Program Strategies Research Articles

The Consequences of COVID-19 on Breast Cancer Screenings in an Underserved Urban Population and the Screening Access of Value for Essex Program's Efforts to Control the Damage.

This study aims to examine the impact of the COVID-19 pandemic on breast cancer screening in an underserved population, identify patient barriers, and discuss strategies to promote the importance of screening. Methods/operations: The Rutgers New Jersey Medical School Screening Access of Value for Essex (SAVE) program delivers cancer prevention services to the most vulnerable population in Essex County, New Jersey. The SAVE program was shut down from March 2020 to June 2020 due to COVID-19. The number of mammograms performed 18 months before the pandemic (September 2018 to March 2020) and 18 months after the shutdown of the program (July 2020 to December 2021) were recorded. A calling project was created in response to the pandemic to educate patients about COVID-19 precautions and provide healthcare and social services resources. There was a 15.4% reduction in screening mammograms during the post-shutdown period (1,459 pre-COVID-19 versus 1,234 post-shutdown). The number of diagnostic mammogramsincreased from 264 to 272. The calling project spoke with 1,548 patients and identified the following concerns: exposure to COVID-19, language barriers, and lack of health insurance. Although COVID-19 had a profound impact on most patients, especially in the realm of breast cancer screening, the implementation of the SAVE program's strategies such as transitioning to an appointment-only system has helped minimize the negative impacts. Reaching out to the patients, partnering with community organizations, and promoting SAVE services have played a vital role in encouraging more patients to have screening done.

Evaluasi Program Pendidikan Inklusif pada Sekolah Dasar di Lingkup Dinas Pendidikan Kota Mataram Tahun 2020/2021

This study was conducted to evaluate and analyze inclusion education programs in elementary schools in Mataram City. This study focuses on: 1). The purpose, goals, and needs of the community towards inclusive education, 2). Plans and strategies for inclusive education programs which include; Human resources, curriculum, and facilities at the Provincial Education Office, 3). program implementation; capacity building, technical assistance and program monitoring and 4) Inclusive school performance outcomes. This study used a mixed method; quantitative and qualitative approach. Quantitative data were collected through simple and qualitative questionnaires through FGDs, in-depth interviews, and observations. The data was analyzed using the CIPP approach to summarize and determine recommendations. Program evaluation criteria are divided into 4 criteria, namely: 1). Context, consisting of community goals and needs for inclusive education programs, 2). Input; plans and strategies of human resources, curriculum and school facilities,3). Process; implementation of capacity building, technical assistance, and monitoring, 4). External; school performance.

Quality assessment of childhood immunisation services in primary health centres in Oron, Akwa Ibom State, Nigeria

Introduction. With 20% of the African population, low routine immunization coverage, and a wild poliovirus reservoir, Nigeria contributes significantly to the overall regional burden of vaccine-preventable diseases. Since the introduction of the EPI in 1974 (which later became the National Programme on Immunization), Nigeria’s immunization program has suffered declining coverage. Poor quality affects service utilization, even where the services are provided free, just as immunization services are. Quality assessment will give an indication of the degree of satisfaction of clients with services as well as provide a framework for review of program priorities, strategies, and componentsPurpose of the study. The purpose of the study is to evaluate the quality of immunisation services provided to children in primary health centres in Oron, Akwa Ibom State, Nigeria. The study aims to identify the strengths and weaknesses of the immunisation services, assess the level of compliance with national and international standards for immunisation, and make recommendations for improvement where necessary. Additionally, the study seeks to contribute to the body of knowledge on the quality of childhood immunisation services in Nigeria, particularly in the context of primary health centres. Ultimately, the findings of this study may help to improve the delivery of immunisation services in the region and ensure that more children are vaccinated and protected against vaccine-preventable diseases. Materials and methods. This was a cross-sectional descriptive study of the quality of immunization services in Primary Health Centers in Akwa Ibom State, Nigeria. This study utilized some variables as indicators which included physical environment, resource availability, client satisfaction etc. formed into a questionnaire. The study involved 402 caregivers and 156 healthcare providers in 12 Primary Health Centers. The study utilized six instruments namely the Client questionnaire, Facility staff questionnaire, Facility Checklist, Personal Observation, Focus Group Discussion Guide, and Client Flow Chart.Outcomes. The results showed that the quality of immunization services was poor. The caregivers were dissatisfied with the reception by the providers. They were also not satisfied with the waiting time which they complained of as being too long. The attitude of the health care providers was also a cause of dissatisfaction.Discussion. This study found that the Community Health Extension Workers constituted the majority (39,4%) of the immunization service providers. Of the 152 healthcare providers that participated in the study, 92 (60,9%) had attended in-service training on immunization within the previous two years while 59 (39,1%) had not. A comparison of staff categories with attendance at in-service training showed a statistically significant difference (p=0.0072),suggesting that whether one attended in-service training or not depended on the category of staff he/she belongs to. One hundred and twelve (73,3%) of staff knew the correct vaccine storage temperature while 40 (26,7%) did not know. Healthcare providers who do not know the correct vaccine storage temperature may administer vaccines whose potency has been compromised. One-hundred and forty-nine (98,0%) healthcare providers were aware that clients have certain rights collectively referred to as clients’ rights. It is only by knowing the rights of clients that providers would be expected to respect these rights. The clients’ right to which most providers indicated strong agreement that clients are entitled to, was the right to information as indicated by 105 (70,2%) providers while the right to which most providers indicated disagreement was the right to choice of where and when to access services. Fifty-two (34,0%) health care providers felt clients were not entitled to this right.Conclusion. In conclusion, the study conducted a thorough quality assessment of childhood immunisation services in primary health centres in Oron, Akwa Ibom State, Nigeria. The findings reveal both strengths and weaknesses in the delivery of immunisation services to children in the region. While there were areas of average performance, such as experienced and trained healthcare workers, there were also areas of concern, such as inadequate cold chain storage and insufficient record-keeping practices.The study recommends that steps be taken to improve the quality of immunisation services in the region, including strengthening the cold chain system, ensuring adequate record-keeping practices, and implementing regular training and supervision of healthcare workers. These measures are crucial to ensuring that more children are vaccinated and protected against vaccine-preventable diseases.Overall, the findings of this study contribute to the body of knowledge on the quality of childhood immunisation services in Nigeria and underscore the importance of continued efforts to improve the delivery of immunisation services to children. It is hoped that the recommendations put forth in this study will inform policy decisions and ultimately lead to better health outcomes for children in Oron, Akwa Ibom State, and beyond

Exploring and Designing Employee Training and Development Programs for SMEs in Jabodetabek and Bandung

This study gives a general overview of the training and development programs available to SMEs in Bandung and Jabodetabek (Jakarta, Bogor, Depok, Tangerang, and Bekasi). The problem that SMEs in Jabodetabek (Jakarta, Bogor, Depok, Tangerang, Bekasi) and Bandung is a lack of productivity and abilities, as well as resource limitations that make the business undergo difficult times. To assure the reliability and validity of the research, a qualitative methodology is employed. To gain insight into their perceptions, experiences, and expectations regarding training and development programs, the researcher determines to conduct interviews with business owners, managers, and employees. There are suggestions and feedback from respondents regarding how to enhance training, started with available resources, time constraints, and the diverse learning preferences of the owner and employee to ensure maximum effectiveness. By implementing this type of training, SME employees can increase their skills and knowledge, boost their productivity, and ultimately contribute to the development and competitiveness of their business. Additionally, this research provides more valuable insights and strategies for SME training and development programs.

Applying User-Centered Design and Implementation Science to the Early-Stage Development of a Telehealth-Enhanced Hybrid Cardiac Rehabilitation Program: Quality Improvement Study.

Cardiac rehabilitation (CR) is an evidence-based intervention that improves event-free survival in patients with cardiac conditions, yet <27% of all eligible patients use CR in the United States. CR is traditionally delivered in clinic-based settings where implementation barriers abound. Innovative nontraditional program designs and strategies are needed to support widespread CR uptake. This study aimed to demonstrate how user-centered design (UCD) and implementation science (IS) principles and methods can be integrated into the early-stage development of nontraditional CR interventions. As part of a NewYork-Presbyterian Hospital (NYPH) quality improvement initiative (March 2020-February 2022), we combined UCD and IS principles and methods to design a novel home- and clinic-based telehealth-enhanced hybrid CR (THCR) program. We co-designed this program with multilevel stakeholders using an iterative 3-step UCD process to identify user and contextual barriers and facilitators to CR uptake (using semistructured interviews and contextual inquiry [step 1]), design an intervention prototype that targets contextual and user factors and emulates the evidence-based practice (through design workshops and journey mapping [step 2]), and review and refine the prototype (according to real-world usability testing and feedback [step 3]). The UCD process was informed by the Theoretical Domains Framework and Consolidated Framework for Implementation Research. At step 1, we conducted semistructured interviews with 9 provider- and system-level stakeholders (female: n=6, 67%) at 3 geographically diverse academic medical centers, which revealed behavioral (eg, self-efficacy and knowledge) and contextual (eg, social distancing guidelines, physical space, staffing, and reimbursement) barriers to uptake; hybrid delivery was a key facilitator. Step 2 involved conducting 20 design workshops and 3 journey-mapping sessions with multidisciplinary NYPH stakeholders (eg, digital health team, CR clinicians, and creative director) where we identified key design elements (eg, mix of clinic- and home-based CR and synchronous remote patient monitoring), yielding an initial THCR prototype that leveraged NYPH's telehealth infrastructure. At step 3, we conducted usability testing with 2 CR clinicians (both female) administering home-based sessions to 3 CR patients (female: n=1, 33%), which revealed usability themes (eg, ease of using remote patient monitoring devices or a telehealth platform, technology disruptions, and confidence in using the telehealth platform to safely monitor patients) and design solutions (eg, onboarding sessions, safety surveys, and fully supervised remote sessions) to be included in the final THCR prototype. Combining UCD and IS methods while engaging multidisciplinary stakeholders in an iterative process yielded a theory-informed THCR program targeting user and contextual barriers to real-world CR implementation. We provide a detailed summary of the process and guidance for incorporating UCD and IS principles and methods into the early-stage development of a nontraditional CR intervention. The feasibility, acceptability, appropriateness, and usability of the final THCR prototype is being evaluated in an ongoing study.

Aquaculture and its conservation potential of critically endangered Jipe Tilapia (Oreochromis jipe) in Lake Jipe

Tilapia jipe (Oreochromis jipe) is listed as a critically endangered Cichlidae endemic to fast-shrinking Lake Jipe. Climate change and anthropogenic activities have significantly impacted the lakes’ ecology and species’ genetic integrity. Four months of Jipe tilapia culture growth performance was conducted in four selected farms within the Chala area, Taveta Sub-County of Taita Taveta County along the slopes of Mt. Kilimanjaro’s Kenya side. The study assessed the growth performance of 3rd generation mixed-sex Oreochromis jipe under aquaculture conditions. Fish sampling was done monthly to assess the growth performance of fingerlings stocked at an average weight of 5 ± 0.02 g and a stocking density of 5/m3. Total weight ranged between 123.72 g, and 74.70 g from the entire growth trial sample population. The highest and the least mean weight gains recorded were 108.87 ± 4.31g and 87.12 ± 4.40g for Farm B and D respectively. Similarly, farm B recorded the highest mean length (18.80 ± 0.27) while farm C recorded the least (17.31 ± 0.25) with no significant difference between the selected farms. Water quality parameters were within the normally acceptable tilapia culture ranges. The study findings indicated a negative allometric growth (b &lt; 3) for all farms except Farm A. All growth trials demonstrated a good Condition factor (K) with a range of 1.82 to 2.19. The present study concluded that O. jipe has the potential for aquaculture and species genetic conservation and restocking due to its ease of propagation. The study recommends further G x E breeding program strategies, nutritional and general management studies, and a policy limiting genetic material transfer from its catchment.

Development of theoretically informed audit and feedback: An exemplar from a complex implementation strategy to improve asthma self-management in UK primary care.

Audit and feedback is an evidence-based implementation strategy, but studies reporting the use of theory to guide design elements are limited. Within the context of a programme of research aiming to improve the implementation of supported asthma self-management in UK primary care (IMPlementing IMProved Asthma self-management as RouTine [IMP2 ART]), we aimed to design and develop theoretically-informed audit and feedback that highlighted supported asthma self-management provision and areas for improvement in primary care general practices. Aligned with the Medical Research Council (MRC) complex intervention framework, the audit and feedback was developed in three phases: (1) Development: literature and theory exploration, and prototype audit and feedback design; (2) Feasibility: eliciting feedback on the audit and feedback from general practice staff (n = 9); (3) Prepiloting: delivering the audit and feedback within the IMP2 ART implementation strategy (incorporating patient and professional resources and an asthma review template) and eliciting clinician feedback (n = 9). Audit and feedback design was guided by and mapped to existing literature suggestions and theory (e.g., Theoretical Domains Framework, Behaviour Change Technique Taxonomy). Feedback on the prototype audit and feedback confirmed feasibility but identified some refinements (a need to highlight supporting self-management and importance of asthma action plans). Prepiloting informed integration with other IMP2 ART programme strategies (e.g., patient resources and professional education). We conclude that a multistage development process including theory exploration and mapping, contributed to the design and delivery of the audit and feedback. Aligned with the MRC framework, the IMP2 ART strategy (incorporating the audit and feedback) is now being tested in a UK-wide cluster randomised controlled trial.

CONTENT STRATEGIES OF TRANSLATORS’ TRAINING IN COLLEGES

Translators training programs have been or are going to be introduced in some colleges at the level of professional junior bachelor, which can be explained by the increased demand for such specialists in different fields. The article studies the case of Viacheslav Chornovil Halytskyi Professional College which was among the first institutions that developed and introduced the professional junior bachelor program of translator training. The article identifies the peculiarities of professional translator training in colleges, grounds the most effective strategies of educational program and syllabus design; determines effective methods of professional translator training in colleges.&#x0D; Three different design strategies are usually determined in modern literature – forward design, central design, and backward design. Forward design means developing a program/curriculum starting with content, then moving to process, and then to outcomes. Central design focuses first on the process and classroom methodology and then deals with content and outcomes. Backward design starts from outcomes and then determines content and process.&#x0D; The analysis of professional translator training in colleges enabled the conclusions that backward design seems to be the most appropriate for education program development; forward and backward designs can be recommended for syllabus development; Content and Language Integrated Learning with reasonable use of authentic scenarios, activities and immersion in professional situations proved its effectiveness.

GOVERNMENT COMMUNICATION STRATEGIES IN PUBLICIZING POLICIES, PROGRAMS, ACTIVITIES AND REGIONAL DEVELOPMENT ACHIEVEMENTS IN THE DIGITAL ERA (Case Study in The Leadership Administration Bureau of The Regional Secretariat of The Northern Sulawesi Province)

This research aims to analyze the government's communication strategy through the Bureau of Leadership Administration at the Regional Secretariat of North Sulawesi Province in publicizing policies, programs, activities, and regional development achievements in the digital era. The method used in this research is a descriptive qualitative method. The informants used in this study were selected using purposive sampling technique, totaling 11 people. Data collection was carried out through observation, interviews, and documentation. The research focused on planning aspects, objectives, message aspects, and media aspects. Data analysis was conducted by data reduction, data presentation, and drawing conclusions. The findings reveal that the government's communication strategy for publishing policies, programs, activities, and regional development achievements involves a systematic approach. The planning aspect consists of message preparation, design, and publication stages. The strategy primarily targets the community, aiming to provide them with government communication. The message aspect includes conveying information about upcoming and implemented policies, as well as regional development programs, activities, and achievements. The chosen media platform for publishing is Instagram, a popular social media application. In conclusion, the government's communication strategy in publicizing policies, programs, activities, and achievements of regional development in the Bureau of Administration of the Regional Secretariat of North Sulawesi Province is effective, despite relying solely on Instagram as the chosen social media platform. Therefore, it is recommended to utilize other social media platforms such as Facebook, YouTube, and others for broader reach and dissemination.

Community-based family peer navigator programme to facilitate linkage to coordinated specialty care for early psychosis among Black families in the USA: A protocol for a hybrid type I feasibility study

BackgroundApproximately 70% of Black/African American family members report no contact with mental health providers prior to initial diagnosis and the receipt of services for early psychosis. Black families often encounter...

Effectiveness of programmes focused on disease care or clinics of excellence versus conventional care programmes in treating psoriasis and psoriatic arthritis. A systematic review of the literature

IntroductionPsoriasis (PsO) and psoriatic arthritis (PsA) are chronic rheumatic diseases with a significant impact on quality of life. Consensus has been described in the literature to determine the preliminary points for implementing a centralized patient care programme. However, there is no clarity regarding its effectiveness in real-life conditions. ObjectiveTo collect the evidence systematically and exhaustively that meets the search and eligibility criteria for effectiveness of centralized care programmes in the population diagnosed with PsO and PsA. Materials and methodsA systematic review of the literature was carried out over 5 years using the electronic bases Medline, PubMed, Cochrane, Virtual Health Library, and Embase of models focused on disease care or clinics of excellence versus programmes of conventional care. ResultsA total of 8902 articles were identified, of which 16 studies were selected and grouped into 3 domains: multidisciplinary care, telemedicine, and training by health professional, and patient self-management, determining the programmes’ effectiveness through scales such as PASI, DAPSA, DAS28, EQ-5D-5L, DLQI, SF36, and MMAS-8, as well as adherence to medication, satisfaction levels, improvement perception, comorbidities assessment, and early diagnosis of joint involvement. DiscussionThe clinical evidence that supports the effectiveness of centralized patient care programme strategies is scarce. However, the information collected demonstrates the efficacy of these interventions using activity and quality of life outcomes, demonstrating the importance of their use and implementation in PsO and PsA care.

PROBABILITAS PRAKTEK PEMBERIAN MAKANAN PENDAMPING AIR SUSU IBU (MP-ASI) PADA ANAK USIA 6-23 BULAN DI INDONESIA: STUDI CROSS-SECTIONAL

The cause of the double nutritional burden problem in Indonesia is one of the reasons for giving complementary food to ASI (MP-ASI) earlier (&lt;6 months). The practice of giving MP-ASI in several countries, including Indonesia, has not yet reached the national target and the influencing factors are unknown based on national survey data. This study aims to determine the practice of giving MP-ASI to children aged 6-23 months in Indonesia and the influencing factors based on IDHS 2017 data. Research design using a cross-sectional study. The data comes from the results of the 2017 IDHS. The population is all mothers aged 15-49 years who have children aged 6-23 months. The sample is mothers aged 15-49 years who have children aged 6-23 months of 4,985 children. Data analysis used multivariate logistic regression. The practice of giving MP-ASI according to recommendations is 55.53%. Socioeconomic status (p= 0.0001; OR=1.172), place of residence (p= 0.0001; OR=1.168), education (p= 0.002; OR= 1.126), and parity (p= 0.001; OR=0.982) are significantly related to the practice of giving MP-ASI to children aged 6-23 months in Indonesia. The most dominant factor related to the practice of giving MP-ASI is socio-economic status. The probability that the practice of giving MP-ASI is not in accordance with recommendations based on risk factors is 86%. Socioeconomic status, place of residence, education, employment, parity as determinants of the practice of giving MP-ASI to children aged 6-23 months. Need to strengthen strategies to reduce poverty and increase education levels, increase access to health services in rural areas, increase visits of pregnant women and toddlers to posyandu, and improve strategies for family planning programs.

Determination of the degree of burnout syndrome in engineering student-workers of the UTCH

The aim of the following article is to identify the degree of burnout syndrome in engineering students from the evening shift, who work full time in the morning. The objective is to obtain accurate data to improve the tutorial action plan from UTCH. The research starts from the hypothesis that engineer students from the evening shift, who work, experience a high degree of emotional exhaustion, depersonalization and difficulty in personal fulfillment (Burnout). To achieve this, 175 Test «Maslach Burnout Inventory» (MBI), were administered and analyzed using the categorization by summation of classes to determine the level of burnout among students. The categories are validated individually using Cronbach Alfa, resulting in scores above 70%. The items are analyzed individually and in groups according to their category and dispersion in respect to normality. Finding validity in the research generates significant contributions to improve the strategies of the Tutorial Action Program and therefore address the socioemotional necessities of the students

Show Me the Way! Bilevel Search for Synthesizing Programmatic Strategies

The synthesis of programmatic strategies requires one to search in large non-differentiable spaces of computer programs. Current search algorithms use self-play approaches to guide this search. The issue with these approaches is that the guiding function often provides a weak search signal. This is because self-play functions only measure how well a program performs against other programs. Thus, while small changes to a losing program might not transform it into a winning one, such changes might represent steps in the direction of a winning program. In this paper we introduce a bilevel search algorithm that searches concurrently in the space of programs and in a space of state features. Each iteration of the search in the space of features defines a set of target features that the search in the program space attempts to achieve (i.e., features one observes while following the strategy encoded in a program). We hypothesize the combination of a self-play function and a feature-based one provides a stronger search signal for synthesis. While both functions are used to guide the search in the program space, the self-play function is used to guide the search in the feature space, to allow for the selection of target features that are more likely to lead to winning programs. We evaluated our bilevel algorithm in MicroRTS, a real-time strategy game. Our results show that the bilevel search synthesizes stronger strategies than methods that search only in the program space. Also, the strategies our method synthesizes obtained the highest winning rate in a simulated tournament with several baseline agents, including the best agents from the two latest MicroRTS competitions.

Strategic Management Of Literacy Programs at Madrasah Aliyah Darut Taqwa

The literacy program at Madrasa Aliyah Darut Taqwa is the flagship program of the madrasa. The school or madrasah literacy program is one of the important programs that must be formulated using strategic management concepts. Strategic management helps organizations formulate better strategies. In this case strategic management is very important in the literacy program, therefore the author wants to know more about the strategic management literacy program at MA Darut Taqwa through, formulation literacy program strategies, strategic implementation literacy programs, and evaluation of literacy program strategies madrasa aliyah Darut Taqwa. The type of research used is descriptive qualitative research. The data and data sources used are secondary data and primary data. Data collection techniques used are (a). Observation, (b). Interview, (c). Documentation. The results of the study show that, 1) The strategic formulation of the literacy program implemented in Madrasah Aliyah Darut Taqwa is carried out through the formulation of program objectives, vision and mission, swot analysis, program implementation plans, short-medium-long term goals, identifying internal and external factors that can influence program; 2) The strategic implementation of the literacy program at Madrasa Aliyah Darut Taqwa is currently carried out through determining policies, providing motivation, and carrying out useful habits to develop the culture of the literacy program; 3) Strategic evaluation of the literacy program at Madrasah Aliyah Darut Taqwa is carried out with activity evaluation meetings carried out by the entire literacy driving team, then carrying out evaluation standards on planned targets, and standard results or product feasibility.

Effects of an individualised exercise programme plus Behavioural Change Enhancement (BCE) strategies for managing fatigue in frail older adults: a cluster randomised controlled trial

BackgroundTo the best of our knowledge, although ageing-induced fatigue could cause adverse outcomes such as frailty, there is currently no intervention for it. This study evaluated the effects of an individualised exercise programme with/without BCE strategies on reducing fatigue in older adults.MethodsA three-armed cluster-randomised controlled trial (RCT) was conducted with 184 participants (mean age: 79.1 ± 6.4; mean frailty score: 2.8 + 0.8) from 21 community centres (ClinicalTrials.gov: NCT03394495). They were randomised into either: the COMB group (n = 64), receiving 16 weeks of exercise training plus the BCE programme; the EXER group (n = 65), receiving exercise training and health talks; or the control group (n = 55), receiving only health talks. Fatigue was assessed using the Multi-dimensional Fatigue Inventory (range: 20 to 100, with higher scores indicating higher fatigue levels) at baseline, and immediately, 6 months, and 12 months post-intervention.ResultsThe GEE analyses showed significant interaction (time x group) between the COMB and control groups immediately (p < 0.001), 6 months (p < 0.001), and 12 months (p < 0.001) post-intervention. Comparing the COMB and EXER groups, there was a significant interaction immediately (p = 0.013) and at 12 months post-intervention (p = 0.007). However, no significant difference was seen between the EXER group and control group at any time point.ConclusionsThe COMB intervention showed better immediate and sustainable effects (i.e., 12 months after the intervention) on reducing fatigue in frail older adults than exercise training or health education alone.Trial registrationClinicalTrials.gov (NCT03394495), registered on 09/01/2018.

Why “mealtime chatter matters”: A process evaluation of a preventive health brief intervention

How parents communicate about food is important for building children’s emotional relationships with food. “Mealtime Chatter Matters” (MCM) is an evidence-informed brief intervention providing behavioral strategies for parents focusing on positive communication at mealtimes. This process study explored parents’ experiences of the brief intervention. Nine mothers participated in interviews, followed by a qualitative inductive analysis. Findings revealed the strengths and weaknesses of MCM and critical reflections of participants’ experiences that can be used to inform future program strategies. This study has important health marketing implications for developing preventive health resources and indicates that future research on mealtime communication is warranted.

Temporal trends of de novo urological malignancy in renal transplant recipients without a cancer history: A longitudinal cohort study.

The incidence of malignancies after successful kidney transplantation has historically been higher than in the general population, with adverse impact on clinical outcomes. However, uncertainty remains as to which cancers occur at what time points after kidney transplantation. We conducted a longitudinal cohort study to investigate the temporal trends and topographic patterns of de novo malignancies to optimize surveillance protocols and improve transplant outcome in renal transplant recipients. Measurement of death and cancer events was performed to calculate the cumulative risk of events of interest. Between 2000 and 2013, 3169 renal transplant recipients were retrospectively screened; 3035 (96%) of them met eligibility criteria and were evaluated with a follow-up of 27612 person-years. There was suboptimal overall survival and malignancy-free survival in renal transplant recipients compared to reference groups (HR: 1.65; 95% CI: 1.50-1.82; p<.001; HR: 2.33; 95% CI: 2.04-2.66; p<.001, respectively). Among renal transplant recipients, urological malignancies were predominant (57.5%), followed by digestive tract malignancies (21.4%). The cancer risks of the urinary bladder and upper urinary tract were lower in male subjects (HR: .48; 95% CI: .33-.72; p<.001; HR: .34; 95% CI: .20-.59; p<.001, respectively). The temporal trends of urological malignancies among renal transplant recipients were expressed in a bimodal pattern, with M-shaped peaks at 3 and 9 years, with gender disparity. In renal transplant recipients, cancer occurrences are shown as M-shaped twin peaks. Our study highlights that specific customized 'targeted' strategies for cancer surveillance programs are required to optimize posttransplant care.

Educational tools to dismantle disparities by addressing social determinants of health

Background: Social determinants of health (SDOH) are personal, social, economic, and environmental factors that contribute to health disparities in the United States. Objectives: To develop educational interventions to teach and assess students’ knowledge about health disparities using a SDOH framework, and design assessment methods to identify theory-based interventions to improve patient health outcomes. Methods: Educational tools utilising a SDOH framework were designed for students to learn about health disparities. A socio-ecological model allowed students to assess multi-level determinants of health and propose more effective interventions. Evidence-based questions were designed to address the health of a specified population. A case study allowed students to apply therapeutic knowledge and clinical interventions to improve patient health. Results: Exactly 44 students enrolled in three iterations of the course and completed pre- and post-surveys. Upon completion, students’ perception of health disparities significantly increased. Conclusion: The SDOH model offers strategies for other pharmacy programs seeking to increase public health-related topics. Students can develop skills to directly apply to a current problem and then build theory to engage in problem-solving. This innovative approach utilising SDOH for pharmacy students positively impacted awareness and knowledge.

Progress and Unfinished Business: Hepatitis B in the United States, 1980-2019.

During 1990-2019, universal infant and childhood vaccination for hepatitis B resulted in a 99% decline in reported cases of acute hepatitis B among children, adolescents, and young adults aged <19 years in the United States; however, during 2010-2019, cases of acute hepatitis B plateaued or increased among adults aged ≥40 years. We conducted a topical review of surveillance strategies that will be critical to support the elimination of hepatitis B as a public health threat in the United States. In 2019, notifiable disease surveillance for acute hepatitis B showed continued transmission, especially among people who inject drugs and people with multiple sexual partners; rates were highest among people who were aged 30-59 years, non-Hispanic White, and living in rural areas. In contrast, newly reported cases of chronic hepatitis B (CHB) were highest among people who were aged 30-49 years, Asian or Pacific Islander, and living in urban areas. The National Health and Nutrition Examination Survey documented the highest CHB prevalence among non-US-born, non-Hispanic Asian people during 2013-2018; only one-third of people with CHB were aware of their infection. In the context of universal adult vaccination (2022) and screening (2023) recommendations for hepatitis B, better data are needed to support programmatic strategies to improve (1) vaccination rates among people with behaviors that put them at risk for transmission and (2) screening and linkage to care among non-US-born people. Surveillance for hepatitis B needs to be strengthened throughout the health care and public health systems.