, successful contact, and treatment linkage through the program. RESULTS From 2020-2022, the program attempted outreach to 3,437 individuals. The median age was 37 years (interquartile range, IQR, 30-47). Most individuals were white/non-Hispanic (n = 2,077, 63.1%) and male (n = 2,084, 61.2%). Few were unhoused at the time of outreach (n = 246, 7.2%). The program made a total of 7,935 outreach attempts with a median of 2 outreach attempts (IQR 1-3) per individual. The most common outreach modalities were in-person visit (n = 3,300, 41.6%) and text message (n = 2,776, 35.0%), though phone calls and in-person visits most often resulted in successful contact (52.6% and 23.7%, respectively). Outreach attempts resulted in 743 (21.6%) successful contacts and the program linked 304 individuals (40.9% of all contacted individuals, 8.8% of all attempted outreach) to treatment. Notably, 160 (52.6%) of the 304 individuals linked to treatment required 3 or more outreach attempts before treatment linkage occurred. CONCLUSIONS Post-overdose outreach initiated by EMS can successfully find and link individuals to substance use treatment following a non-fatal opioid overdose. However, this intervention may be resource intensive, often requiring multiple attempts at outreach and several modalities of interaction to facilitate treatment linkage.

Improvement in the effective cataract surgical coverage in Malaysia: evidence of impact from a mobile cataract outreach program

BackgroundEffective Cataract Surgical Coverage (eCSC) is one of the Universal Health Coverage (UHC) indicators recommended by the World Health Organization (WHO). It is calculated from a population survey and measures access and quality of eye care services in the community. We conducted simultaneous population-based eye surveys in two regions in Malaysia in 2023 to estimate eCSC and compare the results with the survey in 2014 following the implementation of a mobile cataract program.MethodsThe surveys were simultaneously done in Eastern and Sarawak administrative regions using the Rapid Assessment of Avoidable Blindness (RAAB) technique. It involved a multistage cluster sampling method, each cluster comprising 50 residents aged 50 years and older. Presenting visual acuity (PVA) was checked, and subjects with cataracts were identified. The corrected VA (Pinhole) of those who had undergone cataract surgery was measured. eCSC was calculated at all levels of cataract surgical thresholds according to the protocol. The findings were compared with the previous survey.ResultsA total of 10,184 subjects were enumerated, with 9,709 examined and 475 non-respondents. Females had a significantly lower Cataract Surgical Coverage (CSC) than males for cataract surgical threshold of < 3/60 for both regions in National Eye Survey (NES) II in 2014, [Eastern female 82.0%, 95% Confidence Interval (CI) (72.5, 91.5) vs. male 97.8%, 95% CI (92.8, 100.0), Sarawak female 76.9%, 95% CI (66.4, 87.3) vs. male 96.4%, 95% CI (91.6, 100.0)]. However, there was no significant gender difference in eCSC. Comparing NES II (2014) and NES III (2023) at various levels of cataract surgical threshold, eCSC improved within the range of 13.8-19.2% and 18.6-23.8% for Eastern and Sarawak, respectively.ConclusionThe improvement in eCSC could likely be attributed to both quality outcome enhancement and increased coverage, possibly due to the impact of the mobile cataract services in both regions. However, a coordinated approach is necessary to further strengthen and expand the coverage of the program to enable the country to achieve the 30% increase in eCSC as targeted by WHO.

Costs and outcomes of routine HIV oral pre-exposure prophylaxis implementation across different service delivery models and key populations in South Africa: a retrospective cohort study.

Despite several service delivery models that aim to improve uptake and persistence of pre-exposure prophylaxis (PrEP) in sub-Saharan Africa, the full costs of daily oral PrEP provision in routine care settings remain largely unknown. We aimed to evaluate outcomes and costs of daily oral PrEP delivery among key and priority populations at in-facility and community outreach programmes in South Africa. This retrospective cohort study was done at seven urban sites across South Africa with in-facility or community outreach PrEP service delivery models. We did top-down and bottom-up microcosting, from the provider perspective, of routine oral PrEP provision in programmes focusing on men who have sex with men (MSM), female sex workers, and adolescent girls and young women (aged 15-24 years) who initiated oral PrEP between March 12, 2018, and Aug 13, 2019. The primary outcome was PrEP in-hand at 6 months, defined as having sufficient PrEP drug dispensed at the last visit to have the drug available 6 months after PrEP initiation. A subset of enrolled participants with sufficient potential follow-up were included in a 12-month outcome analysis. We report the cost per client initiated on PrEP in 2021 US dollars. We enrolled 1281 people aged at least 15 years who initiated oral PrEP in either in-facility or community outreach programmes between March 12, 2018, and Aug 13, 2019. The proportion of participants with PrEP in-hand at 6 months varied from 41·8% (95% CI 31·9-52·2; 41 of 98 participants) at one MSM-focused clinic to 0% (0-6·7; 0 of 53 participants) in an MSM-focused outreach programme. Among 633 clients receiving oral PrEP with the potential for 12 months follow-up, 86 (13·6%) had PrEP in-hand at 12 months. The mean average 6-month costs per client initiating oral PrEP ranged from US$29 (95% CI 26-31) to $590 (488-692), with higher costs generally observed for in-facility programmes ($152, 140-164) than for outreach programmes ($84, 79-88). The mean average monthly cost per client with PrEP in-hand at 6 months ranged from $18 (15-21) to $160 (126-194). Costs and outcomes of daily oral PrEP provision across several populations and service delivery models in real-world settings show substantial variability. Policy makers should consider this variability when planning further scale-up of oral PrEP programmes in South Africa and the sub-Saharan Africa region to maximise opportunities to improve efficiency based on local context. The US President's Emergency Plan for AIDS Relief, the US Agency for International Development, and the National Institutes of Health.

Socialization on Public Service Standards in Ohoi Faan, Kei Kecil District, Southeast Maluku Regency

The public service standards outreach program in Ohoi Faan, Kei Kecil Subdistrict, Southeast Maluku Regency, aims to improve service quality for the community in line with excellent service principles. These standards include transparency, accountability, responsiveness, fairness, and effectiveness. Transparency emphasizes the importance of the village office providing clear, accessible, and open information, such as the types of services, process flow, and the rights and responsibilities of the public. This ensures the community understands the services they receive. Accountability requires service providers to take responsibility for their actions and decisions, adhere to established procedures, prevent discrimination, and maintain integrity. Responsiveness demands that staff respond promptly and appropriately to community requests and complaints, enhancing public satisfaction by meeting their needs efficiently. Fairness ensures that all residents receive equal services without discrimination based on race, religion, gender, or social status, fostering social justice. Effectiveness and efficiency focus on optimizing resources to deliver quality services while saving time and costs for both service providers and recipients. The outreach program also encourages active community participation in evaluating services by providing constructive feedback and suggestions. Service providers are expected to respond positively to feedback to achieve continuous improvement. By understanding public service standards, village officials can deliver services more professionally and responsibly, while the community feels valued and gains greater trust in the local government. This outreach initiative strengthens the relationship between the government and the community, creating a better service environment.

Barriers LGBTQ+ Individuals Face in Accessing Healthcare Services Including HIV Prevention and Treatment Due to Stigma and Discrimination in Lesotho

Background: Lesotho faces significant challenges in providing equitable healthcare services to LGBTQ+ individuals, particularly regarding HIV prevention and treatment. The country has one of the highest HIV prevalence rates globally, with marginalized populations, including LGBTQ+ individuals, experiencing heightened vulnerability due to systemic stigma and discrimination. Aim: The study assessed the barriers LGBTQ+ individuals face in accessing healthcare services including HIV prevention and treatment due to stigma and discrimination in Lesotho. Setting: The study was conducted in three districts of Lesotho which are Maseru, Leribe, and Mokhotlong. Methods: The study cross-sectional, descriptive, qualitative research study utilized semi-structured interviews with LGBTQ+ individuals and healthcare providers to explore the interplay between stigma, mental health, and HIV vulnerabilities. Results: The findings reveal a complex relationship between stigma and health outcomes, where social marginalization leads to increased HIV vulnerabilities among LGBTQ+ populations. Discriminatory attitudes within healthcare settings discourage individuals from seeking major HIV preventive services, ultimately impacting public health efforts to control the epidemic. Conclusion: Addressing the barriers faced by LGBTQ+ individuals in Lesotho requires a multifaceted approach such as training for healthcare providers on LGBTQ+ issues, and integrating sexual and reproductive health services into community outreach programs. By fostering an inclusive healthcare environment, can enhance access to HIV prevention and treatment services, improving overall public health outcomes in Lesotho. Contribution: The findings and recommendation of the study could contribute to a better health outcome for LGBTQ+ individuals in Lesotho.

Adverse Events in a Mobile Eye Health Outreach Program

This survey study describes the postprocedure conditions experienced by individuals who received eye screening from the mobile Casey Outreach Program clinics in Oregon.

Mapping Key Populations to Develop Improved HIV and AIDS Interventions: Multiphase Cross-Sectional Observational Mapping Study Using a District and City Approach.

Indonesia's vast archipelago and substantial population size present unique challenges in addressing its multifaceted HIV epidemic, with 90% of its 514 districts and cities reporting cases. Identifying key populations (KPs) is essential for effectively targeting interventions and allocating resources to address the changing dynamics of the epidemic. We examine the 2022 mapping of Indonesia's KPs to develop improved HIV and AIDS interventions. In 2022, a district-based mapping of KPs was conducted across 201 districts and cities chosen for their HIV program intensity. This multiphase process included participatory workshops for hotspot identification, followed by direct hotspot observation, then followed by a second direct observation in selected hotspots for quality control. Data from 49,346 informants (KPs) were collected and analyzed. The results from individual hotspots were aggregated at the district or city level, and a formula was used to estimate the population size. The mapping initiative identified 18,339 hotspots across 201 districts and cities, revealing substantial disparities in hotspot distribution. Of the 18,339 hotspots, 16,964 (92.5%) were observed, of which 1822 (10.74%) underwent a second review to enhance data accuracy. The findings mostly aligned with local stakeholders' estimates, but showed a lower median. Interviews indicated a shift in KP dynamics, with a median decline in hotspot attendance since the pandemic, and there was notable variation in mapping results across district categories. In "comprehensive" areas, the average results for men who have sex with men (MSM), people who inject drugs, transgender women, and female sex workers (FSWs) were 1008 (median 694, IQR 317-1367), 224 (median 114, IQR 59-202), 196 (median 167, IQR 81-265), and 775 (median 573, IQR 352-1131), respectively. "Medium" areas had lower averages: MSM at 381 (median 199, IQR 91-454), people who inject drugs at 51 (median 54, IQR 15-63), transgender women at 101 (median 55, IQR 29-127), and FSWs at 304 (median 231, IQR 118-425). "Basic" areas showed the lowest averages: MSM at 161 (median 73, IQR 49-285), people who inject drugs at 7 (median 7, IQR 7-7), transgender women at 59 (median 26, IQR 12-60), and FSWs at 161 (median 131, IQR 59-188). Comparisons with ongoing outreach programs revealed substantial differences: the mapped MSM population was >50% lower than program coverage; the estimates for people who inject drugs were twice as high as the program coverage. The mapping results highlight significant variations in hotspots and KPs across districts and cities and underscore the necessity of adaptive HIV prevention strategies. The findings informed programmatic decisions, such as reallocating resources to underserved districts and recalibrating outreach strategies to better match KP dynamics. Developing strategies beyond identified hotspots, integrating mapping data into planning, and adopting a longitudinal approach to understand KP behavior over time are critical for effective HIV and AIDS prevention and control.

School Initiatives and Stakeholders’ Involvement

School initiatives are crucial for addressing student and community needs, with the Department of Education (DepEd) mandated to maintain a comprehensive education system aligned with national goals. These initiatives foster holistic student growth and productivity. Increased parental involvement enhances student outcomes and school climate. Education is dynamic, influenced by curriculum changes, global trends, and lifelong learning concepts. The K to 12 program in the Philippines aims to equip students with 21st-century skills, despite quality challenges. The study identifies school initiatives in Ubay, Bohol, and measures stakeholder involvement, grounded in School Improvement Theory and Participatory Development. The study revealed that while not all schools in the southwest district of Ubay, Bohol conducted school-based faculty development programs, they all held In-service Training (INSET) for teachers and Learning Action Cell (LAC) sessions. Additionally, various school-based initiatives, such as symposiums and workshops, have been conducted to further faculty development. The integration of Information and Communications Technology (ICT) in lessons and the establishment of remedial programs for at-risk learners reflect a commitment to enhancing educational quality. Community involvement, through partnerships and outreach programs, has been significant, with teachers and parents actively participating in initiatives aimed at student and community welfare. However, teacher motivation for participation in faculty development initiatives remains an area for improvement.

Blue abyss to enable gravity-related research and training

The new step in space exploration coupled with an exponential increase in the number of astronauts flying in space and preparing future Moon and Mars missions in the coming years will be possible if research and training at different gravity levels is actively pursued. Blue Abyss proposes a versatile approach for astronaut training and research at various gravity levels and in different environments. Blue Abyss is establishing its first research, test and training center in Cleveland, Ohio, USA, with plans to expand to other locations in the USA, Middle-East and the Far-East. The Blue Abyss center will be built around three main axes: (1) A versatile multi-use dive pool with several platforms from 3 to 20 m, a space research area, the Astrolab platform at 12 m, and a 50 m deep shaft; (2) A centrifuge to train astronauts and to study hypergravity physiological effects; and (3) A parabolic flight capability to offer zero, Lunar, Mars, other reduced and hyper gravity accelerations for gravity-related research and training. The ground infrastructure will include classrooms, hypobaric and hyperbaric chambers, and a human performance research center including specialized test and evaluation facilities, microgravity and hypergravity simulators that will be used for physiological studies, rehabilitation and training. A pedagogical and outreach program will offer an interactive, dynamic approach to STEM-related education for students, tomorrow's scientists.

Perception of COVID-19 Vaccination and Uptake Willingness in Northern Nigeria: Understanding Strategies to Optimize Coverage

Background: Vaccination is a proven and safe method for combating COVID-19; however, coverage remains low in many low- and middle-income countries, including Nigeria. There is also a lack of contextual evidence regarding the public perception of and willingness to receive vaccines. This study aims to contribute to efforts to optimize the vaccination coverage and improve public health in northern Nigeria. Objective: This study investigated the perceptions of COVID-19 vaccination and willingness to uptake the vaccine in northern Nigeria, aiming to identify strategies for optimizing coverage and enhancing vaccination rates. Methods: A cross-sectional household survey was conducted across the Federal Capital Territory and five northern states in Nigeria. The survey assessed the respondents’ perceptions of COVID-19, their knowledge of the COVID-19 vaccine, and their willingness to be vaccinated. Descriptive and inferential (multivariate logistic regression) statistical analyses were employed to characterize the population and identify predictors of vaccine uptake. Results: The mean age of the respondents was 28.00 years. The majority reported at least one piece of misinformation regarding COVID-19. While awareness of the vaccine was high, its actual uptake was low, and future willingness to receive the vaccine was also limited. Employment status emerged as a significant predictor of vaccine uptake, as determined through the multivariate analysis. Furthermore, collaboration with NGOs and community-based organizations (CBOs) was identified as the most effective strategy for enhancing vaccine uptake. Conclusions: This study found a concerningly low willingness to receive the COVID-19 vaccine among participants in northern Nigeria. To address this issue, we recommend establishing partnerships with NGOs and CBOs, implementing extensive public awareness campaigns, and conducting community outreach programs. These efforts should focus on dispelling misinformation, building community trust, and promoting vaccine uptake through culturally appropriate communication materials.

Exploratory factor analysis of a precollege quantum information science and technology survey: exploring career aspiration formation and student interest

The present study examined student outcomes from a quantum information science and technology (QIST) summer outreach program for U.S. secondary students. The program focused on foundational principles and skills from classical physics, quantum physics, and quantum computing. Students’ attitudes towards QIST learning and careers were measured through a pretest/posttest research design. Exploratory factor analysis was utilized to identify latent attitudinal themes, followed by comparisons of means to measure changes in these factors and analysis of covariance to assess whether these changes were related to student demographics and prior academic coursework. Two latent themes were identified: (1) QIST career aspiration formation and self-concept, and (2) QIST interest and behavioral intentions. Results indicated that students improved their QIST career aspiration formation and self-concept with a medium to large effect size, yet their QIST interest and behavioral intentions were unchanged. These results were independent of student demographics (gender, ethnicity, grade level) and prior mathematics and computer science course enrollment; however, students who had previously taken chemistry and physics were more likely to improve QIST career aspiration formation and self-concept. Students also increased their intention to take four years of elective mathematics and science with a small effect size. These results suggest that early exposure to QIST principles, skills, and applications may increase students’ consideration of related careers and academic coursetaking plans; however, their interest in QIST may be independent of career aspiration formation. Further research is needed to measure attitudinal sub-domains that may be influenced by early QIST education and specific programmatic elements.

“Woven in”: Mental Health and College Graduation Rates

Despite the benefits of a 4-year degree colleges graduate an average of only 51% of their students within 6 years of matriculation. Previous studies have identified individual-level and institutional-level factors that influence college completion but have not adequately examined institutional actions regarding student mental health that improve completion rates. Using the positive deviance method, we conducted site visits at five institutions and interviewed 172 participants including administrators (44%), faculty (23%), and students (32%) regarding each college's practices. Four recurrent themes emerged: these colleges: (a) recognized the breadth and depth of mental health needs, (b) used proactive approaches with early alert and outreach programming, (c) offered diverse services with a quality improvement approach, and (d) embedded mental health services in the larger social system. Many of these innovations can be accomplished without extensive new resources and may help colleges improve graduation rates, particularly for students with mental health needs.

Feasibility of Implementing Ankle–Brachial Index Screening at a Rural Farm Show

Purpose: Peripheral artery disease (PAD) is a common condition associated with significant morbidity and mortality. Early detection in at-risk populations through ankle-brachial index (ABI) screening is underutilized in community settings. This study assessed the feasibility of ABI screening at a rural community event for early PAD detection. Methods: A cross-sectional study was conducted at a rural farm show, where participants completed a demographic and health behavior survey and underwent ABI screening using an automatic blood pressure device. Ankle–brachial index values were categorized as normal (1.00–1.40), borderline (0.91–0.99), or abnormal (≤0.9 or &gt;1.4). Descriptive statistics were calculated, and Chi-square analysis with odds ratio assessed associations between ABI values and survey responses. Results: Among 91 participants, 18.7% (n = 17) had abnormal ABI values, and 46.2% (n = 42) had borderline or abnormal readings. A significant association was found between diabetes and abnormal ABI values (P = .034). Participants reporting diabetes were about 3.29 times more likely to have an abnormal ABI reading compared with nondiabetic participants (odds ratio 3.29, 95% CI 1.05, 10.23). Conclusions: This study shows that ABI screening can be successfully implemented at community events using cost-effective equipment, enabling early detection of PAD, especially in rural areas with limited access to health care. Physical therapists are ideally suited to lead these screenings and provide subsequent supervised exercise therapy. Expanding ABI screening in community outreach programs has the potential to enhance early intervention and reduce PAD-related health disparities among at-risk populations.

‘Finally shall come the poet, worthy that name’: exploring the role of a cathedral poet-in-residence

ABSTRACT Cathedrals have been hosting poets- and writers-in-residence since 1998, when the first ‘cathedral poet’ came to Worcester under the Poetry Places scheme. Such residencies are steadily increasing, although they reveal mixed priorities and portfolios. Some poets come as unpaid volunteers to reflect primarily on the varied aspects of cathedral life and to offer creative workshops; others may receive external funding to work on a cathedral outreach programme, sometimes in partnership with another institution. The outcome of a residency may be equally varied, ranging from a traditional volume of ‘cathedral poems’ to spontaneous ‘spoken word’ poetry, emphasising performance and community interaction. The very distinctiveness of English cathedrals suggests that there is no obvious blueprint for a successful residency, although the capacity of poetry to help us ‘see differently’ suggests increasingly creative ways in which a poet may transform our encounter with a cathedral and all that it stands for.