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Using the Theoretical Domains Framework (TDF), this rapid review coded the barriers and facilitators to binge-watching and identified corresponding behaviour change techniques (BCTs) for intervention purposes. Twenty-nine studies reporting influences on binge-watching fulfilled the inclusion criteria and passed quality appraisal checks. Data were extracted and coded accordingly, as informed by the TDF. Findings indicate that most facilitators focused on the goals of binge-watching, such as escapism, and the social influences, such as companionship, while most barriers related to behavioural regulation, such as self-control and self-regulation. BCTs included 'Goal setting (outcome)', 'Social comparison', and 'Self-monitoring of behaviour'. Results suggest intervention strategies targeting facilitators to binge-watching by incorporating the identified BCTs may succeed in inhibiting binge-watching behaviours. However, accounting for the intensity of binge-watching was not an objective of the present review; therefore, future research should take into account the varying levels of engagement in binge-watching when developing interventions. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is a neurodegenerative disease that involves multiple systems in the body. Numerous recent studies have revealed bidirectional crosstalk between the brain and bone, but the interaction between bone and brain in AD remains unclear. In this review, we summarize human studies of the association between bone and brain and provide an overview of their interactions and the underlying mechanisms in AD. We review the effects of AD on bone from the aspects of AD pathogenic proteins, AD risk genes, neurohormones, neuropeptides, neurotransmitters, brain‐derived extracellular vesicles (EVs), and the autonomic nervous system. Correspondingly, we elucidate the underlying mechanisms of the involvement of bone in the pathogenesis of AD, including bone‐derived hormones, bone marrow‐derived cells, bone‐derived EVs, and inflammation. On the basis of the crosstalk between bone and the brain, we propose potential strategies for the management of AD with the hope of offering novel perspectives on its prevention and treatment. Highlights: The pathogenesis of AD, along with its consequent changes in the brain, may involve disturbing bone homeostasis.Degenerative bone disorders may influence the progression of AD through a series of pathophysiological mechanisms.Therefore, relevant bone intervention strategies may be beneficial for the comprehensive management of AD. [ABSTRACT FROM AUTHOR]

Using the Theoretical Domains Framework (TDF), this rapid review coded the barriers and facilitators to binge-watching and identified corresponding behaviour change techniques (BCTs) for intervention purposes. Twenty-nine studies reporting influences on binge-watching fulfilled the inclusion criteria and passed quality appraisal checks. Data were extracted and coded accordingly, as informed by the TDF. Findings indicate that most facilitators focused on the goals of binge-watching, such as escapism, and the social influences, such as companionship, while most barriers related to behavioural regulation, such as self-control and self-regulation. BCTs included ‘Goal setting (outcome)’, ‘Social comparison’, and ‘Self-monitoring of behaviour’. Results suggest intervention strategies targeting facilitators to binge-watching by incorporating the identified BCTs may succeed in inhibiting binge-watching behaviours. However, accounting for the intensity of binge-watching was not an objective of the present review; therefore, future research should take into account the varying levels of engagement in binge-watching when developing interventions.

Writing is a facet of learning and daily communication. However, many deaf and hard-of-hearing learners (DHHLs) struggle with writing despite teachers’ efforts to teach writing effectively. For decades, researchers have developed interventions and theories for improving writing instruction with limited implementation research to assess what works and what does not, for whom, where, and how. The international goal to achieve quality education through Sustainable Development Goal 4, with target 4.6 for improving literacy skills by 2030, has increased awareness of improving learners’ literacy skills in developing countries, including those with disabilities. However, there is limited research on evidence-based interventions in improving DHHLs’ literacy skills, particularly in writing. One of these interventions is the self-regulated strategy development model (SRSD). This study describes the implementation of SRSD in Lesotho with two Grade 6 DHHLs, specifically focusing on identifying the teacher’s instructional adaptations and learners’ development as writers during SRSD instruction. This study also considers the pedagogical implications of SRSD instruction when used with DHHLs with limited English backgrounds.

Attention Deficit Hyperactivity Disorder (ADHD) significantly influences children's language acquisition and usage. This theoretical study explores the multifaceted impact of ADHD on language development, specifically focusing on reading and writing challenges. Existing research reveals that approximately 30% of children with ADHD show significant delays in reading proficiency. Additionally, about 40% of these children struggle with phonological processing, which directly impacts their reading and writing skills. Interventions targeting executive function training combined with phonics-based instruction have been shown to significantly improve language outcomes. This study introduces a comprehensive framework connecting these challenges to specific interventions and collaborative strategies, emphasizing the importance of a multi-disciplinary approach. This work provides perspectives on the specific connections between ADHD symptoms and language difficulties, offering detailed potential solutions based on empirical data. Moreover, it features the necessity of adopting integrated intervention strategies to advance academic outcomes and communicative competencies for children with ADHD, providing new understandings into effective educational practices. [ABSTRACT FROM AUTHOR]

In serving college students with mental disorders, on-campus mental health professionals have been lacking integrative theoretical frameworks to guide their missions of prevention, remedy, and development facilitation. In the current paper, we propose the positive clinical psychology as a theoretically and practically valuable framework for these missions by narratively reviewing the preventive, remedial, and developmental mechanisms derived from the theory and summarizing the most recent empirical evidence that supports each mechanism. We further discuss why and how these mechanisms and findings can be applied to on-campus mental health services to facilitate the resilience and optimal development of college students with mental disorders. Particularly, the use of resilience-focused and strength-based intervention strategies are promoted for services. [ABSTRACT FROM AUTHOR]

The ongoing international study on the mental health implications of climate change has prompted a deeper exploration of ecological emotions such as eco-anxiety, eco-worry and eco-grief, which are associated with environmental degradation and the escalating climate crisis. Although psychological and mental health literature has mainly presented preliminary conceptual analyses, the understanding of ecological emotions remains unclear. This narrative review aims to clarify the definition, highlight precipitating factors, and outline the effects of ecological emotions on mental health, emphasizing the need for thorough research to shift the nonclinical intervention approach from merely promoting individual resilience to encouraging collective engagement. Our analysis of the literature reveals that the existing theoretical framework, which predominantly focuses on bolstering individual resilience, provides only temporary relief for acute symptoms without addressing the foundational social and environmental factors that trigger these ecological emotions. We conclude that it is crucial to overcome the limitations of Western anthropocentrism's human-tohuman interaction approach and embrace the unity of humans and nature to effectively manage the increasing ecological emotions. This perspective draws insights from the holistic and collective wisdom of indigenous cultures and traditional Chinese philosophy, offering a potential pathway toward maintaining a sustainable emotional balance amid the worsening global ecological turmoil. [ABSTRACT FROM AUTHOR]

Introduction: The first case of COVID-19 in Kenya was reported on March 13, 2020, prompting the collection of baseline data during the initial spread of the disease. Subsequently, the Kenyan government implemented non-pharmaceutical interventions (NPIs) on April 9, 2020, to mitigate disease transmission over a two-month period. These measures were later gradually relaxed starting from June 9, 2020. Methods: We applied a deterministic mathematical model to simulate the dynamics of COVID-19 transmission in Kenya. Using baseline data, we estimated transmission and recovery rates and proposed a mathematical model of how NPIs affect disease transmission rates. The model extends to interventions that yield an increase in disease transmission, unlike previous models that were limited to a decrease in transmission. We computed the mitigation and relaxation fractions and hence deduced the impact of the interventions. Results: The mitigation measures imposed from April 9, 2020, reduced the disease transmission by 43.7% from the baseline level, while the relaxation from June 9, 2020, increased the transmission by 32% over the mitigation level. Without intervention, the model predicts that infections would have peaked at 30% by late May 2020. However, due to the combined effect of mitigation and relaxation, the epidemic peaked at 13% infection in mid-July 2020. Discussion: The model's projections closely align with observed data, providing valuable insights for planning. Ongoing research aims to refine the model to capture sub-waves and spikes, as well as simulate multiple waves of infection. These efforts will enhance our understanding of COVID-19 dynamics and inform effective public health strategies. The estimated basic reproduction number = 2.76, consistent with previous findings, underscores the validity of our model and its relevance in predicting disease transmission dynamics. [ABSTRACT FROM AUTHOR]

Dual cognitive and mobility impairments are associated with an increased risk of dementia. Recent studies examining temporal trajectories of mobility and cognitive function in aging found that dual decline is associated with higher dementia risk than memory decline or gait decline only. Although initial data show that individuals with dual decline or impairment have excessive cardiovascular and metabolic risk factors, the causes of dual decline or what underlies dual decline with a high risk of dementia remain largely unknown. In December 2021, the National Institute on Aging Intramural and Extramural Programs jointly organized a workshop on Biology Underlying Moving and Thinking to explore the hypothesis that older persons with dual decline may develop dementia through a specific pathophysiological pathway. The working group discussed assessment methods for dual decline and possible mechanisms connecting dual decline with dementia risk and pinpointed the most critical questions to be addressed from a translational perspective.

Abstract Objective Clinician distress is a multidimensional condition that includes burnout, decreased meaning in work, severe fatigue, poor work–life integration, reduced quality of life, and suicidal ideation. It has negative impacts on patients, providers, and healthcare systems. In this three-phase qualitative investigation, we identified workplace-related factors that drive clinician distress and co-designed actionable interventions with inter-professional cardiovascular clinicians to decrease their distress and improve well-being within a Canadian quaternary hospital network. Methods Between October 2021 and May 2022, we invited nurses, allied health professionals, and physicians to participate in a three-phase qualitative investigation. Phases 1 and 2 included individual interviews and focus groups to identify workplace-related factors contributing to distress. Phase 3 involved co-design workshops that engaged inter-professional clinicians to develop interventions addressing drivers of distress identified. Qualitative information was analyzed using descriptive thematic analysis. Results Fifty-one clinicians (24 nurses, 10 allied health professionals, and 17 physicians) participated. Insights from Phases 1 and 2 identified five key thematic drivers of distress: inadequate support within inter-professional teams, decreased joy in work, unsustainable workloads, limited opportunities for learning and professional growth, and a lack of transparent leadership communication. Phase 3 co-design workshops yielded four actionable interventions to mitigate clinician distress in the workplace: re-designing daily safety huddles, formalizing a nursing coaching and mentorship program, creating a value-added program e-newsletter, and implementing an employee experience platform. Conclusion This study increases our understanding on workplace-related factors that contribute to clinician distress, as shared by inter-professional clinicians specializing in cardiovascular care. Healthcare organizations can develop effective interventions to mitigate clinician distress by actively engaging healthcare workers in identifying workplace drivers of distress and collaboratively designing tailored, practical interventions that directly address these challenges.

Financial toxicity adversely affects quality of life and treatment outcomes for patients with cancer. This scoping review examined interventions aimed at mitigating financial toxicity in adult patients with cancer and their effectiveness. We utilized five bibliographical databases to identify studies that met our inclusion criteria. The review included studies conducted among adult patients with cancer in the United States and published in English between January 2011 to March 2023. The review identified eight studies that met the inclusion criteria. Each of the studies discussed the implementation of interventions at the patient/provider and/or health system level. Collectively, the findings from this scoping review highlight both the limited number of published studies that are aimed at mitigating financial toxicity and the need to create and assess interventions that directly impact financial toxicity in demographically diverse populations of adult patients with cancer.

Objective: Clinician distress is a multidimensional condition that includes burnout, decreased meaning in work, severe fatigue, poor work–life integration, reduced quality of life, and suicidal ideation. It has negative impacts on patients, providers, and healthcare systems. In this three-phase qualitative investigation, we identified workplace-related factors that drive clinician distress and co-designed actionable interventions with inter-professional cardiovascular clinicians to decrease their distress and improve well-being within a Canadian quaternary hospital network. Methods: Between October 2021 and May 2022, we invited nurses, allied health professionals, and physicians to participate in a three-phase qualitative investigation. Phases 1 and 2 included individual interviews and focus groups to identify workplace-related factors contributing to distress. Phase 3 involved co-design workshops that engaged inter-professional clinicians to develop interventions addressing drivers of distress identified. Qualitative information was analyzed using descriptive thematic analysis. Results: Fifty-one clinicians (24 nurses, 10 allied health professionals, and 17 physicians) participated. Insights from Phases 1 and 2 identified five key thematic drivers of distress: inadequate support within inter-professional teams, decreased joy in work, unsustainable workloads, limited opportunities for learning and professional growth, and a lack of transparent leadership communication. Phase 3 co-design workshops yielded four actionable interventions to mitigate clinician distress in the workplace: re-designing daily safety huddles, formalizing a nursing coaching and mentorship program, creating a value-added program e-newsletter, and implementing an employee experience platform. Conclusion: This study increases our understanding on workplace-related factors that contribute to clinician distress, as shared by inter-professional clinicians specializing in cardiovascular care. Healthcare organizations can develop effective interventions to mitigate clinician distress by actively engaging healthcare workers in identifying workplace drivers of distress and collaboratively designing tailored, practical interventions that directly address these challenges. [ABSTRACT FROM AUTHOR]

Financial toxicity adversely affects quality of life and treatment outcomes for patients with cancer. This scoping review examined interventions aimed at mitigating financial toxicity in adult patients with cancer and their effectiveness. We utilized five bibliographical databases to identify studies that met our inclusion criteria. The review included studies conducted among adult patients with cancer in the United States and published in English between January 2011 to March 2023. The review identified eight studies that met the inclusion criteria. Each of the studies discussed the implementation of interventions at the patient/provider and/or health system level. Collectively, the findings from this scoping review highlight both the limited number of published studies that are aimed at mitigating financial toxicity and the need to create and assess interventions that directly impact financial toxicity in demographically diverse populations of adult patients with cancer. [ABSTRACT FROM AUTHOR]

Global and country-specific mathematics performance constitutes a major challenge, both for educators and policymakers. Realisation of the African Union Agenda 2013 hinges significantly upon transformation of education. In this regard, mathematics and science education, specifically, are instruments for scientific and technological development to position Africa on the same level as the global league of continents in the future. It is, therefore, important to develop amongst learners a good understanding of a mathematical concept such as number sense from an early age, given that students who have a good sense of numbers can manipulate figures to simplify calculations and have the confidence to approach problems in a variety of ways. It is for this reason that the present study investigates the intervention strategies implemented by educators in enhancing learners’ understanding of number sense in the Ekurhuleni North District schools, Gauteng Province, South Africa. The study used a case study design and a qualitative research approach, both of which were supported by an interpretivist paradigm. The study made use of a semi-structured interview to gather data from mathematics teachers, learners, and a principal in the selected school. Research findings revealed that although mental computation, use of concrete props, use of the number line, and a counting strategy are some of the various strategies employed to enhance learners’ understanding of number sense, teachers need to develop a sound understanding of number sense and be flexible in their approaches in order to assist learners. Based on the findings, it was recommended that curriculum designers and teachers concentrate on teaching methods to help students develop learners’ number sense, as this can lead to potential mathematics success.

This study aimed to investigate the various influencing factors for intraoperative pressure sores in patients with craniocerebral microsurgery and provide nursing intervention strategies for surgical pressure sores in a clinical operating room. This was a case–control study on 2157 patients who underwent craniocerebral microsurgery in the craniocerebral department of the hospital between November 2021 and November 2022. Of these, 62 patients with intraoperative pressure sores were compared with 248 patients without pressure sores during the same period using a 1:4 case–control method. A logistic regression model was used to analyze the effect of possible factors on pressure sores in an operating room. The incidence of pressure sores in craniocerebral microsurgery was 2.87%. The logistic regression analysis showed that skin at the pressure site [odds ratio (OR) = 1.759, 95% confidence interval (CI): 1.137–2.721], surgical position (OR = 1.727, 95% CI: 1.338–2.228), intraoperative body temperature (OR = 2.229, 95% CI: 1.229–4.042), and surgical time (OR = 2.009, 95% CI: 1.221–3.303) were independent factors for the occurrence of intraoperative pressure sores. The high-risk factors for pressure sores in craniocerebral microsurgery included fasting time, surgical position, intraoperative temperature, and skin at the pressure site. Targeted attention and protection had a positive effect in preventing intraoperative pressure sores in patients who underwent craniocerebral microsurgery. [ABSTRACT FROM AUTHOR]

Background: People with disabilities in sheltered workshops are disempowered and face many barriers, adversely affecting their income-generating activities and weakening their competitiveness in the labour market. There is limited evidence on how to overcome these barriers. Objectives: This paper seeks to propose a framework to overcome the barriers experienced by people with disabilities participating in income-generating activities in a sheltered workshop. Method: The qualitative exploratory single case study was done with observations and semi-structured interviews as data collection methods. Purposive sampling was used to select 24 participants between ages 22 and 52 years, and content analysis was done of transcribed interviews. Community-based rehabilitation (CBR) guidelines were used to develop the framework. Results: A proposed framework was developed that outlined intervention strategies to address the barriers experienced by sheltered workshop participants to promote increased participation of people with disabilities in income-generation activities, thereby improving their quality of life. Conclusion: The participation of people with disabilities in income-generating activities is hindered by several barriers. However, the proposed framework overcomes the barriers to effective participation in income-generating activities. Contribution: People with disabilities will benefit from this framework as it will address their challenges and needs for empowerment. It would also inform stakeholders involved about these challenges and strategies. [ABSTRACT FROM AUTHOR]

This study aims to understand the difficulties young Kurdish language learners face with developmental language disorder in bilingual settings and to evaluate their impact on English as a foreign language acquisition. Underscoring the significance of this research, the study's primary objective is to determine the characteristics of developmental language disorder in this context and their implications for academic assimilation. The Clinical Evaluation of Language Fundamentals assessment was selected to achieve this primary objective due to its suitability for assessing the British population's linguistic characteristics and age group. Seven subtests were chosen to comprehensively evaluate various aspects of language proficiency, allowing for a thorough evaluation of the participants' language skills. This research expands its significance. These initiatives include more extensive investigations, innovative participant recruitment methods, exploration of cultural influences, longitudinal studies to discover long-term effects, critical analysis of intervention strategies, examination of the complex relationship between emotional regulation and language development, investigation of genetic and environmental factors contributing to developmental language disorder, and evaluation of the far-reaching consequences. Upon analysis of the collected data, several significant findings shed light on the efficacy of individualised approaches in mitigating communication and academic difficulties in individuals with developmental language disorders. [ABSTRACT FROM AUTHOR]

Major depressive disorder (MDD) represents a serious public health concern, negatively affecting individuals' quality of life and making a substantial contribution to the global burden of disease. Anhedonia is a core symptom of MDD and is associated with poor treatment outcomes. Variability in anhedonia components within MDD has been observed, suggesting heterogeneity in psychopathology across subgroups. However, little is known about anhedonia subgroups in MDD and their underlying neural correlates across subgroups. To address this question, we employed a hierarchical cluster analysis based on Temporal Experience of Pleasure Scale subscales in 60 first-episode, drug-naive MDD patients and 32 healthy controls. Then we conducted a connectome-wide association study and whole-brain voxel-wise functional analyses for identified subgroups. There were three main findings: (1) three subgroups with different anhedonia profiles were identified using a data mining approach; (2) several parts of the reward network (especially pallidum and dorsal striatum) were associated with anticipatory and consummatory pleasure; (3) different patterns of within- and between-network connectivity contributed to the disparities of anhedonia profiles across three MDD subgroups. Here, we show that anhedonia in MDD is not uniform and can be categorized into distinct subgroups, and our research contributes to the understanding of neural underpinnings, offering potential treatment directions. This work emphasizes the need for tailored approaches in the complex landscape of MDD. The identification of homogeneous, stable, and neurobiologically valid MDD subtypes could significantly enhance our comprehension and management of this multifaceted condition. [ABSTRACT FROM AUTHOR]

IntroductionThe first case of COVID-19 in Kenya was reported on March 13, 2020, prompting the collection of baseline data during the initial spread of the disease. Subsequently, the Kenyan government implemented non-pharmaceutical interventions (NPIs) on April 9, 2020, to mitigate disease transmission over a two-month period. These measures were later gradually relaxed starting from June 9, 2020.MethodsWe applied a deterministic mathematical model to simulate the dynamics of COVID-19 transmission in Kenya. Using baseline data, we estimated transmission and recovery rates and proposed a mathematical model of how NPIs affect disease transmission rates. The model extends to interventions that yield an increase in disease transmission, unlike previous models that were limited to a decrease in transmission. We computed the mitigation and relaxation fractions and hence deduced the impact of the interventions.ResultsThe mitigation measures imposed from April 9, 2020, reduced the disease transmission by 43.7% from the baseline level, while the relaxation from June 9, 2020, increased the transmission by 32% over the mitigation level. Without intervention, the model predicts that infections would have peaked at 30% by late May 2020. However, due to the combined effect of mitigation and relaxation, the epidemic peaked at 13% infection in mid-July 2020.DiscussionThe model’s projections closely align with observed data, providing valuable insights for planning. Ongoing research aims to refine the model to capture sub-waves and spikes, as well as simulate multiple waves of infection. These efforts will enhance our understanding of COVID-19 dynamics and inform effective public health strategies. The estimated basic reproduction number R0=2.76, consistent with previous findings, underscores the validity of our model and its relevance in predicting disease transmission dynamics.

The study reported here aimed to explore the Intervention strategies for challenges experienced when supporting learners from child-headed households in secondary schools. Children from child-headed households experience challenges that hinder them from receiving good quality education. It is, therefore important for schools to ensure that classroom teachers are aware of the challenges experienced by children from child-headed households. This study followed the qualitative approach to explore the intervention strategies to be used. The study consisted of 20 participants (principals, Departmental Heads, teachers and School Governing Bodies) in South Africa. Data were collected through individual semi-structured interviews and document analysis. The Bottom-up theory was the underpinning theory for our study. Thematical analysis was followed. This study revealed that children from child-headed households were not identified at schools. Therefore, schools do not have a database of children from child-headed households hence a lack of intervention strategies. We recommended that schools should establish the School Based Support Team and follow the collaborative model as an intervention to support children from child-headed households. The study provided insights on intervention strategies that schools and the Department of Education should implement for challenges experienced by schools when supporting learners from child-headed households.

BackgroundExperiencing financial insecurity and being underserved is often associated with low health literacy, i.e., the ability to identify, obtain, interpret and act upon health information, which may result in poor health outcomes. Little is known about effective interventions for promoting health literacy among underserved populations. The objective of this systematic review is to summarize the literature on such interventions and identify characteristics that differentiate more effective interventions.MethodsFollowing PRISMA guidelines we searched the databases SCOPUS, Pubmed, Web of Science core collection and CINAHL. We included primary studies with a quantitative study design and control groups testing interventions to increase health literacy or health knowledge in underserved populations between 18 and 65 years. Where possible, we converted effect sizes into Cohen’s d and compared mean differences of intervention and control groups. Albatross plots were created to summarize the results according to different health literacy and health knowledge outcomes.ResultsWe screened 3,696 titles and abstracts and 206 full texts. In total, 86 articles were analyzed, of which 55 were summarized in seven albatross plots. The majority of the studies (n = 55) were conducted in the United States and had a randomized controlled study design (n = 44). More effective intervention approaches assessed needs of participants through focus group discussions prior to conducting the intervention, used bilingual educational materials, and included professionals fluent in the first languages of the study population as intervention deliverers. Additionally, the use of educational materials in video and text form, fotonovelas and interactive group education sessions with role playing exercises were observed to be effective.DiscussionAlthough the outcomes addressed in the included studies were heterogeneous, effective intervention approaches were often culturally sensitive and developed tailored educational materials. Interventions aiming to promote health literacy in underserved populations should hence consider applying similar approaches.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=323801, PROSPERO registration ID: CRD42022323801.

Yi Jiang,1 Yanyan Song2 1Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710000, People’s Republic of China; 2Department of Cardiovascular Surgery, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of ChinaCorrespondence: Yanyan Song, Department of Cardiovascular Surgery, General Hospital of Ningxia Medical University, No. 804 Shengli South Street, Xingqing District, Yinchuan, 750004, People’s Republic of China, Tel +86 951-6743014, Fax +86 951-6744302, Email nxfysyy@163.comObjective: To investigate the risk factors and intervention strategies for the development of acute kidney injury (AKI) after cardiac valve replacement with extracorporeal circulation.Methods: Retrospective analysis of the clinical data of a total of 106 patients diagnosed with heart valve disease and undergoing extracorporeal circulation heart valve replacement surgery from January 2021 to December 2021 in the Department of Cardiac and Major Vascular Surgery of our hospital. The two groups were divided into AKI and non-AKI groups according to whether acute kidney injury occurred after surgery, and the preoperative, intraoperative and postoperative clinical data were compared. Single-factor analysis and multi-factor logistic regression analysis were used to explore the risk factors for acute kidney injury after extracorporeal heart valve replacement, and to improve the prognosis by giving kidney function protection strategies as early as possible.Results: Univariate analysis showed that age, preoperative blood creatinine > 130umol/L, LVEF < 45%, presence of subacute infective endocarditis (SIE), concurrent coronary artery bypass grafting (CABG), time to extracorporeal circulation, time to surgery, MAP < 70mmHg, urine output < 0.5mL/(kg-h), pulmonary infection, low cardiac output, and bacteraemia were risk factors for postoperative AKI. Multi-factor regression analysis showed that preoperative blood creatinine > 130umol/l, LVEF < 45%, combined infective endocarditis, extracorporeal circulation time > 2h, intraoperative and postoperative hypotension, low cardiac output, and postoperative bacteremia were independent risk factors for postoperative AKI.Conclusion: Active intervention strategies in the perioperative period can reduce the occurrence of postoperative AKI and improve patient prognosis.Keywords: heart valve replacement surgery, acute kidney injury, risk factors, intervention strategies

Abstract Spillover of trypanosomiasis parasites from wildlife to domestic livestock and humans remains a major challenge world over. With the disease targeted for elimination by 2030, assessing the impact of control strategies in communities where there are human-cattle-wildlife interactions is therefore essential. A compartmental framework incorporating tsetse flies, humans, cattle, wildlife and various disease control strategies is developed and analyzed. The reproduction is derived and its sensitivity to different model parameters is investigated. Meanwhile, the optimal control theory is used to identify a combination of control strategies capable of minimizing the infected human and cattle population over time at minimal costs of implementation. The results indicates that tsetse fly mortality rate is strongly and negatively correlated to the reproduction number. It is also established that tsetse fly feeding rate in strongly and positively correlated to the reproduction number. Simulation results indicates that time dependent control strategies can significantly reduce the infections. Overall, the study shows that screening and treatment of humans may not lead to disease elimination. Combining this strategy with other strategies such as screening and treatment of cattle and vector control strategies will result in maximum reduction of tsetse fly population and disease elimination.

Attention Deficit Hyperactivity Disorder (ADHD) significantly influences children’s language acquisition and usage. This theoretical study explores the multifaceted impact of ADHD on language development, specifically focusing on reading and writing challenges. Existing research reveals that approximately 30% of children with ADHD show significant delays in reading proficiency. Additionally, about 40% of these children struggle with phonological processing, which directly impacts their reading and writing skills. Interventions targeting executive function training combined with phonics-based instruction have been shown to significantly improve language outcomes. This study introduces a comprehensive framework connecting these challenges to specific interventions and collaborative strategies, emphasizing the importance of a multi-disciplinary approach. This work provides perspectives on the specific connections between ADHD symptoms and language difficulties, offering detailed potential solutions based on empirical data. Moreover, it features the necessity of adopting integrated intervention strategies to advance academic outcomes and communicative competencies for children with ADHD, providing new understandings into effective educational practices.

General practitioners are medical personnel with high integrated degree, and are the "gatekeepers" of residents' health. Violent incidents affecting health care not only seriously harm the the physical and psychological health of general practitioners, also affect the quality and level of basic medical services, which increases the turnover of general practitioners and the economic burden on the health care system. Previous studies have shown that more than half of general practitioners had experienced workplace violence, with the most common types including verbal violence and threats, followed by physical violence, sexual harassment and assault, patients and their family members were the main perpetrators. The failure of the medical services quality to meet the demands of patients, alcohol abuse, drug abuse and mental disorders of perpetrators, poor physician-patient communication were important factors associated with workplace violence. It is suggested to improve policies and regulations, norms of conduct related to workplace violence of healthcare workers, establish and improve the reporting and punishment mechanisms, enhance the capacity of healthcare workers and health care institutions to provide medical services and prevent workplace violence, give proper play to the role of the public media, promote the establishment of "zero-tolerance" system for violence.

In contemporary European educational contexts, equal access to education and learning opportunities have become one of the main issues. Socio-economic factors and the surrounding environment are widely recognised as the main barriers to changing an individual’s social position in society, while the disparity between educational opportunities and learning outcomes is seen to be growing. This paper aims to address the ongoing challenges and opportunities to break down barriers to upward mobility and promote equal opportunities for all by looking at different intervention approaches, such as coaching and positive role models. International research involving participants from 6 European countries - Lithuania, Italy, Norway, Greece, Romania and the United Kingdom - was carried out to assess the effectiveness of the coaching method and its impact on unlocking learning potential in the educational setting. The research findings suggest that coaching effectively promotes learning and behavioural change in disadvantaged learners.

Greenwashing leads to consumer skepticism of all green products as well as doubts about company claims regarding sustainability. However, the understanding of how to regain green consumer trust after greenwashing is rather limited. The authors fill this gap by exploring the psychological process of green consumers following intervention strategies designed to reduce greenwashing. We collect and interpret quantitative data from two psychological experiments, the first experiment identified two types of intervention strategies that serve to counter the negative impact of greenwashing and based on our findings from the first studies, we proposed and tested the moderating effect of two factors—implicit beliefs of consumers and companies who implement intervention strategies after greenwashing. The results indicate that distrust regulation (quantifying a product's green attributes) and trustworthiness demonstration (visualizing environmental behaviors) are effective intervention strategies that can enable consumers to re-evaluate the cost-benefit of green products, and which may serve as critical psychological factors for green consumers and contribute to the degree of trust. Validation and comparative study of the derived results show that distrust regulation, followed by trustworthiness demonstration, has the best effect on increasing green trust after intervention. If the sequence is reversed, the effect of the intervention strategy is worse than if only one strategy had been applied. The implicit beliefs of green consumers play a moderating role between intervention strategies and reconsideration of the cost-benefit of green products. The behavior of genuinely green companies and the incremental beliefs of consumers can promote the intervention effect after greenwashing. Alternatively, the behavior of greenwashing companies can easily counter these effects. These findings contribute to knowledge about which psychological factors can promote or hinder the effectiveness of an intervention. [ABSTRACT FROM AUTHOR]

Visceral leishmaniasis (VL) is a severe and often fatal form of leishmaniasis caused by Leishmania donovani in the Indian sub-continent. Post Kala-azar Dermal Leishmaniasis (PKDL) is a late cutaneous manifestation of VL, typically occurring after apparent cure of VL, but sometimes even without a prior history of VL in India. PKDL serves as a significant yet neglected reservoir of infection and plays a crucial role in the transmission of the disease, posing a serious threat to the VL elimination program in the Indian sub-continent. Therefore, the eradication of PKDL should be a priority within the current VL elimination program aimed at achieving a goal of less than 1 case per 10,000 in the population at the district or sub-district levels of VL endemic areas. To accomplish this, a comprehensive understanding of the pathogenesis of PKDL is essential, as well as developing strategies for disease management. This review provides an overview of the current status of diagnosis and treatment options for PKDL, highlighting our current knowledge of the immune responses underlying disease development and progression. Additionally, the review discusses the impact of PKDL on elimination programs and propose strategies to overcome this challenge and achieve the goal of elimination. By addressing the diagnostic and therapeutic gaps, optimizing surveillance and control measures, and implementing effective intervention strategies, it is possible to mitigate the burden of PKDL and facilitate the successful elimination of VL in the Indian sub-continent. [ABSTRACT FROM AUTHOR]

Spillover of trypanosomiasis parasites from wildlife to domestic livestock and humans remains a major challenge world over. With the disease targeted for elimination by 2030, assessing the impact of control strategies in communities where there are human-cattle-wildlife interactions is therefore essential. A compartmental framework incorporating tsetse flies, humans, cattle, wildlife and various disease control strategies is developed and analyzed. The reproduction is derived and its sensitivity to different model parameters is investigated. Meanwhile, the optimal control theory is used to identify a combination of control strategies capable of minimizing the infected human and cattle population over time at minimal costs of implementation. The results indicates that tsetse fly mortality rate is strongly and negatively correlated to the reproduction number. It is also established that tsetse fly feeding rate in strongly and positively correlated to the reproduction number. Simulation results indicates that time dependent control strategies can significantly reduce the infections. Overall, the study shows that screening and treatment of humans may not lead to disease elimination. Combining this strategy with other strategies such as screening and treatment of cattle and vector control strategies will result in maximum reduction of tsetse fly population and disease elimination. [ABSTRACT FROM AUTHOR]

Background: The South African government has developed many policies for the prevention and control of non-communicable diseases. However, non-communicable diseases remain among the major causes of morbidity and mortality in South Africa. Although these diseases are linked to interaction of multiple risk factors, many of which are modifiable, they continue to cause much suffering particularly among the marginalised and people from the lower socio-economic status. Objectives: The objective of this research was to explore and present the inclusion of social determinants of health in the policies meant for the prevention and control of non-communicable diseases in South Africa. Method: The qualitative document analysis approach was used to conduct policy analysis of purposefully selected policies for prevention and control of cancers, obesity and mental and behavioural disorders in South Africa. Results: The analysis revealed that policies for prevention and control of cancers, obesity and mental and behavioural disorders included policy intervention activities that focused on five social determinants of health: (1) governance, (2) social policies, (3) public policies, (4) material circumstances and (5) health system. Conclusion: Excluding most of the important social determinants of health in the policies for prevention and control of non-communicable diseases means that these policies would continue to fail in preventing these diseases from the root causes. Contribution: This article points out weaknesses in the policies meant for prevention and control of obesity, cancers and mental and behavioural disorders. This article further suggests policy improvement strategies that may be considered to effectively address these diseases.

Objectives: In autumn 2021, there was a surge of COVID-19 infections in Austria, and vaccination coverage stagnated at a below-average level compared to the rest of Europe. Surveys showed that both children and adolescents were the main drivers of the rising infection rates and that vaccination numbers were particularly low in this age group. This was due to widespread vaccination skepticism and hesitancy among parents of unvaccinated children and adolescents.Methods: Here, we describe a novel intervention concept that allowed us to efficiently tackle parental vaccine hesitancy. We designed an intervention series that followed a reproducible format based on online face-to-face seminars in groups of a maximum of twenty people. Each seminar included an anonymous online questionnaire for internal quality control. Moreover, we assessed the motives of parental vaccine hesitancy and asked participants to rate subjective vaccine willingness for their children on a scale of zero to ten.Results: Within 8 weeks, more than 580 people participated in the seminar series. We found that concerns about the side effects of the vaccine were the predominant motive of vaccination hesitancy among the study population. Overall, the intervention could successfully increase the median parental vaccination willingness of participants from a score of five to eight. We identified tree hesitancy motives (distrust towards the pharmaceutical industry, the government, or feelings of restriction from personal freedom) that were associated with below-average vaccination willingness and significant lower increase.Conclusion: With this study we analyzed motives driving COVID-19 vaccination hesitancy among parents of unvaccinated children and reasons of parents to restrain their children from getting vaccinated. The intervention method described here, could effectively address individual concerns on a personal level while at the same time reach a large number of people across geographical and language barriers. Thereby we could significantly increase subjective vaccination willingness of the participants. Our approach is easy to apply, highly cost-effective, and can be used to tackle any kind of medical misinformation.

Visceral leishmaniasis (VL) is a severe and often fatal form of leishmaniasis caused by Leishmania donovani in the Indian sub-continent. Post Kala-azar Dermal Leishmaniasis (PKDL) is a late cutaneous manifestation of VL, typically occurring after apparent cure of VL, but sometimes even without a prior history of VL in India. PKDL serves as a significant yet neglected reservoir of infection and plays a crucial role in the transmission of the disease, posing a serious threat to the VL elimination program in the Indian sub-continent. Therefore, the eradication of PKDL should be a priority within the current VL elimination program aimed at achieving a goal of less than 1 case per 10,000 in the population at the district or sub-district levels of VL endemic areas. To accomplish this, a comprehensive understanding of the pathogenesis of PKDL is essential, as well as developing strategies for disease management. This review provides an overview of the current status of diagnosis and treatment options for PKDL, highlighting our current knowledge of the immune responses underlying disease development and progression. Additionally, the review discusses the impact of PKDL on elimination programs and propose strategies to overcome this challenge and achieve the goal of elimination. By addressing the diagnostic and therapeutic gaps, optimizing surveillance and control measures, and implementing effective intervention strategies, it is possible to mitigate the burden of PKDL and facilitate the successful elimination of VL in the Indian sub-continent.

The tourism industry is struggling to recover and overcome the shortfalls due to the ongoing COVID-19 pandemic. The research identified the determinants to consider in the future from a South African supply-side perspective. An online questionnaire was employed in 2020. Exploratory factor analyses identified the dependent (the perceived future of the industry after COVID-19) and independent variables: ways to reach suppliers’ target market(s) during the pandemic, the predicted adopted strategies after COVID-19 and the perceived sector risk. Linear regression analyses revealed the significant variables that provide guidelines for managing the industry’s future.

This study aimed to understand clinician, researcher and consumer views regarding factors which influence eating disorder (ED) risk during behavioral weight management, including individual risk factors, intervention strategies and delivery features. Eighty-seven participants were recruited internationally through professional and consumer organizations and social media and completed an online survey. Individual characteristics, intervention strategies (5-point scale) and delivery features (important/unimportant/unsure) were rated. Participants were mostly women (n = 81), aged 35–49 y, from Australia or United States, were clinicians and/or reported lived experience of overweight/obesity and/or ED. There was agreement (64% to 99%) that individual characteristics were relevant to ED risk, with history of ED, weight-based teasing/stigma and weight bias internalization having the highest agreement. Intervention strategies most frequently rated as likely to increase ED risk included those with a focus on weight, prescription (structured diets, exercise plans) and monitoring strategies, e.g., calorie counting. Strategies most frequently rated as likely to decrease ED risk included having a health focus, flexibility and inclusion of psychosocial support. Delivery features considered most important were who delivered the intervention (profession, qualifications) and support (frequency, duration). Findings will inform future research to quantitatively assess which of these factors predict eating disorder risk, to inform screening and monitoring protocols. [ABSTRACT FROM AUTHOR]

The current dimension of informal settlements in Maputo requires the definition of action models framed by empirical evidence, taking advantage of pre-existing socio-spatial and environmental conditions to define physical interventions through sustainable urban design strategies, with a view to their physical (and socio-economic) upgrading. Thus, this paper highlights the potential of urban design in the environmentally sustainable upgrading of Maputo's informal neighbourhoods. This article aimed to develop sustainable and resilient urban design proposals and identify strategies capable of guiding the future process of physical territorial transformation towards a more sustainable model. Methodologically, a literature review was undertaken for the purpose of understanding the issues related to the theme and the general characteristics of informal neighbourhoods, as well as for exploring a case study: the George Dimitrov Neighbourhood. It was concluded that the current fabric of informal settlements possesses physical characteristics which facilitate the application of sustainable and responsive urban design strategies for the requalification of these deprived areas. Despite the marked difference between the spatial configurations of informal neighbourhoods and those of formal cities, it is possible to increase the level of resilience and sustainability of informal settlements through surgical and deep solutions, anchored on the particularities of the existing fabric. [ABSTRACT FROM AUTHOR]

Scaffolding entails contingency, denoting teachers’ level adaptation in providing transient support. In this study, a symbiosis of the model of contingent teaching (MCT) and the contingent shift framework (CSF) was utilized. Therefore, 360 elementary and advanced EFL learners took a course and filled out two sets of related questionnaires twice, administered at the outset and the end of the course. The transcribed data including the class interactions and intervention strategies were organized into contingent or non-contingent fragments based on models’ criteria. According to the results of the Wilcoxon rank test and the Paired Sample t-test, there was a significant difference between the results of the pre and post-tests in the two mentioned levels for the two constructs. Furthermore, the results of the Single Sample t-test showed that the CSF was more utilized than the MCT in both levels. Moreover, the intervention strategies of the MCT significantly differed in the two levels. Questioning was a highly used strategy at both levels. Hints and modeling were the least utilized strategies in elementary and advanced levels, respectively. Therefore, such contingent symbiosis could have prolific results in self-regulation and gaining willingness to communicate

Background: People with disabilities in sheltered workshops are disempowered and face many barriers, adversely affecting their income-generating activities and weakening their competitiveness in the labour market. There is limited evidence on how to overcome these barriers. Objectives: This paper seeks to propose a framework to overcome the barriers experienced by people with disabilities participating in income-generating activities in a sheltered workshop. Method: The qualitative exploratory single case study was done with observations and semi-structured interviews as data collection methods. Purposive sampling was used to select 24 participants between ages 22 and 52 years, and content analysis was done of transcribed interviews. Community-based rehabilitation (CBR) guidelines were used to develop the framework. Results: A proposed framework was developed that outlined intervention strategies to address the barriers experienced by sheltered workshop participants to promote increased participation of people with disabilities in income-generation activities, thereby improving their quality of life. Conclusion: The participation of people with disabilities in income-generating activities is hindered by several barriers. However, the proposed framework overcomes the barriers to effective participation in income-generating activities. Contribution: People with disabilities will benefit from this framework as it will address their challenges and needs for empowerment. It would also inform stakeholders involved about these challenges and strategies.

Erected in less than a year, the Brunfaut Tower, the first steel-framed housing tower in Brussels, demonstrates an exceptional economy of means and materials. It constitutes a rare testimony of an era when efficiency predominated over performance. Its fine, slender architecture and the design of its facades help define its resolutely modern identity. Despite its qualities, it has had a difficult reception; its inhabitants having given it the nickname “the cardboard box". For more than twenty years, arguments have been raised against the uncomfortable and unhealthy conditions in the building. The experimental dimension of some constructive and technical choices, in addition to the lack of maintenance, make his other more positive qualities unrecognizable. After many years of procrastination, a feasibility survey was conducted by Lacaton, Vassal and Druot that led to the heavy and irreversible renovation of the tower, supporting the advent of a "new image" while also preserving its symbolic imprint in the Brussels landscape. This monographic contribution reveals a certain number of incompatibilities between the stated goals of this renovation and the imposed programmatic constraints. As a result, the designers have struggled to combine all of their stated objectives into a coherent, balanced whole, and the building’s heritage value is now affected. This article is also an occasion to have a look at the state of affairs in Brussels and to cast light on the “interventionist policies" on the post-war built heritage, of which Julien Roggen’s Brunfaut tower is a—regrettably—emblematic example.

IntroductionIn the last couple of decades, numerous intervention strategies (ISs) have been formulated in school/community or clinical sectors using physical activity (PA) in order to prevent youth obesity because they have been highly effective in addressing this issue. These two sectors have revealed some interesting information in terms of efficient results and best practice mechanisms, but comparisons between them to learn about their functioning have been rare.MethodsTherefore, the aim of this systematic review was to analyze and synthesize PA ISs from school/community or clinical domains for the period 2013-2017, in French or English, targeting youths aged 5-19 years old through primary, secondary, and tertiary prevention.ResultsIn total, 68 full articles were reserved for data extraction and synthesis and 617 were excluded because they did not meet eligibility criteria (61 of 68 were kept for the final analysis). The results identified a number of differences between the studies of the various IS sectors and also a third type of IS, mixed sector. Mixed ISs (clinical and school-community) have a special advantage because they can benefit from the strengths of both school/community-based and clinical-based ISs. Mixed ISs showed the most promising results. This review also highlighted the differences between sectors and their ISs in terms of intervention teams, prevention objectives, duration, materials, and efficiency.ConclusionFuture studies should focus on establishing a prevention program in a given geographical area involving all stakeholders with their respective skills/knowledge, in the area of decision-making and in the development of ISs, to ensure that the program is the most efficient and best adapted to its environment.

Introduction: People with disabilities experience loneliness to a greater extent than people without disabilities. To better understand this problem, we have conducted a systematic review of studies that involved disability and loneliness. The aims are to research what loneliness is and to conceptualize and define it in the context of disability, and the intervention strategies that have been developed. Methods: The research protocol is based on the PRISMA guidelines. Two hundred and eighty-one papers were screened and 75 reports were assessed for eligibility. Results: We have not found whether loneliness in disability is a single construct or a collection of various subtypes. We have found that there are protective factors against loneliness in disabled people, such as having a job or living in an environment without physical barriers. Discussion: In terms of the interventions for people with disabilities, the same strategies have been adopted as for the non-disabled: social skills training, enhanced social support, opportunities for interactions, and cognitive training. [ABSTRACT FROM AUTHOR]

Background: Online lending on campus is given more attention by researchers as its prominent adverse effects on students. The deficiencies of the previous studies on its psychological factors and intervention strategies were only based on qualitative research. Moreover, there is no study on gender differences. Therefore, our study aims to analyze the gender differences in psychological risk factors and give some practical suggestions for the intervention by quantitative methods. Method: This is a cross-sectional survey among medical college students in Chengdu. A total of 984 effective questionnaires were collected. The questionnaire includes demographic data, monthly expenses, self-evaluation for three central psychology causing online lending based on empiricism (conformity, comparison, and hedonism), and three psychological assessment instruments (the Chinese version of the Satisfaction with Life Scale, Egna Minnen av Barndoms Uppfostran, and 144-item version of Temperament and Character Inventory). T-test/X2-test and Binary logistic regression were used to analyze the gender differences in variables and the risk factors of online lending for males and females, respectively. Results: The utilization rate of online lending exhibited a significant gender difference (p < 0.001). In addition, there were gender differences in the scores on SWLS and some subscales of C-EMBU and TCI-144. The risk factors for males' were family members using online lending (OR = 5.527, 95% CI = 1.784-17.125) and lower scores on HA (OR = 0.938, 95% CI = 0.888-0.990). The risk factors for females' online lending were family members using online lending (OR = 2.288, 95% CI = 1.201-4.362), hedonism (OR = 5.913, 95% CI = 1.327-26.341), and higher scores on mother's punishment (OR = 1.099, 95% CI = 1.007-1.199). Conclusion: The utilization rate of online lending in males was significantly higher than in females. More attention should be paid to gender differences and the impact of family members' using online lending on students when intervening in online lending. [ABSTRACT FROM AUTHOR]

Non-aureus staphylococci (NAS) are ubiquitous bacteria in livestock-associated environments where they may act as reservoirs of antimicrobial resistance (AMR) genes for pathogens such as Staphylococcus aureus. Here, we tested whether housing conditions in pig farms could influence the overall AMR-NAS burden. Two hundred and forty porcine commensal and environmental NAS isolates from three different farm types (conventional, alternative, and organic) were tested for phenotypic antimicrobial susceptibility and subjected to whole genome sequencing. Genomic data were analysed regarding species identity and AMR gene carriage. Seventeen different NAS species were identified across all farm types. In contrast to conventional farms, no AMR genes were detectable towards methicillin, aminoglycosides, and phenicols in organic farms. Additionally, AMR genes to macrolides and tetracycline were rare among NAS in organic farms, while such genes were common in conventional husbandries. No differences in AMR detection existed between farm types regarding fosfomycin, lincosamides, fusidic acid, and heavy metal resistance gene presence. The combined data show that husbandry conditions influence the occurrence of resistant and multidrug-resistant bacteria in livestock, suggesting that changing husbandry practices may be an appropriate means of limiting the spread of AMR bacteria on farms. [ABSTRACT FROM AUTHOR]

The purpose of this article is to review the mechanism and intervention strategies of alexithymia， in order to provide a new direction for clinical treatment and research of alexithymia. Alexithymia is not only related to a variety of psychosomatic diseases， but also exists in mental diseases such as depression， anxiety and eating disorders， which seriously affects the quality of life of patients. This article reviews alexithymia and its mechanism in different diseases from cognition， neurological and social-psychological factors， and summarizes the intervention strategies， aiming to provide references for the clinical treatment of alexithymia.

IntroductionPeople with disabilities experience loneliness to a greater extent than people without disabilities. To better understand this problem, we have conducted a systematic review of studies that involved disability and loneliness. The aims are to research what loneliness is and to conceptualize and define it in the context of disability, and the intervention strategies that have been developed.MethodsThe research protocol is based on the PRISMA guidelines. Two hundred and eighty-one papers were screened and 75 reports were assessed for eligibility.ResultsWe have not found whether loneliness in disability is a single construct or a collection of various subtypes. We have found that there are protective factors against loneliness in disabled people, such as having a job or living in an environment without physical barriers.DiscussionIn terms of the interventions for people with disabilities, the same strategies have been adopted as for the non-disabled: social skills training, enhanced social support, opportunities for interactions, and cognitive training.

It has been over a year since South Africa officially began its national COVID-19 vaccination programme. Yet, currently only half of the adult population is fully vaccinated. While supply-related challenges continue to contribute to suboptimal vaccination coverage, so too does vaccine hesitancy. Drawing on research conducted over the last year, we highlight some overarching insights around the nature and drivers of COVID-19 vaccine hesitancy in South Africa and how this complex phenomenon might be addressed. We have found multiple socio-economic and political root causes of COVID-19 vaccine hesitancy, many of which are not knowledge-related. These include inter alia fear and uncertainty, practical challenges around access, experiences of poverty and marginalization, and the ongoing geopolitics surrounding the pandemic. Intervention strategies therefore need to form part of broader development and trust-building measures that focus on relationships, transparency, inclusion, equity and justice. This is essential if we hope to bolster acceptance of and demand for vaccines during and beyond the COVID-19 pandemic.