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OBJECTIVELimited formal education is associated with poor cognitive function. This could explain sex differences in cognitive function in the oldest old. Whether limited formal education explains differences in cognitive function...

How to engage farmers that have limited formal education is at the foundation of environmentally-sound and equitable agricultural development. Yet there are few examples of curricula that support the co-development of knowledge with farmers. While transdisciplinary and participatory techniques are considered key components of agroecology, how to do so is rarely specified and few materials are available, especially those relevant to smallholder farmers with limited formal education in Sub-Saharan Africa. The few training materials that exist provide appropriate methods, such as compost making, but do not explain relationships and synergies between nutrition, social inequalities, climate change and agroecology. Some food sovereignty and agroecology courses aim at popular political education for those with more formal education. Here we describe the process of development of an innovative curriculum, which integrates agroecology, nutrition, climate change, gender and other dimensions of social equity across 2 weeks of training explicitly for smallholders in southern Africa with limited formal education. The curriculum is highly participatory; we use concepts in popular education, transformative and experiential-based learning, and theatre. It is also integrative; we link agroecology with climate change, human and soil nutrition, gender, and related components of social equity. Developed in partnership with Malawian farmers, community development experts and academics from fi ve countries, the curriculum was piloted with 520 smallholder farming households in Malawi and Tanzania, and evaluated using qualitative techniques. Clashes of language, cultural norms, and terminology were as great of a challenge as agreeing on and conveying technical information, to weave into a coherent whole. However, farmers who participated in the curriculum training demonstrated high interest, comprehension of material and interest in immediate application to their lives.

BackgroundBovine tuberculosis (BTB) has a significant impact on both the cattle industry and human health. Understanding its transmission, clinical signs, risk factors, and control measures is essential for prevention. This study aimed to evaluate the knowledge, attitudes, and practices regarding BTB in high-burden areas of Malawi.MethodsA stratified sampling design was employed to collect data from 463 butchers, dairy farmers and cattle farmers in different locations and settings in Malawi. Aggregate scores on knowledge, attitudes, and practices were taken as multivariate measurements and fitted with multivariate linear regression models.ResultsParticipants displayed satisfactory knowledge (88.68%), negative attitudes towards risky behaviours (92.27%), and appropriate practices (86.83%) concerning BTB. Most were aware of its presence in cattle (85.71%) and potential transmission to humans (74.09%), yet exhibited gaps in understanding clinical signs and held misconceptions about hereditary transmission. Many participants demonstrated risky behaviours, such as consuming raw animal products and selling products from infected animals. Individuals with secondary (β: −2.148; 95% CI: −4.168, −0.127) and tertiary education (β: −3.488; 95% CI: −6.626, −0.349) exhibited more negative attitudes towards risky behaviours compared to those with informal education. Adults aged 18−30 (β: −2.777; 95% CI: −5.469, −0.085) and those aged 31−45 (β: −3.035; 95% CI: −5.752, −0.319) demonstrated better protective practices than youths under 18.ConclusionThere is an urgent need for targeted health education on BTB, focusing on clinical signs and the myth of hereditary transmission, particularly aimed at young people, individuals with limited formal education, and farmers, to enhance prevention efforts.

Though hesitations to hire formerly incarcerated individuals are often related to assumptions about a person's dangerousness, there remain legitimate reasons, such as limited formal education and basic skills, that prevent returning residents from finding work. Previous research suggests that hiring decisions are confounded by offense type, even if an employer would otherwise consider a person with a criminal history. Thus, it is unclear whether returning residents' level of education or training can mitigate barriers related to their offense history. Using hypothetical case vignettes of a formerly incarcerated job applicant, this study examined whether hiring decisions were influenced by education and offense type. A between-subjects design with a sample of 223 individuals recruited via MTurk was conducted. Results of this study were largely consistent with prior research suggesting that criminal history presents an obstacle when trying to obtain employment. Implications and future directions are provided in the discussion.

PurposeDespite growing emphasis on green skills, innovation, and sustainable livelihoods, research remains limited in the informal economy, particularly in developing countries. This study investigates gaps in green skills training, innovations and livelihoods among informal metal fabricators, shedding light on the challenges and opportunities within this sector. Specifically, the study critically assesses the potential for upskilling informal metal fabricators through Technical and Vocational Education and Training (TVET) institutions and university innovation hubs.Design/methodology/approachEmploying a qualitative interpretive methodology, we conducted 40 key informant interviews with small-scale informal metal fabricators operating in Magaba and Gaza home industries, two of Harare’s largest home industries in Zimbabwe. Subsequent key informant interviews were held with TVET educators and innovation hub lecturers. Observations were carried out over a period of three months to comprehensively explore the issues under investigation.FindingsGender disparities persist within informal innovation spaces, with women making strides in the traditionally male-dominated field of metal fabrication. However, challenges such as prejudices, stigma, ridicule and abuse hinder women’s full participation in manufacturing processes, often relegating them to less physically demanding roles like customer engagement and product marketing. Inequities in support for green skills training were evident, with the innovation hub model primarily catering to formally educated youth in universities, neglecting the active involvement of notable informal innovators with limited formal education. While a gradual shift toward renewable energy sources is observable in the informal economy, government-owned TVET institutions show minimal or no adjustments in course content to incorporate essential green skills. In light of the findings, the study proposes measures to ensure equitable green skills training, innovation and the promotion of sustainable livelihoods in the informal metal fabrication sector.Originality/valueThe findings of this study represent a novel contribution the gaps in green skills training in the informal economy and how these inform reforms for vocational learning and training practices and the incubation of innovations.

This chapter explores participants’ pre-migration English-language learning experiences. Although most had learned some English prior to arrival, their initial encounters with the new language came as a shock. Initially they had difficulty understanding others or making themselves understood. The chapter explores the experiences of two different cohorts of learners: those who brought tested English, and those who brought street English. The former had high levels of formal education and had studied English as a foreign language. For them, English was primarily a school subject and they struggled with the fact that their proficiency had not included development of communicative competence in everyday interactions. The other cohort had encountered English mainly informally and brought high levels of multilingual communicative competence, mostly from Africa. Yet, they found their English devalued by their low levels of literacy, limited formal education, and the transition from a multilingual to a monolingual context.

Previous studies have been limited to the utility of clinical features and invasive nasal mucosal biomarkers in the prediction of chronic rhinosinusitis (CRS) outcomes. This study aimed to identify noninvasive biomarkers associated with difficult- to-treat CRS, enabling physicians to subgroup patients into risk groups for poor outcome before surgery. Three hundred and nine CRS patients undergoing endoscopic sinus surgery were finally enrolled. Patients treated with oral or intranasal glucocorticoids within 3 months or 1 month before surgery, respectively, were excluded. Baseline clinical charac- teristics, nasal secretions and peripheral blood samples were collected before surgery. The protein levels of 39 biological mar- kers were detected by the Bio-Plex suspension chip method. Classification and regression tree analysis was applied to establish prediction model for difficult-to-treat CRS determined one year after surgery. A random forest algorithm was used to confirm the discriminating factors that formed the classification tree. In the cohort with nasal secretion sample (n = 189), 21% of CRS patients were diagnosed as difficult-to-treat after 1 year of follow-up. Nasal secretion CCL17 level, hyposmia score, allergic rhinitis comorbidity, and nasal secretion MIP-1β level were found important predictors of difficult-to-treat CRS. A classification tree separated patients into 5 subgroups leading to an overall predictive accuracy of 94%. However, none of the plasma biological markers were associated with difficult-to-treat CRS in the cohort with blood sample (n = 128). Patients with difficult-to-treat-CRS were characterized by higher nasal secretion levels of CCL17 and MIP-1β severe hyposmia and concomitant allergic rhinitis. The classification tree could be useful to identify patients with high risk of poor outcome prior to surgery and offer more personalized interventions. However, since only patients without preoperative steroid treatments were included in this study, the generalization of our predictive model in other patient populations should be conside- red with caution.

BackgroundDysmenorrhea, or period pain, affects up to 95% of menstruating individuals and is a common cause of educational absenteeism among students who menstruate worldwide. Evidence suggests that students may lack sufficient knowledge about their menstrual health, which may impede self-management. The aim of the current study was to explore pain management strategies used by students in Ireland with painful periods and to identify their unaddressed needs across physical, psychological, educational, and social domains.MethodsThis study used a qualitative, interpretive design and opportunity sampling approach to collect and interpret individual accounts of dysmenorrhea from third-level students in Ireland. Data from 21 students were collected using semi-structured online one-to-one interviews and analysed using reflexive thematic analysis.ResultsAnalysis resulted in the construction of five themes: (1) Pain management is self-directed trial-and-error, (2) Home as safe haven, (3) Prioritising productivity over pain, (4) We’re missing an option between ‘normalise’ and ‘medicalise’, and (5) Cycle of censorship and concealment. Overall, limited formal education on dysmenorrhea and prevailing negative attitudes towards menstruation create an unsupportive environment for students to learn adequate coping skills. Beyond education, menstrual stigma may also restrict the availability of clear management guidance in domestic and medical spheres. Experiences of dysmenorrhea were also influenced by the COVID-19 pandemic, where work-from-home measures were viewed favourably by individuals with dysmenorrhea.ConclusionsThis study indicates that students in Ireland are inadequately prepared to cope with dysmenorrhea. The current findings have substantial implications for evaluating and reforming current menstrual education standards, in addition to clarifying the negative effects of social stigma on menstrual health literacy.

Knee osteoarthritis significantly limits mobility and increases pain in patients. Pain self-efficacy, a crucial psychological construct, is essential for optimal recovery outcomes. This study,grounded in Bandura's self-efficacy theory and Linton's cognitive-behavioral model, evaluated the effectiveness of an empowerment program on pain intensity indices and self-efficacy in patients undergoing total knee arthroplasty. A quasi-experimental design was employed. Ninety-eight patients were recruited via convenience sampling and randomly assigned to intervention (n=49) or control (n=49) groups. The intervention group received six structured sessions (one preoperative, five postoperative) including education on pain management, coping strategies, and goal setting, in addition to routine care. Pain intensity was assessed using the Short McGill Pain Questionnaire (SF-MPQ), Present Pain Intensity (PPI) index, and Visual Analogue Scale (VAS), while Pain self-efficacy was measured with the Pain Self-Efficacy Questionnaire (PSEQ). Evaluations were conducted at baseline (preoperatively) and six weeks postoperatively. Demographic (age, sex, education), medical (BMI), and theory-related variables were collected. Analysis of covariance, adjusting for confounders, was used to compare outcomes, with statistical significance set at p < 0.05. Among 98 participants (predominantly women; mean age 62.72 years, mean BMI 29.77, limited formal education), no significant baseline differences existed between groups. Post-intervention, the intervention group demonstrated significantly greater pain reduction: sensory-affective pain (MD = 1.8, 95% CI [-3.86 to -0.96], p = 0.015), Present Pain Intensity (0.62, [-1.04 to -0.18], p = 0.023), and Visual Analogue Scale scores (1.57, [-2.12 to -1.01], p < 0.001). Pain self-efficacy increased significantly (9.81, [0.71 to 1.24], p < 0.001). Analysis of covariance confirmed intervention effectiveness after adjusting for confounding variables. The empowerment program proved effective as an interactive, applicable, and non-invasive approach for enhancing pain management and self-efficacy in total knee arthroplasty patients.

As the number of resettlement places worldwide has drastically declined in recent years, selection for resettlement has increasingly become a privilege granted to only a small fraction of refugees in need of a durable solution. Although resettlement provides protection and new opportunities, it can also perpetuate precarity. Drawing on interviews with Norwegian public officers who interact with refugees before and after resettlement, this study examines institutional, legal, and policy barriers that can contribute to precarity for refugees with limited education. These challenges highlight a tension between migration policies which prioritise individuals from protracted refugee situations, often with limited formal education, and integration policies which emphasise rapid labour-market entry and impose stringent requirements for permanent residency. Building on these insights, this article contributes to the academic debate on durable solutions by exploring how the challenges refugees encounter both before and after resettlement can transform and prolong, rather than eliminate, precarity.

Rapid urbanization in Africa leads to a spatial concentration of people with different cultural origins and socioeconomic backgrounds resulting in a great diversity of life styles and livelihood strategies. One common strategy in Maroua/Cameroon and Bobo-Dioulasso/Burkina Faso is urban sheep keeping. Cluster analyses identified distinct socioeconomic groups with similarities between the towns: traditional livestock keepers, households headed by well educated government employees or traders, and more vulnerable groups formed of households headed by females, retired people or people with limited formal education. The household types in Bobo varied in their perception of the importance and the development of urban sheep keeping and their future plans. Those in Maroua differed in management intensity and in the potential to adapt their practices to the urban environment. Development interventions to reduce environmental pollution and risks for human health associated with urban sheep keeping need to account for these differences in the target group.

Internationally, football is increasingly employed as a key development tool focussed on young men. ‘Sports-as-development’ initiatives have proliferated since the United Nation’s ‘Year of Sports’ in 2005 and the amateur football field offers a critique of such initiatives and points towards the need to situate them within specific historical, social, and sporting contexts. This thesis considers the implications for ‘sports-as-development’, suggesting that football provides avenues for both social mobility and also economic exploitation. Black River is a small town on the south coast of Jamaica. Each weekday evening on a farmer’s field a team of educated, middle-aged men with well-respected careers plays football against a team of younger men with limited formal education and few employment prospects. The thesis examines the embodiment and enactment of wealth and age among football players. It explores the background to these matches, and looks at how they shape and affect the players away from the field. Also, I investigate the ramifications of support for the English Premier League in relation to men’s experiences of migration. In particular, I am concerned with the questions: ‘why do these two groups play football against one another?’; and ‘what happens when they do?’. Data collection methods included informal interviewing, long-term engagement on the football field, and participation in the lives of research participants and observation of their social interactions in bars and on street corners. The thesis investigates the historical and social background to inequalities between older and younger competitors and the trajectories of these disparities across the town. Football in this context provides an informal apprenticeship and mediation of inter-generational conflict whilst situating players more broadly within global hierarchies of wealth and potential.

To characterize the epidemiological profile of the hospitalized population in the ICU of Hospital das Clínicas de Marília (Famema). A retrospective, descriptive and quantitative study. Data regarding patients admitted to the ICU Famema was obtained from the Technical Information Center (Núcleo Técnico de Informações, NTI, Famema). For data analysis, we used the distribution of absolute and relative frequencies with simple statistical treatment. 2,022 ICU admissions were recorded from June 2010 to July 2012 with 1,936 being coded according to the ICD-10. The epidemiological profile comprised mostly males (57.91%), predominantly seniors ≥ 60 years (48.89%), at an average age of 56.64 years (±19.18), with limited formal education (63.3% complete primary school), mostly white (77.10%), Catholic (75.12%), from the city of Marília, state of São Paulo, Brazil (53.81%). The average occupancy rate was 94.42%. The predominant cause of morbidity was diseases of the circulatory system with 494 admissions (25.5%), followed by traumas and external causes with 446 admissions (23.03%) and neoplasms with 213 admissions (11.00%). The average stay was 8.09 days (±10.73). The longest average stay was due to skin and subcutaneous tissue diseases, with average stay of 12.77 days (±17.07). There were 471 deaths (24.32%), mainly caused by diseases of the circulatory system (30.99%). The age group with the highest mortality was the range from 70 to 79 years with 102 deaths (21.65%). The ICU Famema presents an epidemiological profile similar to other intensive care units in Brazil and worldwide, despite the few studies available in the literature. Thus, we feel in tune with the treatment of critical care patients.

Purpose: The aim of this study was to assess knowledge and attitude about benign prostatic hypertrophy (BPH) among male adult patients attending surgical department at CHUB. Methodology: This was a cross-sectional stud of 256 of adult male patients attending surgical department at CHUB. Data were analyzed using SPSS version 25 and the results expressed in form of frequencies and percentage. A non-probability convenience sampling technique was utilized to select study participants. Results: 256 patients were enrolled in the study most of them being in the 50-70 years age group (57.8%). Most were rural population, less educated and farmers. Most rural participants didn’t know anything about prostate diseases (51%) compared to 41.9% of urban participants. Most people especially the old ones think that the prostate is an illness rather than an organ. Highly educated people have better knowledge of prostate. Perceived reasons of delays include not knowing symptoms, poverty among others. Unique Contribution to Theory, Policy and Practice: This study adds to the theoretical understanding of health literacy by highlighting the link between socio-demographic factors such as education level, occupation, and residence on the knowledge about benign prostatic hyperplasia (BPH). From a policy perspective, the findings emphasize the need for targeted health education policies that prioritize rural communities and populations with limited formal education. In practice, the results support the design and implementation of community-based awareness programs, particularly for farmers and other high-risk groups, to improve early detection and management of BPH.

Most human capital and migration studies classify migrants with limited formal education as "unskilled," despite substantial skills developed through job and life experiences. Drawing on a binational multi-stage research project that involved interviews with 320 Mexican migrants and return migrants in North Carolina and Guanajuato, Mexico, we identify the lifelong human capital they acquired and transferred throughout their careers and discovered that these include not only basic education and English, but also technical and social skills and competences acquired informally on and off the job throughout life cycle. We further found that the learning and transfer of skills is a lifelong, gendered process, reflecting the different social contexts and jobs in which men and women learn. In this paper we document several mobility pathways associated with the acquisition and transfer of skills across the migratory circuit, including reskilling, occupational mobility, job jumping, and entrepreneurship.