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Objective To explore the relationship between the interaction of health literacy and mobile phone dependence and sub - health status of college students, so as to provide evidence - based evidence for improving sub - health status of college students. Methods Cluster sampling was used to investigate the social demographic characteristics, health literacy, mobile phone dependence and sub - health of college students in Shandong Second Medical University. logistic regression model was used to analyze the correlation between each factor and sub - health status, and the interaction between health literacy and mobile phone dependence and sub - health status was analyzed. Results The total detection rates of mobile phone dependence and sub - health were 83. 8% (461/550) and 66. 7% (367/550), respectively. After adjusting relevant variables, logistic regression analysis found that college students with low health literacy and dependence on mobile phones had the highest risk of sub - health, which was 31. 901 times that of college students with high health literacy and no dependence on mobile phones, and the college students without mobile phone dependence and high health literacy were taken as the reference group, and mobile phone dependence and medium and low health literacy had positive synergistic interactions with sub - health, OR values were 5. 030 (95% CI: 3. 079 - 8. 217) and 8. 014 (95% CI: 4. 404 - 14. 583) . The calculated relative values of RERI, AP and SI didn't meet the conditions and cannot indicate the existence of additive interaction. Conclusion The interaction between health literacy and mobile phone dependence is associated with sub - health status of college students, which can be used as an evidence - based basis to improve health. [ABSTRACT FROM AUTHOR]

Introduction: The Caries Impacts and Experiences Questionnaire for Children (CARIES-QC) is a disease-specific questionnaire that assesses the impact of caries on the oral health-related quality of life of children. This study aimed to establish a baseline for caries-specific impact on schoolchildren in Saudi Arabia and to examine its association with dental care utilization. Methods: This cross-sectional study used random stratified cluster sampling among 4th–6th graders in Jeddah. Two surveys were administered: (1) a general parental survey and (2) CARIES-QC, a self-reported survey for children. Clinical examinations were conducted using the decayed, missing due to caries, and filled teeth (DMFT/dmft) index. Descriptive statistics provided CARIES-QC baseline estimates, and multilevel linear regression was performed to examine the relationships between CARIES-QC scores, DMFT/dmft index, and care utilization. Results: A total of 805 children aged 8–13 years participated. The overall median CARIES-QC score was six (interquartile range, 3–11). A higher DMFT/dmft index was associated with a higher CARIES-QC score (p < 0.05). Children who had never visited a dentist had lower CARIES-QC scores (β = −1.18, 95% confidence interval: −2.33; −0.02, p = 0.045) than those who had visited a dentist in the past 12 months. After adjusting for reasons for dental visits, the CARIES-QC scores were not associated with prior dental visits (p = 0.086). Conclusion: A higher DMFT/dmft index was associated with higher CARIES-QC scores, but prior dental care utilization was not significantly associated with improved CARIES-QC scores. Future research should explore other factors that influence the relationship between care utilization and caries-specific quality of life. [ABSTRACT FROM AUTHOR]

Objective: This study aims to examine the influence of socio-economic status (SES) on the national identity of youth aged 18-30 in District 1 of Shiraz, Iran. Methods and Materials: A descriptive-correlational research design was employed, with a sample of 384 youth selected through multi-stage cluster sampling. Data were collected using a structured questionnaire that assessed SES and national identity. The questionnaire was self-administered, and the data were analyzed using SPSS and SMART PLS software. Descriptive statistics, factor loadings, and structural equation modeling (SEM) were used to explore the relationships between variables. Findings: The results indicate that SES significantly influences national identity among youth in Shiraz. Higher levels of education, income, and occupational status were associated with stronger national identity. Additionally, mental wellbeing, linked to SES, was found to play a critical role in the development of national identity. The study also found that cultural capital, tied to family affluence, significantly contributes to national identity, with youth from higher SES backgrounds exhibiting a stronger sense of national belonging. Conclusion: The findings suggest that socio-economic status is a critical determinant of national identity among youth. Educational attainment, income, and occupational status, along with mental well-being and cultural capital, are key factors that influence how youth perceive and engage with their national identity. The study highlights the need for targeted interventions to address socio-economic disparities and promote a strong, inclusive national identity. [ABSTRACT FROM AUTHOR]

Background: Although challenges in breastfeeding are more common in mothers of preterm infants, maternal breastfeeding self-efficacy is a modifiable factor that may improve breastfeeding rates. Objective: To evaluate the factors affecting breastfeeding self-efficacy among mothers with preterm babies. Design: A cross-sectional study. Methods: This study was carried out using a double-stage cluster sampling method. In total, 360 mothers of preterm infants under 6 months of age were included. Data were collected using sociodemographic characteristics, Breastfeeding Self-efficacy Scale-Short Form (BSES-SF), multiple scales of perceived social support, and Depression, Anxiety, and Stress questionnaires. Results: The results showed social support (15.6%), depression (12.2%), anxiety (11%), and stress (12.2%) contributed independently, and together they explained 25% of the variance in BSES-SF. The higher levels of social support (β = 0.283), lower levels of mental health problems (β = −0.340), having breastfeeding experience (β = −0.253), and higher gestational age at birth (β = 0.106) were significantly related to the high level of BSES-SF. Conclusion: These findings can help healthcare providers be aware of effective factors in improving breastfeeding self-efficacy. Increased access to counselors, active support for mothers after preterm labor, and increased support facilities for mothers with preterm delivery may be helpful to improve breastfeeding self-efficacy. Plain language summary: Can the status of social support and psychological factors of women with preterm babies affect their breastfeeding efficiency? Why we did this study: There is little evidence of current factors affecting breastfeeding self-efficacy among mothers of preterm infants in Iran. What we wanted to learn: We wanted to know, if there is a relationship between perceived social support and the mental health of mothers with preterm babies, their self-efficacy, and their sense of breastfeeding ability. Additionally, we investigated the impact of other socio-demographic factors. What we did: We asked mothers of preterm infants to complete breastfeeding self-efficacy, perceived social support, and depression, anxiety, and stress questionnaires. What we learned: We found that Iranian mothers of preterm infants had very low rates of breastfeeding self-efficacy. Factors associated with breastfeeding self-efficacy included higher levels of social support, lower levels of mental health problems, previous breastfeeding experience, and higher gestational age at birth. Support and education are needed for mothers of preterm infants and their families to facilitate breastfeeding. [ABSTRACT FROM AUTHOR]

Background/Objectives: Hand grip strength (HGS) reflects muscle strength and is an important indicator of sarcopenia. There is a gap in the research regarding the determinants of relative HGS that take sex differences into account. Therefore, this study aimed to evaluate the association between relative HGS and physical, behavioral, and psychological factors in menopausal women from South Korea. Methods: This study used data obtained from the 7th National Health and Nutrition Examination Survey (2016–2018), which had a complex, stratified, and multistage sample design. A total of 2129 menopausal women aged between 40 and 64 were included in this cross-sectional study. To evaluate physical, behavioral, and psychological factors associated with relative HGS, a multiple regression analysis was used. Results: In this study, the sociodemographic factors that influenced relative HGS were education (high school: B = 0.03, p = 0.001; college: B = 0.04, p = 0.003) and marital status (live with: B = 0.04, p = 0.004). Among the physical factors, abdominal obesity (B = −0.16, p < 0.001) and comorbidities (B = −0.03, p = 0.026) were associated with a significantly lower relative HGS. Regarding behavioral factors, relative HGS was significantly lower for those who slept more than 8 h (B = −0.03, p = 0.041) than for those who slept 6–8 h. Regarding psychological factors, relative HGS was significantly higher for those with fair (B = 0.04, p = 0.001) and good (B = 0.06, p < 0.001) self-rated health. Conclusions: Relative HGS is associated with physical, behavioral, and psychological factors in menopausal women. These findings can inform research and guidelines for sarcopenia prevention using relative HGS as an indicator of health status. [ABSTRACT FROM AUTHOR]

Objective: We aimed to determine the prevalence and factors associated with loneliness among adolescent students in three South Asian countries.Methods: We used data from the latest Global School-Based Health Survey of Afghanistan, Bangladesh, and Pakistan. A two-stage cluster sampling design was used to collect the cross-sectional survey data. Data from 8 089 in-school adolescents were analysed using STATA 14.0.Results: Among all the participants, the prevalence of loneliness was 14.9%. The prevalence of loneliness was significantly higher in females (19.7%), Afghan adolescents (35.5%), participants having anxiety-induced sleep disturbance (51.4%), often experiencing bullying (28.9%), feeling hungry often or always (23.9%), suffering parental emotional neglect (21.2%), and spending ≥ 8 hours/day leisure time (35.8%), than their counterparts. The final adjusted model of multiple logistic regression showed that females (OR = 1.36, 95% CI: 1.02 –1.80), having no close friends (OR = 2.00, 95% CI: 1.30 – 3.10), having an anxiety-induced sleep disturbance (OR = 5.25, 95% CI: 3.75 – 7.34), being bullied 1 to 2 days in the past month (OR = 2.13, 95% CI: 1.60 – 2.84), being physically attacked 2 or more times in the past year (OR = 1.69, 95% CI: 1.26 – 2.26), suffering parental emotional neglect (OR = 1.67, 95% CI: 1.18–2.34), and current tobacco user (OR = 2.70, 95% CI: 1.39 – 5.25) had significantly higher odds of having loneliness.Conclusion: We found a higher prevalence of loneliness and identified several risk factors among in-school adolescents in three South Asian countries. To reduce loneliness among in-school adolescents, target-oriented interventions, such as peer, parental, and counselling support, are needed at schools. [ABSTRACT FROM AUTHOR]

Background: Chronic diseases contribute significantly to global morbidity and mortality, with their prevalence projected to rise due to lifestyle changes and socioeconomic factors. This study examines the prevalence and determinants of chronic diseases in Somaliland, utilizing data from the 2020 Somaliland Demographic and Health Survey (SLDHS) data. Methodology: The SLDHS employed a stratified multi-stage probability cluster sampling technique to select 5,994 households. Data was collected using computer-assisted personal interviewing (CAPI) through smartphones. The study analyzed data from 5,709 individuals to assess the prevalence and determinants of chronic diseases. Results: The study revealed a significant prevalence rate of 8.25% for chronic diseases in Somaliland. Several risk factors were identified, including smoking, age, obesity, regional disparities, marital status, and Khat chewing. Individuals residing in the Sool region had a significantly higher risk of developing chronic diseases (Adjusted Odds Ratio (AOR) = 2.31; 95% CI 1.594–3.348) compared to those in the Awdal region. Individuals who were abandoned had a significantly higher likelihood of experiencing chronic diseases (AOR = 2.631; 95% CI 1.042–6.646) compared to those who were married. Widowed individuals also had a significantly higher likelihood of experiencing chronic diseases (AOR = 1.759; 95% CI 1.006–3.076) compared to those who were married. Individuals classified as obese had a significantly higher odds ratio of having a chronic disease (AOR = 2.013; 95% CI 1.354–2.994) compared to those who were underweight. Conclusion: The significant prevalence of chronic diseases in Somaliland necessitates immediate preventive interventions and targeted strategies. Addressing risk factors such as smoking, age-related vulnerabilities, obesity, regional disparities, marital status, and Khat chewing is crucial to reduce the burden of chronic diseases. Future research should focus on longitudinal designs and broader risk factor analysis to inform effective prevention and control strategies. [ABSTRACT FROM AUTHOR]

Background: The use of Anabolic-androgenic steroids (AAS) among gym members has become a significant concern due to their impact on physical training and performance. Research worldwide indicates a notable prevalence of AAS use among athletes and gym attendees, often involving substances that are neither safe nor legal. Objectives: This study aims to determine the prevalence of AAS use among gym attendees in Amman, Jordan, and to explore the knowledge, attitudes, and behaviors associated with AAS use. Methods: The study involved 399 participants from 35 randomly selected gyms in the metropolitan area of Amman, Jordan. A cluster sampling technique was used to select a diverse and representative sample of gym attendees. Data was collected using a self-administered questionnaire that assessed AAS use, knowledge, attitudes, and behavioral factors. Statistical analyses were conducted using chi-square tests to explore the relationships between AAS use and categorical variables, while logistic regression was employed to identify predictors of AAS use. Results: The analysis revealed significant associations between AAS use and various factors, including knowledge, attitudes, behavioral factors, and demographic variables such as gender, age, exercise frequency, reasons for exercise, and total exercise duration. The study identified key predictors of AAS use among gym attendees in Amman, highlighting the importance of demographic and behavioral factors. Conclusion: The findings underscore the need for targeted interventions to address misconceptions and promote safer practices among gym-goers in Amman. The study provides critical insights that can guide the development of strategies, policy adjustments, and educational initiatives aimed at reducing AAS misuse and fostering a healthier gym culture in the region. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the mediating role of early maladaptive schemas in the relationship between individual and contextual risk-protective factors and attitudes towards substance use in adolescents. Methods and Materials: The statistical population of this research included all high school students in Gorgan city. A sample of 400 individuals was selected through multi-stage cluster sampling. The research instruments included the Young Schema Questionnaire-Short Form (Young, 1998), the Risk and Protective Factors Scale (Mohammad Khani, 2007), and the Substance Use Attitude Questionnaire (Delavar et al., 2004). Data analysis was conducted using structural equation modeling in the PLS software. Findings: The findings indicated that the model, which included individual and contextual risk/protective factors as predictors of substance use, significantly explained the variance in scores attributed to the mediating variables of impaired autonomy and performance, impaired limits, other-directedness, and hypervigilance. Additionally, the model, which included individual and contextual risk/protective factors as predictors of substance use, significantly explained the variance in scores attributed to the criterion variable of attitudes towards substance use. Conclusion: Based on the results, it can be concluded that maladaptive schemas can explain part of the shared variance between the two factors, risk/protective factors, and attitudes towards substance use in adolescents. In fact, maladaptive schemas play a mediating role in the relationship between risk/protective factors and attitudes towards substance use. [ABSTRACT FROM AUTHOR]

Introduction: Hypertensive patients may lack time to visit clinics and attend educational sessions, resulting in poor blood pressure control. Uncontrolled blood pressure in people with hypertension can increase the risk of heart disease and stroke. Objective: The specific purpose of this study was to determine the effect of online group education on knowledge, motivation, self-efficacy, self-care behavior, and blood pressure control of hypertensive patients. Method: The research method used a quasi-experiment method. The subjects were hypertensive patients in Indonesia. The sampling technique used was cluster random sampling. Total sampling consisted of 96 participants, consisting of 48 intervention groups and 48 control groups. The inclusion criteria in the study were patients with primary hypertension who were willing to become research respondents. The exclusion criteria in this study were respondents who were sick and unable to follow therapy, had hearing problems, and had complications of other diseases (kidney disease, heart disease, diabetes mellitus, and stroke). Data collection methods include observation. The instruments used were the HKLS, HBP-SCP questionnaire, and Sphygmomanometer digital. Result: Data analysis using repeated ANOVA and Friedman tests. There was a significant decrease in systolic (p <.001) and diastolic (p =.001) blood pressure and an increase in knowledge (p <.001), motivation (p <.001), self-efficacy (p <.001), and self-care behavior (p <.001) in the intervention group. Conclusion: Online group education effectively reduces blood pressure and increases self-care behaviors in hypertensive patients. [ABSTRACT FROM AUTHOR]

To explore the potential categories of problem behaviours among high school students and their relationships with parental support and optimism–pessimism, a cluster sampling method was utilized to survey 682 first‐ and second‐year high school students. The results of the latent profile analysis indicated: (1) There were differences between male and female students across various dimensions of problem behaviours, with males scoring significantly higher in aggressive behaviour and delinquency, whereas females scored significantly higher in withdrawal behaviour, neuroticism and exam anxiety. (2) The study identified three latent categories of high school students based on their problem behaviours: the low‐risk group, the moderate‐risk group and the high‐risk group. The majority of students with problem behaviours belong to the low and moderate‐risk groups, suggesting that most high school students exhibit problem behaviours at a moderate or low level. (3) As environmental and individual factors, respectively, parental support and optimism–pessimism have a correlation with problem behaviours among high school students. The above research findings can assist educators in developing more targeted prevention and intervention strategies for different categories of high school students based on their levels of problem behaviours. [ABSTRACT FROM AUTHOR]

Purpose: As future doctors, medical students' prosocial behaviors may affect the relationship between doctors and patients. This study aims to explore the effects of trait mindfulness on prosocial behaviors, as well as the mediating role of psychological capital and the moderating role of moral identity among medical students. Methods: A cross-sectional survey was conducted between July and October 2023 across four medical colleges in China, using cluster random sampling. The questionnaire included general demographic information, the Prosocial Tendencies Measurement Scale, the Five-Facet Mindfulness Questionnaire, the Psychological Capital Questionnaire, and the Moral Identity Scale. The SPSS 25.0 and PROCESS v3.4 macro were used for descriptive statistics, correlation analysis, and mediation and moderation analyses. Results: A total of 2,285 samples were included. The analyses showed that prosocial behavior was positively correlated with trait mindfulness, psychological capital, and moral identity (r = 0.293, 0.444, and 0.528, p < 0.01); trait mindfulness predicts prosocial behavior (β = 0.292, 95% CI [0.253, 0.332]); and psychological capital played a partial mediation role between trait mindfulness and prosocial behaviors (β = 0.413, 95% CI [0.368, 0.459]). Furthermore, moral identity played the moderating roles between trait mindfulness and prosocial behavior (β = 0.049, 95% CI [0.011, 0.087]) and between PsyCap and prosocial behavior (β = 0.062, 95% CI [0.032, 0.092]). Conclusion: Trait mindfulness, psychological capital, and moral identity are conducive to the development of medical students' prosocial behavior. These findings provide evidence for the cultivation of prosocial behaviors and for the development of mental health courses, which should be tailored to medical students. [ABSTRACT FROM AUTHOR]

Head lice infestations significantly impact schoolchildren, with permethrin being the primary treatment. The escalation in the prevalence of the knockdown resistance (kdr) mutation, potentially affecting treatment efficacy, is highly concerning. This study examined head lice infestation prevalence, the efficacy of 1% permethrin lotion, kdr mutation frequency, and the association between kdr genotype and permethrin treatment outcomes in schoolchildren in Nonthaburi province, Thailand. Participants and lice samples were collected from six primary schools using cluster sampling. Clinical outcomes and adverse events were assessed on days 7 and 14 post-treatment. Kdr mutations (T917I) in head lice samples were analyzed using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Head lice infestation prevalence was 6.1%, with a kdr mutation frequency of 63.2% and a permethrin cure rate of approximately 50%. Multivariate regression analysis revealed the association between kdr genotype and clinical response to permethrin treatment (Odds Ratio (OR) = 13.15, p = 0.005). The presence of resistance genes hinders the cure rate (presence 35.9% versus absence 85.7%). These findings highlight the importance of the kdr genotype in predicting permethrin treatment responses in head lice infestations. Furthermore, in regions with documented reduced permethrin efficacy and a high prevalence of kdr mutations, alternative non-pyrethroid-based pediculicides should be considered. This research could help improve the control of head lice infestations, especially in problematic areas of Thailand. [ABSTRACT FROM AUTHOR]

Background: In baseline trachoma prevalence surveys, six districts in two governorates of Yemen were identified as requiring interventions. We set out to estimate the prevalence of trachoma 6−12 months after one round of antibiotic mass drug administration (MDA) and implementation of measures to encourage facial cleanliness. Methods: A population-based prevalence survey was conducted in each of the four evaluation units in October 2019. Contemporary World Health Organization recommendations for trachoma surveys were followed. Participants were selected using a two-stage cluster sampling process. The prevalence of inflammatory and late-stage trachoma was measured through eye examination. Water, sanitation, and hygiene facility access among visited households was estimated. Results: The prevalence of trachomatous inflammation—,follicular (TF) in 1–9-year-olds per EU was <5.0% in three EUs (Al Mighlaf, Al Munirah, and As Salif; Az Zaydiyah; and Mudhaykhirah districts) and 5.0–9.9% in one EU (Far Al Udayn District). The prevalence of TT unknown to the health system in ≥15-year-olds per EU was <0.2% in all four EUs. Per EU, the proportion of households with an improved drinking water source ranged from 40% to 100%; access to an improved drinking water source within 30-minute return journey of the household ranged from 45% to 100%; and with an improved latrine ranged from 32% to 83%. Conclusion: An additional round of antibiotic MDA should be administered in Far Al Udayn district before it is resurveyed. In the other surveyed districts, pre-validation surveillance surveys should be conducted in 2 years' time to determine if the TF prevalence <5% has been maintained. [ABSTRACT FROM AUTHOR]

Purpose: Trachoma is an infectious eye disease caused by Chlamydia trachomatis. Infection causes conjunctival inflammation, which can be manifested by the sign known as trachomatous inflammation—follicular (TF). Repeated inflammation leads to eyelid scarring, which in susceptible individuals can cause in-turning of the eyelashes, referred to as trachomatous trichiasis (TT). This article describes 23 population-based surveys conducted in northern and central Benin to determine TF and/or TT prevalence for trachoma elimination purposes. Methods: A total of 18 surveys estimated the prevalence of both TF and TT: two baseline surveys, eight impact surveys after implementation of interventions against trachoma, and eight surveillance surveys. Five other evaluation units (EUs) were surveyed for TT only. To estimate the TF prevalence, a target sample size of 1701 (baseline) and 1164 1–9-year-olds (impact and surveillance) was required, whereas 2818 ≥ 15-year-olds were required to estimate the less prevalent TT. In each EU, individuals were selected by two-stage cluster sampling and examined by certified graders for TF and/or TT. Results: A total of 68,613 people were examined. TF prevalence estimates were under the 5% elimination threshold in all surveys. TT prevalence estimates were above the 0.2% elimination threshold in all five TT-only surveys and in four impact surveys, ranging from 0.2–0.57% Conclusion: TF prevalence in Benin is low, but TT was above 0.2% in nine districts. Increased case-finding and continuing efforts to improve surgery accessibility will be needed to reduce the burden of TT in Benin. [ABSTRACT FROM AUTHOR]

Introduction: Trichiasis is present when in-turned eyelashes touch the eyeball. It may result in permanent vision loss. Trachomatous trichiasis (TT) is caused by multiple rounds of inflammation associated with conjunctival Chlamydia trachomatis infection. Surveys have been designed to estimate the prevalence of TT in evaluation units (EUs) of trachoma-endemic countries in order to help develop appropriate programme-level plans. In this study, TT-only surveys were conducted in five EUs of The Gambia to determine whether further intensive programmatic action was required. Methods: Two-stage cluster sampling was used to select 27 villages per EU and ~25 households per village. Graders assessed the TT status of individuals aged ≥15 years in each selected household, including the presence or absence of conjunctival scarring in those with TT. Results: From February to March 2019, 11595 people aged ≥15 years were examined. A total of 34 cases of TT were identified. All five EUs had an age- and gender-adjusted prevalence of TT unknown to the health system <0.2%. Three of five EUs had a prevalence of 0.0%. Conclusion: Using these and other previously collected data, in 2021, The Gambia was validated as having achieved national elimination of trachoma as a public health problem. Trachoma is still present in the population, but as its prevalence is low, it is unlikely that today's youth will experience the exposure to C. trachomatis required to precipitate TT. The Gambia demonstrates that with political will and consistent application of human and financial resources, trachoma can be eliminated as a public health problem. [ABSTRACT FROM AUTHOR]

Ostracism and school engagement have important implications for adolescents' academic perseverance and success. However, limited previous studies have investigated the mediating effects of school engagement on the association between ostracism and academic achievement in the Chinese cultural context. The present study fills in this research gap by examining the mediating effects of emotional engagement, cognitive engagement, and behavioral engagement on the association between ostracism and adolescents' academic achievement. Clustered random sampling was employed, and a total of 728 adolescents (52.6% female) were recruited as participants. The results showed that ostracism was negatively associated with academic achievement. Ostracism was negatively associated with emotional engagement and cognitive engagement, which in turn were related to worse academic achievement. Notably, within the Chinese cultural context, behavioral engagement did not exhibit a mediating effect between ostracism and academic achievement. The findings of the present research have theoretical and practical implications for curtailing ostracism and improving adolescents' academic achievement. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Does the prevalence of 12-month infertility in Burkina Faso, Côte d'Ivoire, Kenya, and Uganda differ between women trying to conceive and the broader population of women exposed to unprotected sex, and how are prevalence estimates affected by model assumptions and adjustments? SUMMARY ANSWER Estimates of 12-month infertility among tryers ranged from 8% in Burkina Faso to 30% in Côte d'Ivoire, increasing substantially among a larger population of women exposed to unprotected intercourse. WHAT IS KNOWN ALREADY While having a child is a fundamental human experience, the extent to which women and couples experience infertility is a neglected area of research, particularly in sub-Saharan Africa. Existing estimates of infertility in this region vary widely from 2% to 32%, however, potential impacts of variability in study populations and model assumptions have not been well-examined. STUDY DESIGN, SIZE, DURATION We used cross-sectional nationally representative survey data from Burkina Faso, Côte d'Ivoire, Kenya, and Uganda. We employed a multi-stage cluster random sampling design with probability proportional to the size selection of clusters within each country to produce representative samples of women aged 15–49. Samples ranged from 3864 in Côte d'Ivoire to 9489 in Kenya. PARTICIPANTS/MATERIALS, SETTING, METHODS We created two analytic samples in each country—tryers and a broader sample of women exposed to unprotected sex—exploring differences in population characteristics and estimating the period prevalence of 12-month infertility using the current duration (CD) approach. We also examined the impact of several model assumptions within each of the two analytic samples, including adjustments for recent injectable contraceptive use, unrecognized pregnancy, infertility treatment, underreported contraceptive use, and sexual activity. MAIN RESULTS AND THE ROLE OF CHANCE Employing the CD approach among tryers produced an overall 12-month infertility prevalence of 7.9% (95% CI 6.6–12.7) in Burkina Faso, 29.6% (95% CI 15.3–100.0) in Côte d'Ivoire, 24.5% (95% CI 16.5–34.6) in Kenya, and 14.7% (95% CI 8.1–22.4) in Uganda. Results among women exposed to unprotected intercourse indicated much higher levels of infertility, ranging from 22.4% (95% CI 18.6–30.8) in Uganda to 63.7% (95% CI 48.8–87.9) in Côte d'Ivoire. Sensitivity analyses suggest infertility estimates are particularly sensitive to adjustments around pregnancy recognition timing and sexual activity, with little impact of adjustments for recent injectable contraceptive use, infertility treatment, and underreporting of traditional and coital dependent contraceptive use. LIMITATIONS, REASONS FOR CAUTION There was substantial digit preference in responses at 12 months, particularly among the tryers, which could introduce bias. Data quality concerns in the reproductive calendar may impact the accuracy of the CD approach among the broader sample of women exposed to unprotected sex, particularly with regard to underreported contraceptive use, induced and spontaneous abortions, and unrecognized pregnancies. Lastly, we lacked information on postpartum amenorrhea or abstinence. WIDER IMPLICATIONS OF THE FINDINGS Understanding the inconsistencies in definition and analytic approach and their implications for infertility estimation is important for reliably monitoring population-level infertility trends, identifying factors influencing infertility, improving prevention programs, and ensuring access to quality treatment and services. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by grants from the Bill & Melinda Gates Foundation (INV009639) and the National Institute of Child Health and Human Development (K01HD107172). The funders were not involved in the study design, analyses, manuscript writing, or the decision to publish. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess the association between psychological reactions (e.g., stress, anxiety, and depression), resilience, and work engagement among Palestinian critical care nurses in the West Bank and examine the correlation of psychological reactions and resilience with work engagement. Background: Work engagement is associated with psychological reactions and resilience, particularly among critical care nurses. There is a lack of studies on work engagement and these factors in Palestine. Methods: A cross‐sectional, descriptive correlational design was adopted. A convenience sample consisting of 273 critical care nurses from private and governmental hospitals was recruited to participate. Depression, Anxiety, Stress Scale‐21 (DASS‐21), Connor–Davidson Resilience Scale‐25 (CDRS‐25), Utrecht Work Engagement Scale‐9 (UWES‐9), and demographic data were used to collect data during the period from March 20 to May 20, 2023. Results: Findings demonstrated that 53.9% of the nurses reported mild‐to‐moderate levels of depression, 49.8% reported moderate‐to‐severe levels of anxiety, and 49.1% reported moderate‐to‐severe levels of stress. Additionally, 57.5% and 52.7% of them had low resilience and work engagement, respectively. Moreover, work engagement negatively correlated with depression (r = −0.796, P < 0.01), anxiety (r = −0.654, P < 0.01), and stress (r = −0.796, P < 0.01), while positively correlated with resilience (r = 0.42, P < 0.01) and gender (r = 0.121, P < 0.05). Depression, anxiety, stress, resilience, and gender were the main predictors of work engagement. Discussion: The majority of the nurses suffered from depression, anxiety, and stress. Additionally, more than half of the participants had low resilience and work engagement. Moreover, increased depression, anxiety, and stress were correlated with decreased work engagement, while high resilience and gender as being female positively correlated with high work engagement. Conclusion and implications for nursing and health policy: Policymakers and hospital administrators should develop interventions to improve critical care nurses' resilience and minimize psychological reactions, which have a significant influence on work engagement. Future studies should be conducted to examine the effectiveness of these interventions. [ABSTRACT FROM AUTHOR]

Background: Nursing and health policy focus on retaining nurses in practice, especially because the world lacks more than 6 million nurses. Rewards are believed to be an effective strategy to attract, retain, and improve the performance of nurses in rural and remote areas where nursing shortages are more severe. However, Generations X and Y have been found to have different preferences for rewards in various settings, so a one‐size‐fits‐all approach may not work for rewarding work. Objective: To examine the perceptions of satisfaction and the importance of rewards among two generations of Thai registered nurses. Methods: Using the Total Reward Scale, a descriptive comparative study design was employed and the data was collected from 354 nurses in rural and remote Thai community hospitals. This study is reported using the STROBE checklist. Descriptive statistics and the Mann–Whitney U test were used to analyze data. Results: Generations X (born in 1965–1980) and Y (born in 1981–2000) were most satisfied with and rated base salary as the most important reward. However, these generations significantly differed in their perspective about importance of healthcare, leadership, long‐term incentives, time‐off leave, and variable pay. Conclusion: Different types of rewards were satisfying and essential for Thai nurses in Generations X and Y. Implications for nursing and health policy: National reward policies and management should be designed on priorities regarding reasonable base salary, and retirement benefits to address nursing shortages in rural and remote areas. Policymakers in health and nursing must invest in developing funded policies that consider the needs of different generations of nurses if they want success in retaining them on the job. [ABSTRACT FROM AUTHOR]

South Sudan is the newest country in the world - it has been experiencing recurrent conflict and climatic shocks such as flooding and hunger, creating a protracted humanitarian situation where 9 million people - three-quarters of South Sudan's population - are projected to require humanitarian and protection assistance in 2024. Two million people remain displaced due to decades of conflict, intercommunal violence and extreme effects and events of climate change, such as flooding and dry spells (OCHA 2024). Lack of coherent early warning identifiers and adequate monitoring mechanisms exacerbate acute shocks and chronic stresses due to both manmade and natural calamities amongst vulnerable communities in Ulang County. This paper aims at ascertaining the existing mechanisms and indicators that the community utilize for monitoring and early warning of habitual natural and man-made disasters. This study used both quantitative and qualitative data collection techniques. Quantitative data were gathered through a household survey using a structured questionnaire from 120 displaced households had been affected by floods and episodes of inter-communal violence. The household survey used two-stage cluster sampling with probability proportionate to size (PPS) to identify respondents. The qualitative data were collected through focus group discussions with men and women representatives located along the Sobat river. Key informant interviews with local leaders at County, Payam and Boma level were equally conducted to gather comprehensive information, and gain a better understanding of the context and draw sound recommendations and conclusions. Descriptive and comparative methods were used in the bid to grasp the prevailing early warning identifiers and the monitoring systems or mechanisms in place for repeated flooding, inter-communal violence and revenge killings. The research findings uncovered that 55.8% of respondents are aware of both traditional early warning indicators to climate-related shocks as well as to inter-communal violence. Community Managed Disaster Risk Reduction (CMDRR) committees have been established to bolster preparation against disasters and facilitate early response. The CMDRR structure has enabled timely preparedness and provides leadership for any response or post-disaster activities prior to receiving assistance from humanitarian actors. On the other hand, inadequate monitoring systems and tools amongst the duty bearers and limited capacity of the County leadership and other public institutions both at State and County level make the monitoring and early warning of recurrent disasters less effective. Furthermore, funding constraints remains one of the major challenges cited by humanitarian actors that often curtails their efforts in collaborating with government counterparts in tackling disaster risks in a more sustainable manner. [ABSTRACT FROM AUTHOR]

Aims: Based on the two‐factor model of caregiving appraisals, this study aims to (1) investigate the relationships between competence in dementia care and job satisfaction (work attitudes in positive aspect) and turnover intention (work attitudes in negative aspect) among formal caregivers in nursing homes, and (2) examine the mediating roles of positive aspects of caregiving (caregiving appraisals in positive aspect) and caregiving burden (caregiving appraisals in negative aspect) in the above associations. Design: A cross‐sectional design was used. Structural equation modelling was employed to test the proposed model. STROBE checklist guides the reporting of this study. Methods: Using the multistage cluster sampling method, 407 formal caregivers were selected from 43 nursing homes across 7 districts/counties in China. Results: The proposed model shows a good model fit. Competence in dementia care shows significant positive associations with increased job satisfaction and decreased turnover intention among formal caregivers in nursing homes. Caregiving burden and positive aspects of caregiving mediate the relationships between competence in dementia care and both job satisfaction and turnover intention. Furthermore, the relationship between positive aspects of caregiving and job satisfaction is stronger than that with turnover intention, but the relationship between caregiving burden and turnover intention is not stronger than that with job satisfaction. Conclusions: The results demonstrate that the two‐factor model of caregiving appraisals effectively elucidates the associations and underlying mechanisms between competence in dementia care and formal caregivers' work attitudes. Specifically, two crucial conclusions are drawn: (1) competence in dementia care is associated with higher levels of job satisfaction and lower levels of turnover intention among formal caregivers in nursing homes; (2) caregiving burden and positive aspects of caregiving serve as parallel mediators in these associations. Implications for the Profession and/or Patient Care: Policymakers and nursing homes managers should implement a series of measures aimed at formal caregivers in nursing home. Specifically, allocating more resources to enhance the competence in dementia care of formal caregivers is crucial, given its significant association with elevated job satisfaction and reduced turnover intention. Besides, positive and negative caregiving appraisals emerge as proximal factors influencing work attitudes of formal caregivers. Therefore, intervention projects focused on formal caregivers in nursing home should target enhancing positive experiences and alleviating caregiving burden. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Objectives: There is little data on the oral health conditions of Somali children. The aim was to assess the dental caries status and related risk factors of 12‐aged children in primary schools in Hargeisa, Somaliland. Methods: A school‐based survey was conducted in Hargeisa in December 2022. Using 2‐stage cluster sampling, 405 children (12‐aged) were randomly selected from 16 primary schools. Data collection involved WHO structured interviewer‐administered questionnaire and clinical examinations. The DMFT index was measured according to WHO criteria, and accordingly, the mean for the significant caries index (SiC) was calculated. The association between the DMFT and the relevant variables was analysed using negative binomial regression in STATA. Results: The overall prevalence of dental caries was found to be 62.7%, with a mean DMFT of 1.7 and a SiC score of 3.7. Non‐public school pupils showed significantly higher prevalence of dental caries and mean DMFT compared to public school counterparts (68.5% vs. 58.6%) and (1.91 vs. 1.48), respectively. Merely 14.7% of the participants utilized dental care services in the previous year. The multivariable analysis showed a significant positive association of the DMFT outcome with attending a non‐public school (95% CI 1.16–2.12) and having many previous dental visits (95% CI 1.22–2.83). In the adjusted model, fathers of low education had children with better dental caries status (lower mean DMFT) than their well‐educated counterparts. The mean DMFT was not significantly influenced by the factors sex, location, educational attainment (school class of the participants) and frequency of teeth cleaning. Conclusion: Although the overall mean DMFT of school children in Hargeisa could be regarded low, the high levels of untreated caries especially in the one‐third most affected are a cause for concern. Children enrolled in non‐public schools formed the high‐risk group. Preventive oral public health programs targeting Somali school children are recommended. [ABSTRACT FROM AUTHOR]

Objectives: To assess the prevalence and severity of periodontal disease of the Rohingya refugees and host community in Bangladesh. Methods: An unpublished pilot was conducted for the sample size calculation. Two‐stage cluster sampling method was used to select 50 participants from refugee camps and 50 from the host community. Structured questionnaire and periodontal examination were completed. Composite measures of periodontal disease were based on the World Workshop (WW) and Centers for Disease Control and Prevention‐American Academy of Periodontology. Linear regression models, for clinical attachment level and periodontal pocket depth (PPD) and ordered logistic regression models, for composite measures, were fitted to test the association of periodontal measures and refugee status. Results: Compared to the host community, a smaller percentage of refugees reported good oral health‐related behaviours. Refugees exhibited lower levels of bleeding on probing but higher PPD, hence a higher proportion had severe stages of periodontitis. As per the WW, prevalence of periodontal disease was 88% and 100% in the host and refugee groups, respectively. In the unadjusted models, refugees were three times more likely to have severe stages of periodontitis; this association was attenuated when adjusted for confounders (sociodemographic variables and oral health‐related behaviours). Conclusions: Prevalence of periodontitis was high both in the host community and refugees. The refugees exhibited a more severe disease profile. The oral health of both groups is under‐researched impacting the response of the health system. Large‐scale research systematically exploring the oral health of both groups will inform the design and delivery of community‐based interventions. [ABSTRACT FROM AUTHOR]

Objective To explore the categories of depression among college students and their influencing factors. Methods A cluster convenience sampling method was employed, utilizing a depression scale and an online social exclusion questionnaire to conduct a longitudinal study over four months at two time points, involving 2 000 college students from seven universities across Jiangsu, Henan, Fujian, Gansu, Liaoning, Heilongjiang provinces, and the Inner Mongolia Autonomous Region. Latent transition analysis was used to investigate the latent categories of depression among college students and the probabilities of transitions between these categories. Results The overall incidence of depression among college students showed a declining trend. College students' depression can be classified into two latent categories: low depression symptom group and high depression symptom group. The high depression symptom group exhibited the strongest stability, with a probability of maintaining the original latent state at 92.4%. The probability of transition from the low depression symptom group to the high depression symptom group was 52.7%, while the probability of transition from the high depression symptom group to the low depression symptom group was 7.6%. Gender (OR=0.73, 95%C7: 0.57-0.93), age (OR=0.88, 95%C7: 0.79-0.98), and online social exclusion (OR=1.94, 95%C7: 1.56-2.41) were identified as significant influencing factors in college students' depression and its category transitions. Conclusion There are two latent categories of depression among college students, which change over time and are influenced by various factors. [ABSTRACT FROM AUTHOR]

Objective: This study explores the relationship between PTSD symptoms and cognition in patients with persistent post-concussive symptoms (PPCS). Methods: Adults with PPCS presenting to a specialized brain injury clinic provided demographic and injury information and completed the PTSD checklist for DSM-5, Generalized Anxiety Disorder Scale-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). The Montreal Cognitive Assessment (MoCA) was used to screen for possible cognitive concerns. Multiple regression analysis (MLR) adjusting for age, sex, mechanism of injury, psychiatric history, number of previous concussions, months since most recent injury, and mental health questionnaire scores was used to determine associations between PTSD and cognition. Binomial logistic regression explored the relationship between domains of the MoCA and PCL-5 scores. Results: We found a negative correlation between MoCA scores, PCL-5 (ρ=-0.211, p = 0.009) and PHQ-9 (ρ=-0.187, p = 0.021) in patients with PPCS and collinearity of PCL-5 and PHQ-9 scores. Significantly higher Arousal and Reactivity cluster scores within the PCL-5 were associated with poorer scores on naming and abstract tasks on the MoCA. Conclusion: The association between specific PCL-5 clusters and lower MoCA scores may represent a viable target for psychotherapeutic and psychopharmacologic intervention in patients with cognitive changes associated with PPCS. [ABSTRACT FROM AUTHOR]

Birth registration is an important channel that allows children to be documented, providing them with legal identity and nationality early in life and protecting them against violence, abuse and exploitation. However, this privilege has been denied to millions of children, particularly in developing countries. Registration is limited in Nigeria with about three in every five births unregistered. Using data from three waves of the Nigeria Demographic and Health Survey, we adopt a geostatistical model to assess the space-time variations in registration coverage across Nigeria and compute the exceedance maps at different probabilities. The findings indicate a North-South divide in coverage but with improved coverage over time across the country. The probability of attaining about 60% coverage is low in the northern part of the country. The generated maps provide guiding tools to the Nigerian government to set priorities in order to scale up birth registration coverage in the country. [ABSTRACT FROM AUTHOR]

Background: Project‐based collaborative learning (PBCL) is a technique that supports knowledge and skill development through complex, real‐world projects. Understanding factors that influence group performance in PBCL, such as gender composition, is crucial. Objectives: This study investigates the impact of gender composition on group performance in PBCL, specifically focusing on the critical thinking, creativity, communication, and collaboration (4Cs) 21st‐century learning skills. Methods: A total of 312 students were divided into distinct Python programming groups for the experiment. Group performance was assessed using an agglomerative clustering algorithm guided by the ontological group learner model, which examined gender composition, communication patterns, collaboration strategies and project assessment outcomes. Results and Conclusion: Gender‐balanced groups demonstrated positive outcomes in the 4Cs skills, with groups containing a greater proportion of women exhibiting superior performance in collaboration and communication, whereas majority‐male groups performed relatively poorer across all skills. Notably, in the context of PBCL, the presence of more women in small groups enhanced the 4Cs skills project assessment outcomes. Takeaways: Future research should focus on providing effective support for male online learners in developing the 4Cs skills. The findings offer insights and recommendations for group formation in collaborative learning, facilitating the design of inclusive and impactful learning environments. Lay Description: What is (not) known about the subject matter?: Assessment may be influenced by diverse perspectives on group work practices, such as what constitutes valuable involvement in a collaborative process. In light of this, gender composition must be taken into account when interpreting evaluation results.Little is known about the effect of gender composition on group assessment results, particularly in the context of project‐based collaborative learning. What is the contribution of this paper?: 312 pupils enrolled in our institution's introductory programming course took part in the experiment. The students were grouped into varied, small groups based on their Python programming abilities.We developed semantic web technologies to define the characteristics and accomplishments of groups in terms of the 4Cs of 21st‐century learning skills.We deployed ontological models to characterize the data we gathered about our learners' groups and their performance on assessments.Using an agglomerative clustering machine learning algorithm, we categorized groups based on the results of the assessment of the proposed collaborative project. What are the implications of the findings?: The findings indicate that groups with a greater proportion of women achieve outcomes that are superior to those obtained by groups with an equal gender split, particularly in terms of collaborations and communications.The greater the number of women in a small group, the better the project assessment results for the 4Cs 21st‐century learning skills in a PBCL setting.In future research, we should make inferences based on the ontological models to reason about assessment data by executing logical rules and then analysing them in order to develop an intelligent assessment environment.Also, we should concentrate on how to provide male e‐learners with high‐quality 4Cs support. We might additionally examine the potential effects of gender variations on the performance of large groups. [ABSTRACT FROM AUTHOR]

Authors of few studies have used randomized controlled trials (RCTs) to quantify clinical intervention safety of rehabilitation after sport-related concussion across sport levels. Describe symptom exacerbation and adverse events (AEs) associated with two concussion rehabilitation interventions. Cluster RCT (NCT02988596) Sports medicine clinic and field settings. The RCT enrolled 251 concussed athletes (median age = 20 years; female, n = 48) across 28 sites from New Zealand professional rugby (n = 31), Canadian professional football (n = 52), US/Canadian colleges (n = 128) and US high schools (n = 40). Two medically supervised interventions: (1) enhanced graded exertion (EGE): international return-to-sport strategy and sport-specific activities only (EGE only, n = 119); and (2) multidimensional rehabilitation (MDR) followed by EGE: early symptom-directed exercises once symptoms were stable, followed by EGE after symptoms resolved (MDR + EGE, n = 132). Primary outcomes were intrasession total symptom severity score exacerbation and significant intersession (increase 10+ severity points) sustained total symptom severity exacerbation, each measured with the Postconcussion Symptom Scale (132 total severity points on scale). Reported AEs were also described. Activity-based rehabilitation sessions (n = 1437) were the primary analysis unit. Frequencies, proportions, medians, and interquartile ranges were calculated for outcomes by treatment group. The 251 postinjury participants completed 1437 (MDR + EGE = 819, EGE only = 618) activity-based intervention sessions. A total of 110 and 105 participants contributed data (those missing had no documented session data) to at least 1 activity-based session in the MDR + EGE and EGE-only arms, respectively. Intrasession symptom exacerbations were equivalently low in MDR + EGE and EGE-only arms (MDR + EGE: 16.7%, 95% CI = 14.1%, 19.1%; EGE only: 15.7%, 95% CI = 12.8%, 18.6%). In total, 9/819 MDR + EGE sessions (0.9%) and 1/618 EGE-only sessions (0.2%) resulted in a presession to postsession symptom exacerbation beyond a 10+ severity point increase; 8/9 resolved to <10 points by the next session. Two study-related AEs (1 in each arm) were reported. Participants in MDR + EGE and EGE-only activities reported equivalently low rates of symptom exacerbation. [ABSTRACT FROM AUTHOR]

The present work endeavours to explore the experiences of university-level students from Pakistan and Nepal after the COVID-19 outbreak. A comprehensive electronic survey was carried out utilising a meticulous cluster sampling technique encompassing two distinct populations, i.e. Pakistan and Nepal, during the period extending from September 2022 to January 2023. A total of 2496 participants completed the questionnaire (Pakistani population: 55.45% and Nepalese population: 44.55%). We utilised the Mental Health Continuum–Short Form (MHC-SF), Pittsburgh Sleep Quality Index (PSQI), feeling of loneliness (UCLA), interdependent happy scale (IHS), and fear of COVID-19 scale (FCV-19S). Notably, a significant intercultural disparity was observed, particularly concerning the level of COVID-19 fear which was higher among the Nepalese population. However, this particular variable did not demonstrate any significant associations with other variables, except for the social dimension of MHC-SF. There was a negative correlation observed between this variable and IHS within the Pakistani population. Irrespective of the varying degrees of apprehension towards COVID-19 within the two distinct cultural contexts, there exists a significant positive correlation between the assessed psychological assets and individual well-being, as well as the resumption of regular activities after the outbreak. [ABSTRACT FROM AUTHOR]

Background: Emotional and behavioral problems among adolescents is a global concern. Previous studies conducted in Bangladesh have highlighted the importance to effectively prevent and address emotional and behavioral problems among adolescents to improve their psychological well-being. Despite these efforts, there remains limited research specifically addressing emotional and behavioral problems, conduct disorders, hyperactivity/attention disorders, and peer relationship problems among adolescents in Bangladesh in terms of age, gender, grade, and location. To address this knowledge gap, the present study aimed to comprehensively investigate the prevalence of emotional and behavioral problems among school-going adolescents in Bangladesh. Methods: The study employed a two-stage stratified cluster sampling technique to recruit a total of 1496 participants. The socio-demographic characteristics of the participants, such as age, gender, grade, location, birth order, family type, monthly family income, and parental education were collected. Emotional and behavioral problems were assessed using the Strength and Difficulties Questionnaire (SDQ), while the chi-square test and logistic regression were used to analyze the data with STATA software. Results: The prevalence of emotional disorder was 9.09% (7.73 − 10.65%). The rate was 21.72% (19.70 − 23.88%) for conduct disorder, 6.21% (5.09 − 7.55%) for hyperactivity, and for peer-relationship problem, the rate was 15.10% (13.37 − 17.01%) among adolescents. Overall, gender, grade, location, monthly family income, and parental education were significantly associated with emotional and behavioral problems. More specifically, adolescent girls (OR = 2.90 for the emotional disorder), grade (8th: OR = 2.07, 9th: OR = 1.95, for the emotional disorder), urban residents (OR = 2.46, for conduct disorder; OR = 2.29, for hyperactivity; OR = 2.03, for peer-relationship problem), poor monthly family income (OR = 2.84, for peer-relationship problem) significantly increased the risk of psychiatric morbidity. Conclusion: The study highlights the need for school-based intervention programs to address adolescent emotional and behavioral problems. By targeting vulnerable individuals, these programs can effectively reduce mental health problems among adolescents. [ABSTRACT FROM AUTHOR]

Holistic development of school-going students has gained momentum. Developing countries need to equip students with skills to thrive in the contemporary world, yet research on this topic in Pakistan is limited. This study, therefore, examines students' non-cognitive skills (i.e., social capabilities and life skills) using a sequential mixed-methods approach. The sample was selected through multi-stage cluster sampling technique. The quantitative sample comprised students (n=263) from eight schools. The qualitative sample of students (n=16), teachers (n=8), and school leaders (n=4) was purposively selected. The results revealed that students are socially capable and possess basic life skills. However, schools do not explicitly prioritise the development of social capabilities and life skills. As a result, the holistic development of students is generally a neglected aspect in Pakistan. Moreover, educational structures and the school system strongly predict students' non-cognitive skills. This study has implications for policy, practice, and further research. [ABSTRACT FROM AUTHOR]

Copyright of Gazi University Journal of Gazi Educational Faculty (GUJGEF) is the property of Gazi University Journal of Gazi Educational Faculty (GUJGEF) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Mobile learning utilizes mobile technology, such as smartphones, tablets, and other mobile devices, to facilitate a flexible and collaborative learning process. This research aims to implement the integration of mobile learning into the Rifdarmon model in the learning process and evaluate the effectiveness of mobile learning integration into the Rifdarmon model in improving student learning outcomes in the Sensors and Transducers course. This research uses a quantitative approach with an experimental method. The subjects in this study are active students in the Automotive Engineering Department of Padang State University taking the Sensors and Transducers course. The sampling technique used is cluster random sampling, where the researcher randomly selects two classes, the control and experimental classes. Then all students in the selected clusters become the sample. The data in this study were collected based on the pre-test and post-test scores obtained by students in the Sensors and Transducers course. Based on the results and discussion, the implementation of mobile learning integration into the Rifdarmon model in the learning process was successfully carried out in this research. There was a significant increase in learning outcomes for students after following the learning process, both with the conventional learning model (control class) and mobile learning integration into the Rifdarmon model (experimental class). [ABSTRACT FROM AUTHOR]

This research studied the effect of coloring mandalas on attention and test anxiety in grade 12 female high school students in Ahvaz City, Iran. This was an experimental study with a pretest-posttest design, a control group, and one-month follow-up. The statistical population included all grade 12 female high school students in Ahvaz. The study sample was selected using cluster sampling based on the inclusion and exclusion criteria. For this purpose, one education district was selected first and all grade 12 students in this school took the GHQ-28 screening test. Thirty of those scoring above the cut-off point were randomly assigned to the experimental and control groups (15 students in each group). Both groups were evaluated in the pretest, posttest, and follow-up stages using the Mindful Attention Awareness Scale (MAAS) (Brown, Ryan, 2003) and Friedman Test Anxiety Scale (Friedman, 1997). The experimental group attended eleven 45-minute sessions of coloring mandalas, but the control group received no intervention program. The data were analyzed using repeated measures MANOVA in SPSS. The results indicated that coloring mandalas was effective and reducing test anxiety in students in the posttest stage, and its effects remained stable in the follow-up stage (P<0.05). but it does not affect attention. Based on the findings of the research, coloring mandalas can be used to reduce test anxiety in female high school students, and it can also be employed by counselors and psychologists. [ABSTRACT FROM AUTHOR]

The service and social inequalities resulting from poor urban conditions underline the necessity of focusing more on children, who constitute a vulnerable and crucial segment of society. Meeting children's needs and demands within the framework of child-friendly city principles is essential. This study aims to assess the status of child-friendly city components and indicators in Amol, prioritizing them based on feedback from children and their parents. The research methodology involves surveys, questionnaires, and interviews with children as the analysis units and the entire child population of Amol as the statistical population. Through Cochran's sampling method, 250 samples were chosen using cluster random sampling. Data analysis employed the one-sample t-test and Friedman's test. The findings indicate that not all components of a child-friendly city are deficient and exhibit a notable deviation from the desired level. Moreover, there is a significant variance in the importance levels of these components; notably, access to services ranks highest in priority, while participation and valuing of children rank lowest. This suggests a lack of attention to fulfilling children's needs and desires within the context of child-friendly city components. Children have not been adequately acknowledged as stakeholders in development decisions. To enhance child-friendly indicators, prioritizing children's participation and recognizing their value are imperative. [ABSTRACT FROM AUTHOR]

This research aims to determine birdcage creative economic branding in facing business competition using SWOT Analysis, study of birdcage craftsman in Argosari Village, Sedayu, Bantul, Yogyakarta. This research uses SWOT analysis to find out what strategies are appropriate for Argosari Village bird craftsmen to overcome the problems they face. Development strategy using SWOT analysis is hoped that this can increase the added value of bird cage crafts in Argosari Village and can open up opportunities for the results of these bird cage crafts to be more widely known by the community so that it is hoped that they can support economic growth and improve the welfare of craftsmen and the surrounding community. The data source used is a primary data source, namely bird cage craftsmen in Argosari Village, which was taken using techniques of cluster random sampling, namely determining samples based on regional groups from members of the research population. [ABSTRACT FROM AUTHOR]

Hypertension, a severe chronic disease and a primary risk factor for cardiovascular issues, poses significant challenges in treatment and decision-making for physicians. Recommender systems present a promising avenue for enhancing hypertension care decision-making processes. However, traditional approaches such as collaborative filtering encounter challenges like data sparsity and scalability. To address these challenges, machine learning based recommender systems have been explored. This study presents an enhanced collaborative filtering method, integrating clustering and group recommendation techniques. The proposed research aggregates group recommendations for each cluster using static and dynamic methods. For new patients, three similarity measures are employed to select relevant recommendations from the most similar case cluster. The findings demonstrate the model's satisfactory performance, particularly when employing dynamic group recommendation and Euclidean similarity, showcasing improved accuracy in terms of Mean Absolute Error (MAE). [ABSTRACT FROM AUTHOR]

Objectives: To analyze the factors influencing myopia and construct a nomogram to forecast the risk of myopia among school-age children, providing a reference for identifying high-risk groups to aid prevention and control. Methods: This case-control study enrolled 3512 students from three primary schools in Shenzhen using random cluster sampling for a questionnaire survey, myopia screening and ocular biometric parameter measurement. Logistic regression was used to analyze the influencing factors of myopia, and a nomogram was constructed to forecast myopia risk. Bootstrap resampling was used to verify the practicability of the nomogram. Results: Older age (odds ratio[OR]=1.164; 95% confidence interval [CI]: 1.111-1.219), female sex (OR = 2.405; 95% CI: 2.003-2.887), maternal myopia (OR = 1.331; 95% CI: 1.114-1.589), incorrect posture during reading and writing (OR = 1.283; 95% CI: 1.078-1.528) and axial length (OR = 7.708; 95% CI: 6.044-8.288) are risk factors for myopia, whereas an increase in corneal radius (OR = 0.036; 95% CI: 0.025-0.052) is a protective factor against myopia. The area under the receiver operating characteristic (ROC) curve of the nomogram was 0.857, and the net benefit was high when the risk threshold of the decision curve analyses (DCA) ranged from 0.20 to 1.00. The measured values were consistent with the prediction. Conclusion: The nomogram was accurate in predicting the risk of myopia among schoolchildren. This study provides a reference for screening high-risk students and for individualized myopia prevention and control. [ABSTRACT FROM AUTHOR]

The reduction of the gender gap in deviant behaviors has recently attracted a lot of attention. Therefore, the current article aims to test the validity of Braithwaite's assertion that this theory is not gender neutral and its potential to be generalized to both genders. The present study is divided into two sections. First, the library method was employed to analyze the theoretical issues; second, the survey technique was employed to evaluate the results. The multi-stage cluster sampling method was employed to gather the questionnaire from 831 students at five public universities in Tehran. The method involved clustering universities based on majors, selecting universities based on the number of students, and selecting universities based on gender. The regression coefficients of independent variables and students’ deviant behavior for both sexes indicate that the regression model of girls encompassed only four variables: adherence to moral values, deviant friends, stigmatization, and shame displacement. These variables were capable of accounting for 39% of the variance in the variable of girls’ deviant behavior. Additionally, the linear regression model of males has been supplemented with five variables: shame internalization, deviant friends, stigmatization, reintegration, and adherence to moral values. These variables have the capacity to explain 40% of the variance in their deviant behavior. In general, reintegrative shaming theory has the ability to generalize to the deviant behaviors of female students. Braithwaite’s assertion regarding the theory’s ability to generalize gender was not an ambitious assumption, and the theory has the capacity to generalize to both sexes. [ABSTRACT FROM AUTHOR]

Copyright of Iranian Journal of Educational Research is the property of University of Hormozgan and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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This paper examines the use of ranked set sampling in the second stage of the two-stage sampling design to improve the regression estimator. The mean square errors of the suggested estimators are computed, and both theoretical and simulation results demonstrate improved estimates as compared to the conventional sampling methods, particularly in situations with limited resources or costly measurements. This approach provides a promising method for enhancing regression analysis in complex sampling scenarios. [ABSTRACT FROM AUTHOR]

BACKGROUND: Work-related musculoskeletal disorders (WMSDs) are among the most commonly reported occupational diseases worldwide. Healthcare workers, such as medical radiation staff, are susceptible to WMSDs. OBJECTIVE: To analyze the prevalence of work-related musculoskeletal disorders (WMSDs) and their influencing factors among professionals working in medical radiation institutions. METHODS: This study employed cluster random sampling and included 1669 medical radiation staff members from medical units and institutions in Guangdong Province, China. The modified Nordic Musculoskeletal Questionnaire was used to analyze musculoskeletal symptoms in nine body regions over the previous 12 months. The chi-square test was used to analyze the association between WMSDs and these factors. Logistic regression was used to identify potential influencing factors. RESULTS: This study collected 1669 complete and valid questionnaires. The overall self-reported prevalence of WMSDs among medical radiation staff was 15.3%. Multivariate logistic regression showed that gender, alcohol consumption, senior rank hospital, repetitive motions at work, overtime work, and prolonged maintenance of the same posture increased the risk of WMSDs (P < 0.05). Adjustable work chairs and comfortable workplace temperatures were protective factors against WMSDs (P < 0.05). CONCLUSION: Being female, alcohol consumption, higher hospital level, repetitive motions, working overtime, and maintaining a single posture contributed to the risk of neck, shoulder, and lower back WMSDs among medical radiation staff. Prevention and management strategies to facilitate reduction in adverse health effects on the occupational health of the medical radiation staff should be considered. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to investigate the factors that affect the acceptance of artificial intelligence among faculty members, as well as their level of artificial intelligence literacy. Methods: The current applied research is grounded in the philosophy of pragmatism, utilizing a mixed-method (sequential explanatory approach). The statistical population for the quantitative aspect consisted of 1220 faculty members at Farhangian University campuses during the academic year 2023- 2024. Through Cochran's formula, 315 individuals were selected via random cluster sampling. For the qualitative component, 15 experts were chosen using snowball sampling. Quantitative data were analyzed using SPSS, while thematic analysis was applied to the qualitative data. Results: Factors such as behavioral intention, perceived ease of use, perceived usefulness, job relevance, social norms, facilitating conditions, and attitude towards AI have been identified as influencing artificial intelligence acceptance. The results revealed that the artificial intelligence literacy levels of faculty members were suboptimal. The second-order factor analysis of the structure showed significant fit indices, validating the statistical analysis. Conclusion: Enhancing AI literacy of professors in higher education is crucial in addressing resistance to AI adoption. Therefore, increased support from relevant authorities and educational leaders is essential to assist professors in developing their artificial intelligence skills and literacy. [ABSTRACT FROM AUTHOR]

The Smallholder Irrigation Revitalisation Programme (SIRP), a seven-year programme which started in 2016 and ended in 2023, is one recent initiative rolled out in Zimbabwe to improve smallholder irrigation in arid to semi-arid areas. The main goal of the SIRP was to help rural households become resilient to the effects of climatic change and economic volatility while simultaneously achieving food and nutrition security. This study aimed to assess the impact of SIRP on the Exchange irrigation scheme in Kwekwe District, Zimbabwe. Quantitative and qualitative data collection instruments, namely a structured questionnaire and focus group discussions (FGDs), were used to obtain responses from the participants. A multistage cluster sampling method was used, and 134 irrigators, or 13.6% of the irrigators, were sampled from a sampling frame of 982 scheme beneficiaries. A purposive sampling method was used to select 25 critical stakeholders for FGDs. Data was processed using SPSS software. Bar charts and tables were utilised to display the frequency distributions of responses graphically. Also, frequency distributions were used to summarise the response counts and percentages for each survey question. Results obtained established that while not without difficulties, smallholder irrigation has the potential to dramatically increase the incomes and quality of life for lowincome rural communities in developing countries like Zimbabwe. The study concluded that despite the current challenges, SIRP is bringing about poverty alleviation and improving the livelihoods of the Exchange irrigation scheme households and the irrigation scheme's water use efficiency and profitability. [ABSTRACT FROM AUTHOR]

This paper aims to explore the perspectives of academic scholars on Imam alShafi'i's categorization of bidaah into hasanah (good) and sayyi'ah (bad). The selected scholars are from the Academy of Islamic Studies at Universiti Malaya, Universiti Kebangsaan Malaysia, Universiti Sains Islam Malaysia, and Universiti Islam Antarabangsa, representing various fields within Islamic Studies. The research employs a survey method, specifically using cluster sampling. The author distributed the survey forms to academic staff at these universities. Based on the descriptive analysis of the survey results, it can be concluded that the scholars possess a strong understanding of hadith and the concept of bidaah. They also perceive that the study of hadith is insufficiently emphasized within society. Analyzing the overall responses, particularly regarding the concept of bidaah as derived from the hadiths of Kutub al-Tis'ah, their views align closely with those of scholars such as al-Nawawi, al-Syatibi, Ibn Hajar al-'Asqalani, and others. Consequently, these scholars are wellpositioned to serve as references for the community in addressing issues related to bidaah, particularly those specializing in hadith. It is hoped that this paper will provide guidance to educators, institutions, religious departments, and others in contributing valuable knowledge to the Muslim community, enhancing their understanding of the hadith of the Prophet Muhammad (SAW), applying these teachings in their lives, and clarifying any confusion or misunderstandings regarding Imam al-Shafi'i's categorization of bidaah. [ABSTRACT FROM AUTHOR]

Background: Functional bowel disorders (FBDs) have detrimental effects on young adults, but the risk factors were not fully explored. This study aimed to investigate the prevalence and potential risk factors of FBDs in college freshmen, including, in particular, the association between passive smoking and the risk and symptoms of FBDs. Methods: A cross-sectional study was conducted in September 2019 in freshmen of Huazhong University of Science and Technology with a random cluster sampling method. Validated questionnaires were voluntarily completed by participants. Rome IV criteria were applied for the diagnosis of FBDs. Univariate analysis and multivariate logistic regression analysis (Model 1: unadjusted; Model 2: adjusted for age and sex; Model 3: adjusted for age, sex, intake frequency of coffee and juice, regular exercise, total sedentary time, sleep quality, interpersonal relationship, and SLSI scores) were performed to determine the potential risk factors of FBDs. Results: A total of 3074 participants were included in this study, among whom 236 college freshmen were diagnosed with FBDs. There was a positive relationship between passive smoking and the risk of FBDs (crude odds ratio [OR] = 2.084, 95% confidence interval [CI]: 1.480, 2.936, Model 1; adjusted OR = 1.825, 95%CI: 1.245, 2.675, Model 3). Moreover, the symptoms of hard stool, exertion, and sensation of obstruction in defecation were more frequent in passive smokers than non-passive smokers among FBD patients. Meanwhile, diarrhea was comparable between passive smokers and non-passive smokers among FBD patients. Conclusions: In the present study, around 7.68% of college freshmen were found to have FBDs. Passive smoking was positively associated with the risk of FBDs. Furthermore, passive smoking was significantly associated with constipation-related symptoms rather than diarrhea among FBD patients. [ABSTRACT FROM AUTHOR]

Background: Previous research has indicated that health literacy has a good influence on the mental health among older adults. The current study aims to determine whether health literacy is linked to depressive symptoms in older adults in west China, and tries to detect the mechanisms underlying the linkage between health literacy and depressive symptoms in the Chinese context. Methods: Study data were obtained from a cross-sectional ageing health literacy survey conducted in 2017 in Western China, and 812 urban individuals aged 60 and older were selected. Results: Health literacy was associated with fewer symptoms of depression; additionally, older adults who reported harmonious family and filial piety, those with greater self-rated health, and those with a higher level of life satisfaction tended to have fewer depressive symptoms, whereas older individuals who reported a poor financial status and those with functional impairment had more depressive symptoms. Conclusions: The findings indicate the protective role of health literacy against depressive symptoms among urban older adults. In addition, the findings also indicate the potential impact of financial strain and functional impairment on the development of depressive symptoms and show that other factors including a harmonious family, filial piety, self-rated health and life satisfaction are generally protective against depressive symptoms. Specific evidence is presented for the national action plans and public health strategies needed to reinforce and promote health literacy in the Chinese context. The current results also suggest that health education and promotion programs designed to strengthen financial assistance, functional improvement, family relationships, life satisfaction and self-rated health should gain a growing importance on the health agenda. Future longitudinal studies, mediation or moderator models, and structural equation modeling would be needed to identify a causal relationship, the moderating or mediating effect, and the possible pathways underlying the linkage between health literacy and depressive symptoms, respectively. [ABSTRACT FROM AUTHOR]

Background: Due to the enormous caregiving burden faced by informal caregivers, providing appropriate skills training has become an important supporting strategy in many countries/regions. Understanding caregivers' training needs is instrumental in designing effective training intervention programs, which are expected to reduce the caregiving burden of informal caregivers and avoid the health deterioration associated with caregiving. This paper aims to explore the potential training needs of informal caregivers in Shanghai, and to identify the factors associated with these perceived training needs. Methods: A total of 196 eligible informal caregivers participated in this survey. A multivariate analysis was conducted to explore the factors associated with informal caregivers' perceived training needs. Results: 86.7% (N = 170) of the caregivers reported at least one need for targeted training activity, and 62.7% (N = 123) of them identified two or more training needs. The top three activities requiring training included the following: self-care skills; safety supervision; and functional rehabilitation. The factors associated with various training needs included the health status of the care recipient, complementary caregiving support, caregiving stress, and the personal attributes of the informal caregiver. The technical skills training needs were more related to the care recipients' health status (e.g., dependency level, disease progression) and formal care support resources. Conversely, the intangible skills training needs were more sensitive to caregiver attributes (e.g., gender, age, and education level). Conclusions: A personalized training strategy and early-stage intervention program are critical to providing effective support to informal caregivers. The potential implications are to raise awareness of the importance of skills training for informal caregivers, and to inform the implementation of effective training strategies for improving the quality of informal care and the well-being of informal caregivers in China. [ABSTRACT FROM AUTHOR]