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Purpose: Although there exists a substantial body of research discussing the efficient implementation of classroom-based assessment (CBA), there is a dearth of knowledge regarding its application within the context of English as a Second Language (ESL) education in Malaysia. The current study aimed to investigate the ESL teachers' practices in implementing CBA, with a specific emphasis on the alignment of their assessment procedures with the policy requirements. Methodology: Hence, this research utilizes a qualitative approach, employing data triangulation through semi-structured interviews, classroom observations, and document analysis. Four ESL teachers from two public secondary schools in the northeast district of the Malaysian city of Pulau Pinang were selected to participate in the study. The four ESL teachers taught the same grade (Form 2) at the secondary level. The data collected were analyzed through thematic analysis procedures. Findings: This research discovered that teachers demonstrate commendable practices in planning the CBA. They exhibited discernment by formulating instructional objectives in line with the curriculum document. However, a misalignment was observed in teachers' practices during the implementation phase. Despite employing various assessment methods, teachers predominantly leaned towards formal assessments, with less emphasis on student-centred approaches. Challenges surfaced when explicit learning objectives were not effectively communicated, and the use of standardized rubrics, was not tailored to students' diverse capabilities. At the reporting phase, concerns were raised about an excessive focus on administrative data recording. This study brought to light that teachers relied on the accumulation of students' grades and marks to determine the mastery levels, thus corroborating with the examoriented practices. Significance: This study holds significant value for the field of ESL education in Malaysia by shedding light on the actual implementation of CBA and its alignment with policy directives. By providing information on how policies are implemented at the local level, contributes to the improvement of assessment policies that can be tailored to classroom realities.

Artificial intelligence (AI) can play a vital role in achieving a shift towards predictive, preventive, and personalized medicine, provided we are guided by the science with and of patient input. Patient-reported outcome measures (PROMs) represent a unique opportunity to capture experiential knowledge from people living with health conditions and make it scientifically relevant for all other stakeholders. Despite this, there is limited uptake of the use of standardized outcomes including PROMs within the research and healthcare system. This perspective article discusses the challenges of using PROMs at scale, with a focus on multiple sclerosis. AI approaches can enable learning health systems that improve the quality of care by examining the care health systems presently give, as well as accelerating research and innovation. However, we argue that it is crucial that advances in AI – whether relating to research, clinical practice or health systems policy – are not developed in isolation and implemented ‘to’ people, but in collaboration ‘with’ them. This implementation of science with patient input, which is at the heart of the Global PROs for Multiple Sclerosis (PROMS) Initiative, will ensure that we maximize the potential benefits of AI for people with MS, whilst avoiding unintended consequences.

BackgroundIschemic heart disease (IHD) has a significant impact on public health and healthcare expenditures in the United States (US).MethodsWe used data from the CDC WONDER database from 1999-2020 to identify trends in the IHD-related mortality of patients ≥ 75 years in the US. AAMRs per 100,000 population and APC were calculated and categorized by year, sex, race, and geographic divisions.ResultsBetween 1999 and 2020, a total of 8,124,568 IHD-related deaths were recorded. Notable declines in AAMR were observed from 1999 to 2014 (APC: -3.86) and from 2014 to 2018 (APC: -2.55), with an overall increase from 2018 to 2020 (APC: 3.76). Older men consistently demonstrated higher AAMRs than older females, with AAMRs for both sexes decreasing steadily from 1999 to 2018 and increasing in 2020. When stratified by race/ethnicity, Whites (1931.7) had the highest AAMR, followed by Blacks (1836.5), American Indians (1510.5), Hispanics (1464.4), and Asians (1093.6). Furthermore, nonmetropolitan areas (2015.2) showed greater AAMRs than metropolitan areas (1841.8). The ≥ 85-year group consistently exhibited higher IHD-related mortality rates compared to the 75-84 years group. In comparison, the older group [≥75 years] (1873.0) consistently exhibited higher IHD-related AAMRs than the younger group [ConclusionTargeted interventions and resource allocation are crucial for areas with high IHD-related mortality. Public health policies should address demographic and geographical disparities, with further research for effective strategies.

Background The Danish clinical quality registries monitor and improve the quality of care, using quality indicators and defined development targets referred to as ‘standards’. This study aims to investigate the fulfilment of standards in the Danish clinical quality registries in cancer care and screening.Methods Data was included from annual reports in the 27 Danish clinical quality registries in cancer care and screening. The most recent report from each registry was downloaded the 13 December 2023. Indicators were included if: evaluating care or screening over 12 months, presenting a well-defined standard with a desired direction and presenting the proportion and number of individuals for which the standard was fulfilled. Data were extracted on national and regional levels for the last 3 years, and fulfilment of standards was presented as the proportion of indicators that fulfilled the standard within each unit of comparison.Results In total, 216 quality indicators were included. At the national and regional level, standards were fulfilled for 75% and 71%, respectively. Fulfilment within the registries varied from 5% to 100% on national and 12% to 99% on regional level. Standards were more often fulfilled for result (than process indicators) and for established (than supplemental indicators). Altogether, 43% of the standards were fulfilled across all regions delivering data for the specific indicator.Conclusions The approach to defining standards for clinical quality indicators as conservative minimum or ambitious development targets varied in the Danish clinical quality registries in cancer care and screening. This deviating behaviour seriously restrains possibilities for comparing clinical quality across cancers despite the robust infrastructure of the quality registries, limiting the possibilities for overview and prioritising resources and attention to the most urgent cancers.

Significant advancements have been achieved in delineating the progress of the Global PROMS (PROMS) Initiative. The PROMS Initiative, a collaborative endeavor by the European Charcot Foundation and the Multiple Sclerosis International Federation, strives to amplify the influence of patient input on MS care and establish a cohesive perspective on Patient-Reported Outcomes (PROs) for diverse stakeholders. This initiative has established an expansive, participatory governance framework launching four dedicated working groups that have made substantive contributions to research, clinical management, eHealth, and healthcare system reform. The initiative prioritizes the global integration of patient (For the purposes of the Global PROMS Initiative, the term “patient” refers to the people with the disease (aka People with Multiple Sclerosis – pwMS): any individual with lived experience of the disease. People affected by the disease/Multiple Sclerosis: any individual or group that is affected by the disease: E.g., family members, caregivers will be also engaged as the other stakeholders in the initiative). insights into the management of MS care. It merges subjective PROs with objective clinical metrics, thereby addressing the complex variability of disease presentation and progression. Following the completion of its second phase, the initiative aims to help increasing the uptake of eHealth tools and passive PROs within research and clinical settings, affirming its unwavering dedication to the progressive refinement of MS care. Looking forward, the initiative is poised to continue enhancing global surveys, rethinking to the relevant statistical approaches in clinical trials, and cultivating a unified stance among ‘industry’, regulatory bodies and health policy making regarding the application of PROs in MS healthcare strategies.

In this paper we investigate the translation of research into professional development (PD) materials for teachers of primary mathematics, by England's National Centre for Excellence in the Teaching of Mathematics, and related changes in teacher practices of teachers using the materials. We use interview data gathered from three teachers, via six teacher interviews, conducted over a two-year period. The small sample allows us to explore the richness of their stories, while not being able to generalise to all teachers. Our results show that both implicit and explicit messages from research can become visible in new classroom practices. For instance, the teachers in our study all came to view the concept of number quite differently to how they had in the past, and in a way that was in keeping with research that informed the PD materials. A new view of number was implicit in the PD materials and in the teachers' descriptions of their practice. Other changes in teaching practices were explicitly spoken about by the teachers and were explicitly written about in the PD materials. Our work points to the efficacy of a team of practitioners working, with guidance, to create practical resources which embody research results. We propose viewing teachers as active partners in the process of translating research into practice.

BackgroundThe HEALing Communities Study (HCS) included health campaigns as part of a community-engaged intervention to reduce opioid-related overdose deaths in 67 highly impacted communities across Kentucky, Massachusetts, New York, and Ohio. Five campaigns were developed with community input to provide information on opioid use disorder (OUD) and overdose prevention, reduce stigma, and build demand for evidence-based practices (EBPs). An evaluation examined the recognition of campaign messages about naloxone and whether stigma and efficacy beliefs regarding OUD treatment and naloxone changed in HCS intervention communities.MethodsData were collected through surveys offered on Facebook/Instagram to members of communities participating in the HCS intervention and wait-list control communities.ResultsParticipants in HCS intervention communities reported a reduction in stigma regarding OUD and increased efficacy beliefs regarding naloxone associated with recognition of campaign messages. However, this finding is cautiously interpreted as there was no clear evidence for recognition differences between the treatment/control conditions.ConclusionStudy findings indicate associations between campaign message recognition and positive outcomes. Results also highlight possible challenges concerning evaluations of social media campaigns using conventional evaluation techniques.Trial registrationClinicalTrials.gov NCT04111939.

Purpose – Although there exists a substantial body of research discussing the efficient implementation of classroom-based assessment (CBA), there is a dearth of knowledge regarding its application within the context of English as a Second Language (ESL) education in Malaysia. The current study aimed to investigate the ESL teachers’ practices in implementing CBA, with a specific emphasis on the alignment of their assessment procedures with the policy requirements. Methodology – Hence, this research utilizes a qualitative approach, employing data triangulation through semi-structured interviews, classroom observations, and document analysis. Four ESL teachers from two public secondary schools in the northeast district of the Malaysian city of Pulau Pinang were selected to participate in the study. The four ESL teachers taught the same grade (Form 2) at the secondary level. The data collected were analyzed through thematic analysis procedures. Findings – This research discovered that teachers demonstrate commendable practices in planning the CBA. They exhibited discernment by formulating instructional objectives in line with the curriculum document. However, a misalignment was observed in teachers’ practices during the implementation phase. Despite employing various assessment methods, teachers predominantly leaned towards formal assessments, with less emphasis on studentcentred approaches. Challenges surfaced when explicit learning objectives were not effectively communicated, and the use of standardized rubrics, was not tailored to students’ diverse capabilities. At the reporting phase, concerns were raised about an excessive focus on administrative data recording. This study brought to light that teachers relied on the accumulation of students’ grades and marks to determine the mastery levels, thus corroborating with the examoriented practices. Significance – This study holds significant value for the field of ESL education in Malaysia by shedding light on the actual implementation of CBA and its alignment with policy directives. By providing information on how policies are implemented at the local level, contributes to the improvement of assessment policies that can be tailored to classroom realities.

BackgroundNumerous mobile health apps are marketed globally, and these have specific features including physical activity tracking, motivational feedback, and recipe provision. It is important to understand which features individuals prefer and whether these preferences differ between consumer groups. ObjectiveIn this study, we aimed to identify consumers’ most preferred features and rewards for a mobile app that targets healthy eating and physical activity and to reduce the number of individual mobile health app features to a smaller number of key categories as perceived by consumers. In addition, we investigated the impact of differences in consumers’ BMI and self-efficacy on their intention to use and willingness to pay for such an app. Finally, we identified the characteristics of different target groups of consumers and their responses toward app features via cluster analysis. MethodsA total of 212 participants from France, Italy, the United Kingdom, and Germany were recruited via the web to answer questions about app features, motivation, self-efficacy, demographics, and geographic factors. It is important to note that our study included an evenly distributed sample of people in the age range of 23 to 50 years (23-35 and 35-50 years). The app features in question were generated from a 14-day cocreation session by a group of consumers from the United Kingdom and the Republic of Ireland. Results“Home work out suggestions,” “exercise tips,” and “progress charts” were the most preferred app features, whereas “gift vouchers” and “shopping discounts” were the most preferred rewards. “Connections with other communication apps” was the least preferred feature, and “charitable giving” was the least preferred reward. Importantly, consumers’ positive attitude toward the “social support and connectedness and mindfulness” app feature predicted willingness to pay for such an app (β=.229; P=.004). Differences in consumers’ health status, motivational factors, and basic demographics moderated these results and consumers’ intention to use and willingness to pay for such an app. Notably, younger and more motivated consumers with more experience and knowledge about health apps indicated more positive attitudes and intentions to use and willingness to pay for this type of app. ConclusionsThis study indicated that consumers tend to prefer app features that are activity based and demonstrate progress. It also suggested a potential role for monetary rewards in promoting healthy lifestyle behaviors. Moreover, the results highlighted the role of consumers’ health status, motivational factors, and socioeconomic status in predicting their app use. These results provide up-to-date, practical, and pragmatic information for the future design and operation of mobile health apps.

Xenia Gatopoulou,1 Wafae Iraqi,2 Kate Morgan,3 Kawitha Helme,4 Victoria A Spain,5 Jennifer Redfearn,5 Brett Gardiner5 1Health Economics, Market Access and Reimbursement EMEA, Janssen Pharmaceuticals, Athens, Greece; 2Patient Engagement, Janssen Pharmaceuticals, Issy-les-Moulineaux, France; 3Myeloma Patients Europe, Brussels, Belgium; 4Health Economics, Market Access and Reimbursement EMEA, Janssen Pharmaceuticals, High Wycombe, UK; 5The Research Partnership, London, UKCorrespondence: Wafae Iraqi, Janssen Pharmaceuticals, 1, Rue Camille Desmoulins, TSA 91003, Issy-les-Moulineaux, 92787, France, Email wiraqi@its.jnj.comBackground: This research aimed to quantify the burden of illness (BoI) in transplant eligible (TE) and transplant non-eligible (TNE) newly diagnosed multiple myeloma (NDMM) patients and their caregivers, in the first year after diagnosis: at months 0, 3, and 12.Methods: Prospective, cross-sectional, observational NDMM study of TE and TNE patients and their caregivers from France, Germany, Italy, and Spain was conducted between May 2019 and January 2021. A structured, online questionnaire measuring disease burden, direct and costs, out-of-pocket expenses, and health-related quality of life (HRQoL) was used. Descriptive statistics were performed.Results: A total of 164, 160, and 190 NDMM patients [> 65 years; self-described healthy; not working; living with caregiver] answered at months 0, 3, and 12. Patients lost independence to perform daily activities; mean pain intensity rose and opioid utilization increased, more significantly among TNE patients. Overall health status and HRQoL remained stable. Median 3-month direct medical costs peaked at month 3. Specialist consultations and hospital admissions were the greatest cost amongst TE and TNE patients. Home adaptations increased out-of-pocket expenditures amongst TNE patients. Patients describing themselves as working spent a median 0 hours in the office at all time points. A total of 131, 122, and 124 caregivers answered at months 0, 3, and 12. Mean self-rated burden score rose. By month 12, half of caregivers developed stress, anxiety or depression. Most employed caregivers continued working. Productivity was low at month 0 with a trend of recovering at month 12. Caregivers of TNE compared to TE patients reported greater time burden. Caregivers’ HRQoL was stable over time.Conclusion: NDMM is burdensome for patients and caregivers in the first year after diagnosis. TNE patients are more dependent on caregivers and incur higher care costs than TE patients. Despite the financial, physical, and emotional burden, HRQoL remains stable possibly indicating resilience and illness adjustment amongst patients and caregivers.Keywords: burden of illness, costs of disease, newly diagnosed multiple myeloma, health-related quality of life

Real-world evidence supports SARS-CoV-2 vaccination strategies during the COVID-19 pandemic. This real-world retrospective study utilized the German Disease Analyzer database to characterize recipients of NVX-CoV2373 and explore vaccination outcomes. Recipients (≥12 years) of NVX-CoV2373 as a primary series or booster in Germany were vaccinated between March and December 2022. Outcomes included demographics and clinical characteristics of recipients, tolerability/reactogenicity-related events within 7 and 14 days post-vaccination, and protection from COVID-19. Overall, there were 597 recipients (mean age ~60 years) of NVX-CoV2373; 81% were vaccinated by a general practitioner, and 68% had a Standing Committee on Vaccination (STIKO) high-risk factor. The most common baseline comorbidities were chronic neurological (36%) and chronic intestinal (21%) diseases. Among recipients with metabolic disease (~11%), 65% had diabetes. Tolerability/reactogenicity-related symptoms were recorded in ~1% of recipients. There were no sick-leave notes associated with NVX-CoV2373. After 10 months (median, 7 months) of follow-up, 95% (95% CI, 93–95) of recipients were estimated to be protected from COVID-19. Outcomes were similar across the primary series, booster, and STIKO populations. Tolerability and COVID-19 protection support the use of NVX-CoV2373 as a primary/booster vaccination for all authorized populations, including high-risk.

The Appalachian region has been disproportionately impacted by the opioid epidemic. This study, informed by the Health Belief Model (HBM), explored Appalachian community members perspectives on prescription opioid misuse and community-based programs to dispose of unused opioid analgesics. In 2018, we conducted ten focus groups (n=94 participants) in 5 Appalachian counties. Thirteen themes across 5 of the HBM constructs emerged from our analysis. Participants perceived that their communities are susceptible to the harms associated with opioid misuse, these harms are serious, suggesting they could be motivated to change disposal behaviors. Many participants recognized the benefit to disposing of unused prescription opioids including protecting household members from misusing and protecting the home from robbery. Nevertheless, participants identified barriers to proper disposal, including keeping the medications just in case for future ailments and the location of drop boxes near law enforcement (due to deep-seated mistrust of law enforcement agencies). Self-efficacy was difficult to assess as many participants were completely unaware of the presence of dropboxes in the community and also expressed concerns about the inconvenience of proper disposal using dropboxes These findings have implications for developing community-based campaign messages promoting proper disposal of unused opioids.

Background: Ischemic heart disease (IHD) has a significant impact on public health and healthcare expenditures in the United States (US). Methods: We used data from the CDC WONDER database from 1999–2020 to identify trends in the IHD-related mortality of patients ≥ 75 years in the US. AAMRs per 100,000 population and APC were calculated and categorized by year, sex, race, and geographic divisions. Results: Between 1999 and 2020, a total of 8,124,568 IHD-related deaths were recorded. Notable declines in AAMR were observed from 1999 to 2014 (APC: -3.86) and from 2014 to 2018 (APC: -2.55), with an overall increase from 2018 to 2020 (APC: 3.76). Older men consistently demonstrated higher AAMRs than older females, with AAMRs for both sexes decreasing steadily from 1999 to 2018 and increasing in 2020. When stratified by race/ethnicity, Whites (1931.7) had the highest AAMR, followed by Blacks (1836.5), American Indians (1510.5), Hispanics (1464.4), and Asians (1093.6). Furthermore, nonmetropolitan areas (2015.2) showed greater AAMRs than metropolitan areas (1841.8). The ≥ 85-year group consistently exhibited higher IHD-related mortality rates compared to the 75–84 years group. In comparison, the older group [≥75 years] (1873.0) consistently exhibited higher IHD-related AAMRs than the younger group [<75 years] (64.0) throughout the study, showing a significant disparity. Chronic IHD (1552.0) consistently showed the highest AAMRs throughout the study, surpassing myocardial infarction (515.6), other ischemic heart diseases (24.0), and angina pectoris (5.6). Conclusion: Targeted interventions and resource allocation are crucial for areas with high IHD-related mortality. Public health policies should address demographic and geographical disparities, with further research for effective strategies. [ABSTRACT FROM AUTHOR]

Ripple effects mapping is a qualitative and participatory method, developed to capture the dynamic nature and interacting elements of an initiative, and its impacts. We present our experiences of using ripple effects mapping to evaluate complex public health initiatives across seven case studies in Bradford, UK. Seven researchers engaged in qualitative reflective practice to capture their individual experiences of using ripple effects mapping within their research and practice; outlining how the method has been adapted and highlighting key reflections and recommendations for implementing ripple effects mapping in the future. We developed ten recommendations, with corresponding strategies, for implementing ripple effects mapping sessions. The recommendations outline how ripple effects mapping can be implemented to improve engagement and anticipate and overcome potential barriers. In doing so, we outline how ripple effects mapping can be used, and adapted, to evaluate various public health initiatives, in research and practice. [ABSTRACT FROM AUTHOR]

Background: The HEALing Communities Study (HCS) included health campaigns as part of a community-engaged intervention to reduce opioid-related overdose deaths in 67 highly impacted communities across Kentucky, Massachusetts, New York, and Ohio. Five campaigns were developed with community input to provide information on opioid use disorder (OUD) and overdose prevention, reduce stigma, and build demand for evidence-based practices (EBPs). An evaluation examined the recognition of campaign messages about naloxone and whether stigma and efficacy beliefs regarding OUD treatment and naloxone changed in HCS intervention communities. Methods: Data were collected through surveys offered on Facebook/Instagram to members of communities participating in the HCS intervention and wait-list control communities. Results: Participants in HCS intervention communities reported a reduction in stigma regarding OUD and increased efficacy beliefs regarding naloxone associated with recognition of campaign messages. However, this finding is cautiously interpreted as there was no clear evidence for recognition differences between the treatment/control conditions. Conclusion: Study findings indicate associations between campaign message recognition and positive outcomes. Results also highlight possible challenges concerning evaluations of social media campaigns using conventional evaluation techniques. Trial registration: ClinicalTrials.gov NCT04111939. [ABSTRACT FROM AUTHOR]

Traineeships are becoming too big an issue to ignore: over half of all young Europeans now complete one. This article provides the first comprehensive critique of EU-level regulation on traineeships, uncovering the problems and paradoxes within the existing regime and offering solutions. Part I examines the problems with the current patchwork of regulation, comprised of the Quality Framework on Traineeships, Court of Justice case-law and European Committee of Social Rights' decision in YFJ v Belgium on unpaid internships. Challenges include the 'hollow' status of a trainee, the paradoxical requirements for employers to provide 'solid and meaningful' learning content without offering 'real or genuine' work and the incoherence of the 'bogus' traineeship approach, which is dependent upon a 'non-bogus' traineeship that does not exist. Part II then outlines three criteria for future regulation with a view to resolving the problems of the existing regime. Part III then evaluates the new regulatory proposals of the European Parliament and the Commission against these criteria. It is ultimately argued that the European Parliament's approach is preferable to the Commission's 'disguised employee' approach, since it fundamentally re-envisions trainees as workers with additional rights, reversing the current negative trainee status as those without working rights. [ABSTRACT FROM AUTHOR]

Students who are labelled as low attaining in mathematics are often seen as a homogeneous group and as such can be assigned learning attributes by others that observe their identity work in the classroom. Rachel Helme argues that by giving attention to an otherwise marginalised voice, it may be possible to challenge the discourse of deficiency, and influence the teaching and learning experiences of students who are labelled as low attaining. In this article Helme reflects on the use of poetic structures to analyse the narrative of Darren, one of a class of students labelled as low attaining. From her observations, it was evident that Darren had difficulties related to showing written workings out when attempting class work, and this was being positioned by his teacher as due to lack of effort. Darren was subsequently interviewed to listen to his experiences of learning mathematics and for his interpretation around the difficulties he presented. In the process of analysis, Helme used the poetic structure of an "I" poem within the Listening Guide method (Gilligan, Spencer, Weinberg & Bertsch, 2006) to enable her to focus on the intertwining of the hitherto unheard coexisting voices of the student. Her analysis seemed to illuminate a narrative that challenged the teacher's positioning of this student, however, the two voices that were exposed seemed to be in juxtaposition. The contribution of this article is to introduce, into the methodology of the Listening Guide, the novel poetic structure of a "they" poem, found in the narrative of the teacher talking about this student, as a contextual foil.

BackgroundDaily physical activity is vital for the health and development of children. However, many children are inactive. Previous attempts to achieve sustained increases in daily physical activity in children have been ineffective. Join Us: Move Play (JU:MP) is a whole-system, complex, community-based intervention aiming to increase the physical activity levels of children aged 7 to 11 years who live in areas of Bradford, England, which are multicultural and have high levels of deprivation. ObjectiveThe purpose of this quasiexperimental controlled trial is to assess whether the JU:MP program increases primary school children’s physical activity. MethodsThe study has a 2-arm, quasiexperimental, nonblinded, nonequivalent group design and will be conducted with primary school children aged 5 to 11 years at 3 timepoints, including baseline (before intervention), 24 months (during intervention), and 36 months (after intervention). Children attending primary schools within the intervention area will be invited to participate. Children attending similar schools within similar neighborhoods based on school and community census demographics (deprivation, free school meals, and ethnicity) outside of the JU:MP geographical area will be invited to participate in the control condition. At each timepoint, consenting participants will wear an accelerometer for 7 consecutive days (24 hours a day) to measure the primary outcome (average daily moderate-to-vigorous physical activity). Multivariable mixed effects linear regression will be applied to estimate differences in the primary outcome between the 2 arms at 24 months and 36 months on an intention-to-treat basis. The secondary outcome analysis will explore changes in socioemotional well-being (teacher reported), quality of life (parental/carer reported), and other contextual factors (parents/carer reported), as well as segments of the day activity, sleep, sedentary screen time, frequency of places to be active, parent practices (nondirective support and autonomy support), social cohesion, and neighborhood walking/exercise environment. ResultsRecruitment occurred from July 2021 to March 2022, and baseline data were collected from September 2021 to March 2022. As of March 2022 (end of baseline data collection), a total of 1454 children from 37 schools (17 intervention schools and 20 control schools) have been recruited. The first follow-up data collection will occur from September 2023 to March 2024, and the second and final follow-up data collection will occur from September 2024 to March 2025. Data analysis has not begun, and the final results will be published in December 2025. ConclusionsThis article describes the protocol for a quasiexperimental controlled trial examining a novel whole-system intervention. Trial RegistrationISRCTN ISRCTN14332797; https://www.isrctn.com/ISRCTN14332797 International Registered Report Identifier (IRRID)DERR1-10.2196/43619

Background: Folk Egyptian medicine considered from the most important source of the use of wild plants in medication. Wild plants are considered a perfect source of natural compounds that have been used as antimicrobial andante virus activities. Aims and Objective: The aim of the current study was to investigate the effect of the commonly used wild plants in the treatment of jaundice and they effect on HAV. This article provides much-needed insight into the effect of wild plants on the hepatitis A virus to shed more light on the important subject, which is unfortunately poorly investigated. Materials and Methods: In this investigation, the aqueous plant extracts of twenty-five wild Egyptian species, 16 perennials, and 9 annuals; three concentrations, 1%, 3% & 5%; were tested for HAV replication by using PA and PCR techniques. Questionnaires and interviews with Bedouins have been carried to know the most used species in the treatment of jaundice, and the usage values were calculated. Those species were collected from their habitats, rare ones purchased and reviewed their identifications and used in this work. Fecal and blood samples were taken from 9-10Y old patients, 35 girls and 25 boys. Results: The PA test revealed that 16 species out of twenty-five gave positive results, while the rest of the species gave negative results on Vero cells. Twelve of the sixteen species were perennial species, and the rest are annuals. The Plaque assay results showed that the most effective aqueous extract species, with the three concentrations, on HAV activity were those of Salvia verbennaca, Mentha microphylla, Ocimum basilicum, Cassia senna, Solenostemma argel, and Thymus capitatus, respectively. PCR test has been carried for the first three species and gave very faint nucleic acid tapes, which means that the plant extract of these species, the three concentrations, minimize the virus activity by a way or another. Samples from the patients tested for the antibodies for IgM and IgG using the ELISA test. Within both the females (58%) and males (42%), 6% have positive antibodies for IgM, while 36% in females and 34% in males’ have positive antibodies for IgG and 8% females and 10% males have both antibodies (IgM & IgG). Conclusion: Wild plants, especially those with essential oils can tolerate the Hepatitis A virus (HAV) activity and reduce its symptoms.

Introduction: Multiple sclerosis (MS) is an immune-mediated central nervous system disorder and a growing global health challenge affecting nearly 3 million people worldwide. Incidence and prevalence continue to increase with no known cause or cure. Globally governments and non-profit organizations fund research toward better understanding of and treatments for multiple sclerosis. Methods: This study identified MS research projects funded between 2021 and 2023 by government and non-profit organization sources. Projects were described by type of scientific approach, Pathways to Cure research category (i.e. Stop, Restore, End), and other key characteristics. Results: Over 2,300 MS research projects were identified through 16 non-profit MS organizations and 18 government databases. The overall global portfolio of these projects is valued at nearly one and a half billion Euros. The majority of projects were classified in the Stop category (60%). Research collaboration occurs in many forms among the research community; around 272 projects were reported to be co-funded. Conclusion: Global MS research collaboration will accelerate progress toward increased knowledge, effective treatments, improved health outcomes, and ultimately cures for MS. This landscape analysis highlights the current distribution of MS research investment between topics and begins to suggest where the MS community should focus to increase potential impact for current and future endeavors. [ABSTRACT FROM AUTHOR]

Background: Medication disposal programs have been promoted as one solution to the opioid crisis, but uptake by community members has been minimal. Objectives: To clarify perceptions of medication disposal options among people who have been prescribed an opioid analgesic in North Carolina to inform interventions that can facilitate the disposal of unused opioids. Methods: In 2022, we conducted focus groups with participants who received an opioid medication in the past year to gain information to develop an intervention related to the disposal of unused opioid medication (12 focus group discussions (FGDs); total N = 37; 30 identified as female, 6 as male, and 1 as another gender). Participants were shown a slide with the Food and Drug Administration's recommended disposal options and asked about their perceptions of each option. Themes were derived using an inductive, thematic, qualitative approach. Results: Seven themes about perceptions of medication disposal programs emerged from the data. Four of the themes reflect potential barriers to medication disposal: failed disposal attempts, lack of sufficient education on proper disposal, unclear meaning of specific disposal language, and concerns about existing disposal options. Three of the themes provide insight on potential facilitators of medication disposal: preference of low-cost disposal options, ease and accessibility among disposal methods, and preferred disposal methods. Conclusion: Patients should be provided clear and consistent guidance from prescribers and dispensing pharmacists on when and how to dispose of unused medications and opportunities to dispose of medications at no cost to the patient. [ABSTRACT FROM AUTHOR]