Literature review on sexuality in the elderly: What is being taught and with what technologies. / Revisión de literatura sobre sexualidad en las personas mayores: qué se educa y con qué tecnologías.

Chile is facing an increasingly aging population and, with it, changes in its demographic, epidemiological, and healthcare structure. As a result, the sexual health of the elderly is an emerging area at the social level and in healthcare systems. This research aims to identify general aspects of sexuality in the elderly and learn about educational content delivered to this group using digital technologies. To do this, we proposed a review of scientific literature on the subject between January 1st, 2018, and December 31st, 2022, in the databases Web of Science, MEDLINE/PubMed, LILACS, Cochrane, Scopus, and Google Scholar. The articles found, and the emerging information was analyzed. A total of 1573 articles were found, of which 21 papers were finally included, 11 with qualitative methodology, six quantitative, and four mixed. In addition, nine addressed the area of sexuality, and 12 focused on technological innovations for the elderly. Sexuality is a growing topic worldwide, carrying with it sociocultural beliefs associated with dogmatic opinions and myths, with discrimination against this age group, especially if they belong to sexual minorities. This group also has better access to new digital technologies that facilitate access to training, social integration, and timely healthcare. Scientific evidence shows that the sexuality of the elderly is a topic of global interest, invisibilized, with low education and training of healthcare workers. The latter are neither informed nor able to solve the reasons for consultation in the traditional way or with new digital health technologies.

Chile es un país que enfrenta un envejecimiento poblacional acelerado, y con ello cambios en la estructura demográfica, epidemiológica y asistencial, donde la salud sexual de las personas mayores es un área emergente a nivel social y en los sistemas de salud. Esta investigación tiene por objetivos identificar aspectos generales de la sexualidad en las personas mayores, y conocer contenidos educativos entregados a este grupo con tecnologías digitales. Para ello, se propuso una revisión de literatura científica que buscó investigaciones en la materia entre el 1 de enero de 2018 y el 31 diciembre de 2022, en las bases de datos, A partir de ello se analizaron los artículos encontrados y la información emergente. Se encontraron 1573 artículos de los cuales se incluyeron 21 trabajos, 11 con metodología cualitativa, 6 cuantitativa y 4 mixta. Además, 9 trataron el área de sexualidad y 12 respecto de innovaciones tecnológicas en personas mayores. Se aprecia que la sexualidad es un tema creciente a nivel mundial, que arrastra idearios socioculturales asociados a visiones dogmáticas y a mitos, con discriminación hacia este grupo de edad, sobre todo si pertenecen a minorías sexuales. También se observa en este grupo de interés un mejor acceso a nuevas tecnologías digitales para acceder a capacitación, integración social y atención oportuna en salud. La evidencia científica demuestra que la sexualidad de las personas mayores es un tema de interés mundial, invisibilizado, con baja formación y capacitación del personal sanitario. Este personal no educa ni resuelve estos motivos de consulta en forma tradicional o con nuevas tecnologías digitales en salud.

Applying the UTAUT2 framework to patients' attitudes toward healthcare task shifting with artificial intelligence.

BACKGROUND: Increasing patient loads, healthcare inflation and ageing population have put pressure on the healthcare system. Artificial intelligence and machine learning innovations can aid in task shifting to help healthcare systems remain efficient and cost effective. To gain an understanding of patients' acceptance toward such task shifting with the aid of AI, this study adapted the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2), looking at performance and effort expectancy, facilitating conditions, social influence, hedonic motivation and behavioural intention. METHODS: This was a cross-sectional study which took place between September 2021 to June 2022 at the National Heart Centre, Singapore. One hundred patients, aged ≥ 21 years with at least one heart failure symptom (pedal oedema, New York Heart Association II-III effort limitation, orthopnoea, breathlessness), who presented to the cardiac imaging laboratory for physician-ordered clinical echocardiogram, underwent both echocardiogram by skilled sonographers and the experience of echocardiogram by a novice guided by AI technologies. They were then given a survey which looked at the above-mentioned constructs using the UTAUT2 framework. RESULTS: Significant, direct, and positive effects of all constructs on the behavioral intention of accepting the AI-novice combination were found. Facilitating conditions, hedonic motivation and performance expectancy were the top 3 constructs. The analysis of the moderating variables, age, gender and education levels, found no impact on behavioral intention. CONCLUSIONS: These results are important for stakeholders and changemakers such as policymakers, governments, physicians, and insurance companies, as they design adoption strategies to ensure successful patient engagement by focusing on factors affecting the facilitating conditions, hedonic motivation and performance expectancy for AI technologies used in healthcare task shifting.

Few LGBTQ+ Science and Engineering Instructors Come Out to Students, Despite Potential Benefits.

LGBTQ+ undergraduates have higher attrition from science and engineering (S&E) than straight and cisgender undergraduates and perceive that having LGBTQ+ instructors would benefit them. However, it is unknown how many S&E instructors are LGBTQ+, the extent to which they disclose this information to students, and how disclosure affects all students, both LGBTQ+ and non-LGBTQ+. In study I, we surveyed 108 LGBTQ+ S&E instructors across the U.S. to explore the extent to which they reveal their LGBTQ+ identities across professional contexts and why they reveal or conceal their identities to undergraduates. Overall, 75% of instructors came out to at least some colleagues but only 48% came out to any undergraduates. Instructors most commonly chose to conceal LGBTQ+ identities from undergraduates because they perceived their identities to be irrelevant to course content and anticipated negative student reactions. In study II, 666 introductory biology undergraduates were randomly assigned to evaluate one of two identical teaching demonstration videos except the instructor revealed her LGBTQ+ identity in one but not the other. We assessed differences in students' impressions of the instructor across conditions. We found no differences in most ratings of the instructor except participants reported higher rapport with the instructor when she came out.

Comfort with LGB people and attitudes toward same-sex parenting in Continental American Hispanic Nations.

Negative attitudes toward Lesbian, Gay, and Bisexual (LGB) individuals leads to a perceived inability of LGB individuals to foster 'appropriate' family relationships, inciting negative attitudes specifically toward same-sex parenting. Intergroup and interpersonal relationships play a critical role in fostering attitudes toward others wherein type of contact, frequency, degree of closeness in the relationship, and the positivity/negativity of interactions are potential mediator of these relations, Moreover, the mechanism behind co-constructing positive relationships with sexual and gender minorities is comfort with contact with LGB individuals. The present study explored the effects of interpersonal contact and the mediator role of comfort with LGB people in explaining attitudes toward same-sex parenting in Spanish-speaking countries in North, Central, and South America. These countries are of particular interest given the dearth of research in the region on attitudes toward same-sex parenting as well as the varying degrees of acceptance of and protections for same-sex parented families. A non-probabilistic sample of 1955 heterosexual cisgender participants from 14 countries was asked to complete a series of sociodemographic questions, a questionnaire about their interpersonal contact/comfort experiences with LGB people, and the Attitudes Toward Gay and Lesbian Parenting Scale. Results showed that comfort was vital in fostering accepting attitudes toward Same-Sex Parenting across countries. Findings also suggested that comfort with LGB people has a particularly powerful influence in regions with less legal and cultural acceptance of LGB individuals. Policies are not enough to instill widespread change: we must encourage, facilitate, and supervise the formation of relationships with LGB people.

Scientific supremacy: How do genetic narratives relate to racism?

Recent research suggests that contemporary American society is marked by heightened hostile racial rhetoric, alongside increasing salience of White nationalists who justify an ideology of racial hierarchy with claims of biological superiority. Media coverage of such genetics research has often emphasized a deterministic (or causal) narrative by suggesting that specific genes directly increase negative outcomes and highlighting reported genetic differences between racial groups. Across two experimental studies, we examine the effect of the media's portrayal of scientific findings linking genes with negative health and behavioral outcomes on measures of racism. We find that deterministic genetic attributions for health and behavioral outcomes can lead to more negative racial out-group attitudes. Importantly, we also investigate potential interventions in the presentation of genetic science research. Our research has implications for understanding racial attitudes and racialized ideology in contemporary American politics, as well as for framing scientific communication in intergroup contexts.

Factors influencing the intention to purchase health insurance: a study of Indian tobacco and alcohol consumers.

Introduction: This study empirically investigates the attitude of tobacco and alcohol consumers towards health insurance purchase in India. The study aims to determine the factors which plays a significant role in determining the purchase intention of health insurance among tobacco and alcohol consumers. Methods: We propose an extended theory of planned behavior (TPB) model comprising factors like attitude, subjective norms, perceived behavior control, perceived usefulness, perceived product risk, and intention to purchase. We collected responses from 420 tobacco and alcohol consumers through a Google Form link shared via different social media platforms. SPSS has been used to perform exploratory factor analysis, whereas AMOS has been used to validate the constructs, confirm the relationships among the variables, and analyze the data. Results: The analysis outcomes demonstrate that subjective norms, perceived product risk, and perceived behavioral control are the factors that have a positive and significant effect on health insurance purchase intention among consumers. Discussion: This research offers valuable insights to the insurance sector, government officials, policymakers, and academicians. Insurance companies may consider the criteria analysed when creating policies to promote the expansion of the health insurance sector.

Development and validation of a scale for the assessment of the knowledge-attitude-practice of parents towards children snoring.

BACKGROUND: Children Snoring is a common childhood disorder that affects the growth and development of children and is detrimental to their health. Increasing awareness of Children Snoring among parents is important. AIM: To develop the Knowledge-Attitude-Practice of Parents towards Children Snoring Scale and test the reliability and validity of the scale. METHODS: The development of the tool was divided into two phases involving 1257 parents from China. In the first phase, an initial project bank was created through a literature review. This was followed by a Delphi expert consultation, group discussion and pre-survey. The second stage screened the items and conducted an exploratory factor analysis, then conducted a confirmatory factor analysis and tested for reliability and validity. RESULTS: Support was found for the 25-item Knowledge-Attitude-Practice toward Children Snoring scale. Exploratory and confirmatory factor analyses provide support for four subscales: (parental basic cognition toward Children Snoring; parents' perception of complications of Children Snoring; parents' attitude towards Children Snoring; parents' concern and prevention of Children Snoring). Internal consistency for the total scale was high (Cronbach's α = 0.93). The intraclass correlation coefficient of test-retest reliability was 0.92 (95%CI: 0.85 to 0.95), which provided support for the stability of the scale. CONCLUSION: The Knowledge-Attitude-Practice of Parents towards Children Snoring scale shows promise as a measure that may be used by medical workers and community children's health managers.

Spiritual Experiences, Attitudes, and Behaviors of Yoga Practitioners: Findings from a Cross-Sectional Study in Germany.

The present study aimed to analyze the extent to which yoga practitioners (n = 784) live by their faith/spirituality and how this influences their perceived prosocial behaviors. For that purpose, the model of transformational spirituality was applied. This model assumes that people who experience the sacred in their lives change their attitudes and behaviors and take responsibility in the world. Data from this cross-sectional anonymous online survey with standardized questionnaires (e.g., Franciscan-Inspired Spirituality Questionnaire, Awe/Gratitude Scale, World Health Organization Five Well-Being Index) showed that for most of the enrolled yoga practitioners, yoga is a conscious way of life and a path of spiritual development. Thus, they search for the Divine in the world, live in accordance with their spiritual convictions, and regard their faith/spiritual convictions as an orientation in their lives. Moreover, they score highly on peaceful attitudes and respectful treatment of others, and on commitment to disadvantaged people and the environment. Although the frequency of asana (postural) or pranayama (breathwork) practices was only marginally related to the indicators of spirituality, the frequency of meditation and studying the philosophical background of yoga was weakly to moderately related to Spiritual Experiences, Awe/Gratitude, and Living by Faith. Respondents' well-being was best predicted by experiential aspects of spirituality, inner congruence/emotional involvement with yoga, and with yoga seen as a spiritual path (R2 = 0.21). Regression analyses (R2 = 0.32) further showed that participants' inner congruence with yoga practices could best be predicted by the experiential aspects of spirituality and, to a lesser extent, by the frequency of asana practices, duration of yoga practice, and Peaceful Attitude/Respectful Treatment. The core dimension of faith and the related experiential aspect of spirituality were thus crucial for the ways the enrolled yoga practitioners behave in the world and interact with others and the environment.

Perceived usefulness of medical teachers towards online learning using technology acceptance model.

Objective: To determine medical teachers' acceptance of and attitude towards online learning, and to gather their recommendations about how it can be incorporated in the educational system. METHODS: The mixed method study was conducted at Gujranwala Medical College, Gujranwala, Pakistan, from August 2021 to January 2022, and comprised medical teachers involved in online teaching during the coronavirus disease-2019 pandemic. Quantitative data was gathered using an online questionnaire based on the technology acceptance model. The qualitative component was explored through 2 focussed group discussions. Data was analysed using SPSS 25. RESULTS: Of the 50 teachers, 31(62%) were males and 19(38%) were females. The overall mean age was 42.9±7.9 years, and the mean teaching experience was 10.9±7.9 years. Mean perceived usefulness score was 3.2±0.9 and the mean perceived ease of use score was 3.6±0.6. The mean scores were 3.3±0.9 for intention to use and 3.5±0.7 for attitude towards computer use. There was a strong positive correlation of perceived usefulness with intention to use and attitude towards computer use (p<0.05), while perceived ease of use and intention to use had a strong correlation with attitude towards computer use (p<0.05). There were total 12 participants in focussed group discussions; 2(16.7%) females and 10(83.3%) males with mean age 44.34±5.23 years. A total of 4 major themes were identified. Conclusion: Majority of medical teachers strongly agreed with the acceptance of e-learning, and agreed with its perceived usefulness and perceived ease of use for online learning.

Exploring the factors influencing public intention for spectator sports consumption based on grounded theory.

Spectator sports consumption serves as a vital component in the development of the sports industry. However, numerous challenges exist in fostering public engagement in this domain. Therefore, in order to explore the factors that influence public participation in spectator sport consumption, this study analyzes the intention to participate in spectator sports consumption from the perspective of consumers. On this basis, Semi-structured interviews were conducted with a sample of 25 members of the public, and three levels of coding were analyzed using the qualitative research method of procedural rooting theory and establish a model on the influence of public intention to participate in spectator sports consumption, and on this basis, we reveal the influence of crucial elements. The results of the study indicate that: Firstly, personal and psychological factors are significant internal drivers, while external drivers cover product and contextual factors. Secondly, the key to filling the attitudinal and behavioral gaps is the depth of perception individually, which is of great importance in increasing public participation. Thirdly, external contextual factors impacting consumer support primarily consist of external incentives, social influences, and urban contextual variables, which also serve a moderating role in the integration model. The results suggest that guiding the public to actively participate in spectator sport consumption should be based on an understanding of individual perceptions, emotions as well as attitudes. This paper develops a model examining public motivation to engage in spectator sports locally in China, pinpoints the primary influencing factors and mechanisms, and presents novel concepts for the sustainable growth of the sports sector.

Analysis of the chain mediation effect between intergenerational support and mental health of older adults in urban China: a structural equation model.

BACKGROUND: This study aimed investigate the impact of intergenerational support on the mental health of older adults in urban China. It also sought to evaluate the chain mediation effect of attitudes toward younger people and willingness to interact with younger people within a non-familial context between intergenerational support and mental health. METHODS: Data were derived from a community survey that adopted quota sampling in mainland China in 2022 (N = 780). Structural equation modeling was used to analyze the data, and the bootstrap technique was used to test the mediation effect. RESULTS: A significant positive association was found between intergenerational support and the mental health of older adults in urban China (B = 0.852, 95% confidence interval CI [0.157,1.617]). Intergenerational support had a specific indirect effect on mental health through older adults' attitudes toward younger people within a non-familial context (B = 0.665, 95% CI [0.443,1.046]). There was a chain mediation effect (B = 0.126, 95% CI [0.069,0.224]) in relation to attitudes toward younger people and the willingness to interact with younger people between intergenerational support and mental health. Mediation accounted for 44.44% of the total effects in the model. CONCLUSION: These findings help identify modifiable factors that can improve the mental health of older adults. In line with the proposed serial multiple mediation model, this study provides theoretical and practical insights concerning the synergistic effect of intergenerational support at the family level and intergenerational interaction at the community level. Policy and social service implications are also discussed.

How do people who use opioids express their qualities and capacities? An assessment of attitudes, behaviors, and opportunities.

People who nonmedically use drugs (PWUD) face intricate social issues that suppress self-actualization, communal integration, and overall health and wellness. "Strengths-based" approaches, an under-used pedagogy and practice in addiction medicine, underscore the significance of identifying and recognizing the inherent and acquired skills, attributes, and capacities of PWUD. A strengths-based approach engenders client affirmation and improves their capacity to reduce drug use-related harms by leveraging existing capabilities. Exploring this paradigm, we conducted and analyzed interviews with 46 PWUD who were clients at syringe services programs in New York City and rural southern Illinois, two areas with elevated rates of opioid-related morbidity and mortality, to assess respondents' perceived strengths. We located two primary thematic modalities in which strengths-based ethos is expressed: individuals (1) being and advocate and resource for harm reduction knowledge and practices and (2) engaging in acts of continuous self-actualization. These dynamics demonstrate PWUD strengths populating and manifesting in complex ways that both affirm and challenge humanist and biomedical notions of individual agency, as PWUD refract enacted, anticipated, and perceived stigmas. In conclusion, programs that blend evidence-based, systems-level interventions on drug use stigma and disenfranchisement with meso and micro-level strengths-based interventions that affirm and leverage personal identity, decision-making capacity, and endemic knowledge may help disrupt health promotion cleavages among PWUD.

The effect of the Sport Education Model in physical education on student learning attitude: a systematic review.

BACKGROUND: Evidence indicates that the Sport Education Model (SEM) has demonstrated effectiveness in enhancing students' athletic capabilities and fostering their enthusiasm for sports. Nevertheless, there remains a dearth of comprehensive reviews examining the impact of the SEM on students' attitudes toward physical education learning. PURPOSE: The purpose of this review is to elucidate the influence of the SEM on students' attitudes toward physical education learning. METHODS: Employing the preferred reporting items of the Systematic Review and Meta-analysis (PRISMA) statement guidelines, a systematic search of PubMed, SCOPUS, EBSCOhost (SPORTDiscus and CINAHL Plus), and Web of Science databases was conducted in mid-January 2023. A set of keywords associated with the SEM, attitudes toward physical education learning, and students were employed to identify relevant studies. Out of 477 studies, only 13 articles fulfilled all the eligibility criteria and were consequently incorporated into this systematic review. The validated checklist of Downs and Black (1998) was employed for the assessment, and the included studies achieved quality scores ranging from 11 to 13. The ROBINS-I tool was utilized to evaluate the risk of bias in the literature, whereby only one paper exhibited a moderate risk of bias, while the remainder were deemed to have a high risk. RESULTS: The findings unveiled significant disparities in cognitive aspects (n = 8) and affective components (n = 12) between the SEM intervention and the Traditional Teaching (TT) comparison. Existing evidence suggests that the majority of scholars concur that the SEM yields significantly superior effects in terms of students' affective and cognitive aspects compared to the TT. CONCLUSIONS: Nonetheless, several issues persist, including a lack of data regarding junior high school students and gender differences, insufficient frequency of weekly interventions, inadequate control of inter-group atmosphere disparities resulting from the same teaching setting, lack of reasonable testing, model fidelity check and consideration for regulating variables, of course, learning content, and unsuitable tools for measuring learning attitudes. In contrast, the SEM proves more effective than the TT in enhancing students' attitudes toward physical learning. SYSTEMATIC REVIEW REGISTRATION: ( https://inplasy.com/ ) (INPLASY2022100040).

Neural alignment during outgroup intervention predicts future change of affect towards outgroup.

While social psychology studies have shown that paradoxical thinking intervention has a moderating effect on negative attitudes toward members from rival social groups (i.e. outgroup), the neural underpinnings of the intervention have not been studied. Here, we investigate this by examining neural alignment across individuals at different phases during the intervention regarding Covid-19 vaccine-supporters' attitudes against vaccine-opposers. We raise two questions: Whether neural alignment varies during the intervention, and whether it predicts a change in outgroup attitudes measured via a survey 2 days after the intervention and compared to baseline. We test the neural alignment using magnetoencephalography-recorded neural oscillations and multiset canonical correlation analysis. We find a build-up of neural alignment which emerges at the final phase of the paradoxical thinking intervention in the precuneus-a hub of mentalizing; there was no such effect in the control conditions. In parallel, we find a behavioral build-up of dissent to the interventional stimuli. These neural and behavioral patterns predict a prosocial future change in affect and actions toward the outgroup. Together, these findings reveal a new operational pattern of mentalizing on the outgroup, which can change the way individuals may feel and behave toward members of that outgroup.

Systems approach in planetary health education for medical students: a mixed methods study.

BACKGROUND: Introducing students to the "planetary health lenses" perspective is crucial. Comprehensive strategies for teaching this perspective are lacking, especially in the domains of "interconnection within nature (IWN)" and "systems thinking/complexity." There is also a scarcity of studies assessing medical students' opinions on planetary health and evaluating teaching strategies. OBJECTIVE: To understand Brazilian medical students' perceptions and knowledge of planetary health (PH) and evaluate the application of the educational material "Patient and Clinic through the Lens of Planetary Health," which addresses "IWN" and "complexity" through the sociological lens of Actor-Network Theory, in an integrative course at a medical school in Brazil. METHODS: A mixed-methods, quasi-experimental design involving two medical student classes during 2022/2023. Participants completed a questionnaire on sociodemographic data; pre- and post-intervention closed-ended questions about perceptions related to PH, and an open-ended questionnaire on experience and learning. Each student group presented a portfolio under the planetary health lenses regarding a real patient, developing a network diagram that described the social network involving both human and non-human actors with which this person is interconnected. The cohorts participated in "IWN" activities: a contemplative trail or reflection on belonging to the planet. RESULTS: Ninety-six students and 9 professors participated. The majority of students (66.7%) reported significant or extremely significant learning from the sessions. There was an increase in perception of the need for physicians to incorporate PH into their clinical practice (p = 0.002; r = 0.46) and an intensification of the sense of interconnection with the environment (p = 0.003; r = 0.46). There was a gain in knowledge about how many diseases were related to PH (p < 0.02 for all 13 listed diseases). The majority (83%) found the sessions relevant or highly relevant and commented on their impact, both professionally and personally. CONCLUSIONS: Teaching PH in a medical school allowed students to learn from the patient's perspective, considering psychosocial and environmental determinants, about the intrinsic interdependence between population's health and PH. This strategy made a significant contribution by proposing pioneering didactics and offering valuable insights into the challenges and nuances of teaching PH.

Comparison of dysfunctional attitudes, cognitive vulnerability to depression, before and during the COVID-19 pandemic in healthy participants.

BACKGROUND: During the COVID-19 pandemic, depression and suicide rates increased worldwide, and in Japan. Presumably, an increase of neuroticism-related personality traits mediates the relation linking the COVID-19 pandemic with depression and suicide. This study examined COVID-19 pandemic effects on dysfunctional attitudes, cognitive vulnerability to depression, in healthy participants. METHODS: The study used Dysfunctional Attitude Scale (DAS) -24 data of three subscales (i.e., achievement, dependency, and self-control) obtained from 270 Japanese medical students during October 2017 - June 2022. Participants were divided into two groups: those for whom DAS-24 was assessed before the pandemic (phase 1 group, October 2017 - March 2020, n = 178) and those for whom DAS-24 was assessed during the pandemic (phase 2 group, April 2020 - June 2022, n = 92). RESULTS: Total DAS-24 scores of the phase 2 group were significantly (p = 0.047) lower than those of the phase 1 group. Scores of the dependency subscale for the phase 2 group were significantly (p = 0.002) lower than those for the phase 1 group, but no significant difference was found in the scores of the achievement and self-control subscales. CONCLUSIONS: These findings suggest that a decrease in DAS-24 scores, particularly of the dependency subscale, occurred during the COVID-19 pandemic. Possible mechanisms underlying these results are 1) individuals became less preoccupied with receiving evaluation, 2) individuals realized that self-cognition depending on the approval of others is unimportant, and 3) high levels of dysfunctional attitude were maladaptive for obtaining affective benefits via social interactions during the COVID-19 pandemic.

Co-development of a training programme on disability for healthcare workers in Uganda.

BACKGROUND: Approximately 1.3 billion people worldwide face barriers in accessing inclusive healthcare due to disabilities, leading to worse health outcomes, particularly in low and middle-income countries (LMIC). However, there is a lack of training of healthcare workers about disability, both globally and in Uganda. OBJECTIVES: To use mixed research methods to develop a comprehensive training program with standardisedelements for healthcare workers in Uganda, focusing on improving their knowledge, attitudes, and skills inproviding care for people with disabilities. METHODS: The Medical Research Council (MRC) approach was employed to guide the development of the training intervention. We conducted an umbrella review to gather relevant literature on disability training for healthcare workers. Interviews were conducted with international experts to gain insights and perspectives on the topic. Additionally, interviews were undertaken with people with disabilities and healthcare workers in Uganda to understand their experiences and needs. A participatory workshop was organised involving key stakeholders, to collaboratively design the training material based on the findings from these data sources. RESULTS: Eight review articles examined training programs for healthcare workers on disability. Training settings ranged from specialised clinical settings to non-clinical settings, and the duration and evaluation methods of the training varied widely. Lectures and didactic methods were commonly used, often combined with other approaches such as case studies and simulations. The impact of the training was assessed through healthcare worker reports on attitudes, knowledge, and self-efficacy. Interviews emphasised the importance of involving people with disabilities in the training and improving communication and understanding between healthcare providers and people with disabilities. Five themes for a training on disability for healthcare workers were generated through the workshop, including responsibilities and rights, communication, informed consent, accommodation, and referral and connection, which were used to guide the development of the curriculum, training materials and training approach. CONCLUSION: This study presents a novel approach to develop a training program that aims to enhance healthcare services for people with disabilities in Uganda. The findings offer practical insights for the development of similar programs in LMICs. The effectiveness of the training program will be evaluated through a pilot test, and policy support is crucial for its successful implementation at scale.

KEY MESSAGES: 1. Healthcare workers require training to effectively address the health concerns of people with disabilities, yet this is rarely included in curricula worldwide. 2. Uganda recognises the importance of addressing this issue and is taking steps to improve training programs about disability for healthcare workers. 3. We used multiple research methods (umbrella review, semi-structured interviews, participatory research and collaborative design) to co-develop a comprehensive training program with standardised elements for healthcare workers in Uganda, focusing on improving their knowledge, attitudes, and skills in providing care for people with disabilities. 4. The developed training material could be adapted for healthcare workers in other resource-limited settings, and policy support is needed to ensure its implementation at scale.

Attitudes of the Portuguese population towards advance directives: an online survey.

BACKGROUND: Advance directives (ADs) were implemented in Portugal in 2012. Although more than a decade has passed since Law 25/2012 came into force, Portuguese people have very low levels of adherence. In this context, this study aimed to identify and analyse the attitudes of people aged 18 or older living in Portugal towards ADs and to determine the relationships between sociodemographic variables (gender/marital status/religion/level of education/residence/whether they were a health professional/whether they had already drawn up a living will) and people's attitudes towards ADs. METHODS: An online cross-sectional analytical study was conducted using a convenience sample. For this purpose, a request (email) that publicized the link to a -form-which included sociodemographic data and the General Public Attitudes Toward Advance Care Directives (GPATACD) scale-was sent to 28 higher education institutions and 30 senior universities, covering all of mainland Portugal and the islands (Azores and Madeira). The data were collected between January and February 2023. RESULTS: A total of 950 adults from completed the online form. The lower scores (mean 1 and 2) obtained in most responses by applying the GPATACD scale show that the sample of the Portuguese population has a very positive attitude towards ADs. The data showed that women, agnostics/atheists, health professionals and those who had already made a living will had more positive attitudes (p < 0.001) towards ADs. There were no statistically significant differences in the attitudes of the Portuguese population sample towards ADs in relation to marital status, education level, and residence. CONCLUSION: The results obtained enable us to confirm that this sample of the Portuguese population has a positive attitude towards ADs. We verify that there are certain fringes of this sample with certain sociodemographic characteristics (women, agnostics/atheists, health professionals and those who had already made a living will) that have a more positive attitude towards ADs. This data could facilitate the implementation and adjustment of relevant measures, particularly in the field of health education and aimed at groups with less favourable attitudes, to increase the effectiveness of voluntary exercise of citizens' autonomy in end-of-life care planning.

Predicting attitudes toward ambiguity using natural language processing on free descriptions for open-ended question measurements.

Individual traits and reactions to ambiguity differ and are conceptualized in terms of an individual's attitudes toward ambiguity or ambiguity tolerance. The development of natural language processing technology has made it possible to measure mental states and reactions through open-ended questions, rather than predefined numerical rating scales, which have traditionally been the dominant method in psychological research. This study presented three ambiguity-related situations and responses collected online from 591 participants in an open-ended format. After the analysis with bidirectional encoder representations from transformers, correlations were calculated using scores from the numerical evaluation by conventional questionnaire, and a significant moderate positive correlation was found. Therefore, this study found that attitudes toward ambiguity can be measured using an open-ended response method of reporting everyday life states. It is a novel methodology that can be expanded to other scales in psychology and can potentially be used in educational and clinical situations where participants can be asked to respond with minimal burden.

Using mobile health in primiparous women: effect on awareness, attitude and choice of delivery type, semi-experimental.

BACKGROUND: One of the reasons for the increase in cesarean section is the lack of knowledge of mothers in choosing the type of delivery. The present study aimed to determine the effect of education through pregnancy application during pregnancy on awareness and attitude and choice of delivery type in primiparous women at Shahid Alavi Specialized Medical Center clinic in Mashhad. METHODS: This study was a semi-experimental type. Seventy primiparous pregnant women who had no restrictions for birth was selected. Sampling was randomized and purpose-based. The data collection tool was a questionnaire. The starting time of the training was considered from the end of the 27th week of pregnancy and continued with regular intervals until the end of the pregnancy. The questionnaires were completed once before the training and once after the training as a pre-test and post-test by the research units. SPSS software (version 26) and MacNemar test and descriptive statistics were used for data analysis. RESULTS: According to the results of the MacNemar test, a significant statistical difference was seen between women's knowledge and attitude after the training compared to before (p-value < 0.01). Choosing the type of birth was preferred before and after the training. But following the performance of women showed that only 62.86% of them chose natural birth. In fact, before the training, 40% and after 72.86% of women had chosen birth. CONCLUSION: Pregnancy education and application during pregnancy is effective in reducing the choice of cesarean section, so this application with the topic of birth and cesarean section has improved the level of attitude and also the positive attitude of pregnant women towards birth. Creation of facilities and promotion of different methods of painless childbirth and training of maternity staff to perform birth is expected.