Influence of Basic Health Care Provision Fund in improving primary Health Care in Kano state, a descriptive cross-sectional study.

BACKGROUND: The Basic Health Care Provision Fund (BHCPF) is a direct financial investment that funds Primary Healthcare (PHC) to improve the quality of services. This study assessed the influence of the BHCPF in improving PHC services. METHODS: A descriptive cross-sectional study was conducted among PHC workers in 100 facilities randomly selected from the 484 designated PHCs for implementing the BHCPF project in Kano state. Using multiple sampling methods, 200 healthcare workers in PHC facilities were selected and assisted by trained data collectors to respond to the questionnaires. Chi-square analysis was used to show associated factors, while binary regression analysis was used to determine the relationship between factors influencing the BHCPF implementation in PHC. RESULT: The findings showed healthcare workers had higher awareness (61.7%) and good utilization (57.1%) of BHCPF. Challenges of the BHCPF implementation were insufficiently skilled health professionals (85%), lack of data management capacity (52.6%), low community participation and awareness (52.0%), delay in releasing funds (60.7%), poor infrastructure (87.8%), and weak financial management and accountability system (58.2%). Healthcare professionals having a diploma were four times more likely to have the National Health Management Information System (NHMIS) in their facilities (AOR = 4.955, 95% CI = 1.120-21.036; P-value 0.035) than those without. Primary healthcare facilities were two times more likely to have the NHMIS (AOR = 2.549, 95% CI = 1.167-5.566: P-value 0. 019) than health post. CONCLUSION: The factors that influenced PHC facilities to promote the implementation of BHCPF included: periodic evaluation of the facilities, availability of functional storage facilities, and improving the standard of care in PHC facilities. There is a need for retraining healthcare workers and creating more community awareness of the BHCPF.

Development and pilot implementation of an activity-based emotional support intervention for caregivers of children with cancer.

OBJECTIVE: This study aimed to pilot PAX ("Play, Act & Interact"), an activity-based emotional support intervention for caregivers of child with cancer, which focuses on addressing their psychological distress and post-traumatic stress symptoms (PTSSs). METHOD: Sixteen mothers whose children were child with cancer participated in this 4-week intervention. Their children (n = 16; 14 males; median age at diagnosis = 10.3 years; the median amount of time from diagnosis = 9 months) were at different treatment stages for a range of different diagnoses. Caregivers completed self-report instruments assessing their psychological distress including PTSSs and family functioning before and after the intervention and a brief open-response exit survey. Paired sample t-tests were computed to compare the pre-and post-intervention scores. RESULTS: The Post-traumatic Stress Disorder Checklist scores significantly decreased from pre- (M = 37.00, SD = 14.75) to post-intervention (M = 32.56, SD = 15.52), t(15) = 4.25, p < .001. There was also a significant difference between pre- (M = 33.5, SD = 3.18) and post-intervention (M = 35.7, SD = 3.14) scores on the Family Adherence subscale of the Family Adaptability and Cohesion Evaluation Scales III, t(15) = -2.58, p = .02. CONCLUSIONS: PAX was a promising intervention for supporting caregivers' PTSSs and family adaptability. Future studies investigating the long-term effects and replicating the current study with more participants and a control group are needed.

Public health law coverage in support of the health-related sustainable development goals (SDGs) among 33 Western Pacific countries.

BACKGROUND: A resilient health system is inevitable in attaining the health-related Sustainable Development Goals (SDGs). One way of strengthening health systems is improving the coverage of public health laws for better health governance. The aim of this study is to describe the public health law situation in the Western Pacific Region and analyse the association of public health law coverage with health-related SDGs statistics. METHODS: A total of 33 Western Pacific countries were selected and analysed using a multi-group ecological study design. Public health law coverage was measured from April 2013 to October 2016 based on the public health law coverage module in the 'Tool to Assess Health Law' developed by the WHO Western Pacific Regional Office and Asian Institute for Bioethics and Health Law of Yonsei University. The health-related SDGs status were examined using health statistics data from World Health Statistics 2017 and 2018 by WHO and SDGs index scores of previous research. RESULTS: Countries with high public health law coverage were Vietnam, Republic of Korea, Hong Kong, and Singapore. Low coverage countries were mainly Pacific Island countries. High public health law coverage issues were health care organisation, communicable diseases, and substance abuse, whereas those of low coverage were human reproduction, family health, and oral health. Public health law coverage was associated with health-related SDGs statistics such as life expectancy at birth (r = 0.47, p = 0.03), health life expectancy at birth (r = 0.47, p = 0.04), health-related SDGs index (r = 0.43, p = 0.05). Among the SDG 3 indicators, maternal mortality ratio (r = - 0.53, p = 0.01), neonatal mortality rate (r = - 0.44, p = 0.02), new HIV infections (r = 0.78, p = 0.04), total alcohol consumption (r = 0.45, p = 0.02), adolescent birth rate (r = - 0.40, p = 0.04), UHC service coverage index (r = 0.50, p = 0.02), and IHR average core capacity score (r = 0.54, p = 0.004) were statistically meaningful. However, there was no association of public health law coverage with health statistics in other SDGs. CONCLUSIONS: This study proved the importance of public health law in supporting the attainment of health-related SDGs. These results should be used as the basis for review and action at country level in improving public health law for better health systems, consequently achieving health-related SDGs.

Loss of Cyclin-dependent Kinase 2 in the Pancreas Links Primary ß-Cell Dysfunction to Progressive Depletion of ß-Cell Mass and Diabetes.

The failure of pancreatic islet ß-cells is a major contributor to the etiology of type 2 diabetes. ß-Cell dysfunction and declining ß-cell mass are two mechanisms that contribute to this failure, although it is unclear whether they are molecularly linked. Here, we show that the cell cycle regulator, cyclin-dependent kinase 2 (CDK2), couples primary ß-cell dysfunction to the progressive deterioration of ß-cell mass in diabetes. Mice with pancreas-specific deletion of Cdk2 are glucose-intolerant, primarily due to defects in glucose-stimulated insulin secretion. Accompanying this loss of secretion are defects in ß-cell metabolism and perturbed mitochondrial structure. Persistent insulin secretion defects culminate in progressive deficits in ß-cell proliferation, reduced ß-cell mass, and diabetes. These outcomes may be mediated directly by the loss of CDK2, which binds to and phosphorylates the transcription factor FOXO1 in a glucose-dependent manner. Further, we identified a requirement for CDK2 in the compensatory increases in ß-cell mass that occur in response to age- and diet-induced stress. Thus, CDK2 serves as an important nexus linking primary ß-cell dysfunction to progressive ß-cell mass deterioration in diabetes.

South Korea: in the midst of a privacy reform centered on data sharing.

With rapid developments in genomic and digital technologies, genomic data sharing has become a key issue for the achievement of precision medicine in South Korea. The legal and administrative framework for data sharing and protection in this country is currently under intense scrutiny from national and international stakeholders. Policymakers are assessing the relevance of specific restrictions in national laws and guidelines for better alignment with international approaches. This manuscript will consider key issues in international genome data sharing in South Korea, including consent, privacy, security measures, compatible adequacy and oversight, and map out an approach to genomic data sharing that recognizes the importance of patient engagement and responsible use of data in South Korea.

The Legal Doctrine on the Liability of Physicians in Medical Malpractice Lawsuits Involving Complex Regional Pain Syndrome.

BACKGROUND: Complex regional pain syndrome (CRPS) involves severe pain and it is difficult to identify the exact cause or pathogenesis. Therefore, there are controversies regarding legal issues related to the establishment of damage in medical malpractice lawsuits involving CRPS. This study aimed to analyze malpractice lawsuits involving CRPS, which occurred after the disputed medical treatment, to provide information on the courts' opinion and characteristics of the cases. METHODS: This study analyzed 23 lawsuit judgments involving CRPS that were sentenced from 2005 to 2015. RESULTS: A total of 12 of the 23 cases were partially ruled in favor of the plaintiff. The average amount (KRW) claimed was 470,638,385 ± 860,634,092 (21,000,000 to 4,020,000,000), and that awarded was 72,906,843 ± 53,389,367 (15,000,000 to 181,080,803). Sixteen of the 23 cases had CRPS type I. In 11 of 23 cases, the site of the pain was located in the lower limb and in 14 cases there was no presence of trauma or event prior to medical treatment. CONCLUSION: Nerve injury was the most frequent reason for taking responsibility in compensating damage in malpractice cases involving CRPS. Physicians should consider various possibilities of such complications in medical practices. It is important to identify and improve areas which need to be improved for patient safety through analyzing the lawsuit judgment cases.

Barriers to reporting of patient safety incidents in tertiary hospitals: A qualitative study of nurses and resident physicians in South Korea.

We explored the barriers to reporting patient safety incidents experienced by nurses and resident physicians while working in tertiary hospitals in South Korea. Sixteen in-depth interviews with 10 nurses and 6 resident physicians, all of whom had experienced patient safety incidents, were conducted. The interviews were analyzed using directed content analysis in accordance with a coding scheme developed in this study, which contains 4 categories (incidents and reporters, reporting procedures and systems, feedbacks, and reporting culture) and 9 subcategories. The barriers to reporting near-misses included the following: characteristics of the incident (eg, nonhazardous and high frequency), reporters' lack of knowledge, uncertainty, fear of blame, lack of role model, and inappropriate responses. Reporting adverse/sentinel events was also prevented by feelings of pressure or guilt, the fact that reporting was nonmandatory, and a belief that reporting was not part of the job. Some other barriers included lack of education, review process after reporting, lack of confidentiality when reporting, absence of feedback for reporting, unfair reporting based on work experience, perception of potential blame, and stigmatization resulting from it. In South Korea, a national system for reporting and learning of patient safety accidents has been operating since July 2016. To fully implement this system, it is necessary to encourage reporting at the institutional level. Our results might help reduce the barriers to patient safety incident reporting among nurses and resident physicians in tertiary hospitals in Korea through informing the development of improvement plans.

RB regulates pancreas development by stabilizing Pdx1.

RB is a key substrate of Cdks and an important regulator of the mammalian cell cycle. RB either represses E2Fs that promote cell proliferation or enhances the activity of cell-specific factors that promote differentiation, although the mechanism that facilitates this dual interaction is unclear. Here, we demonstrate that RB associates with and stabilizes pancreatic duodenal homeobox-1 (Pdx-1) that is essential for embryonic pancreas development and adult ß-cell function. Interestingly, Pdx-1 utilizes a conserved RB-interaction motif (RIM) that is also present in E2Fs. Point mutations within the RIM reduce RB-Pdx-1 complex formation, destabilize Pdx-1 and promote its proteasomal degradation. Glucose regulates RB and Pdx-1 levels, RB/Pdx-1 complex formation and Pdx-1 degradation. RB occupies the promoters of ß-cell-specific genes, and knockdown of RB results in reduced expression of Pdx-1 and its target genes. Further, RB-deficiency in vivo results in reduced pancreas size due to decreased proliferation of Pdx-1(+) pancreatic progenitors, increased apoptosis and aberrant expression of regulators of pancreatic development. These results demonstrate an unanticipated regulatory mechanism for pancreatic development and ß-cell function, which involves RB-mediated stabilization of the pancreas-specific transcription factor Pdx-1.

Long-term trends in intraocular pressure after combined vitrectomy with sub-tenon injection of triamcinolone acetonide.

PURPOSE: To evaluate the long-term effect of vitrectomy by itself and combined vitrectomy with sub-Tenon injection of triamcinolone acetonide (TA) on intraocular pressure (IOP). METHODS: In a retrospective cohort study, the medical records of 56 eyes of 56 patients who underwent nonemergent vitrectomy and were followed up for at least 24 months were reviewed. Thirty-two eyes of 32 patients underwent combined vitrectomy with sub-Tenon injection of TA. Twenty-four eyes of 24 patients underwent vitrectomy only. Increased IOP of >4 mmHg from the baseline, change in IOP from the baseline, and preoperative and postoperative measured IOPs were recorded and compared between the two groups, and with fellow eyes. RESULTS: Minimum follow-up period was 24 months. Except the IOP at postoperative 1 day, there were no significant differences between vitrectomized eyes and nonvitrectomized fellow eyes. There were also no differences between vitrectomized eyes and eyes that underwent combined vitrectomy with sub-Tenon injection of TA. And in the comparison of the vitrectomy-only eye group and the vitrectomy with sub-Tenon TA eye group, there was also no significant difference during the whole follow-up period. CONCLUSION: Vitrectomy by itself or combined vitrectomy with sub-Tenon injection of TA does not seem to increase IOP in the long term.

The Cdk4-E2f1 pathway regulates early pancreas development by targeting Pdx1+ progenitors and Ngn3+ endocrine precursors.

Cell division and cell differentiation are intricately regulated processes vital to organ development. Cyclin-dependent kinases (Cdks) are master regulators of the cell cycle that orchestrate the cell division and differentiation programs. Cdk1 is essential to drive cell division and is required for the first embryonic divisions, whereas Cdks 2, 4 and 6 are dispensable for organogenesis but vital for tissue-specific cell development. Here, we illustrate an important role for Cdk4 in regulating early pancreas development. Pancreatic development involves extensive morphogenesis, proliferation and differentiation of the epithelium to give rise to the distinct cell lineages of the adult pancreas. The cell cycle molecules that specify lineage commitment within the early pancreas are unknown. We show that Cdk4 and its downstream transcription factor E2f1 regulate mouse pancreas development prior to and during the secondary transition. Cdk4 deficiency reduces embryonic pancreas size owing to impaired mesenchyme development and fewer Pdx1(+) pancreatic progenitor cells. Expression of activated Cdk4(R24C) kinase leads to increased Nkx2.2(+) and Nkx6.1(+) cells and a rise in the number and proliferation of Ngn3(+) endocrine precursors, resulting in expansion of the ß cell lineage. We show that E2f1 binds and activates the Ngn3 promoter to modulate Ngn3 expression levels in the embryonic pancreas in a Cdk4-dependent manner. These results suggest that Cdk4 promotes ß cell development by directing E2f1-mediated activation of Ngn3 and increasing the pool of endocrine precursors, and identify Cdk4 as an important regulator of early pancreas development that modulates the proliferation potential of pancreatic progenitors and endocrine precursors.

Effectiveness of School-Based Oral Health Education for Children and Adolescents in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.

The global burden of oral diseases is high, but access to oral health care is still problematic, especially in low- and middle-income countries. The prevention of oral diseases in the child and adolescent population is the key as it can be prevented and potentially reversed at its early stages. This study aimed to provide evidence on the effectiveness of school-based oral health education in low- and middle-income countries through a systematic review and meta-analysis. Eligible studies had outcomes, such as oral health knowledge, behavior, oral hygiene, gingival health, and caries index, and those published from 1995 to 2019 in English. After screening and reviewing the retrieved articles, 20 studies were included in the systematic review and six eligible studies were selected for meta-analysis. The computed effect size of school-based oral health education in low- and middle-income countries showed improved knowledge, behavior, oral hygiene, and gingival health from the selected studies. However, most of the interventions took place for less than one year, and long-term evidence is still lacking. As repetition and reinforcement are critical in maintaining long-term effects, both country context and sustainability should be considered in school-based oral health education.

Barriers to Providing Transitional Supports for Autistic Students: Insights of School Professionals.

Following high school exit, many autistic young adults are not enrolled in post-secondary education or employed, and few are engaged in community activities. This disengagement among autistic young adults may be a result of the limited or inadequate supports provided to autistic transition-age youth in schools. Therefore, the purpose of the current study is to explore how school professionals report preparing transition-age autistic youth for adulthood and the barriers that make it difficult for school professionals to provide quality transition services. We surveyed 21 school professionals who work with transition-age autistic students. The survey solicited descriptions of transition supports provided to youth, and barriers that make it difficult for school professionals to provide high quality transition supports. Qualitative content analysis was used to identify themes from the data. Participants described barriers related to the autistic youth they taught or supported, their families, the classroom environment, and the community. Barriers were either framed as deficits inherent to autistic students and their families, or larger systemic issues that make it challenging to implement high quality transition supports. We recommend implementation of autism-specific trainings within teacher preparation programs and school districts, professional development opportunities that create spaces for educators to challenge and resist deficit views of autism, and development of strengths-based transition programs that are implemented by school-based professionals who work with autistic students.

A Cross-Cultural Examination of Blatant and Subtle Dehumanization of Autistic People.

PURPOSE: This cross-cultural study examined various domains of dehumanization, including both blatant (viewing autistic people as animal-like, child-like, or machine-like) and subtle (denying agency and experience capabilities) dehumanization, of autistic individuals by Koreans and Americans. METHODS: A total of 404 Koreans and 229 Americans participated in an online survey, assessing blatant and subtle dehumanization, knowledge about autism, stigma toward and contact with autistic people, cultural factors, and demographic information. Robust linear mixed-effects regressions were conducted to examine the impact of the target group (autistic vs. non-autistic) and the country (South Korea vs. the US) on dehumanization. Additionally, correlations and multiple regressions were employed to identify individual variables associated with dehumanization. RESULTS: Both Koreans and Americans exhibited more dehumanizing attitudes towards autistic individuals than non-autistic individuals across all domains. Koreans showed greater dehumanization of autistic individuals than Americans in all domains except for the machine-like domain. Stigma toward autistic people was associated with all dehumanization domains among Koreans and with some of the domains among Americans. Individual variables associated with dehumanization varied across countries and domains. Positive contact quality frequently predicted lower dehumanization in both cultures. CONCLUSIONS: Non-autistic individuals consistently rated autistic people as less human than non-autistic people. Future research examining how autistic characteristics or societal perceptions that influence the consideration of an autistic person's humanness vary across cultures is needed. Implementing interventions aimed at enhancing non-autistic people's understanding of autistic individuals' agency and experience capabilities and promoting high-quality contact opportunities with autistic individuals may help reduce dehumanizing attitudes.

Time to level up: A systematic review of interventions aiming to reduce stigma toward autistic people.

LAY ABSTRACT: How non-autistic people think about autistic people impacts autistic people negatively. Many studies developed trainings to reduce autism stigma. The existing trainings vary a lot in terms of study design, content, and reported effectiveness. This means that a review studying how the studies have been conducted is needed. We also looked at the quality of these studies. We collected and studied 26 studies that tried to reduce stigma toward autistic people. The studies often targeted White K-12 students and college students. Most trainings were implemented once. Trainings frequently used video or computer. Especially, recent studies tended to use online platforms. The study quality was poor for most studies. Some studies made inaccurate claims about the intervention effectiveness. Studies did not sufficiently address study limitations. Future trainings should aim to figure out why and how interventions work. How intervention changes people's behavior and thoughts should be studied. Researchers should study whether the training can change the societal stigma. Also, researchers should use a better study design.

Problems with "problem behavior": A secondary systematic review of intervention research on transition-age autistic youth.

LAY ABSTRACT: In a previous study, we looked at research done on strategies to support autistic people who were between 14 and 22 years old. For this study, we looked at all of the studies in our previous study that tried to decrease or stop autistic people from doing certain things-many researchers call these things "problem behavior." There were 48 studies that tried to reduce problem behavior, and most of them used strategies like prompting and reinforcement to try get autistic people to change their behavior. We found many things wrong with these studies. Most of them did not define the group of behaviors they were trying to stop autistic people from doing. None of the studies looked at whether any side effects happened when they tried the strategy they were studying. Also, most of the studies tried to stop autistic people from doing behaviors that probably were not harmful, like stereotypic behavior. Most of the studies did not say how they decided that the behaviors they tried to stop were a problem for the autistic people in the study, and most studies did not try to figure out why the autistic people in the study did the behaviors the researchers were trying to stop them from doing.

Developing a Framework for Self-regulatory Governance in Healthcare AI Research: Insights from South Korea.

This paper elucidates and rationalizes the ethical governance system for healthcare AI research, as outlined in the 'Research Ethics Guidelines for AI Researchers in Healthcare' published by the South Korean government in August 2023. In developing the guidelines, a four-phase clinical trial process was expanded to six stages for healthcare AI research: preliminary ethics review (stage 1); creating datasets (stage 2); model development (stage 3); training, validation, and evaluation (stage 4); application (stage 5); and post-deployment monitoring (stage 6). Researchers identified similarities between clinical trials and healthcare AI research, particularly in research subjects, management and regulations, and application of research results. In the step-by-step articulation of ethical requirements, this similarity benefits from a reliable and flexible use of existing research ethics governance resources, research management, and regulatory functions. In contrast to clinical trials, this procedural approach to healthcare AI research governance effectively highlights the distinct characteristics of healthcare AI research in research and development process, evaluation of results, and modifiability of findings. The model exhibits limitations, primarily in its reliance on self-regulation and lack of clear delineation of responsibilities. While formulated through multidisciplinary deliberations, its application in the research field remains untested. To overcome the limitations, the researchers' ongoing efforts for educating AI researchers and public and the revision of the guidelines are expected to contribute to establish an ethical research governance framework for healthcare AI research in the South Korean context in the future.

Do Autistic People's Support Needs and Non-Autistic People's Support for the Neurodiversity Movement Contribute to Heightened Autism Stigma in South Korea vs. the US?

We examined stigma towards vignette characters representing diverse autistic characteristics (social, non-speaking, or repetitive interests or restricted behaviors; RIRB) among 259 South Korean and 240 American participants (age range = 18 ~ 74). Within each domain, participants were randomized to read a vignette depicting low or high support needs. Koreans reported greater stigma towards autistic characteristics and less awareness of and support for the neurodiversity movement than Americans. Autistic characters' support needs and rater characteristics (autism knowledge, neurodiversity endorsement, and contact quantity) predicted stigma in at least one domain, and after accounting for these variables, participants' nationality was suggestively associated only with stigma towards social characteristics and RIRB. Findings highlight the need for culturally adapted-training that provides contact with diverse autistic people.

Adsorption behavior of polyamide microplastics as a vector of the cyanotoxin microcystin-LR in environmental freshwaters.

Microplastics are ubiquitous environmental contaminants, and concern about microplastics functioning as vectors for coexisting environmental contaminants has been increasing. In this study, we evaluated the potential of microplastics as a vector for microcystins (MCs) in an aquatic environment. Six microplastics-polyvinylidene chloride, polystyrene, polyamide-6 (PA-6), polyvinyl chloride, poly(ethylene terephthalate), and polyethylene-were used in the experiments, and the PA-6 microplastics showed strong affinity toward the cyanotoxin microcystin-leucine arginine (MC-LR) with an adsorption efficiency of 89.5 ± 0.1 %. The adsorption of MC-LR onto PA-6 microplastics was well described by the pseudo-first-order kinetics and Langmuir isotherm models, and the adsorption was considered to be driven mainly by polar-polar interactions. The maximum adsorption capacity (qm) of MC-LR onto PA-6 microplastics was estimated to be 85.64-129.05 µg per g of PA-6 microplastics. Coexisting ions of NaCl, MgSO4, KH2PO4, CaCO3, and Na2HPO4 marginally affected the adsorption of MC-LR onto the PA-6 microplastics. However, water-quality parameters of conductivity and total-nitrogen content in environmental freshwaters influenced the adsorption of MC-LR onto PA-6 microplastics. The adsorption capability of PA-6 microplastics was evaluated using extracellular MCs (i.e., MC-LR, MC-YR, MC-RR, and total MCs) released from Microcystis aeruginosa cells during their growth.

Explicit stigma and implicit biases toward autism in South Korea versus the United States.

LAY ABSTRACT: How people report their feelings about autism may be different from how they actually think about autism because some people may not want to reveal their true feelings. People who value the group's goal tend to present themselves as more socially acceptable than people who value one person's interests. We studied how people in South Korea and the United States report their feelings about autism and think about autism. Koreans tend to value the group's goals. Americans tend to prefer one person's goals. Koreans reported that they wanted more space from autistic people than Americans did. Koreans were more likely to think about autism with negative words (and think more negatively about autism). How Koreans and Americans report their feelings about autism was not related to their thoughts about autism. People who knew about autism and liked meeting with autistic people wanted to get closer to autistic people in South Korea and the US, Koreans who had met autistic people and thought that people who newly came to Korea from abroad should be more like Koreans did not want to get very close to autistic people. This could be because very few foreign people live in South Korea compared to the United States. Teaching Koreans that all cultures have values and should be appreciated will help them like autistic people more.

A systematic review and meta-analysis of associations between primarily non-autistic people's characteristics and attitudes toward autistic people.

This systematic review includes a narrative synthesis and meta-analysis of research on the associations between primarily non-autistic people's characteristics and their attitudes toward autistic people. Of 47 studies included in the narrative synthesis, White undergraduate students were surveyed most frequently. Demographic characteristics were the factors most frequently tested for associations with attitudes, followed by contact-related factors (i.e., quantity and quality), knowledge about autism, trait and personality factors, and other factors that did not fit into a single category. Internal consistency was not reported for some instruments assessing raters' characteristics; some instruments had alpha levels lower than 0.70, and many characteristics of raters were measured using one-item measures. Moreover, theoretical motivations for investigating the raters' characteristics were rarely provided. A total of 36 studies were included in the meta-analysis, which showed that attitudes toward autistic people were significantly associated with participants' gender, knowledge about autism, and quality and quantity of their previous contact with autistic people, but not with their age or autistic traits. These findings indicate a need for more studies that focus on context-related characteristics (e.g., institutional variables such as support/commitment to inclusion), use reliable instruments to measure non-autistic people's characteristics, and situate their investigation in a theoretical framework.