Search Results (97)

Background: Nutrition problems among primary school children increase the risk of illness, reduce school attendance, and impair academic performance. The Indonesian national school feeding program (ProGAS—Program Gizi Anak Sekolah) was developed to address these issues through the provision of healthy breakfast, nutrition education, and character building. Methods: This study employed a mixed-methods design involving 454 primary school students aged 8–14 years from 24 schools across four provinces. Data collection included structured questionnaires, 24 h dietary recalls, and anthropometric measurements. In-depth interviews with school principals, teachers, cooking teams, parents, students, nutritionists, and district education office staff were conducted to capture experiences and opinions on the ProGAS implementation. Results: ProGAS significantly improved students’ dietary diversity, meal frequency, handwashing with soap, and nutrition knowledge, alongside a positive trend in school attendance. Improvements included higher mean dietary diversity, increased proportion of students eating ≥3 meals/day, greater correct responses on balanced nutrition, and higher rates of handwashing before meals (all p < 0.01). Children also developed positive behaviors such as praying before meals, queuing, and taking responsibility for cleaning dishes. However, students’ breakfast habits did not significantly improve, the delivery of nutrition education was suboptimal, and no significant changes were observed in nutrient intakes or nutritional status based on BMI-for-age. While the energy and protein contributions of the ProGAS menu met the recommended 25–30% of daily requirements for breakfast, its micronutrient contributions remained below the recommended levels. Key management gaps include the delivery of nutrition education to students and the monitoring of implementation by local and national authorities. Conclusions: ProGAS demonstrated positive impacts on some dietary and hygiene practices as well as learning environment. To achieve greater improvements in breakfast habits, nutrient intake and nutritional status, it is recommended to strengthen the school feeding menus not only for dietary diversity but also for nutrient density, enhance capacity building for teachers, deliver regular and engaging nutrition education, and reinforce program monitoring. Full article

Giftedness remains a largely unrecognised phenomenon within the Italian school system, where teacher training and educational strategies are still predominantly focused on the needs of students with learning difficulties where special education is concerned. Through a qualitative analysis of three focus groups conducted with 15 teachers from various Italian regions, this study explores the perceptions, challenges, and training needs of primary school teachers in relation to gifted education. Participants, selected from a previous nationwide survey on teachers’ perceptions of giftedness, represented diverse geographical and professional contexts and discussed their experiences in moderated sessions of about 90 min each. Data were transcribed and examined through thematic analysis, following an inductive coding process conducted collaboratively by the research team to ensure reliability and depth of interpretation. The analysis revealed five main themes: an uncertain and fragmented definition of giftedness, often confused with high academic achievement or learning disorders; difficulties in early identification due to a lack of training and suitable diagnostic tools; challenges in classroom management; inadequate teaching strategies, often ineffective in addressing the needs of gifted students; and the need for specific training and practical support tools. Teachers also emphasised relational difficulties, issues in collaborating with families, and the frequent marginalisation of giftedness in school discourse. The focus groups, beyond being research instruments, proved to be meaningful formative experiences, allowing teachers to reflect on practice and co-construct possible solutions. Among the most shared proposals were the introduction of mandatory training, both at the university and in-service level, and the creation of a teacher-friendly vademecum to support early identification and suggest practical classroom strategies. The findings suggest that the absence of an institutional culture around giftedness significantly limits the recognition and development of these students within the Italian educational system, highlighting the urgent need to integrate this topic into teacher training programmes and to provide operational tools to support teachers in their practice. Full article

Aim: This study assessed how pharmacists perceive the impact of their role in the mental health (MH) services in two National Health Service (NHS) Trusts in England and their views on this service. Methods: An interview-based study was conducted from September to December 2023 on Microsoft Teams^® by interviewing the pharmacists involved in MH services in Berkshire Healthcare NHS Foundation Trust & the Birmingham and Solihull Mental Health Trust (BSMHFT) in England. Interviews were conducted using a semi-structured interview guide containing questions related to pharmacists’ roles, activities, perceptions about the service, and future recommendations. Transcripts were prepared and analysed using thematic analysis. The study was approved by the ethics committee of the School of Pharmacy at the University of Reading and was registered as a service evaluation with both Trusts. Results: A total of 11 participants attended the interviews. Most of the participants self-identified as women (n = 9), worked between 25 and 40 h on average weekly (n = 8), and had training in MH (n = 7). Few (n = 4) had work experience >20 years. Four themes emerged: (1) Roles and responsibilities—pharmacists play a vital role in medication management, clinical decision-making, and patient counselling; (2) satisfaction and positive impacts—a high job satisfaction derived from improved patient outcomes and effective multidisciplinary collaboration was reported; (3) challenges and barriers—stigma, role ambiguity, limited training in mental health, and institutional challenges (workload, funding, etc.), were identified; participants also expressed scepticism about the readiness of newly qualified prescriber pharmacists; (4) recommendations—participants advocated for enhanced MH content in pharmacy curricula, societal awareness and de-stigmatisation. Conclusions: Pharmacists viewed their role as integral to providing MH services; however, progress is impeded by challenges such as stigma, fragmented care, training gaps, and staffing shortages. It seemed unclear at the moment how the new prescriber-ready pharmacists will contribute to services. Additional findings from primary-care settings would provide a collective account of the current roles of pharmacists and their potential in MH. Full article

The quality of initial and continuous training for primary-school teachers is essential to fostering science education and building strong scientific foundations. This qualitative case study, conducted over two consecutive school years in Portugal, examines the impact of a continuous professional development program aimed at addressing gaps in primary teachers’ experimental science teaching. The program took place in the municipality of Penafiel and was organized by a university research team in collaboration with local schools. The program combined face-to-face sessions, in-school support from expert monitors, and the provision of teaching resources. Data were drawn from Individual Final Reflective Reports written by 108 teachers, all of whom participated through mandatory enrollment in the local training initiative. The sample was therefore exhaustive, covering the entire population targeted by the municipality. The reports were analyzed using qualitative content analysis, following an inductive coding process supported by peer validation. NVivo (version 14) software was used to assist in the categorization and management of textual data. The analysis revealed that teachers highly valued the training, particularly highlighting the relevance of the content, the effectiveness of the methodologies, and the training’s practical utility in overcoming classroom challenges. The program enhanced teachers’ confidence in implementing experimental activities and improved their teaching practices. The study underscores the importance of continuous professional development in strengthening teacher qualifications and science education. Limitations include reliance on self-reported reflections, the focus on a single municipality, and the absence of triangulation with classroom observations. Nevertheless, the program demonstrates that combining active methodologies, contextualized classroom support, and resource provision is a promising model for teacher professional development. The implications are relevant for policymakers, training centers, and teacher educators designing continuous professional development initiatives. Future research should explore scalability, longitudinal effects, and the comparative effectiveness of different continuous professional development mode. Full article

In the context of digital school development, the leadership practices of school leadership teams play a significant role. If leadership teams want to enact leadership practices effectively, they require strong connections to the entire teaching staff as well as close contact with other key actors in the digital process. Since little is known about these connection patterns of school leadership teams, this study aims to uncover them. The aim is to provide practical advice to school administrators and schools regarding digital school development, and to derive concrete recommendations for action concerning their relationships and management. To this end, we examined the social networks of the teaching staff of 13 German secondary schools (N = 817 teachers) by asking all the teachers to complete a questionnaire about their contacts in relation to digital school development. We conducted a social network analysis and extracted various network metrics pertaining to the school leadership teams of these institutions, considering not only their integration within the overall network but also their connections with a pivotal stakeholder: the digital coordinator. To contextualize our findings, we compared the network metrics of the two different professional target groups using t-tests. The results reveal significant variability in the connection patterns of school leadership teams across different schools. Furthermore, our analysis indicates that digital coordinators consistently exhibit higher levels of connectedness within the realm of digital school development than the members of the school leadership teams. These findings highlight the importance of close collaboration between school leadership teams and the digital coordinator in order to advance digital school development. It is also suggested that school leadership teams should consider delegating more responsibilities to the digital coordinator, particularly those necessitating close collaboration with the teaching staff. Full article

Inclusive education is a central pillar of contemporary educational policy worldwide, aiming to ensure equity, participation, and success for all learners. Understanding how inclusive policies are implemented in everyday school contexts is essential to identify both enabling factors and persistent barriers. In Portugal, this process has been shaped by a progressive legislative framework, notably Decree-Law 54/2018 and its regional adaptation in the Autonomous Region of Madeira (RAM) through Regional Legislative Decree 11/2020/M. This case study combined qualitative documentary analysis with a questionnaire applied to coordinators of the Multidisciplinary Teams to Support Inclusive Education (EMAEI) from 11 of the 14 secondary schools in the RAM (79% of the total). The questionnaire covered five domains: inclusive principles, leadership, professional development, resources, and diagnosis of learning barriers. Descriptive statistics and content analysis were used to interpret the data. Results show that coordinators share a strong ethical commitment to inclusion and recognize EMAEI as a strategic organizational structure. However, they point to irregular and insufficient training, delays and mismatches in resource allocation, and limited institutionalization of co-teaching and joint planning. Leadership emerges as a decisive enabler of collaborative cultures. The study concludes that ambitious legislation must be complemented by agile resource management, sustained context-based training, and distributed leadership for inclusive schooling to become everyday practice. Full article

Screening for diabetes-specific distress should be considered a standard component of diabetes management. This study aimed to evaluate the psychometric properties of the Serbian adaptation of the Problem Areas in Diabetes—Teen Version (PAID-T). Methods: A multicentre, validation, cross-sectional study was conducted with 374 adolescents (aged 13–18 years) diagnosed with type 1 diabetes (T1D), all of whom completed the Serbian version of the PAID-T. The psychometric evaluation included assessments of construct validity through exploratory (EFA, first subsample, n = 140) and confirmatory (CFA, second subsample, n = 234) factor analyses, as well as examinations of concurrent and convergent validity. Reliability was evaluated using measures of internal consistency and test–retest stability (n = 289). Results: Factor analyses indicated some multidimensionality; however, the high correlations between factors in the three-factor model and the optimal fit of the hierarchical three-factor model with a single second-order factor supported the interpretation that the PAID-T measures a unified construct, with satisfactory fit indices (CFI = 0.95; TLI = 0.93; RMSEA = 0.08; SRMR = 0.05). Concurrent validity testing demonstrated gender-based differences in adolescents’ perceptions of the emotional burden of diabetes (W = 19.718, p = 0.03, small effect size = 0.11). Convergent validity analyses showed that adolescents who were non-adherent to treatment (W = 11.390, p = 0.01, small effect size = 0.13) or experienced difficulties managing diabetes at school (W = 16.333, p < 0.001, small effect size = 0.16) reported significantly higher levels of diabetes-specific distress. A significant negative correlation was also observed between PAID-T scores and perceived social support (ρ = −0.24, p < 0.001). Importantly, Serbian adolescents with T1D reported mean PAID-T scores close to the cutoff point of 44, indicating clinically relevant levels of distress. The Serbian version demonstrated strong internal consistency (Cronbach’s α = 0.92; McDonald’s ω = 0.93) and excellent test–retest reliability (ICC = 0.99, 95% CI), confirming stability over time. Conclusions: The Serbian adaptation of the PAID-T demonstrated strong validity and reliability, supporting its use as a robust tool for assessing self-reported diabetes-specific distress in adolescents. Notably, the mean PAID-T scores in Serbian adolescents with T1D were close to the established cutoff point of 44, underscoring the clinical relevance of routine screening in this population. The early identification of diabetes distress can enable nurses and other members of the multidisciplinary healthcare team to deliver tailored interventions, ultimately improving psychological well-being and health outcomes. Full article

We examined the effects of emotional intelligence (EI) and the Big Five on students’ performance in collaborative problem solving (CPS). 162 secondary-school students completed the Mayer-Salovey-Caruso Emotional Intelligence Test and the Big Five Inventory. Divided into 54 triads (64.8% female), they then collaboratively solved a complex social problem. Based on video-recordings of the CPS sessions, we assessed four CPS processes: the team’s socio-cognitive exchange, socio-emotional interaction, task management, and relationship management. The CPS product (solution) of each team was judged by two independent raters. Using structural equation modelling (1) with team-level EI abilities as predictors, we found a small indirect effect (via CPS processes) of both understanding and managing emotions on the CPS product, and a medium-size direct effect of understanding emotions on the same criterion; (2) with team-level traits as predictors, a medium-size positive effect of neuroticism on task management, a small negative effect of extraversion on relationship management, and a small positive effect of openness on the CPS product. A model including both EI and personality confirmed their independent contributions to CPS performance, with EI abilities contributing both directly and indirectly to the CPS product, and the contribution of personality narrowed down to neuroticism positively affecting task management. Full article

Background: With increasing involvement of pharmacists in clinical situations and expanding scope of practice, the expectation and management of uncertainty is a desirable component of pharmacy education, leading to improved uncertainty tolerance (UT) as pharmacists. Methods: The purpose of this pilot study was to determine whether an inpatient rounding simulation (IRS) that exposes student pharmacists to a level of uncertainty leads to changes in tolerance of ambiguity scale (TAS) scores and self-reflection comments. A pre-/post-observational, pilot survey study was conducted, including student pharmacists in their second professional year at the United States School of Pharmacy who were enrolled in an associated lab-based course in Spring 2024. Student teams completed a mock IRS and responded to clinical questions in a timed environment. Students completed pre-/post-simulation TAS and self-reflection on uncertainty/UT within the simulation. Pre-/post-simulation TAS scores were analyzed with a paired t-test. Qualitative analysis was used to identify themes in self-reflection. Results: 59 students responded (48% response rate). TAS was not different pre-/post-IRS (63.2 vs. 62.6, p = 0.63). When individual subscales were compared, a statistically significant difference was found in the insolubility subscale (10.5 vs. 9.5; p = 0.02). Themes of uncertainty that emerged during qualitative analysis of pre-simulation included the clinical question posed to the team. Student pharmacists overcame uncertainty pre-simulation by working with their team and relying on the availability of resources. Themes of uncertainty emerging during qualitative analysis of post-simulation included discerning the best answer. Student pharmacists overcame uncertainty post-simulation by working with their team and cited working with their team as a positive aspect of the IRS experience. Conclusions: In this pilot study, student pharmacists had high TAS scores both pre- and post-simulation. Students utilized their teams and cited this as a positive in an uncertain environment. Full article

Middle leaders are acknowledged as important leaders within schools to support and improve teaching and learning. While middle leaders’ (MLs) knowledge and skills are foundational for contributing to school improvement, social emotional intelligence (SEI) has been identified as a crucial capability for developing and maintaining trusting relationships and collaborative teams, both of which are essential for leading school improvement, a central focus of ML work. To understand the empirical evidence base on MLs and SEI, a scoping literature review was conducted. Although empirical research was limited, SEI consistently emerged as a critical factor influencing a range of middle leadership (ML) outcomes. To extend the review findings, a problem-centered interview approach was undertaken with five MLs. The interviews sought to identify the SEI competencies perceived as supportive of ML practices and positive outcomes for both MLs and colleagues. Insights from the literature review and interviews converged to highlight empathy and emotional self-management as foundational SEI competencies. Both competencies were found to underpin several key leadership outcomes, including the regulation of emotions, both personal and interpersonal, for the development of collegial relationships, and the enhancement of ML wellbeing. Considering these findings, professional learning (PL) to foster ML SEI competencies is presented. Full article

Aims/Background: Polypharmacy, or the concurrent intake of five or more medications, is a significant issue in clinical practice, particularly in multimorbid elderly individuals. Despite its importance for patient safety, medical education often lacks systematic training in recognising and managing polypharmacy within the framework of patient-centred care. We investigated the impact of a structured learning intervention introducing polypharmacy as a chronic condition, assessing whether it enhances medical students’ diagnostic competence, confidence, and interprofessional collaboration. Methods: A prospective cohort study was conducted with 50 final-year medical students who received a three-phase educational intervention. Phase 1 was interactive workshops on the principles of polypharmacy, its dangers, and diagnostic tools. Phase 2 involved simulated patient consultations and medication review exercises with pharmacists. Phase 3 involved reflection through debriefing sessions, reflective diaries, and standardised patient feedback. Student knowledge, confidence, and attitudes towards polypharmacy management were assessed using pre- and post-intervention questionnaires. Quantitative data were analysed through paired t-tests, and qualitative data were analysed thematically from reflective diaries. Results: Students demonstrated considerable improvement after the intervention in identifying symptoms of polypharmacy, suggesting deprescribing strategies, and working in multidisciplinary teams. Confidence in prioritising polypharmacy as a primary diagnostic problem increased from 32% to 86% (p < 0.01), and knowledge of diagnostic tools increased from 3.1 ± 0.6 to 4.7 ± 0.3 (p < 0.01). Standardised patients felt communication and patient-centredness had improved, with satisfaction scores increasing from 3.5 ± 0.8 to 4.8 ± 0.4 (p < 0.01). Reflective diaries indicated a shift towards more holistic thinking regarding medication burden. The small sample size limits the generalisability of the results. Conclusions: Teaching polypharmacy as a chronic condition in medical school enhances diagnostic competence, interprofessional teamwork, and patient safety. Education is a structured way of integrating the management of polypharmacy into routine clinical practice. This model provides valuable insights for designing medical curricula. Future research must assess the impact of such training on patient outcomes and clinical decision-making in the long term. Full article

Paraprofessionals play a crucial role in supporting both teachers and students within a classroom, even though the specifics of their duties vary. While their responsibilities involve supporting student achievement, research has shed light that many paraprofessionals feel unprepared for their responsibilities in the classroom. This study aimed to address a gap in the existing literature by exploring how a professional development program that mirrors the trainings special education teachers receive would impact paraprofessionals and help them feel more prepared for their responsibilities in the classroom. Employing a generic qualitative methodology, this study sought to capture the experiences of 43 paraprofessionals. Data collection involved an online open-ended questionnaire at the start and conclusion of the school year. The study’s outcomes revealed five patterns in the data: (a) paraprofessionals struggled with collaborating with classroom teams at the start of the school year, (b) paraprofessionals struggled with managing student behavior at the start of the school year, (c) professional development was helpful to most of the paraprofessionals, (d) professional development led to better preparedness to address challenging behavior, and (e) professional development led to better preparedness to address the instructional needs of students with disabilities. Following a thorough analysis and synthesis, these patterns were condensed into two general themes: the importance of professional development for paraprofessionals and the importance of presenting the professional development that teachers receive on a continuous basis to paraprofessionals as well. These findings are significant for school leaders and educators, as they highlight the importance of providing professional development to paraprofessionals while supporting students with disabilities. Full article

When designing, implementing and assessing public policies, and, in particular, those affecting the public management of religious diversity, it is increasingly common to include ethnographic approaches from the field of social anthropology and the broader social sciences. Ethnographic practice can provide more representative and accurate perspectives on the actors, settings, and social phenomena subject to regulation. This article presents the findings of an ethnographic study on two minority religious communities, conducted by a team of anthropologists within the framework of a broader research project on religious freedom in Spain, led by jurists. Based on two case studies—the teaching of Evangelical religion in state schools and Islamic burial practices—our study analyses the implications of the varying degrees of public recognition, as well as how this recognition actually manifests in the everyday practice of religious groups within a context of religious diversity. The study also examines the barriers to the full participation of these communities in public institutions and civil society, as well as the discourses, strategies, and practices they develop to overcome these challenges. Full article

Background/Objectives: Sexual health research involving young adolescents remains scarce despite rising rates of early sexual debut, pregnancies, and sexually transmitted infections (STIs) in this population. We explored community stakeholders’ perspectives on engaging young adolescents in sexual health research in Western New York to inform strategies for engaging young adolescents in sexual health research. Methods: This qualitative descriptive study was conducted from April 2022 to June 2023. Seventeen community stakeholders, including health education teachers, youth counselors, and adolescent health providers, participated in semi-structured in-depth interviews. Data were analyzed using conventional content analysis, managed by MAXQDA 2020. The rigor and trustworthiness of the data were ensured through triangulation with observations, peer debriefing, team analysis, and respondent validation. Results: Participants were predominantly female (94.1%), 52.9% Black/African American, 41.2% White, and 5.9% Caucasian–Indian American, and aged 23–59 years. Four themes emerged: perspectives on conducting sexual health research with young adolescents, recruitment strategies, sexual health questions appropriate for young adolescents, and building readiness for participation in sexual health research. Participants reported the need for sexual health research with young adolescents and recommended building a trusting relationship and involving schools, parents, and trusted community organizations in the research process. Suggested research questions included those related to awareness of sex, STIs, available resources, experiences with sexual education, and desired support. The findings also revealed the need to initiate sexual health conversations early when children start asking questions, as a foundation for meaningful participation in sexual health research. Conclusions: The findings suggest that sexual health research with young adolescents is feasible and necessary, with implications for the design of developmentally appropriate sexual health research and interventions grounded in trust and community collaboration. Future research should explore the perspectives of caregivers and young adolescents to inform studies and programs that are attuned to young adolescents’ developmental needs. Full article

Background/Objectives: The pediatric mental health crisis in the United States has reached unprecedented levels. Severe shortages in specialized health care professionals, particularly child and adolescent psychiatrists (CAPs), exacerbate the challenge of delivering timely and quality mental health care, especially in rural areas like Kansas. Innovative models such as Pediatric Mental Health Care Access (PMHCA) programs and School-Based Health Clinics (SBHCs) aim to integrate mental health expertise into primary care settings to address this gap. Methods: This paper examines an integrated care model to support SBHCs developed by the Kansas PMHCA. The Interprofessional Child-Centered Integrated Care Model (ICX2) was implemented within an SBHC in Haysville, KS. ICX2 utilizes biweekly collaborative team meetings (CTMs) via zoom involving primary care, psychology, child psychiatry, social work, and school resource coordinators to discuss patient cases and enhance the primary care management of pediatric mental health. This descriptive study analyzes data from January 2023 to June 2023, focusing on patient demographics, case characteristics discussed during CTMs, and recommendations made by the interprofessional team. Results: Findings illustrate the complex biopsychosocial needs of patients seen and define themes of case consultation and recommendations. Conclusions: Integrated care programs like ICX2 can be feasibly implemented through PMHCA programs and may be an efficient intervention to bridge resource gaps. Full article