Transition Program Research Articles

Determinants of access to primary healthcare for formerly incarcerated women transitioning into the community: a systematic review of the literature

BackgroundWomen with a history of incarceration experience significantly poorer health outcomes and encounter barriers to accessing healthcare, both during incarceration and after release. These challenges are more pronounced compared with...

Austerity Measures and the Resilience of Zimbabwe's Healthcare System: Challenges and Solutions.

Austerity measures have become a contentious topic, shaping the landscape of health care systems around the world. As governments grapple with economic challenges, the impact of austerity on health care has emerged as a critical concern. This study focuses on the consequences of austerity actions adopted by the Zimbabwean government under the Transitional Stabilization Program (TSP) from August 2018 to December 2025. This research examines the impact of austerity measures on Zimbabwe's health care sector, exploring its connections with health infrastructure and resources, accessibility and affordability of health care, health funding, health care inequalities, and the health care workforce. Using a quantitative approach and data from 970 participants, including the general populace, health care providers, and government officials, significant positive correlations between austerity measures and these health care variables were identified. The findings indicated a noteworthy positive correlation between the independent variable "austerity measures" and five dependent variables: health care accessibility and affordability, health care inequalities, infrastructure and resources, health care funding, and health care workforce. The t-statistics values exceeded the threshold of 1.96, with values of 5.085, 3.120, 6.459, 8.517, and 3.830, respectively. These findings highlight the importance of considering the effects of austerity on health care access, health funding, health care inequalities, health workforce, health infrastructure and resources development. Policymakers should prioritize equitable resource allocation and targeted investments to strengthen the resilience of the health care system during economic challenges. Understanding these associations is crucial for evidence-based policy decisions and fostering a more equitable and resilient health care system in Zimbabwe.

Transition from paediatric to adult neurological care: What do we know?

IntroductionHealthcare advances have allowed an increase in the survival of paediatric patients with neurological diseases. As a result, it is increasingly common to find these patients in adult neurology consultations. The aim of this study is to evaluate the current level of consensus on the transition of neuropaediatric patients among neurology and paediatric professionals in the Balearic Islands. Material and methodsWe conducted an observational, analytical, cross-sectional study through an anonymous questionnaire consisting of 27 questions, which was distributed to neurologists, paediatric neurologists, hospital paediatricians, and primary care paediatricians in the healthcare network of the Balearic Islands. It was developed using Google Forms and distributed by the competent professional societies. Consensus was considered to exist for answers with 70% or more agreement. ResultsResponses were received from 58 professionals; 46.6% were hospital paediatricians, 29.9% were neurologists, 13.8% were paediatric neurologists, and 13.8% were primary care paediatricians. Among other issues, consensus was observed on the need for a transition programme for patients with neurological diseases. No consensus was observed regarding the duration of the transition (P=.029) and how long simultaneous follow-up must last after the transfer (P=.09). ConclusionsDue to increased survival rates, there is a need to create transition programmes for paediatric patients with neurological diseases. In our study, more than 70% of professionals believed that it would be beneficial to create such programmes.

Critical soft skill competencies that clinical nurse educators consider important to evaluate in nurses.

Guided by Benner's framework, From Novice to Expert, this study aimed to identify (1) critical soft skills to be evaluated in nurses and (2) levels of nursing behaviour indicating achievement of soft skills to provide a framework for developing a soft skills rubric. Nurse shortages are often attributable to high turnover rates among nurses. To improve this situation, healthcare facilities implement transition programmes and continuing education with a primary focus on developing and maintaining nurses' knowledge and performance (hard skills). However, balancing hard and soft skills (beliefs, values and attitudes) is key to nurses' quality of care and ultimately to their retention. Despite the importance of soft skills, their intangible nature creates problems in evaluating nurses' attainment of these skills and in providing constructive feedback to help them set concrete goals for improving their practice. This qualitative descriptive study described critical soft skills in the nursing context. A purposeful sampling strategy was used to enrol 13 clinical nurse educators from multiple hospital units; each had more than 2 years of clinical nurse educator experience and had completed preceptor training. One-to-one interviews with these individuals were audio recorded, transcribed and subjected to direct content analysis using NVivo 12. The study follows the Consolidated criteria for reporting qualitative research (COREQ) guidelines for qualitative studies. Five main competencies, comprising 20 subcompetencies, were identified: personal growth, effective interactions, professionalism, teamwork and the caring role. For each subcompetency, four skill levels were delineated using clinical indicators. This study's findings can enhance understanding of clinical nurse educators' perceptions regarding soft skills required of nurses. The soft skills identified can be incorporated into a rubric to be used by clinical nurse educators to evaluate and guide nurses' professional development and contribute to improving quality of care. No patient or public contribution is required for this study.

An Enhanced Postpartum Transition Program to Primary Care.

Background: Gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) are risk factors for future cardiovascular disease, yet few individuals receive postpartum care with primary care clinicians (PCP). To facilitate transitions of care to PCPs and improve cardiovascular health monitoring within the first 13 months postpartum, we developed and piloted an enhanced postpartum referral pathway for patients with GDM or HDP. Methods: Eligible patients included those who received perinatal care at a large, urban, academic medical center, experienced GDM or HDP during their most recent pregnancy, and lacked an existing PCP. Resident, faculty, and advanced practitioners referred patients during antenatal, delivery-related, or postpartum visits. A dedicated scheduler contacted patients to schedule an appointment with a women's health-focused resident or faculty PCP. The percent of patients who attended a postpartum PCP visit, who had an HbA1c and cholesterol panel checked within the first 13 months postpartum, were compared between patients referred and not referred to the program using adjusted odds ratios (aOR). Results: Of 129 individuals referred, 48.1% attended a PCP visit, 31.8% completed cholesterol screening, and 41.9% completed HbA1c screening within 13 months postpartum. After adjusting for age, parity, insurance, and referral indication, referred individuals had greater odds for each outcome (PCP visit: aOR = 6.0, 95% CI 4.0-9.0; cholesterol: aOR = 2.4, 95% 1.6-3.9; HbA1c: aOR = 2.5, 95% CI 1.7-3.7) compared with nonreferred individuals in the same time period. Discussion: A enhanced postpartum PCP referral pathway pilot for birthing individuals was associated with improved follow-up in the first year postpartum.

An adaptive Epithelial-Mesenchymal Transition Program Enables Basal Epithelial Cells to Bypass Stress-Induced Stasis and Contributes to Metaplastic Breast Cancer Progenitor State.

Human mammary epithelial cell (HMEC) cultures encounter a stress-associated barrier termed stasis, during which most cells adopt a senescence-like phenotype. From these cultures, rare variants emerge from the basal epithelial population, re-initiating growth. Variants exhibit pre-malignant properties, including an aberrant epigenetic program that enables continued proliferation and acquisition of genetic changes. Following oncogenic transformation, variants produce tumors that recapitulate the histopathological characteristics of metaplastic breast cancer (MBC), a rare subtype characterized by squamous and mesenchymal differentiation. Using the conventional serum-free HMEC culture system, we probed the capacity for phenotypic plasticity inherent to basal epithelial cell populations from human breast tissue as they navigated stasis and emerged as variant populations. We observed robust activation of a TGF-β-dependent epithelial-mesenchymal transition (EMT) program in basal epithelial cells during stasis, followed by subsequent attenuation of this program in emerging variants. Inhibiting the TGF-β pathway or depleting the EMT regulators Snail or Slug allowed basal epithelial cells to collectively bypass stasis, demonstrating that cellular dysfunction and arrest resulting from TGF-β and EMT activation are central to this in vitro barrier. The spontaneous emergence of variants from stasis cultures was associated with a restricted EMT trajectory, which diverted cells away from a complete mesenchymal state characterized by irreversible growth arrest, and instead limited variants to epithelial and intermediate EMT states associated with greater proliferative capacity and stemness. Epigenetic mechanisms, which contributed to the dysregulated growth control characteristic of the variant phenotype, also contributed to the constrained EMT program in variants. By overcoming the cellular dysfunction and growth arrest resulting from TGF-β and EMT activation, variants exhibited increased oncogenic transformation efficiency compared to pre-stasis basal epithelial cells. Inhibiting the TGF-β pathway prior to stasis significantly reduced EMT in the basal epithelial population, alleviated selective pressure driving variant emergence, and enhanced oncogenic transformation efficiency, resulting in tumors with markedly diminished metaplastic differentiation. This study reveals how adaptive EMT reprogramming governs basal epithelial cell fate decisions and contributes to the development of MBC progenitors by restricting access to terminal mesenchymal states that induce growth arrest and, instead, favoring intermediate states with enhanced tumorigenic potential.

The Lived Experience of Caregivers in the Older Stroke Survivors' Care Pathway during the Transitional Home Program-A Qualitative Study.

stroke is a major cause of disability and death, globally. Many stroke survivors live with disabilities, requiring significant caregiving support. Caregivers often feel unprepared and burdened, experiencing isolation and health declines. Their well-being and involvement in discharge planning impact post-discharge care quality. to investigate the experiences of caregivers of older stroke survivors regarding their expectations in the care pathway during the transitional home program, as this phenomenon is currently understudied in the present context. by employing a qualitative design, this study utilized a phenomenological approach developed by Cohen. Eighteen caregivers of stroke survivors participated. four main themes emerged from the analysis: (1) the sense of loss experienced by stroke survivors and perceived by caregivers; (2) the importance of social support in the recovery and well-being of both stroke survivors and caregivers; (3) the increased workload of caregivers; and (4) the lack of awareness of the needs during the transition, leading to resignation when facing complications. the findings highlight the significant impact of stroke on caregivers, affecting both the individual characteristics and social relationships of stroke survivors and their caregivers. There is a need for a nuanced understanding of caregivers' roles and responsibilities.

Effectiveness of the 5As Model-Based Transitional Care Program among Chinese Patients with Type B Aortic Dissection Post-TEVAR: A Randomized Controlled Trial.

Thoracic aortic endovascular repair (TEVAR) is the primary treatment for Stanford type B aortic dissection (type B AD). However, patients often encounter significant difficulties post-TEVAR that endanger their safety when transitioning from hospital- to home-based care. Moreover, information on the ideal transitional care for patients with type B AD post-TEVAR is scarce in China. This single-masked randomized clinical trial aimed to assess the effectiveness of the Assess, Advise, Agree, Assist, and Arrange (5As) model-based transitional care in improving discharge preparation level and transitional care quality post-TEVAR among patients with type B AD in China. This study was conducted at a hospital in China between January 2021 and October 2021. Patients with type B AD were randomly divided into intervention and control groups. Participants in the intervention group received the 5As model-based transitional nursing care. The 5As model is an evidence-based intervention strategy comprising: (1) Assess: assessing the preoperative cardiovascular risk behavior of patients with AD. (2) Advise: making suggestions according to the risk behaviors of the patients. (3) Agree: reaching a consensus on goals and action plans by making decisions with the patients and their families. (4) Assist: assisting patients in solving obstacles to implementing health plans. (5) Arrange: arranging follow-up visits according to the actual situation of the patients and guiding them in adhering to a schedule. The control group received the usual nursing care for the same duration and number of follow-up visits. A trained research nurse collected all the baseline data of the patients on admission, assessed discharge readiness level (using the Readiness for Hospital Discharge Scale) on the day of discharge, and collected transitional quality of care (by the Care Transition Measure-15) data on day 30 after discharge. Overall, 72 patients with type B AD were recruited. Discharge readiness level and transitional care quality in the intervention group were significantly superior to those in the control group. This study showed that the 5As model-based transitional care program can effectively promote discharge readiness and transitional care quality of patients with type B AD post-TEVAR. The Chinese Clinical Trial Registry Center: ChiCTR2200060797 (https://www.chictr.org.cn/showproj.html?proj=167403).

Induction of Invasive Basal Phenotype in Triple-Negative Breast Cancers by Long Noncoding RNA BORG.

Long noncoding RNAs (lncRNAs) are known to play key roles in breast cancers; however, detailed mechanistic studies of lncRNA function have not been conducted in large cohorts of breast cancer tumors, nor has inter-donor and inter-subtype variability been taken into consideration for these analyses. Here we provide the first identification and annotation of the human BORG lncRNA gene. Using multiple tumor cohorts of human breast cancers, we show that while BORG expression is strongly induced in breast tumors as compared to normal breast tissues, the extent of BORG induction varies widely between breast cancer subtypes and even between different tumors within the same subtype. Elevated levels of BORG in breast tumors are associated with the acquisition of core cancer aggression pathways, including those associated with basal tumor and pluripotency phenotypes and with epithelial-mesenchymal transition (EMT) programs. While a subset of BORG-associated pathways was present in high BORG-expressing tumors across all breast cancer subtypes, many were specific to tumors categorized as triple-negative breast cancers. Finally, we show that genes induced by heterologous expression of BORG in murine models of TNBC both in vitro and in vivo strongly overlap with those associated with high BORG expression levels in human TNBC tumors. Our findings implicate human BORG as a novel driver of the highly aggressive basal TNBC tumor phenotype.

ERN eUROGEN Guidelines on the Management of Anorectal Malformations Part III: Lifelong Follow-up and Transition of Care

Abstract Introduction Anorectal malformations (ARMs) are complex congenital anomalies of the anorectal region, oftentimes also affecting the genitourinary system. Although successful surgical correction can often be achieved in the neonatal period, many children will experience functional problems in the long term. The European Reference Network for rare and complex urogenital conditions (eUROGEN) assembled a panel of experts to address these challenges and develop comprehensive guidelines for the management of ARM. Methods The Dutch Quality Standard for ARM served as the foundation for the development of guidelines applicable on a European level. Literature was searched in Medline, Embase, and Cochrane. The ADAPTE method was utilized to incorporate the newest available evidence. A panel of 15 experts from 7 European countries assessed currency, acceptability, and applicability of recommendations. Recommendations from the Dutch Quality Standard were adapted, adopted, or rejected and recommendations were formed considering the current evidence and/or expert consensus. Results Lifelong follow-up, integration, and transition of care were assessed. A total of eight new studies were identified. The panel adapted 18 recommendations, adopted 6, and developed 6 de novo. Overall, the level of evidence was considered low. Conclusion Successful lifelong follow-up and transition of care require a dedicated team of pediatric and adult specialist and an individually tailored patient-centered approach. This guideline summarizes the best available evidence on follow-up of ARM patients and provides guidance for the development of structured transition programs.

Challenges and opportunities in transitional care process in Behçet's syndrome.

Behçet's syndrome (BS) is a rare chronic multi-systemic inflammatory disorder that usually involves adults between third and fourth decades of life, while pediatric and juvenile onset are relatively rare. BS young patients (YP) often develop a full-blown disease late after onset, requiring careful diagnostic workup and regular follow-up while they grow up. In this regard, the purpose of transitional programs is to ensure continuous high-quality care to YP with chronic conditions, providing them with the skills necessary to become independent and empowered adults able to chronically self-manage their disease. EULAR/PReS released the first set of standards and recommendations for transitional care (TC) of YP with juvenile-onset rheumatic diseases, but the appropriate timing for transition, the tools to evaluate patients' readiness, and indicators of transition plans effectiveness still need to be identified. Although little is known regarding TC in BS, it is easy to assume that BS YP will benefit from developmentally and disease-specifically appropriate transition plans, which may promote continuity of care, improve perceived quality of life and prevent poor disease outcomes. This perspective article discusses the key concepts and the goals of TC, addressing the potential challenges and opportunities of TC for YP with BS in clinical practice.

Operationalizing Predictors of Postschool Success in Secondary Transition: A Delphi Study

To improve postschool outcomes for students with disabilities, research in secondary transition has increasingly aimed to identify in-school experiences that contribute to positive outcomes after high school. Although research on postschool success for this population has recently identified seven new predictors, operational definitions and essential program characteristics remain missing. Therefore, the purpose of this Delphi study was to operationally define the seven newest predictors of postschool success in secondary transition and identify their essential program characteristics. Experts in the field of secondary transition reached consensus on an operational definition and a set of essential program characteristics for each of the seven newest predictors of postschool success. These definitions and essential program characteristics provide additional information needed to develop, implement, and evaluate effective secondary transition programs. Moreover, these results continue to move research to practice in meaningful and actionable ways. Suggestions for further research and implications are discussed.

Locked-in to Dirty Fuel for Cooking: A Micro-Ethnographic Study in a Rural Area in Nusa Tenggara Timur, Indonesia

Ensuring sufficient access to clean and safe energy is a pre-requisite for enhancing the quality of human life. However, in some regions, such as Pitai village in Nusa Tenggara Timur, East Indonesia, people face challenges in accessing safe and clean energy, leading to the problem of energy poverty. Despite the government’s introduction of LPG in 2007, many households in Pitai continue to rely on firewood for cooking fuel. This article aims to investigate why most rural households in Pitai, Kupang and Nusa Tenggara Timur are still trapped in using dirty fuels like firewood, and how they perceived and accepted LPG after the national transition programme. To achieve this, a micro-ethnography study was conducted in Pitai village. The study’s results reveal that most of the community still prefers using firewood, which is more comfortable than LPG. Additionally, an inadequate supply of LPG, coupled with the abandonment of the firewood supply, has led to a lack of interest in adopting LPG. Consequently, the price of LPG remains higher than that of firewood, further discouraging its adoption. Addressing the issue of energy poverty in Pitai requires a comprehensive approach by the government involving providing adequate LPG supply and initiatives to raise awareness and change perceptions about LPG usage. By overcoming these challenges, the community can transition towards cleaner and safer energy sources, improving their overall quality of life. On the other hand, the government must address the accessibility and affordability of the LPG supply chain to inland areas, taking into account the challenges posed by the archipelagic nature of the country.

Abstract C061: Loss of CaMK2B accelerates tumor formation and enhances metastatic competency in genetically engineered mouse models of PDAC

Abstract Background Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer- related deaths in the United States and is often not diagnosed until it has already metastasized. Our prior work established that calcium signaling pathways facilitate a pro-metastatic phenotype through the induction of an epithelial-to-mesenchymal transition (EMT) program in PDAC tumor cells, but the downstream signaling molecules mediating this phenotype have remained elusive. MethodsUsing a novel genetically engineered model of pancreatic cancer, we demonstrate that loss of Calcium/calmodulin-dependent kinase-II B (CaMK2B), a downstream effector kinase activated by calcium, enhances cellular plasticity, and increases metastasis. To this end, we generated a genetically engineered mouse model where Camk2b was knocked out in tumor cells in a lineage-labeled Kras- and p53-driven PDAC mouse model (herein KPCY-Camk2bcKO). Results Genetic deletion of Camk2b in the KPCY genetically engineered model accelerated tumor formation and dramatically reduced the overall median survival of KPCY- Camk2b cKO mice (78 days) relative to KPCY controls (136 days). Pathological and immunofluorescence analysis of KPCY-Camk2b cKO animals showed an increased number of poorly differentiated tumor regions and a higher metastatic burden, with >85% of KPCY- Camk2b cKO animals presenting with multi-focal metastases. Further analysis of tumor cells in KPCY-Camk2b cKO mice showed enhanced expression of markers of the highly aggressive squamous PDAC subtypes. Strikingly, Camk2b deletion combined with oncogenic Kras G12D (in the absence of p53 alterations), was sufficient to form lethal metastatic PDAC tumors, while age-matched control Kras G12D tumors with intact Camk2b only progressed to the acinar-to-ductal metaplasia (ADM) or Pancreatic Intraepithelial Neoplasia (PanIN) stage. Collectively, these results establish Camk2b loss as a new oncogenic and pro-metastatic mechanism in PDAC Conclusion This work demonstrates that Camk2b loss enhances tumor cell evolution and plasticity within PDAC to promote metastasis. In this context, we speculate that loss of Camk2b rewires calcium signaling to drive an aggressive subtype of PDAC with increased metastasis. Citation Format: Jessica Peura, Nikita Bhalerao, Calvin Johnson, Yamini Ogoti, Faith Keller, Emma Watson, Zhen Zhao, Jason Pitarresi. Loss of CaMK2B accelerates tumor formation and enhances metastatic competency in genetically engineered mouse models of PDAC [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr C061.

“English Is Not Really a Subject”: Language Ideologies and Language Learning in an Introduction Program

AbstractThis paper explores the construction of language ideologies and language learning within English‐language education in a Language Introduction Program (LIP) in Sweden. LIP is an individual transitional program for newly arrived migrant students that seeks to quickly transition adolescents into further education or the job market. High proficiency in English is important in Swedish society and insufficient knowledge of English might lead to consequences for individuals, but also long‐term consequences for society regarding inequality and inequity. The methodology is based on linguistic ethnography, with observations and interviews at two schools. Data from interviews with English teachers and principals at LIP are analyzed using Foucauldian perspectives to discuss power and individualization. Our results show that LIP is organized in a manner that reduces teachers' possibilities to cooperate and assist each other in planning, assessing, and in developing teaching practices. To a certain extent, principals withdraw from their responsibility and place a significant amount of organizational responsibility on individual English teachers. Furthermore, monolingual ideologies are prominent in educational practices, and LIP is often positioned as different from the rest of the school which increases isolation.

Interests, Plans, and Hopes for Life After High School From Autistic Young Adults’ Perspectives

Obtaining the perspectives of autistic young adults is critical for planning educational and service delivery systems focused on the preparation for a high life quality after high school. The perspective and voice of autistic young adults who participated in the Center on Secondary Education for Students with Autism (CSESA) multi-site follow-up study conducted across three states (North Carolina, Wisconsin, and California) are described. Participants who exited high school or were enrolled in a district transition program responded to short-answer items on a Young Adult Questionnaire and Interview ( n = 148) and completed the Adolescent and Young Adult Activity Card Sort (Berg, 2015; n = 150) to address research questions about their current interests, future plans, and perceived barriers to fulfilling future plans using descriptive statistics and coding of interview responses. The young adults report current engagement in leisure activities, and 79% seek a job change and the opportunity to date and engage in a long-term relationship.

Association of internship with performance on American Board of Physical Medicine and Rehabilitation certification examinations.

Physical Medicine and Rehabilitation (PM&R) residents must complete twelve months of fundamental skills training prior to beginning PM&R residency. The objective of this study is to determine if characteristics of the first post-graduate year (PGY-1) impact performance on American Board of PM&R (ABPMR) initial certification examinations. A retrospective review was conducted on a deidentified ABPMR database of physicians who completed PM&R residency and took the Part I Examination between 2008 and 2022. Physicians who completed categorical residency programs in PM&R had higher pass rates on Part I than physicians who completed advanced programs. Physicians who completed a categorical program had higher scaled scores on the Part II Examination than physicians who completed either a transitional or non-transitional advanced program but pass rates did not differ. Completing less than 3 months of training in internal medicine prior to starting PM&R was associated with lower Part I and Part II Examination scaled scores than completing 3 or more months. Physicians who completed six or more months of internal medicine had higher Part I and Part II Examination pass rates and scaled scores than physicians who completed six or more months in surgery.

Health status, functioning and risk profiles for secondary health conditions in adolescents and young adults with spina bifida: a cross-sectional study at time of transition.

The transition from paediatric to adult medical care is a critical period for adolescents with spina bifida, often marked by deteriorating health and functional status. To describe the health status and functioning of individuals with spina bifida at the time of transition from paediatric to adult care and to identify risk profiles for potentially modifiable secondary health conditions (urinary tract infections, pressure injuries, respiratory problems and obesity). Descriptive study of data (derived from medical records) from all adolescents and young adults with spina bifida aged 15-25 years who were referred to a single specialised spinal cord injury centre as part of the transition programme during the period from 1 September 2015 to 31 May 2022. Descriptive statistics were used to describe the study population and to analyse the frequency and co-occurrence of congenital and acquired secondary health conditions. The equality of proportions test was used to test the prevalence of secondary health conditions based on important personal and clinical characteristics. We included 43 adolescents with spina bifida with a mean age of 18.4 years (SD 2.5); in 63% of them the neurological level was lumbar, and around 50% of them were wheelchair-dependent. The median Spinal Cord Injury Measure (SCIM) III score was 72 (IQR 61-89). The mean number of secondary health conditions at time of transition was 8.8. The most prevalent secondary health conditions were lower urinary tract dysfunction, bowel dysfunction, sexual dysfunction and contractures. Respiratory problems were more prevalent in females and in individuals with lower SCIM III scores, whereas no differences were observed in the prevalence of other modifiable secondary health conditions. Clustering of secondary health conditions was mainly seen for urinary tract infection + pressure injury and for urinary tract infection + pressure injury + obesity. The prevalence of secondary health conditions among individuals with spina bifida at time of transition is alarmingly high and functional profiles underscore the need for supporting adolescents and young adults with daily medical issues. The study highlights the critical role of transition programmes and interdisciplinary follow-up care in preventing health problems and improving functioning and independence in everyday life.

Can energy transition interventions promote financial inclusion? Measuring unintended effects of Ghana's energy transition program

Global concerns about climate change and its effects and the quest for sustainable development have necessitated policy actions, including energy interventions. Besides the intended goal of energy transition, these interventions often have unintended impacts, which ought to be measured when assessing the overall effects of these energy interventions. This study investigated the impact of a clean cooking fuel transition program in Ghana on financial inclusion. It used a cross-sectional survey of over 900 households in two districts in Ghana where a clean energy transition intervention had been implemented. The study employed linear probability and matching techniques and found that clean energy interventions can promote financial inclusion among beneficiary households. The probability of being significantly associated with financial inclusion is at least 6.6% higher for treated households than it is for households that did not benefit from the program. The findings are robust across different outcome variables and the potential transmission mechanisms are discussed. The study provides evidence for policymakers to count the effect of financial inclusion in measuring the program's overall impact. Furthermore, the findings underscore the need for policies that provide the needed infrastructure and financial ‘ecosystem’ to support financial inclusion, particularly in rural areas where the energy interventions are implemented.

Assessment of patients' baseline cystic fibrosis knowledge levels following translation and adaptation of the CF R.I.S.E translation program into Turkish.

Cystic fibrosis (CF) patients have a limited life expectancy, but significant medical advances now highlight the need for successful transition programs from pediatric to adult care. The goal of this project was to introduce the transition program CF R.I.S.E (Responsibility. Independence. Self-care. Education.) to a CF center with limited resources at Marmara University (MU). The program was adapted and translated into Turkish with the CF Foundation's permission. A team of experts collaborated to develop educational materials for patients and families. After translation and implementation of the CF S.O.B.E program, 11 Knowledge Assessment Questionnaire (KQA) tests were administered online to the patients aged between 16 and 25 years to assess the lack of patient knowledge. The CF R.I.S.E program was successfully implemented within 6 months. A pilot study showed positive feedback from randomly selected patients, indicating the program's effectiveness and understandability. The mean age of the patients was 19.4 ± 2.9 years, and 42 (52%) were female. The mean forced expiratory volume (FEV1pp) was 76.3 ± 23.2. Fourteen (17.3%) and 4 (4.9%) of the patients colonized with Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (MRSA), respectively. Fifteen (18.5%) were on modulator therapy. Eleven Knowledge Assessment Questionnaires (KAQ) surveys were administered to 81 patients. The percentage of correct responses to the KAQs ranged from 47.9% to 68.3%. MU CF Center in Turkey implemented the CF S.O.B.E (Responsibility, Self-care, Independence, and Education in Turkish) program. The center aims to make the program a regular practice and expand collaboration with adult clinics. Future studies will assess its long-term impact and applicability in different health settings. The final goal is to disseminate the program's resources and promote structured transition practices across the country.