Loss of helicase C-terminal domain of SMARCAL1 protein associated with severe Schimke immuno-osseous dysplasia.

Schimke immuno-osseous dysplasia (SIOD) is a rare multi-system condition caused by biallelic loss-of-function mutations in the SMARCAL1 gene. This disorder is characterized by disproportionate growth failure, T-cell deficiency, and renal dysfunction. Pathogenic variants in the SMARCAL1 gene have been reported in only approximately half of SIOD-affected individuals. Among these alterations, nonsense and frameshift mutations generally lead to a severe phenotype with early onset. In this study, we identified novel mutations in an Iranian patient with SIOD. A 4-year-old girl with developmental delay and facial dysmorphism was referred to our center for molecular diagnosis. We applied whole-exome and Sanger sequencing for co-segregation analysis. Subsequently, bioinformatic analysis was performed to assess the pathogenic effects of the variants and their post-transcriptional effects. We discovered two novel mutations (c.2281delT and c.2283delA) in exon 15 of the SMARCAL1 gene, resulting in a truncated protein with a loss of 193 amino acids (p.S761Rfs*1). Variant effect predictors indicated that these variants are pathogenic, and multi-sequence alignments revealed high conservation of this region among different species. Given that our patient exhibited severe a phenotype and passed away soon after receiving a definitive molecular diagnosis, we propose that the loss of the helicase C-terminal domain in the deleted part of SMARCAL1 may lead to the severe form of SIOD. Besides, the combination of growth retardation and bone abnormalities also plays a crucial role in the early diagnosis of the disease.

Healthcare Providers' Attitudes and Experiences of the Quality Use of Medications Among Culturally and Linguistically Diverse Patients in Australia: A Systematic Review of Qualitative Studies.

This review aims to identify healthcare providers' (HCPs) experiences with issues related to the quality use of medicines among culturally and linguistically diverse (CALD) patients, the underlying factors, and the enablers of and barriers to providing culturally safe care to promote quality use of medicines. The searched databases were Scopus, Web of Science, Academic search complete, CINHAL-Plus, Google Scholar and PubMed/Medline. The initial search returned 643 articles, of which 14 papers were included. HCPs reported that CALD patients were more likely to face challenges in accessing treatment and sufficient information about treatment. According to the theoretical domains framework, determinants such as social influences due to cultural and religious factors, lack of appropriate resources about health information and cultural needs, lack of physical and psychological capabilities such as lack of knowledge and skills, and lack of motivation could impede HCPs' abilities to provide culturally safe care. Future interventions should deploy multilevel interventions, such as education, training, and organisation structural reforms.

The Effect of a Patient Activation Tailored Intervention on Type 2 Diabetes Self-Management and Clinical Outcomes: A Study from Saudi Arabian Primary Care Settings.

Background: Type 2 diabetes mellitus (T2DM) is a global public health challenge. T2DM self-management, including diet, physical activity, blood glucose self-monitoring, foot care, and adherence to medication, is considered a primary tool for managing diabetes. Patient activation, an individual's knowledge, skill, and confidence in managing their health and healthcare, was recognized to be associated with better T2DM self-management and clinical outcomes. Patient activation intervention has been described as a potential approach for enhancing chronic disease self-management. This study is aimed at examining the effect of a patient activation-tailored intervention on T2DM self-management and clinical outcomes in primary care settings in Saudi Arabia. Method: A pre- and postintervention study was conducted among ≥18 years old T2DM patients attending primary healthcare centers in Saudi Arabia. Collected data included demographics, clinical data, the Patient Activation Measure (PAM), the Summary of Diabetes Self-Care Activities (SDSCA), the diabetes knowledge test (DKT2), the problem area in diabetes test (PAID-5), and the diabetes quality of life test (DQOL). The intervention was tailored based on the participants' patient activation level. The intervention consisted of monthly face-to-face sessions for three months and a telephone follow-up per month for three months postintervention. Descriptive statistics, a paired sample t-test for scale variables, and Wilcoxon's signed-rank test for categorical variables were used for data analysis. Results: A total of 82 patients, mostly female (61%) with a mean age of 51.3 ± 9.9 years old, completed baseline and postintervention surveys. After six months of intervention, there was a significant change in patient activation score from 54.74 to 61.58 (p < 0.001), hemoglobin A1c (HbA1c) from 8.38 to 7.55 (p < 0.001), and body mass index (BMI) from 30.90 to 29.16 (p < 0.001). Also, there was a significant change in SDSCA scores (diet from 3.12 to 3.67, exercise from 2.54 to 3.49, and blood glucose self-testing from 2.37 to 3.24) (p < 0.001) and DKT from 6.29 to 7.22 (p = 0.01). Conclusion: Our findings suggested that tailoring interventions based on patients' activation levels is more likely to yield promising T2DM self-management and clinical outcomes.

Relationship Between Patient Activation and Type 2 Diabetes Mellitus Self-management and Clinical Outcomes in Saudi Arabian Primary Care Setting.

PURPOSE: Type 2 diabetes mellitus (T2DM) self-management is a comprehensive approach that individuals with T2DM employ to manage and control their condition. Patients' activation, "an individual's knowledge, skill, and confidence for managing their health and health care", has been used as a major driver of self-management. This study aimed to assess the relationship of patient activation with T2DM self-management and clinical outcomes. DESIGN: A cross-sectional study. SUBJECTS: Patients with type T2DM who age 18-years and older. SETTING: The primary care centers in Saudi Arabia. MEASURES: Patient activation measure (PAM) and the Summary of Diabetes Self-Care Activities (SDSCA). ANALYSIS: Descriptive statistic, T-test, One-way ANOVA test, Chi-square test, and linear and logistic regressions were performed. RESULTS: A total of 398 patients, mostly male (54.9%) with a mean age of 53.2 (±10.7) years old participated in the study. The participants' mean of Hemoglobin A1c (HbA1c) was 8.4% (±1.7%) and most of them (74.5%) had an uncontrolled HbA1c level (>7% %). The mean patient activation score was 55.9 (±13.5). 24.4% were at [PA1], 26.7% at [PA2], 37.4% at [PA3], and 11.5% at [PA4]. Patient activation level was positively associated with better glycemic control and self-management behaviors including diet, physical activity, blood glucose self-testing, foot care, and smoking (P < .05) but not with adherence to medication. CONCLUSIONS: Our findings reveal a positive association between patient activation level and enhanced glycemic control and self-management behaviors and suggest that patient activation-informed self-management interventions are more likely to yield promising health outcomes.

The impact of health literacy interventions on glycemic control and self-management outcomes among type 2 diabetes mellitus: A systematic review.

Diabetes imposes an increasing health and economic burden on individuals living with it and their societies worldwide. Glycemic control is necessary to reduce morbidity and mortality of type 2 diabetes mellitus (T2DM). Self-management is the primary tool for managing diabetes. Health literacy (HL) is the primary driver of self-management activities. The aim of this review is to evaluate the impact of HL interventions on glycemic control and self-management outcomes among T2DM. MEDLINE, CINAHL, PubMed, Cochrane, Scopus, and Web of Science were searched for eligible papers. Fifteen randomized controlled trials published in English between 1997 and 2021, used HL-driven intervention, and measured the level of glycohemoglobin A1c (HbA1c) and self-management of T2DM patients were included in this review. The findings showed that HL-driven intervention had a positive impact on glycemic control and improved self-management behaviors. The level of glycemic control and self-management skills were improved through individual and telephone-based intervention respectively. Community worker-led interventions were effective in improvements in diabetes knowledge and self-care behaviors; however, nurse-led interventions were effective in glycemic control. Better glycemic control is achieved in hospital settings compared to outpatient settings. HL interventions yielded better improvement in self-management among people with longer diabetes duration (more than 7 years). It was possible to achieve a large reduction in HbA1c level after a 3-month intervention in hospital settings. HL-driven interventions are effective in glycemic and diabetes self-management outcomes.

Antiviral activities of ginseng and its potential and putative benefits against monkeypox virus: A mini review.

Due to the Covid-19 pandemic more than 6 million people have died, and it has bought unprecedented challenges to our lives. The recent outbreak of monkeypox virus (MPXV) has brought out new tensions among the scientific community. Currently, there is no specific treatment protocol for MPXV. Several antivirals, vaccinia immune globulin (VIG) and smallpox vaccines have been used to treat MPXV. Ginseng, one of the more famous among traditional medicines, has been used for infectious disease for thousands of years. It has shown promising antiviral effects. Ginseng could be used as a potential adaptogenic agent to help prevent infection by MPXV along with other drugs and vaccines. In this mini review, we explore the possible use of ginseng in MPXV prevention based on its antiviral activity.

Medicines use issues perceived by Arabic-speaking patients living in English-speaking countries: A systematic review.

OBJECTIVES: Quality use of medicines, or rational medicines use, requires patients' adherence to the quality principles of medication use. There is a limited number of reviews about quality medication use among migrant patients. This review aims to fill this gap by exploring medication-related issues experienced by Arabic-speaking patients living in English-speaking countries. METHODS: The searched databases included WebMD, EMBASE, Scopus, CINHAL, PubMed/Medline and Web of science. KEY FINDINGS: The initial search retrieved 2071 publications and 23 publications met the inclusion criteria. Our review found that the most frequently reported medication-related issues among Arabic-speaking patients residing in English-speaking countries were problems related to decision-making regarding treatment options, inappropriate counselling and lack of information about medicines and diseases, lack of monitoring and follow-up, and intentional and unintentional medication non-adherence. Informed by the bio-psycho-socio-systems model, contributing factors to the medication issues included used coping strategies, ethno-cultural and religious beliefs and ineffective relationships with healthcare providers. CONCLUSIONS: Our review suggests that cultural factors can significantly influence individuals' perceptions and actions around the use of medication. Thus, healthcare providers need to be mindful of the specific cultural affiliations of ethnic minorities and exhibit cultural sensitivity when prescribing medication to migrant patients to foster a better relationship between patients and healthcare providers. Applying a patient-centred approach using shared decision-making can help. Our findings also suggest that pharmacy practice is critical in improving medication safety among Arabic-speaking patients.

Challenges and strategies to improve the provision of end-of-life cancer care in rural and regional communities: Perspectives from Australian rural health professionals.

OBJECTIVE: To identify challenges and strategies to improve the provision of end-of-life (EOL) cancer care in an underserved rural and regional Australian local health district (LHD) from the perspective of general practitioners (GPs) and specialist clinicians while exploring the benefits of adopting a generalist health care approach to delivering EOL care in rural and regional communities. SETTING: Rural and regional Australia. PARTICIPANTS: General practitioners and palliative care and cancer care specialists (medical and nursing) involved in the provision of EOL care to people with advanced cancer in the rural and regional areas of an Australian LHD. DESIGN: Qualitative descriptive study involving 22 participants in four face-to-face and online focus groups. Thematic analysis of the transcripts identified key issues affecting EOL care for people with advanced cancer in rural and regional areas of the LHD. RESULTS: Four themes including geographical remoteness, system structures, medical management and expertise and training emerged from the focus groups. Key barriers to effective EOL care included insufficient remuneration for GPs and other clinicians (especially home visits), resource limitations, limited community awareness of palliative care and lack of confidence and training of clinicians. Continuity of care was identified as an important facilitator to effective EOL care. Participants suggested greater Medicare rebates for palliative care and home visits, adequate equipment and resources, technology-enabled clinician training and greater rural-based training for specialist PC clinicians may improve the provision of EOL care in regional and rural communities. CONCLUSIONS: Rural-based clinicians delivering EOL cancer care appear to be disproportionately affected by geographical challenges including resource and funding limitations. A multi-pronged strategy aimed at greater interdisciplinary collaboration, community awareness and greater resourcing and funding could help to improve the provision of EOL care in underserved rural and remote communities of Australia.

Does Geography Play a Role in the Receipt of End-of-Life Care for Advanced Cancer Patients? Evidence from an Australian Local Health District Population-Based Study.

Objectives: To assess the influence of geographic remoteness on health care utilization at end of life (EOL) by people with advanced cancer in a geographically diverse Australian local health district, using two objective measures of rurality and travel-time estimations to health care facilities. Methods: This retrospective cohort study examined the association between rurality (using the Modified Monash Model) and travel-time estimation, and demographic and clinical factors, with the receipt of >1 inpatient and outpatient health service in the last year of life in multivariate models. The study cohort comprised of 3546 patients with cancer, aged ≥18 years, who died in a public hospital between 2015 and 2019. Results: Compared with decedents from metropolitan areas, decedents from some rural areas had higher rates of emergency department visits (small rural towns: aRR 1.29, 95% CI: 1.07-1.57) and ICU admissions (large rural towns: aRR 1.32, 95% CI: 1.03-1.69), but lower rates of acute hospital admissions (large rural towns: aRR 0.83, 95% CI: 0.76-0.90), inpatient palliative care (PC) (regional centers: aRR 0.85, 95% CI: 0.75-0.97), and inpatient radiotherapy (lowest in small rural towns: aRR 0.07, 95% CI: 0.03-0.18). Decedents from rural and regional centers had lower rates of outpatient chemotherapy and radiotherapy use, yet higher rates of outpatient cancer service utilization (p < 0.05). Shorter travel times (10-<30 minutes) were associated with higher rates of inpatient specialist PC (aRR 1.48, 95% CI: 1.09-1.98). Conclusions: Reporting on a series of inpatient and outpatient services used in the last year of life, measures of rurality and travel-time estimates can be useful tools to estimate geographic variation in EOL cancer care provision, with significant gaps uncovered in inpatient PC and outpatient service utilization in rural areas. Policies aimed at redistributing EOL resources in rural and regional communities to reduce travel times to health care facilities could help to reduce regional disparities and ensure equitable access to EOL care services.

Culturally and linguistically diverse patients' perspectives and experiences on medicines management in Australia: a systematic review.

BACKGROUND: Within the quality use of medicines (QUM)-which entails timely access to, and the rational use of, medicines-medicine safety is a global health priority. In multicultural countries, such as Australia, national medicines policies are focused on achieving QUM, although this is more challenging among their Culturally and Linguistically Diverse (CALD) patients (i.e., those from ethnic minority groups). AIM: This review aimed to identify and explore the specific challenges to achieving QUM, as experienced by CALD patients living in Australia. METHOD: A systematic literature search was conducted using Web of Science, Scopus, Academic search complete, CINHAL, PubMed and Medline. Qualitative studies describing any aspects of QUM among CALD patients in Australia were included. RESULTS: Major challenges in facilitating QUM among CALD patients in Australia were identified, particularly in relation to the following medicines management pathway steps: difficulties around participation in treatment decision-making alongside deficiencies in information provision about medicines. Furthermore, medication non-adherence was commonly observed and reported. When mapped against the bio-psycho-socio-systems model, the main contributors to the medicine management challenges identified related to "social" and "system" factors, reflecting the current health-system's lack of capacity and resourcing to respond to patients' low health literacy levels, communication and language barriers, and cultural and religious perceptions about medicines. CONCLUSION: QUM challenges were different among different ethnic groups. This review suggests a need to engage with CALD patients in co-designing culturally appropriate resources and/or interventions to enable the health-system to address the identified barriers to QUM.

Complete Loss of Myelin protein zero (MPZ) in a patient with a late onset Charcot-Marie-Tooth (CMT).

Charcot-Marie-Tooth (CMT) comprises a group of hereditary neuropathies with clinical, epidemiological, and molecular heterogeneity in which variants in more than 80 different genes have been reported. One of the important genes which cause 5% of all CMT cases is Myelin protein zero (P0, MPZ). Variants in this gene have been reported in association with different forms of CMT including classical CMT1, severe DSS (CMT3B), DI-CMT, CMT2I and CMT2J with autosomal dominant (AD) inheritance. To our knowledge, MPZ variants have not been described in autosomal recessive (AR) form of CMT in previous studies. Moreover, its complete deletion has not been reported in human. Here, we described clinical characteristics of a patient with CMT symptoms who demonstrated manifestations of the disease late in his life. We performed exome sequencing for identifying CMT subtype and its associated gene, and follow that co-segregation analysis has been done to characterize inheritance pattern of the disorder. Through using exome sequencing, we identified a novel 4074 bp homozygote deletion which encompasses all 6 exons of the MPZ gene in this patient. After identifying the alteration, variant confirmation and co-segregation analysis have been performed by using specific primers. Our result revealed that the patient's parents were heterozygous for the alteration and they did not show any symptoms of CMT. Although most MPZ variants have been described with early onset CMT with AD pattern of inheritance, the reported patient in our study had late onset form and his parents did not show any symptoms. Considering substantial role of MPZ protein in the biogenesis of peripheral nervous system (PNS) myelin, we proposed that there should be another protein in PNS that compensates for lack of MPZ protein. Taken together, our finding is the first report of MPZ association with AR form of CMT with late onset features. Moreover, our results propose the presence of another protein in PNS myelin biogenesis and its assembly. However, functional studies alongside with other molecular studies are needed to confirm our results and identify the proposed protein.

Application of Artificial Intelligence in Assessing the Self-Management Practices of Patients with Type 2 Diabetes.

The use of Artificial intelligence in healthcare has evolved substantially in recent years. In medical diagnosis, Artificial intelligence algorithms are used to forecast or diagnose a variety of life-threatening illnesses, including breast cancer, diabetes, heart disease, etc. The main objective of this study is to assess self-management practices among patients with type 2 diabetes in rural areas of Pakistan using Artificial intelligence and machine learning algorithms. Of particular note is the assessment of the factors associated with poor self-management activities, such as non-adhering to medications, poor eating habits, lack of physical activities, and poor glycemic control (HbA1c %). The sample of 200 participants was purposefully recruited from the medical clinics in rural areas of Pakistan. The artificial neural network algorithm and logistic regression classification algorithms were used to assess diabetes self-management activities. The diabetes dataset was split 80:20 between training and testing; 80% (160) instances were used for training purposes and 20% (40) instances were used for testing purposes, while the algorithms' overall performance was measured using a confusion matrix. The current study found that self-management efforts and glycemic control were poor among diabetes patients in rural areas of Pakistan. The logistic regression model performance was evaluated based on the confusion matrix. The accuracy of the training set was 98%, while the test set's accuracy was 97.5%; each set had a recall rate of 79% and 75%, respectively. The output of the confusion matrix showed that only 11 out of 200 patients were correctly assessed/classified as meeting diabetes self-management targets based on the values of HbA1c < 7%. We added a wide range of neurons (32 to 128) in the hidden layers to train the artificial neural network models. The results showed that the model with three hidden layers and Adam's optimisation function achieved 98% accuracy on the validation set. This study has assessed the factors associated with poor self-management activities among patients with type 2 diabetes in rural areas of Pakistan. The use of a wide range of neurons in the hidden layers to train the artificial neural network models improved outcomes, confirming the model's effectiveness and efficiency in assessing diabetes self-management activities from the required data attributes.

Telemedicine Use and the Perceived Risk of COVID-19: Patient Experience.

INTRODUCTION: The COVID-19 outbreak resulted in an increased demand for telemedicine worldwide. Telemedicine is a technology-based virtual platform that allows the exchange of clinical data and images over remote distances. This study aims to examine the impact of the perceived risk of COVID-19 on telemedicine use in Bangladesh. METHODS: This explanatory study was conducted in hospital settings across Dhaka city in Bangladesh. Patients were eligible to participate if they were aged 18 years or over and had used telemedicine in a hospital at least once since the COVID-19 outbreak. Outcome variables included sociodemographic, the perceived risk of COVID-19, and telehealth use. Study data were collected using an online and paper-based survey. RESULTS: A total of 550 patients participated in this study, mostly male (66.4%), single (58.2%), and highly educated (74.2%). The means of the different domains of telemedicine use reflected a high degree of perceived benefit, accessibility, and satisfaction but a lower degree of privacy and discomfort, care personnel expertise, and usability. COVID 19 perceived risk predicted between 13.0% and 26.6% of variance in telemedicine domains, while the effects of demographic variables were controlled or removed. The perceived risk of COVID-19 was negatively correlated with privacy and discomfort, as well as care personnel concerns. Low and high levels of perceived COVID-19 risk were less likely to encourage the use of telemedicine as a risk reduction tool. DISCUSSION: The participants were mainly satisfied with telemedicine, finding it beneficial and accessible; however, many were concerned about privacy, care personnel expertise, and its usability. The perceived risk of COVID-19 was a strong predictor (contributor) of telemedicine use, suggesting that risk perception can be used to encourage telemedicine use as a risk reduction strategy during pandemics; however, a medium level of risk was more promising.

Prevalence of Smartphone Addiction and Its Association with Sociodemographic, Physical and Mental Well-Being: A Cross-Sectional Study among the Young Adults of Bangladesh.

Smartphones have made our lives easier and have become indispensable for everyday life; however, their uncontrolled and excessive use can trigger "smartphone addiction" (SA). SA is a rising public health issue, particularly among young people around the world. There is a dearth of empirical research about SA and its impacts on young adults, particularly in developing countries such as Bangladesh. This cross-sectional study is an attempt to fill this gap. The data were collected from 440 eligible young adults in Bangladesh using an online survey between July 2021 and February 2022. Study results revealed that 61.4% of the young adults were addicted to their smartphone. Logistic regression analysis showed that being male, aged ≤25, unemployed and living with a large family size (≥8) were the significant sociodemographic predictors of SA. Smartphone-addicted participants were more likely to be less physically active, suffer from insomnia, be overweight or obese and use their phones while driving, walking and eating. In addition, the SA group were more likely to have physical and mental well-being problems. This study brings to light significant implications for policy makers and indicates a need for an SA community awareness programme which aims to reduce SA at the societal level.

The impact of peer coach-led type 2 diabetes mellitus interventions on glycaemic control and self-management outcomes: A systematic review and meta-analysis.

Type 2 diabetes mellitus (T2DM) is a major health risk and dominant cause of global mortality and morbidity. Disease-specific support from peers with similar chronic condition has shown to improve chronic disease self-management outcomes. The purpose of this systematic review is to summarise the existing evidence on the impact of peer coach-led type 2 diabetes mellitus self-management interventions on glycaemic control and self-management outcomes. Databases including MEDLINE, PubMed, CINAHL Plus, Scopus, ProQuest Central, ScienceDirect, web of science, Wiley Online Library and UOW Library were searched for eligible papers. Thirteen randomised controlled trials (RCTs) published between 2008 and 2021 were included in this review. Random-effects meta-analyses found that there were statistically significant changes in Haemoglobin A1c HbA1c) after the interventions. However, the meta-analyses showed no significant changes in LDL (low-density lipoprotein), BMI (Body mass index), systolic BP (Blood Pressure), and HRQoL (Health-related quality of life) among intervention and control groups after the intervention. The identified studies mainly recruited patients with suboptimal glucose levels; majority of them belonging to low-income population. Our findings showed that peer coaching was helpful in improving HbA1c levels, quality of life, self-efficacy, diabetes distress and patient activation. Moreover, peer coaching associations with medication adherence, hypoglycaemic symptoms, diabetes specific social support and depression were inconclusive. This review concludes that peer-led community-based interventions with longer follow up, using a mixed method of delivery among patients with suboptimal levels of HbA1c were more efficient compared to usual care for improving T2DM self-management.

Quality of Life and Adherence to Healthcare Services During the COVID-19 Pandemic: A Cross-Sectional Analysis.

Purpose: To determine the relationship of various domains of quality of life (QoL) with healthcare adherence during the COVID-19 pandemic in Saudi Arabia. Methods: The study sample comprised 795 participants among which 203 had a current diagnosis of any major NCDs, including cardiovascular diseases, diabetes mellitus, asthma, chronic pulmonary diseases, and chronic psychiatric illnesses and a control group of 592 participants who had no NCD. Participants completed an online survey questionnaire which obtained data on socio-demographic variables, types of NCDs, and healthcare adherence during the year 2020, the period during which Saudi Arabia underwent the first two waves of the COVID-19 pandemic. World Health Organization Quality of Life (WHOQOL-BREF) assessed the QoL in four domains physical, psychological, social and environmental and used standard scores in the analysis. GraphPad Prism 5 and SPSS 25V were employed for the statistical analysis. Bar graphs and frequency distribution tables present descriptive data. Bivariate and multivariate logistic regression analyses were computed to determine the significance of the relationship between QoL and healthcare adherence. Results: Almost equal proportions of participants with NCDs (n=109/203; 54%) and without NCDs (n=327/592; 55%) demonstrated nonadherence to their regular healthcare during the COVID-19 pandemic (χ2=0.14; p=0.71). Patients with NCDs experienced lower quality of life in the psychological, social and environmental domains of QoL (p<0.05). Results from the multivariate regression analysis showed that female gender (AOR=1.52; p<0.05) psychological QoL (AOR=1.99; p<0.05), social QoL (AOR=1.98; p<0.05) and environmental QoL (AOR=1.95; p<0.05) significantly relate with adherence to healthcare. Conclusion: Psychological, social and environmental may influence healthcare adherence among patients with NCDs during pandemics and should be focused on while devising future healthcare policy and interventions.

Effectiveness of case scenario-based teaching to transition international Master of Public Health students specialising in health promotion from memorization to critical thinking.

ISSUE ADDRESSED: Critical thinking is essential to health promotion to overcome increasingly complex health issues. International students from Middle East and Asia are however disadvantaged when required to demonstrate critical thinking mainly because of their previous training in memorisation. This study addresses this need by evaluating the effect of case scenario-based teaching on transition from memorisation to critical thinking among international students in an Australia university. METHODS: This was a pre and post intervention study and data were collected from a convenience sample of 79 international Master of Public Health students specialising in health promotion in 2019 at the University of Wollongong. RESULTS: Most of the participants were female (73.4%) and aged 25 years or older (64.6%), predominantly from India (40.5%), Nepal (31.6%) and Saudi Arabia (11.4%). A paired t-test analysis showed that the intervention - case scenario-based teaching - significantly improved the mean post-intervention critical thinking skills (P < 0.001). Case studies improved critical thinking among international students, irrespective of demographic attributes. Multiple regression analyses indicated that critical thinking predicted 78.6 of the total marks, after controlling for demographic attributes. In terms of assessment marks, improved multiple solutions skills yielded better marks for tutorial participations; while improved problem identification skills improved marks for report assessments and exams. Improved communication skills led to better marks for essay assessments. CONCLUSIONS: Case studies improved critical thinking and was a reliable predictor of student performance among the participants. SO WHAT?: This study makes a strong case for case scenario-based teaching to improve critical thinking among international students. However, given the limitations of this study, including the small, non-representative sample, further testing is required.

Perspectives and Experiences of Smartphone Overuse among University Students in Umm Al-Qura University (UQU), Saudi Arabia: A Qualitative Analysis.

Smartphone overuse and addiction is a growing concern worldwide. However, there are limited studies about smartphone addiction and its impacts on university students in Saudi Arabia. This qualitative study aimed to elicit students' and university staff's perspectives and experiences about smartphone overuse/addiction in Umm Al-Qura University (UQU), Saudi Arabia. Fifteen undergraduate students and 18 university staff (13 lecturers and five professionals) were recruited for the purpose of this study. The study data were collected using semi-structured interviews and analysed using thematic analysis. The qualitative data comprising 33 participants (students and staff) identified four major themes including the perception of smartphone use; causes of smartphone overuse; negative impacts of smartphone overuse; and strategies to reduce the overuse of smartphone. The overall findings confirmed that students and staff alike held both positive and negative perceptions about using a smartphone. Potential factors leading to smartphone overuse included personal factors (extended free time and low self-confidence, irresponsibility/escaping certain social gatherings/passing the time); smartphone factors (reasonable price, attractive advertisements (ads), and engaging smartphone Apps); and social factors (social pressure and fear of losing a connection). The main negative impacts of smartphone overuse were found to be related to low academic productivity, poor physical health (body pain, lack of sleep, and low exercise), compromised mental well-being (stress and negative emotions), and decreased socialisation (social isolation and a reduction in face-to-face communication). Our findings suggested that awareness campaigns about smartphone overuse, promoting family and social events, encouraging physical activities, and limiting internet use can reduce smartphone usage among university students. This finding has significant implications for decision-makers.

Smartphone Addiction Prevalence and Its Association on Academic Performance, Physical Health, and Mental Well-Being among University Students in Umm Al-Qura University (UQU), Saudi Arabia.

Smartphone use can lead to smartphone addiction, which is a growing concern worldwide. However, there are limited studies about smartphone addiction and its impacts on university students in Saudi Arabia. This study aims to fill this gap. This is a quantitative study conducted among undergraduate students in Umm Al-Qura University (UQU), Saudi Arabia from May 2019 and February 2021. Study data were collected using both online and hard copy administered surveys. A self-administered questionnaire, Grade point average, Smartphone Addiction Short Version, and Kessler Psychological Distress scales were used to assess the outcomes. A total of 545 undergraduate students, mostly females, aged ≤ 21 years old and lived with large family sizes. More than half owned a smartphone for 5-8 years and the majority used their smartphone on average 6-11 h per day for social networking (82.6%), entertainment (66.2%) and web surfing (59.6%). Most of the participants were smartphone-addicted (67.0%). Logistic regression analysis showed that age ≤ 21, not gainfully employed, small family size and high family income were the main significant socio-demographic predictors of smartphone addiction. Smartphone-addicted participants were more likely to: have lower academic performance (GPA); be physically inactive; have poor sleep; be overweight/obese; have pain in their shoulder (39.2%), eyes (62.2%) and neck (67.7%) and have a serious mental illness (30.7%). This finding has significant implications for decision makers and suggests that smartphone education focusing on the physical and mental health consequences of smartphone addiction among university students can be beneficial.

Lung Cancer and Self-Management Interventions: A Systematic Review of Randomised Controlled Trials.

Background: Lung cancer is the most common cancer worldwide. Evidence suggests self-management (SM) interventions benefit cancer patients. This review aims to determine the effectiveness of SM interventions for lung cancer patients. Method: Searches occurred in PubMed, Cinahl, ProQuest, Psych Info, Scopus, and Medline, using predefined criteria, assessing randomised controlled trials (RCTs). Results: Five hundred and eighty-seven studies were yielded, 10 RCTs met criteria. Of the total patient pool, 1001 of 1089 had Non-Small Cell Lung Cancer (NSCLC). Six studies tested home-based SM exercise, two studies SM education, and one each for diary utilisation and symptom reporting. Fatigue was the most targeted function. Other functions targeted included exercise capacity, anxiety, depression, quality of life (QoL), sleep quality, and symptom burden. Six studies met their primary endpoints (five SM exercise, one SM education). Positive outcomes are described for fatigue, anxiety/depression, sleep quality, self-efficacy, and exercise capacity. With exception to fatigue, early-stage NSCLC, younger age, female, never smokers, partnered patients experienced increased treatment effect. Conclusions: SM interventions improve outcomes among some lung cancer patients. Interventions targeting fatigue yield benefit despite histology, stage or gender and could encourage broader cohort engagement. Consideration of patient characteristics may predict SM effect. Effectiveness of home-based SM exercise by NSCLC stage and SM tailored to sociodemographic variables requires further research.