Secondary Data Analysis Research Articles

The cost burden of adolescent and young adult pregnancy: real-world evidence from the Brazilian public health care system

Background In low- and middle-income countries, pregnancy in adolescence represents an important public health issue. Rates of early pregnancy have significant social and economic consequences that extend beyond the individual sphere, impacting public/governmental budgets. Aim To estimate the cost implications of early pregnancies from the perspective of the Brazilian Unified Public Health System. Methods This retrospective secondary data analysis focuses on assessing direct hospital costs. The study cohort comprises adolescents and young adults who underwent prenatal care at a reference maternity hospital between January and December 2021. Individual procedure costs were extracted from hospital records and converted into monetary values using the Brazilian Federal Fee. The sample size for each group was determined based on preliminary data collected during a pilot study. Descriptive analyses presented costs stratified by age groups. To estimate budgetary impacts and sensitivity we used national live birth incidence rates. Results The mean cost per case of adolescent pregnancy was US$ 704.92 (SD: 1,707.74) and for adult pregnancy was US$ 592.40 (SD: 941.43). The cost of hospital admission accounted for 61% of the total cost of adolescent pregnancies. The annual budget impact of pregnancies among women under 30 years was estimated at US$ 1 billion, with 239 million coming from women under 20 years old. Conclusion Pregnancy in adolescence may lead to a significant annual budget impact, representing 24% of costs attributed to pregnancies among women under 30 years. Costs related to hospital admissions and complications represent a substantial share of the total costs of adolescent pregnancy.

Using English General Practice Patient Survey data to explore Long Covid prevalence

Abstract Background High global burden of Long Covid (LC) has significant implications for population wellbeing, health/social care and the economy. We aimed to assess prevalence of LC, the level of uncertainty general practice (GP) patients felt about whether they were experiencing it and patient characteristics associated with LC. Methods This is a secondary data analysis of GP Patient Survey 2023 data (759,149 participants aged 16+yrs in England). The outcomes included self-reported LC, and being unsure about having LC. Identity and socioeconomic characteristics were explored in relation to these outcomes using univariable and multivariable regression analyses. Results 4.8% of respondents described themselves as having LC, and 9.1% were unsure whether they had it. Patient age (highest odds at 35-54 years), sex (females more than males), ethnicity (highest odds in Gypsy or Irish Traveller), sexual orientation (increased odds in gay or lesbian or bisexual compared to heterosexual), religion, smoking, carer status, parental status, having a long-term condition, and area-level index of multiple deprivation (higher odds in more deprived areas) were all significantly associated with reporting having LC in the multivariable model compared to answering that question with ‘no’. Generally, similar patterns of association to the above were observed in those who answered the Long Covid question with ‘unsure’ compared to those answering ‘no’, except for parental status and sexual orientation which were not significantly associated with the outcome in the multivariable model. Conclusions This study quantitatively highlights the high levels of uncertainty among primary care patients around experiencing LC, and the unequal distribution of LC burden among population groups. Our findings underline the need for better public health and primary care messaging to raise awareness around LC and ensure that those needing support can access services, particularly those already disadvantaged in society. Key messages • There are high levels of uncertainty about having Long Covid among people attending primary care services. • There is unequal burden of Long Covid in England underlining the need for improved awareness and access to support, particularly for minoritised groups.

ANALYSIS OF WOMEN’S SERVICE NETWORKS IN NORTHEAST BRAZIL: CHALLENGES AND PERSPECTIVES FOR THE EFFECTIVENESS OF SERVICES

This article proposes a critical analysis of women's care networks in the Northeast of Brazil, focusing on support services for victims of violence and the promotion of women's health and rights. The research aims to identify the main challenges faced by care networks in the region and explore possible strategies for improving the effectiveness of these services. The analysis will be based on a combination of literature review, secondary data analysis.

The Impact of COVID-19 Pandemic on the Banking Industry and Its Customers

, including customer demand, digital transformation, risk management methods, and overall financial performance. Focusing on shifts in client demand for loans and financial products, the rise of digital banking, and banks' reactions to increased financial risks, this study examines how the pandemic affected conventional banking operations and customer interactions. The goals of the research are to look at how banks changed their services throughout the pandemic, how they dealt with risk, and how well they did financially. The research relies on secondary data analysis that scours academic journals, government documents, business reports, and bank records. Findings highlight a sharp drop in loan demand in the early phases of the epidemic, followed by a dramatic increase in demand for mortgage refinancing and corporate loans supported by the government. Online and mobile banking saw a meteoric rise in popularity as more and more clients made the switch. Lending restrictions and provisions for non-performing loans were tightened by banks in response to financial instability, which had a detrimental impact on their profitability. Better digital banking infrastructure, more robust risk management frameworks, and more adaptable financial products that can react to crises more effectively are some of the long-term consequences that the study emphasizes for the banking sector. At its end, the paper suggests ways financial institutions might be better ready for future disruptions and urges additional investigation into how fintech will play a role and how regulations will alter in the banking industry after a pandemic.

Empowering marginalised communities: Leveraging indigenous knowledge for sustainable energy development in South Africa

AbstractAmidst South Africa's volatile energy landscape—characterised by political turbulence, economic instability and Eskom's chronic financial and operational challenges—the imperative for transformative reform is both urgent and indispensable. Municipalities are confronted with deteriorating infrastructure, recurrent power disruptions and widespread electricity theft, which collectively exacerbate the national energy crisis. This paper investigates the integration of indigenous knowledge systems within the country's energy sector as a strategic response to these persistent challenges, promoting the empowerment of marginalised communities and advancing environmental sustainability. Anchored in the theoretical frameworks of environmental justice and indigenous rights, the paper advocates for Afrocentric paradigms such as traditional resource governance and community‐driven energy solutions. Employing thematic analysis of secondary data, it evaluates the viability and prospective benefits of this paradigm shift. The paper posits that the inclusion of indigenous knowledge in energy practices not only presents tangible solutions to the energy crisis but also cultivates socio‐economic empowerment and reinforces environmental stewardship.

A preliminary cross-sectional and longitudinal examination of acculturation level as a moderator of perceived school discrimination on depressive symptoms among latinx adolescents

ABSTRACT Introduction In an effort to identify risk factors that are associated with depressive symptoms among Latinx adolescents, the study examined the combined concurrent and longitudinal impact of perceived school discrimination and acculturation. Method This secondary data analysis study utilized data from two waves of the Children of Immigrants Longitudinal Study. Participants were 581 Latinx adolescents [(Mage = 14.27 years. SDage = .86) at wave 1; 57.4% female]. Results More acculturated adolescents who perceived school discrimination endorsed greater depressive symptoms cross-sectionally and longitudinally (p-values < .04). The main effects of discrimination and acculturation were inconsistently associated with depressive symptoms. Conclusions This preliminary investigation supports that assessment, prevention, and intervention of depression among Latinx adolescents may benefit from taking into account the role of high acculturation on adolescents who have felt discriminated in their schools.

Action needed to address molecular HIV surveillance ethical concerns.

There have been growing ethical concerns about the widespread use of HIV-related molecular epidemiological public health surveillance and research-or what has come to be known as molecular HIV surveillance. The varied concerns of the practice originate due to lack of informed consent, lack of demonstrated benefit for communities, potential for eroded patient care relationships leading to poor health outcomes, and potential implications for information sharing and findings which could increase stigmatization and other negative impacts in contexts where HIV, drug use, sex work, migration, and poverty are criminalized. As people living with HIV, lawyers, clinicians, and social scientists, we are part of the growing movement calling for critical and ethical attention to the practice of molecular HIV surveillance and the public health logic which underwrites the practice. We urge Canadian public health actors and researchers working with molecular surveillance data to heed global guidance and recommendations for culturally informed ethical practices, to engage community members in HIV surveillance programs, and to ensure that people living with HIV are provided appropriate consent processes for uses of secondary data analysis. Furthermore, we urge researchers and Research Ethics Boards to interrogate assumptions of impracticality in seeking subsequent consent to use persons' health information held in data repositories and explore new methods of informed consent.

Investigation of pregnancy tendency, reproductive characteristics, and disability in women with multiple sclerosis: A secondary data analysis of the national registry in Iran

Abstract Background: Multiple sclerosis (MS) predominantly affects women of childbearing age, significantly impacting their quality of life (QOL).The diagnosis of MS can influence pregnancy intention, and the level of disability associated with MS may change before and after pregnancy. This study aims to analyze the reproductive characteristics of Iranian female patients with MS (PwMS) and their association with the Expanded Disability Status Scale (EDSS) and pregnancy tendency, providing valuable insights into disease progression and the development of tailored treatments. Methods: A cross-sectional study was conducted using data from the nationwide MS registry of Iran (NMSRI) from 2018 to 2021. Patients without a documented history of pregnancy, MS type, or EDSS score were excluded from the study. Various statistical methods, including nonparametric tests, the generalized estimating equation (GEE) model, and multiple logistic regression, were employed to analyze the data. Results: The study included 1120 PwMS with a median diagnostic age of 31 and a disease duration of 6 years. The majority had relapsing-remitting MS (RRMS) and the mean EDSS score at bassline was 1.5 ± 1.4. A history of pregnancy or abortion was associated with higher EDSS scores. Multiparity before MS diagnosis was linked to EDSS score ≥ 5, while this EDSS range was associated with decreased parity after MS diagnosis (all P-values &lt; 0.05). Conclusion: Pregnancy and parity can affect the disability in female PwMS irrespective of clinical symptoms, diagnosis age, and MS type. Moreover, the chance of parity may be affected by a higher disability score, which should be considered in the clinical setting.

A smartphone app for preschool wheezing and reliability of medical history collection

BackgroundThe use of mobile applications helps improving self-management in adolescents with asthma. However, no evidence is available for children with preschool wheezing. In addition, we have no data on the reliability of medical history collected at visits. The first aim was to assess the feasibility of a smartphone app in the management of preschool wheezing; secondly we aimed to evaluate the reliability of anamnestic data collected during face-to-face medical interviews.MethodsChildren with recurrent wheezing, age between 25 and 72 months, were randomly assigned to the intervention group, provided with a smartphone app for symptoms monitoring and asthma attack treatment, or to the control group, with a written action plan. At follow-up medical history was collected and the asthma control test and a clinical questionnaire were completed. App acceptability was also explored. Respiratory symptoms, medication and utilization of healthcare resources were collected. Plus, medical information obtained from the paper questionnaires was compared with data daily recorded by the app.ResultsWe enrolled 85 preschool children with recurrent wheezing: 43 assigned to the intervention and 42 to the control group. The average (SD) adherence to e-Diary compilation was 60 (15)%. The acceptance and usability of the intervention was favorable as 70% and 93% of participants in the intervention arm described the app as ‘’simple and intuitive’’ at Visit1 (after 3 months from enrollement) and Visit2 (3 months later than Visit1), respectively and 95% and 98% found it useful in symptoms management. There were no significant differences between the two groups in clinical outcomes. At Visit1, the cACT median score (IQR) was 23,5 (21–25) for the control group (42 patients) and 23 (21–24) for the intervention group (43 patients). At Visit2 (41 controls and 42 in the intervention group) it was 25 (24–25) and 24 (24–25), respectively. Secondary analysis of data from the intervention group showed higher incidence of daily symptoms recorded by the app in comparison with the paper questionnaire, suggesting that collection of retrospective medical history may not be completely reliable.ConclusionsThe smartphone app is usable and acceptable by families of preschool wheezers. Future controlled trial are needed to prove an impact on clinical outcomes or its efficacy in a telemedicine program. Finally a daily questionnaire could provide physicians with a more reliable clinical picture as reflected better daily asthma symptoms than the written retrospective questionnaire filled at clinical visit.

Objective detection of wheeze at home by parents through a digital device: usage patterns and relationship with SABA administration.

Wheezing is an important indicator of exacerbated respiratory symptoms in early childhood and must be monitored to regulate pharmacological therapy. However, parents' subjective perception of wheezing in their children is not always precise. We investigated the objective identification of children's wheezing by parents using a digital wheeze detector (WheezeScanTM, OMRON Healthcare Co. Ltd), its longitudinal usage patterns, and its relationship with SABA administration. We conducted a secondary nested analysis of data from the intervention arm of a multi-center randomized controlled trial completed in 2021-2022 in Berlin (Germany), London (United Kingdom), and Istanbul (Turkey). Children aged 4 to 84 months with doctor's diagnosed wheezing (GINA step 1 or 2) were included. Using an electronic diary (Wheeze-MonitorTM, TPS), parents monitored and recorded for 120 days at home the presence or absence of their child's wheezing, detected both, with WheezeScanTM ("objective" wheezing), and subjective ("perceived" wheezing). Parents also recorded the child's symptoms, medication intake, and family quality of life. Questionnaires regarding symptom control, quality of life, and parental self-efficacy were answered at baseline and after 90 and 120 days. Eighty-one/87 families completed the intervention arm of the study. WheezeScanTM was on average used 0.7 (SD 0.6) times a day, with each patient reporting a positive, negative, or "error" outcome on average in 57%, 39%, and 5% of measurements, respectively. The use of WheezeScanTM declined slightly during the first 90 days of monitoring and steeply thereafter. Repeated usage of WheezeScanTM in the same day was more frequent after a "wheeze" (HR 1.5, 95% CI 1.37-1.65, p < 0.001) and an "error" (HR 2.01, 95% CI 1.70-2.38, p < 0.001) result, compared to a "no wheeze" outcome. The average per-patient daily agreement between "objective" and "perceived" wheezing/non-wheezing was 75% at the start of the monitoring period and only weakly persisted as time passed (Spearman's rho=0.09). The frequency of short-acting beta-2-agonists (SABA) administration was lower in days with closely interspaced consecutive device uses during which the patient's status was perceived as "never wheeze" (32/455, 7%) than in those perceived as "persistent wheeze" (53/119, 44%; OR 36.6, 95% CI [14.3, 94.1]). Daily use of a digital WheezeScanTM at home allows parents to detect their child's unperceived wheezing and discloses to caregivers the longitudinal patterns of a child's wheezing disorder. Digital monitoring of wheezing also highlights poor adherence to guidelines in SABA administration for wheezing children, with under-treatment being much more frequent than over-treatment. This pioneering study opens new perspectives for further investigation of digital wheeze detectors in the early diagnosis and proper self-management of wheezing disorders in childhood.

Demographic, Clinical, Psychosocial, and Behavioral Predictors of Continuous Glucose Monitor Use in Adults with Type 2 Diabetes.

Continuous glucose monitor (CGM) use is increasing rapidly among people with type 2 diabetes, although little is known about predictors of CGM use beyond clinical and demographic information available in electronic medical records. Behavioral and psychosocial characteristics may also predict CGM use. We examined clinical, psychosocial, and behavioral characteristics that may predict CGM use in adults with type 2 diabetes. This longitudinal observational study comprised a secondary analysis of data collected in a larger trial. Enrollment included HbA1c tests and surveys assessing demographic, clinical, psychosocial, and behavioral characteristics. We queried participants regarding their CGM use during the study on their final self-report surveys, 15months post-enrollment. Participants were 245 community-dwelling adults with type 2 diabetes recruited from primary care. We used logistic regression to predict CGM use during the 15-month trial period from baseline characteristics. Around one-third of participants (37.1%; 91/245) started CGM. Predictors of starting CGM in bivariate models included younger age, higher socioeconomic status, insulin use, higher HbA1c, and more diabetes distress. When including all potential predictors in a single multivariable model, only younger age (aOR = 0.95, p = 0.001), insulin use (aOR = 2.33, p = 0.006), and higher socioeconomic status (aOR = 0.44, p = 0.037) were significant predictors. Despite the association between higher HbA1c and CGM use, neither diabetes self-care behaviors nor diabetes self-efficacy significantly predicted CGM use. Of participants who tried a CGM, 14.3% (13/91) had stopped, with cost being the most-cited reason. Even when including behavioral and psychological characteristics, younger age, using insulin, and higher socioeconomic status remain key predictors of CGM use. These findings emphasize the importance of access and affordability for people who may benefit from CGM. Providers should not bias their introduction of CGM towards those with (perceived or actual) optimal or sub-optimal self-care behaviors.

Relationship between perception of body image on obesity and smoking status by age group in women: Findings of a seven-year Korean National Survey.

This descriptive study examined the relationship between body image perception and smoking status among women aged 19-64 years in Korea, using data from the Korea National Health and Nutrition Examination Survey (KNHANES). This study is a secondary analysis of data gathered from the KNHANES between 2014 and 2020, encompassing 12515 women aged 19-64 years. The final study group consisted of 742 current smokers (CS), 132 hidden smokers (HS), and 11641 non-smokers (NS). Hidden smokers were defined as participants who reported being non-smokers but had urine cotinine levels >50 ng/mL. The participants were divided into three age categories: 19-29, 30-49, and 50-64 years. A multiple logistic regression analysis was used to assess the relationship between body image perception and smoking status, by age group. Baseline statistics indicated that smokers (both CS and HS) generally had a lower socioeconomic status across all age groups. The highest rate of obesity perception was observed in the CS group, followed by the HS group, in both groups of women aged 19-29 and 30-49 years. However, only women aged 19-29 years in the CS group were more likely to perceive themselves as obese than those in the NS group (AOR=2.60; 95% CI: 1.49-4.52; p=0.001). Furthermore, factors such as current smoking status (AOR=2.32; 95% CI: 1.28-4.23; p=0.006), higher body mass index (AOR=2.95; 95% CI: 2.59-3.37; p<0.001), and perceived health status as poor (AOR=3.82; 95% CI: 2.11-6.92; p<0.001), significantly influenced the perception of obesity in this age group. This study identified a notable relationship between obesity perception and smoking among women aged 19-29 years only. These findings suggest that interventions aimed at weight reduction or modifying the perception of obesity, could potentially aid smoking cessation efforts in young women.

Cervical ripening with a double balloon device for 6 h in patients with a long cervix: Secondary analysis of a randomized controlled trial.

To examine whether cervical ripening with a double balloon device for 6 h is as effective as 12 h in patients with a cervical length ≥ 30 mm measured on transvaginal ultrasound before induction of labor, and to determine whether patients with a long cervix need to have the balloon placed for a longer time. This is a secondary analysis of data from a randomized controlled trial that compared maternal and neonatal outcomes between women undergoing cervical ripening with a double balloon device for 6 h (study group) versus 12 h (control group). In this secondary analysis, we included only patients who had cervical length ≥ 30 mm measured on transvaginal ultrasound on admission. Our primary outcome was a Bishop score change after removal of the device. Secondary outcomes included insertion to delivery interval, mode of delivery, and oxytocin infusion duration. Sixty-seven women met the inclusion criteria and were included in the analysis: 33 in the 6-h group and 34 in the 12-h group. Maternal characteristics were similar between both groups. Bishop score difference between the preinsertion and the postremoval scores were similar in the two groups (2.67 ± 1.8 vs. 2.53 ± 1.69, P = 0.76), while insertion to delivery time was 10 h shorter in the 6-h group (20.95 vs. 31.21, P = 0.02; mean difference, -10.26 [95% CI, -19.0 to -1.51]). The other secondary outcomes remained similar in both groups. In women undergoing induction of labor who have a cervical length ≥ 30 mm measured on admission transvaginal ultrasound, removing a double balloon device after 6 h achieved similar Bishop score changes as removal after 12 h, but significantly reduced the time to delivery. REGISTRATION AT CLINICAL TRIALS: https://classic. gov/ct2/show/NCT03045939.

Telemedicine as a tool for bridging geographical inequity: insights in geospatial interactions from a study on chronic heart failure patients

IntroductionChronic heart failure patients experience large disparities in quality of and access to treatment, with rural populations receiving lower levels of care. Telemonitoring of patients is increasingly being used as an important tool for improving patient management and care and might reduce geographical inequities in healthcare.MethodsWe investigate the presence and magnitude of a geospatial interaction effect on the health benefit of a supplementary telemedicine intervention, by analyzing the relationship between distance to regular place of treatment and the benefit of telemedicine in a secondary analysis of data from a previously conducted RCT. We use change in EQ5D health status, SF-36 Physical component score and SF-36 Mental component score as the outcomes. In the unadjusted analysis, intervention group and distance group and the interaction term are included as the independent variables, in the adjusted analysis, multiple socioeconomic and health related variables are included to account for potential confounders.ResultsWe find evidence of a significant interaction between the effects of telemedicine and long distance to treatment for change in EQ5D health status (unadjusted: p = 0.016, adjusted p = 0.009) and unadjusted but not adjusted mental component score (unadjusted: p = 0.013, adjusted p = 0.0728), for the change in physical component score the interaction term was not significant (unadjusted: p = 0.118, adjusted p = 0.092).ConclusionIn our study we find that supplementary telemedicine is likely to reduce the health access inequities associated with geographical distance for chronic heart failure patients. However, our sample size was modest and further research is needed to confirm these findings.

Assessment of Plastic Waste Generation and Environmental Leakage in Hai An Ward, Nghi Son Town, Thanh Hoa Province

The study estimates plastic waste generation and leakage to the environment and the sea in Hai An ward, Thanh Hoa province. The study uses a material flow analysis model, field samplings (include plastic waste sorting and weighing), and secondary data collection and analysis. The plastic waste generated is estimated to be 77.01 ton/year, of which the plastic waste from domestic sources and other sources, including agriculture and aquaculture (fishing), are 71.17 ton/year and 5.84 ton/year, respectively. Research results show the composition of plastic waste from domestic sources is diverse, with bottles being the highest (28.4%), followed by plastic bags (23.1%). The findings of the study also indicate that the plastic waste leakage to the environment is 9.63 ton/year, of which 6.4 tons are from the uncollected plastic waste and 3.23 tons are the plastic waste lost during the collection, transportation, and treatment process. The research also estimates that the plastic waste leakage to the sea accounts for about 7.24 ton/year, plastic waste retained on land is about 2.16 ton/year, and the plastic waste openly burnt is 0.23 ton/year.

Tax knowledge in connection with tax compliance in Hungary

During the examination of tax education, a significant part of the professional literature defines taxpayers as a homogeneous group, however, among others, the level of educational attainment and the digital skills of taxpayers are also important. This research investigates the role of knowledge in connection with tax compliance. The article is based on the statements from the professional literature and analysis of secondary data from national and international authorities and institutions. It also includes some comparisons of the components of the COM-B model on the data of nine European countries and sets up a model of tax behaviour based on Hungarian conditions. According to the classification based on the comparison, the performance of Hungary is at the lowest level among nine examined countries. Considering the complexity of the tax system, the knowledge of taxpayers is incomplete in Hungary. A developed version of the COM-B model points out that there is a close connection between capability and opportunity as well and these components can reinforce each other. With the adequate motivation and literacy as well as the knowledge of procedures can facilitate tax compliance. It can be concluded that successful tax education recognises and targets various groups of taxpayers. The Hungarian tax authorities treat taxpayers as a homogeneous group, however, there are slight developments by using several communication channels. In the current situation, the most important is to find the forms and levels of tax education to make the taxpayer able to comply.

Humanist Proselytizing in Distruptive Era Based on the Sustainable Development Goals (SDG’s)

Aim/Purpose: The disruptive era is an uncertain condition in social, political, and religious life that creates a new trend regarding monolithic religious understanding. A suitable proselytizing approach based on sustainable development goals is needed to improve the dignity of human life. Background: Social media plays an important role in the spread of a more monolithic religion. This triggered a significant conflict, so efforts are needed to improve religious understanding and experience, one of the fields affected by the disruptive era. Methodology: Various scientific research materials are reviewed to understand how proselytizing strategies are used in the disruptive era. Secondary data analysis was carried out for this qualitative and descriptive study. Contribution: This paper helps understand the right proselytizing strategy to minimize conflicts in the disruptive era by utilizing social media. Findings: The practice of humanist proselytizing through religious moderation and the strengthening of preachers is fundamental to strengthening literal religious understanding in the disruptive era. This study finding helps us understand how to apply proselytizing appropriately in this era of uncertainty. Recommendation for Practitioners: Implementing humanist proselytizing through religious moderation can reduce the monolithic understanding of society due to one of the negative impacts of social media. Recommendation for Researcher: To ensure the relevance of research studies, practitioners and researchers must maintain a collaborative approach with research insights to apply relevant proselytizing strategies in the disruptive era . Impact on Society: Analyze how the proselytizing approach is relevant to society in a disruptive era due to the dark side of social media in the religious. Technology evolves, so society must proactively address this problem with more literacy. In addition, the role of government policymakers, clerics, and ulama is important to reduce the monolithic understanding and cause conflict. Future Research: The study's scope will be better if it can determine the effectiveness of humanist proselytizing through religious moderation with a quantitative approach. In general, this study discusses the best proselytizing strategy in the disruptive era. The significant role of the media can be analyzed to dive deep. Similar studies could be conducted on other religious issues because of technological advancements.

The influence of the social environment on the development of critical thinking skills in young people: A study in the city of Durres, Albania

Critical thinking is an essential skill for individuals, especially young people, enabling them to analyze and evaluate information to make informed decisions. Young people who are able to make informed decisions have the opportunity to improve their future and contribute to a better society. In Albania, the level of development of young people's critical thinking skills, according to the Program for International Student Assessment (PISA), is very low. In this context, this work aims to explore the social environments that influence the development of critical thinking in young people. The study employed quantitative and qualitative approaches, as well as an analysis of secondary data extracted from similar studies. The quantitative method consists of the analysis of a questionnaire that was completed by 260 young people from 15–30 years of age. The study data show that schools, society, and social media play a very important role in the development of young people's critical thinking skills. The data confirmed that the socioeconomic status of families influences critical thinking abilities. This highlights the importance of supporting young people from all walks of life to ensure that they all have the opportunity to develop critical thinking, regardless of social background. The findings of this study are important for understanding and fostering the development of critical thinking skills in young people. This research supports teachers, parents, policymakers, researchers, and others in their efforts.

Detection of hypertension from pharyngeal images using deep learning algorithm in primary care settings in Japan

BackgroundThe early detection of hypertension using simple visual images in a way that does not require physical interaction or additional devices may improve quality of care in the era of...

A Seat at the Table: Family Conferences for Infants with Neurological Conditions.

Objective: We aimed to characterize parents' perspectives on the value of and opportunities to improve conferences between parents of critically ill infants and the health care team. Background: The parent perspective on the value of family conferences in the intensive care unit is not well characterized. Methods: In this descriptive qualitative study, parents of infants with neurological conditions in the intensive care unit at a U.S. academic medical center completed longitudinal semi-structured interviews about their experiences making decisions and communicating with clinicians. Parents were included if they had an upcoming family conference to discuss goals of care or neurological prognosis. This secondary data analysis targets interview content about family conferences. Parent responses were characterized using a conventional content analysis approach. Results: Fifty-two parents of 37 infants completed 123 interviews. Parents described valuing when clinicians (1) provided space to process emotions, (2) prioritized "big picture" discussions about serious decisions, (3) dedicated time to parent questions, and (4) responded to parent concerns and made an effort to foster consensus. Parent-identified opportunities for improvement included: (1) having the team assume responsibility for calling regular meetings, (2) prioritizing attendance of consistent and supportive team members, and (3) summarizing meeting content for parents and documenting discussions for clinicians. Conclusions: These findings demonstrate that parents of infants with neurological conditions value family conferences as an important venue for communicating with the health care team. Future studies should explore the feasibility and impact of regularly scheduled family conferences, attendees dedicated to parent support, and accessible meeting summaries on therapeutic alliance, parent well-being, and communication quality.