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The purpose of this paper is to describe the development and process evaluation of an educational intervention, designed to help general practitioners (GPs) identify and manage problem alcohol use among problem drug users.

The educational session was developed as part of a complex intervention which was informed by the Medical Research Council framework for complex interventions. A Cochrane review and a modified Delphi-facilitated consensus process formed the theoretical phase of the development. The modelling phase involved qualitative interviews with professionals and patients. The training's learning outcomes included alcohol screening and delivery of brief psychosocial interventions and this was facilitated by demonstration of clinical guidelines, presentation, video, group discussion and/or role play.

Participants (n=17) from three general practices and local medical school participated in four workshops. They perceived the training as most helpful in improving their ability to perform alcohol screening. Most useful components of the session were the presentation, handout and group discussion with participants appreciating the opportunity to share their ideas with peers.

Training primary healthcare professionals in alcohol screening and brief psychosocial interventions among problem drug users appears feasible. Along with the educational workshops, the implementation strategies should utilise multi-level interventions to support these activities among GPs.

The purpose of this paper is to assess the effectiveness of Kuwait Infection Control Directorate educational program in improving knowledge, attitude and practices (KAP) of environmental service workers (ESWs) regarding the management of infectious and sharps waste.

An interventional educational pre-test/post-test study was conducted over seven months, on a sample of 102 ESWs in Farwaniya General Government Hospital, Kuwait. Educational sessions and practical training using the KAP approach were applied during the intervention phase. The KAP of the participants were assessed using a questionnaire and observation checklist in the pre- and post-intervention phases.

Improvement in all aspects of the KAP regarding infectious and sharps waste management was observed among the participants after implementation of the intervention, with a statistically significant difference between pre- and post-test results (p<0.01).

The applied multi-component educational program in the current study can be successfully implemented for ESWs in all government hospitals in Kuwait and other countries with similar settings.

Early interventions focusing on exercise and lifestyle are important for individuals with a diagnosis of psychosis due to increased risk of poor physical health and reduced life expectancy. This study aims to test the feasibility of a multicomponent lifestyle intervention for individuals with first episode psychosis (FEP).

Individuals attending an Irish FEP service were invited to engage in an eight-week programme including individual and group exercise sessions, group educational sessions and one dietician consultation. Physical activity, physical health, mental health, cognition and personal goals measures were completed pre- and post-intervention and analysed using descriptive statistics. Feasibility data was collected via a non-standardised participant questionnaire and informal data on completion of measures and engagement with the programme.

Ten participants with a diagnosis of FEP completed the intervention. Participants were satisfied with the intervention and adherence rates were high for weekly individual gym sessions but lower for group exercise and education sessions. Mean time spent engaging in physical activity increased and sedentary behaviours decreased. Participants indicated increased readiness for change with 90% moving to the action or maintenance stages of change. Participants attained 74% of their personal goals. There were no changes in average body mass index, cognition or mental health. Data relating to blood pressure, blood tests and steps was missing or incomplete.

This study indicates an eight-week exercise and lifestyle programme is feasible and acceptable in a clinical setting. Recommendations relating to satisfaction, clinical markers and resource requirements are made for future studies.

This study, a theory-based interventional study, aims to promote self-care behaviors regarding sexual and reproductive health in adolescents (female) in Karaj, Iran.

This study was conducted on 90 female students of the Alborz University of Medical Sciences in Iran. For selecting subjects, the researchers went to two girls' dormitories on working days and tried to observe the proportion of students with different fields. Initially, 200 eligible female students were identified in the dormitories of Alborz University of Medical Sciences. Based on the sample size estimation, 100 research units were divided into two groups of receiving counseling (intervention group) and not receiving counseling (control group) by four-digit block randomization. Sexual and reproductive health self-care questionnaire was used as a tool for data collection before, after and one month after intervention. Data were analyzed by using X² and ANOVA tests using SPSS (16).

Both groups were homogeneous in terms of demographic characteristics before the intervention. The results of the study indicated that after education, sexual and reproductive knowledge (p < 0.001), self-care of sexual health (p < 0.001), self-care of menstrual and genital health (p < 0.001) increased significantly. But, regarding parents' communications (p = 0.11), conversation barriers with parents (p = 0.83), interaction with (p = 0.79) and the perceptions of sexual risk behaviors relationships (p = 0.61) differences are not significant.

Failure of parents to participate in this study and the implementation of this study only on the female sex were main limitations of the present study.

Theory-based education can improve sexual and reproductive health in adolescents' girls.

All Authors declare the manuscript entitled “Sexual and reproductive health self-care: a theory-based intervention” is original work of the author. All data, tables, figures, etc. used in the manuscript are prepared originally by authors; otherwise, the sources are cited and reprint permission is attached.

The chapter provides information about the second largest ethnic minority in Romania, Roma people, and the way the Romanian educational system is open to inclusion. Based on factual data about number, groups and legal status, the chapter presents some peculiarities regarding the culture and language, social situation and the level of education. The main part of the presentation is focused on the educational issues, such as information about Romanian educational system and educational attainment of the Roma from preschool till tertiary education and lifelong learning programs. The last part include information about policies and support programs for Roma education and a short analysis of good practice initiatives within Romanian cultural and educational space.

Patients with chronic obstructive pulmonary disease (COPD) suffer many physical disabilities which cause many problems in their life. These patients really need to have continuity of care based on cooperation between patient, the family and their care givers in order to achieve an integration of care. The purpose of this paper is to assess the impact of continuous care on quality of life of patients with COPD.

A before–after quasi-experimental study was carried out with 72 patients with COPD at Beheshti educational hospital of Hamadan University of Medical Sciences. The patients who met inclusion criteria were randomly allocated into an intervention group (n=36) and a control group (n=36). The patients completed the St George’s Respiratory Questionnaire before and after their care. The intervention comprised continuous care with orientation and sensitization sessions (2 weeks), control and evaluation sessions (45 days) for intervention group and with routine care in the control group. Data were analyzed with SPSS, descriptive and inferential statistics were conducted to measure differences between intervention and control group.

Continuity of care improved significantly the quality of life of COPD patients in general, and in the symptoms, activity and impact domains (P=0.001). In contrast, routine care did not improve quality of life for patients in general, and in the symptoms, activity and impact domains (P=0.05).

Continuity of care has a positive impact on quality of life for COPD patients. Health care system should utilize continuity of care models as an overall plan for patients with COPD. Moreover, managers of health care system could reduce burden of chronic diseases by employing continuity of care models in planning patient care.

The purpose of this paper is to critically analyze empirical studies related to the implementation strategies for clinical practice guidelines (CPGs) in intensive care units (ICUs).

A systematic review with a narrative synthesis adapted from Popay et al.’s method for a narrative synthesis was conducted. A search using CINAHL, Google Scholar, Academic search complete, Cochrane Register for Randomized Controlled Trials, MEDLINE via PUBMED and grey literature was conducted in 2014 and updated in 2016 (August). After reading the abstracts, titles and full-text articles, 11 (n=11) research studies met the inclusion criteria.

After critical appraisal, using the Joanna Briggs Critical Appraisal Tools, eight randomized controlled trials conducted in adult and neonatal ICUs using implementation strategies remained. Popay et al.’s method for narrative synthesis was adapted and used to analyze and synthesize the data and formulate concluding statements. Included studies found that multi-faceted strategies appear to be more effective than single strategies. Strategies mostly used were printed educational materials, information/ sessions, audit, feedback, use of champion leaders, educational outreach visits, and computer or internet usage. Practical training, monitoring visits and grand rounds were less used.

Findings can be used by clinicians to implement the best combination of multi-faceted implementation strategies in the ICUs in order to enhance the optimal use of CPGs.

No systematic review was previously done on the implementation strategies that should be used best for optimal CPG implementation in the ICU.

Currently, the health system is a treatment-oriented system focused on service providers. In this system, the main focus is on the health market, with little attention on insured. One way to get out of existing conditions is to empower the insured in order to involve them actively in maintaining and improving health. The paper aims to discuss these issues.

This qualitative study was done using the content analysis method. Based on the purposive sampling method and theoretical saturation criterion, 24 individuals including 12 health insurance experts and 12 insured participated in the study in 2018. The semi-structured interview method was used to collect data. Data were analyzed using MAXQDA10 software.

Having analyzed the interviews, 750 codes were obtained. These codes were categorized into two categories of “insurance experts” and “insured” and ten subcategories of “informing and educating, cost reduction, intersectional activities, expectations from the insured, services package, access to services, inability to pay costs, participation, and expectations from the insurance organization.”

This qualitative study was conducted to assess and determine the effective strategies for empowering the insured under health insurance. The results of this study are helpful to the health insurance organizations and health decision makers to detect the effective ways to develop the quality of insurance services, improve the status of insured, and increase access to health care goods and services.

Team effectiveness is often predicated by a group’s ability to communicate. However, the effect of stress response on communication success, particularly nonverbal engagement, and how this might affect team performance, is not clear; a “phenomenon” this study sought to explore.

This was an observational study in a cohort of professional rugby players. Participants gave presentations to their peers on two separate occasions during a “live-in” camp designed to have psychologically stressful elements. Presentations were video recorded and audience engagement was measured. Testosterone and cortisol were used as biomarkers of stress response, with a high testosterone–cortisol ratio considered positive. A team training session followed the presentations and participants were rated for training quality.

A small decline in testosterone was observed each day after waking. Conversely, cortisol rose after waking, with the rise being the highest on the first day. A decline in testosterone–cortisol ratio was also seen each day after waking; the decline was greatest on the first day. Presentation duration and audience engagement was greatest for the second presentation; when the testosterone-cortisol ratio decline and the cortisol increase after waking was smaller. Training quality was also better that day. Pooled data revealed a moderate inverse relationship and weak positive relationships for audience engagement with post-meeting cortisol and post-meeting testosterone–cortisol ratio, respectively. Training quality was related to testosterone and testosterone–cortisol ratio, but inversely related to cortisol.

This study suggests that in stressful conditions, as suggested by an awakening hormone response, communication and team performance could become compromised with reduced ability to engage with others.