Littérature scientifique sur le sujet « Rural Doctors Association (N.S.W.) »

Abstract Background The pathogenesis of inflammatory bowel disease (IBD) which includes Crohn’s disease (CD) and ulcerative colitis (UC), is believed to involve activation of the intestinal immune system in response to the gut microbiome among genetically susceptible hosts. IBD has been historically regarded as a disease of developed nations, though in the past two decades there has been a reported shift in the epidemiological pattern of disease. High-income nations with known high prevalence of disease are seeing a stabilization of incident cases, while a rapid rise of incident IBD is being observed in developing nations. This suggests that environmental exposures may play a role in mediating the risk of developing IBD. The potential environmental determinants of IBD across various regions is vast, though medications have been increasingly recognized as one broad category of risk factors. Purpose Several medications have been considered to contribute to the etiology of IBD. This study assessed the association between medication use and risk of developing IBD using the Prospective Urban Rural Epidemiology (PURE) cohort. Method This was a prospective cohort study of 133,137 individuals between the ages of 20-80 from 24 countries. Country-specific validated questionnaires documented baseline and follow-up medication use. Participants were followed prospectively at least every 3 years. The main outcome was development of IBD, including CD and UC. Short-term (baseline but not follow-up use) and long-term use (baseline and subsequent follow-up use) was evaluated. Results are presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Result(s) During the median follow-up of 11.0 years [interquartile range (IQR) 9.2-12.2], we recorded 571 incident cases of IBD (143 CD and 428 UC). Higher risk of incident IBD was associated with baseline antibiotic use [aOR: 2.81 (95% CI: 1.67-4.73), p=0.0001] and hormonal medication use [aOR: 4.43 (95% CI: 1.78-11.01), p=0.001]. Among females, previous or current oral contraceptive use was also associated with IBD development [aOR: 2.17 (95% CI: 1.70-2.77), p=5.02E-10]. NSAID users were also observed to have increased risk of IBD [aOR: 1.80 (95% CI: 1.23-2.64), p=0.002], which was driven by long-term users [aOR: 5.58 (95% CI: 2.26-13.80), p<0.001]. All significant results were consistent in direction for CD and UC with low heterogeneity. Conclusion(s) Antibiotics, hormonal medications, oral contraceptives, and long-term NSAID use were associated with increased odds of incident IBD after adjustment for covariates. Please acknowledge all funding agencies by checking the applicable boxes below Other Please indicate your source of funding below: Salim Yusuf is supported by the Heart & Stroke Foundation/Marion W. Burke Chair in Cardiovascular Disease. The PURE Study is an investigator-initiated study funded by the Population Health Research Institute, the Canadian Institutes of Health Research (CIHR), Heart and Stroke Foundation of Ontario, support from CIHR’s Strategy for Patient Oriented Research (SPOR) through the Ontario SPOR Support Unit, as well as the Ontario Ministry of Health and Long-Term Care and through unrestricted grants from several pharmaceutical companies, with major contributions from AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, and GlaxoSmithkline, and additional contributions from Novartis and King Pharma and from various national or local organisations in participating countries; these include: Argentina: Fundacion ECLA; Bangladesh: Independent University, Bangladesh and Mitra and Associates; Brazil: Unilever Health Institute, Brazil; Canada: Public Health Agency of Canada and Champlain Cardiovascular Disease Prevention Network; Chile: Universidad de la Frontera; China: National Center for Cardiovascular Diseases; Colombia: Colciencias, grant number 6566-04-18062; India: Indian Council of Medical Research; Malaysia: Ministry of Science, Technology and Innovation of Malaysia, grant numbers 100 -IRDC/BIOTEK 16/6/21 (13/2007) and 07-05-IFN-BPH 010, Ministry of Higher Education of Malaysia grant number 600 -RMI/LRGS/5/3 (2/2011), Universiti Teknologi MARA, Universiti Kebangsaan Malaysia (UKM-Hejim-Komuniti-15-2010); occupied Palestinian territory: the UN Relief and Works Agency for Palestine Refugees in the Near East, occupied Palestinian territory; International Development Research Centre, Canada; Philippines: Philippine Council for Health Research & Development; Poland: Polish Ministry of Science and Higher Education grant number 290/W-PURE/2008/0, Wroclaw Medical University; Saudi Arabia: the Deanship of Scientific Research at King Saud University, Riyadh, Saudi Arabia (research group number RG -1436-013); South Africa: the North-West University, SANPAD (SA and Netherlands Programme for Alternative Development), National Research Foundation, Medical Research Council of SA, The SA Sugar Association (SASA), Faculty of Community and Health Sciences (UWC); Sweden: grants from the Swedish state under the Agreement concerning research and education of doctors; the Swedish Heart and Lung Foundation; the Swedish Research Council; the Swedish Council for Health, Working Life and Welfare, King Gustaf V’s and Queen Victoria Freemasons Foundation, AFA Insurance, Swedish Council for Working Life and Social Research, Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning, grant from the Swedish State under the Läkar Utbildnings Avtalet agreement, and grant from the Västra Götaland Region; Turkey: Metabolic Syndrome Society, AstraZeneca, Turkey, Sanofi Aventis, Turkey; United Arab Emirates (UAE): Sheikh Hamdan Bin Rashid Al Maktoum Award For Medical Sciences and Dubai Health Authority, Dubai UAE. Disclosure of Interest C. Pray: None Declared, N. Narula Grant / Research support from: Neeraj Narula holds a McMaster University Department of Medicine Internal Career Award. Neeraj Narula has received honoraria from Janssen, Abbvie, Takeda, Pfizer, Merck, and Ferring, E. C. Wong: None Declared, J. K. Marshall Grant / Research support from: John K. Marshall has received honoraria from Janssen, AbbVie, Allergan, Bristol-Meyer-Squibb, Ferring, Janssen, Lilly, Lupin, Merck, Pfizer, Pharmascience, Roche, Shire, Takeda and Teva., S. Rangarajan: None Declared, S. Islam: None Declared, A. Bahonar: None Declared, K. F. Alhabib: None Declared, A. Kontsevaya: None Declared, F. Ariffin: None Declared, H. U. Co: None Declared, W. Al Sharief: None Declared, A. Szuba: None Declared, A. Wielgosz: None Declared, M. L. Diaz: None Declared, R. Yusuf: None Declared, L. Kruger: None Declared, B. Soman: None Declared, Y. Li: None Declared, C. Wang: None Declared, L. Yin: None Declared, M. Erkin: None Declared, F. Lanas: None Declared, K. Davletov: None Declared, A. Rosengren: None Declared, P. Lopez-Jaramillo: None Declared, R. Khatib: None Declared, A. Oguz: None Declared, R. Iqbal: None Declared, K. Yeates: None Declared, Á. Avezum: None Declared, W. Reinisch Consultant of: Speaker for Abbott Laboratories, Abbvie, Aesca, Aptalis, Astellas, Centocor, Celltrion, Danone Austria, Elan, Falk Pharma GmbH, Ferring, Immundiagnostik, Mitsubishi Tanabe Pharma Corporation, MSD, Otsuka, PDL, Pharmacosmos, PLS Education, Schering-Plough, Shire, Takeda, Therakos, Vifor, Yakult, Consultant for Abbott Laboratories, Abbvie, Aesca, Algernon, Amgen, AM Pharma, AMT, AOP Orphan, Arena Pharmaceuticals, Astellas, Astra Zeneca, Avaxia, Roland Berger GmBH, Bioclinica, Biogen IDEC, Boehringer-Ingelheim, Bristol-Myers Squibb, Cellerix, Chemocentryx, Celgene, Centocor, Celltrion, Covance, Danone Austria, DSM, Elan, Eli Lilly, Ernest & Young, Falk Pharma GmbH, Ferring, Galapagos, Genentech, Gilead, Grünenthal, ICON, Index Pharma, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, LivaNova, Mallinckrodt, Medahead, MedImmune, Millenium, Mitsubishi Tanabe Pharma Corporation, MSD, Nash Pharmaceuticals, Nestle, Nippon Kayaku, Novartis, Ocera, Omass, Otsuka, Parexel, PDL, Periconsulting, Pharmacosmos, Philip Morris Institute, Pfizer, Procter & Gamble, Prometheus, Protagonist, Provention, Robarts Clinical Trial, Sandoz, Schering-Plough, Second Genome, Seres Therapeutics, Setpointmedical, Sigmoid, Sublimity, Takeda, Therakos, Theravance, Tigenix, UCB, Vifor, Zealand, Zyngenia, and 4SC, Advisory board member for Abbott Laboratories, Abbvie, Aesca, Amgen, AM Pharma, Astellas, Astra Zeneca, Avaxia, Biogen IDEC, Boehringer-Ingelheim, Bristol-Myers Squibb, Cellerix, Chemocentryx, Celgene, Centocor, Celltrion, Danone Austria, DSM, Elan, Ferring, Galapagos, Genentech, Grünenthal, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, MedImmune, Millenium, Mitsubishi Tanabe Pharma Corporation, MSD, Nestle, Novartis, Ocera, Otsuka, PDL, Pharmacosmos, Pfizer, Procter & Gamble, Prometheus, Sandoz, Schering-Plough, Second Genome, Setpointmedical, Takeda, Therakos, Tigenix, UCB, Zealand, Zyngenia, and 4SC, P. Moayyedi: None Declared, S. Yusuf: None Declared

According to some early childhood education experts, a child is ready for school if they have the specific information and abilities they need to do so. They define readiness in this sense as a state that must be achieved before studying at school. Previous research has linked sustained academic performance across life to preparation for school. In this study, the researchers examined the strategies used by kindergarten teachers to support children's school readiness and transition to elementary school after the pandemic. Specifically, this research aims to find out the learning strategies implemented by kindergarten teachers when children return to school. Focus Group Discussions (FGD) for nineteen kindergarten teachers were used by researchers to collect narrative data, which was then studied using thematic analysis. Based on the results of qualitative data, researchers obtained information about various strategies implemented by teachers and the challenges they faced when accompanying children to learn. It is expected that the results of this research will provide enlightenment for early childhood teachers in general about the various strategies that need to be implemented to motivate children to learn so that they are ready for school and have a successful transition to elementary school. Keywords: early childhood, kindergarten teachers‘ strategy, school readiness, transition to elementary school References: Beaton, W., & McDonell, L. (2013). The transition into kindergarten: A community approach to integrating a child’s fragmented world – A discussion paper examining issues and implications of early childhood transitions to kindergarten. Nanaimo, BC: Tillicum Lelum Aboriginal Friendship Centre and Vancouver Island University. Cushon , J.A; Vu , Lan T; Janzen, T.B.L; & Muhajarine, N. 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INTRODUCTION The medical specialty chosen by the medical practitioner is important for both the practitioner and the society. It is an important determinant of the future supply of doctors in different specialties and the planning of the workforce for the health-care services. METHODOLOGY In order to assess factors affecting the choice of post graduation specialty by medical graduates with special reference to Otorhinolaryngology in Mayo Institute of Medical Sciences, Barabanki; the study was conducted as a cross- sectional questionnaire-based study. CONCLUSION The factors involved in career-related decision making are mostly context-specific. One of the reasons for this is that models of medical education and selection into specialty programs vary globally. We thus conclude that the most meritorious medical graduates in India do not choose ENT as a branch for postgraduation, unlike developed nations and the association must take steps to improve the situation K e y w o r d s : O t o r h i n o l a r y n g o l o g y , Postgraduation, Choice of Speciality

Abstract There are fundamental lack of right methodologies to study the breast cancer disparity in rural India. Here, we have used an ethnographic-phenomenology approach to study the disparity in breast cancer care in Assam by using retrospective database of a rural cancer care non-profit clinic, the KaviKrishna Telemedicine Care (KTC), set up 1994 to develop a CBPR based cancer care (Abstract 3342, AACR 2019). Methodology: For one and half years, the doctors, researchers, nurses, caregivers, and physician assistants of KaviKrishna Laboratory and KaviKrishna Telemedicine Care were interviewed (total number: 15), and plus literature of the lab and the clinic were studied. Then, the breast cancer patients (n=10) and the families were subjected to ethnographies-phenomenology study to find their experiences of treatment and suffering. Next, thematic analysis and grounded theory were applied to come up with novel approaches to reduce breast cancer disparity. For comparison, 5 patients from rich urban families were interviewed. Results: We found that 10/10 patients found it extremely difficult to navigate the complexity of care in urban hospitals, but found the KTC approachable and comfortable. Importantly, these 10 breast cancer patients were positively responding to our KTC based care services/focussed group discussion (https://zenodo.org/records/8062404). They revealed positive experiences in emotionally and psychologically dealing with diagnostic, surgery, and chemotherapy processes. Next, our analysis of the last 25 years of the care data at KTC showed that in rural population, the loweconomic status, inadequate access to breast cancer detection clinics, lack of awareness,indecisive treatment protocols and social stigma are the main reasons for breast cancer disparity. Grounded theory-based analysis indicates that cancer biomarker study in rural populations can be a suitable method for early detection. Whole genome sequencing of cancer tissue frombiopsy samples shall provide landscape of mutation in the entire coding as well as noncodingregions. Mutation profiling along with correlation studies from patients can lead to discoveryof novel marker(s). Primary health care clinics in rural areas can be trained to collect patientsamples, isolate genomic DNA and perform PCR for the markers (a similar model asfollowed during Covid-19). The PCR samples can be sent to non-profit advanced diagnostic center such as KaviKrishna Lab to perform sequencing to study mutation markers. The method is also cost effective to both thecare givers and the patients as compared to setting up advanced diagnostic lab in every part ofrural area. Conclusion: The community based participatory research based model developed by KTC can be an effective strategy to reduce breast cancer disparity in the rural population since the primary health clinics shall act as a bridge between geologically isolated areas and modern technology. Citation Format: Debduti Dutta, Rupam Das, Chayanika Das, Tulika Sarma, Sonali Das, Anuja Dutta, Tutumoni Baishya, Lekhika Pathak, Bikul Das. An ethno-phenomenology based approach to study breast cancer disparity in rural India [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 807.

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Abstract Introduction Pharmacists are the third largest professional healthcare workforce after doctors and nurses and have played a vital role in the fight against COVID-19. Based on the '7-star' pharmacist and 9 standards, pharmacists are essential frontline carers for the safe and effective care of the public.1,2 Pharmacies have operated throughout the COVID-19 pandemic meeting the needs of the population. They have played an important role during the pandemic in providing advice and education to the public as well as maintaining the supply of medicines.3 In Cyprus, there are 663 registered pharmacies. Aim The aim of the study was to identify how community pharmacists, who are at the frontline of primary care, can support and coordinate the effective and rapid response to reduce coronavirus-related hospitalisation and mortality. Methods This quantitative research study took place in all the provinces of Cyprus. The survey-based questionnaire was designed after an extensive literature search of the published data. It consisted of 18 open and closed questions (multiple choice and Likert scale 1-5) as well as 4 demographic questions. The sampling method of the study falls under snowball sampling. A pilot study was conducted for the validity and reliability of the questions with no further changes. Pharmacists were approached via email by the Cyprus Pharmaceutical Association. The questionnaires were distributed electronically via the university’s platform (Moodle). The participation was anonymous and on a voluntary basis. Prior to data collection, all documentation was ethically approved by the Cyprus National Bioethics Committee. Results In total, 71 pharmacists responded to the study. Of those, 53.5% (n=38) were females and 46.5% (n=33) males. Pharmacists characterise their daily relationship/communication with the public as excellent/good (n=42, 58.65%) during the COVID-19 pandemic. More than half (n=49, 69%) stated that the most common way of communicating with the public during the pandemic was face-to-face. Pharmacists seemed to be confident in providing advice related to COVID-19 as most of them (n=64, 90.2%) strongly agreed/agreed that they are in a position and have sufficient knowledge to provide coronavirus prevention advice to the public. Additionally, an equal number of respondents strongly agreed/agreed (n=24, 33.8%) and strongly disagreed/disagreed (n=24, 33.8%) that the public perception regarding the pharmacy profession has changed for the better during the pandemic. More than half of the participants reported that their role as a pharmacist had been upgraded during the pandemic from a drug distribution centre to a primary care, prevention, and public information centre (n=36, 50.7% strongly agreed/agreed). Discussion/Conclusion To our knowledge, this is the first study exploring pharmacists’ perceptions and views about their role during the COVID-19 pandemic. The study’s limitations included the small sample size which may not lead to generalisation of the results and the short data collection period Pharmacists are at the heart of the healthcare system, and they play an essential role in individuals’ healthcare, education, and counselling. Pharmacists in Cyprus should be proud of their strong role and strength during the COVID-19 pandemic and continue to be such an integral part of the healthcare system. References 1. The Role of the Pharmacist in the Health Care System. Preparing the Future Pharmacist: Curricular Development. Report oAPf the Third WHO Consultative Group on the Role of the Pharmacist, Vancouver, Canada, 27- 29 August 1997. Geneva: World Health Organization; 1997. Document no. WHO/PHARM/97/599 2. General Pharmaceutical Council, Standards for Pharmacy Professionals, 2017. Available from: https://www.pharmacyregulation.org/standards/standards-for-pharmacy-professionals 3. Jia X, Zhang W, Du S, Wen L, Li H, Yin Z, Li J and Zhang X, What Is the Role of Pharmacists in Treating COVID-19 Patients? The Experiences and Expectations of Front Line Medical Staff, Front. Public Health, 2021, 9:778863. doi: 10.3389/fpubh.2021.778863

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In the COVID-19 pandemic scenario, parents need to be familiar with health literacy by applying clean and healthy living habits to their family members, especially those with early childhood. This study aims to explain parents' perceptions of health literacy for a clean and healthy behavior in their children during the COVID-19 pandemic. The method used in this study is a cross-sectional study involving 22 men and 62 female respondents. Respondent requirements were used in data analysis to determine parents' perceptions of health literacy and the efforts they have made to practice clean and healthy lifestyle in their children. The research findings show that knowing the health awareness of parents has an impact on a child's balanced lifestyle. Based on six measures of clean and healthy behavior for children, three indicators were determined in the category of discipline and high discipline: using clean water, using the toilet, and doing physical activity. The act of washing children's hands with soap indicators has a high discipline score and the use of masks in children has low discipline. If the use of masks is not disciplined by parents, exposure to COVID-19 in early childhood can be disrupted. Keywords: Early Childhood, Parental health literacy, Clean and healthy behaviors References: Abuhammad, S. (2021). Parents’ knowledge and attitude towards COVID‐19 in children: A Jordanian Study. International Journal of Clinical Practice, 75(2). https://doi.org/10.1111/ijcp.13671 Bauza, V., Sclar, G. D., Bisoyi, A., Majorin, F., Ghugey, A., & Clasen, T. (2021). Water, sanitation, and hygiene practices and challenges during the COVID-19 pandemic: A cross-sectional study in rural Odisha, India [Preprint]. Epidemiology. https://doi.org/10.1101/2021.01.26.21250274 Berkman, N. D., Sheridan, S. L., Donahue, K. E., Halpern, D. J., & Crotty, K. (2011). Low Health Literacy and Health Outcomes: An Updated Systematic Review. Annals of Internal Medicine, 155(2), 97. https://doi.org/10.7326/0003-4819-155-2-201107190-00005 Bröder, J., Okan, O., Bauer, U., Schlupp, S., & Pinheiro, P. (2020). Advancing perspectives on health literacy in childhood and youth. Health Promotion International, 35(3), 575–585. https://doi.org/10.1093/heapro/daz041 Center for Disease ontrol and Prevention (CDC). (2019). How to Protect Yourself and Others. https://www.cdc.gov/ Chanchlani, N., Buchanan, F., & Gill, P. J. (2020). Addressing the indirect effects of COVID-19 on the health of children and young people. Canadian Medical Association Journal, 192(32), E921–E927. https://doi.org/10.1503/cmaj.201008 Clouston, S. A. P., Manganello, J. A., & Richards, M. (2016). A life course approach to health literacy: The role of gender, educational attainment and lifetime cognitive capability. Age and Ageing, ageing; afw229v1. https://doi.org/10.1093/ageing/afw229 Cooper, A. (2019). Health in the eyes of young people. The Lancet Child & Adolescent Health, 3(5), 299. https://doi.org/10.1016/S2352-4642(19)30085-9 Duplaga, M. (2020). Determinants and Consequences of Limited Health Literacy in Polish Society. International Journal of Environmental Research and Public Health, 17(2), 642. https://doi.org/10.3390/ijerph17020642 Duplaga, M., & Grysztar, M. (2021). The Association between Future Anxiety, Health Literacy and the Perception of the COVID-19 Pandemic: A Cross-Sectional Study. Healthcare, 9(1), 43. https://doi.org/10.3390/healthcare9010043 Gagliardi, A. R., Berta, W., Kothari, A., Boyko, J., & Urquhart, R. (2015). Integrated knowledge translation (IKT) in health care: A scoping review. Implementation Science, 11(1), 38. https://doi.org/10.1186/s13012-016-0399-1 Humphrys, E., Burt, J., Rubin, G., Emery, J. D., & Walter, F. M. (2019). The influence of health literacy on the timely diagnosis of symptomatic cancer: A systematic review. European Journal of Cancer Care, 28(1), e12920. https://doi.org/10.1111/ecc.12920 Kementerian Kesehatan RI. (2011). Pedoman Pembinaan Perilaku Hidup Bersih dan Sehat (PHBS). Kementerian Kesehatan RI. Lee, P.-I., Hu, Y.-L., Chen, P.-Y., Huang, Y.-C., & Hsueh, P.-R. (2020). Are children less susceptible to COVID-19? Journal of Microbiology, Immunology and Infection, 53(3), 371–372. https://doi.org/10.1016/j.jmii.2020.02.011 Nutbeam, D. (1998). Health promotion glossary. 13(4), 16. https://doi.org/10.1093/heapro/13.4.349 O’Conor, R., Muellers, K., Arvanitis, M., Vicencio, D. P., Wolf, M. S., Wisnivesky, J. P., & Federman, A. D. (2019). Effects of health literacy and cognitive abilities on COPD self-management behaviors: A prospective cohort study. Respiratory Medicine, 160, 105630. https://doi.org/10.1016/j.rmed.2019.02.006 Okan, O. (2019). The importance of early childhood in addressing equity and health literacy development in the life-course. 5(2), 8. Sentell, T., Vamos, S., & Okan, O. (2020). Interdisciplinary Perspectives on Health Literacy Research Around the World: More Important Than Ever in a Time of COVID-19. International Journal of Environmental Research and Public Health, 17(9), 3010. https://doi.org/10.3390/ijerph17093010 Sørensen, K., Pelikan, J. M., Röthlin, F., Ganahl, K., Slonska, Z., Doyle, G., Fullam, J., Kondilis, B., Agrafiotis, D., Uiters, E., Falcon, M., Mensing, M., Tchamov, K., Broucke, S. van den, & Brand, H. (2015). Health literacy in Europe: Comparative results of the European health literacy survey (HLS-EU). The European Journal of Public Health, 25(6), 1053–1058. https://doi.org/10.1093/eurpub/ckv043 Sørensen, K., Van den Broucke, S., Pelikan, J. M., Fullam, J., Doyle, G., Slonska, Z., Kondilis, B., Stoffels, V., Osborne, R. H., & Brand, H. (2013). Measuring health literacy in populations: Illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health, 13(1), 948. https://doi.org/10.1186/1471-2458-13-948 Toussaint, L. L., Cheadle, A. D., Fox, J., & Williams, D. R. (2020). Clean and Contain: Initial Development of a Measure of Infection Prevention Behaviors During the COVID-19 Pandemic. Annals of Behavioral Medicine, 54(9), 619–625. https://doi.org/10.1093/abm/kaaa064 Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R. S., Choo, F. N., Tran, B., Ho, R., Sharma, V. K., & Ho, C. (2020). A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, Behavior, and Immunity, 87, 40–48. https://doi.org/10.1016/j.bbi.2020.04.028 Weston, D., Hauck, K., & Amlôt, R. (2018). Infection prevention behaviour and infectious disease modelling: A review of the literature and recommendations for the future. BMC Public Health, 18(1), 336. https://doi.org/10.1186/s12889-018-5223-1 Zaben, K., & Khalil, A. (2019). Health Literacy, Self-Care Behavior and Quality of Life in Acute Coronary Syndrome Patients: An Integrative Review. Open Journal of Nursing, 09(04), 383–395. https://doi.org/10.4236/ojn.2019.94035

Eating habits develop during the first years of a child's life, children learn what, when, and how much to eat through direct experience with food and by observing the eating habits of others. The aim of this study is to get a clear picture of the Eating program Healthy, starting from the planning, implementation, supervision, and evaluation as a case study of nutrition education; to get information about the advantages, disadvantages and effects of implementing a healthy eating program for children. This research was conducted through a case study with qualitative data analysed using Miles and Huberman techniques. Sample of children in Ananda Islāmic School Kindergarten. The results showed the Healthy Eating program could be implemented well, the diet was quite varied and could be considered a healthy and nutritious food. The visible impact is the emotion of pleasure experienced by children, children become fond of eating vegetables, and make children disciplined and responsible. Inadequate results were found due to the limitations of an adequate kitchen for cooking healthy food, such as cooking activities still carried out by the cook himself at the Foundation's house which is located not far from the school place; use of melamine and plastic cutlery for food; the spoon and fork used already uses aluminium material but still does not match its size; does not involve nutritionists. Keywords: Early Childhood, Eating Healthy Program References: Bandura, A. (1977). Social learning theory. Englewood Cliffs: Prentice-Hall. Bandura, Albert. (2004). Health promotion by social cognitive means. Health Education and Behavior, 31(2), 143–164. https://doi.org/10.1177/1090198104263660 Battjes-Fries, M. C. E., Haveman-Nies, A., Renes, R. J., Meester, H. J., & Van’T Veer, P. (2015). Effect of the Dutch school-based education programme “Taste Lessons” on behavioural determinants of taste acceptance and healthy eating: A quasi-experimental study. 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Appetite, 113, 84–90. https://doi.org/10.1016/j.appet.2017.02.003 Crain, W. C. (2005). Theories of development: Concepts and applications. Upper Saddle River: Pearson Prentice Hall. Dazeley, P., Houston-Price, C., & Hill, C. (2012). Should healthy eating programmes incorporate interaction with foods in different sensory modalities? A review of the evidence. British Journal of Nutrition, 108(5), 769–777. https://doi.org/10.1017/S0007114511007343 Derscheid, L. E., Umoren, J., Kim, S. Y., Henry, B. W., & Zittel, L. L. (2010). Early childhood teachers’ and staff members’ perceptions of nutrition and physical activity practices for preschoolers. Journal of Research in Childhood Education, 24(3), 248–265. https://doi.org/10.1080/02568543.2010.487405 Eliassen, E. K. (2011). The impact of teachers and families on young children’s eating behaviors. YC Young Children, 66(2), 84–89. Elliott, E., Isaacs, M., & Chugani, C. (2010). Promoting Self-Efficacy in Early Career Teachers: A Principal’s Guide for Differentiated Mentoring and Supervision. Florida Journal of Educational Administration & Policy, 4(1), 131–146. Emm, S., Harris, J., Halterman, J., Chvilicek, S., & Bishop, C. (2019). Increasing Fruit and Vegetable Intake with Reservation and Off-reservation Kindergarten Students in Nevada. Journal of Agriculture, Food Systems, and Community Development, 9, 1–10. https://doi.org/10.5304/jafscd.2019.09b.014 Flynn, M. A. T. (2015). Empowering people to be healthier: Public health nutrition through the Ottawa Charter. Proceedings of the Nutrition Society, 74(3), 303–312. https://doi.org/10.1017/S002966511400161X Franciscato, S. J., Janson, G., Machado, R., Lauris, J. R. P., de Andrade, S. M. J., & Fisberg, M. (2019). Impact of the nutrition education Program Nutriamigos® on levels of awareness on healthy eating habits in school-aged children. Journal of Human Growth and Development, 29(3), 390–402. https://doi.org/10.7322/jhgd.v29.9538 Froehlich Chow, A., & Humbert, M. L. (2014). Perceptions of early childhood educators: Factors influencing the promotion of physical activity opportunities in Canadian rural care centers. Child Indicators Research, 7(1), 57–73. https://doi.org/10.1007/s12187-013-9202-x Graham, H., Feenstra, G., Evans, A. M., & Zidenberg-Cherr, S. (2002). Healthy Eating Habits in Children. California Agriculture, 58(4), 200–205. Gucciardi, E., Nagel, R., Szwiega, S., Chow, B. Y. Y., Barker, C., Nezon, J., ... Butler, A. (2019). Evaluation of a Sensory-Based Food Education Program on Fruit and V egetable Consumption among Kindergarten Children. Journal of Child Nutrition & Management, 43(1). Holley, C. E., Farrow, C., & Haycraft, E. (2017). A Systematic Review of Methods for Increasing Vegetable Consumption in Early Childhood. Current Nutrition Reports, 6(2), 157–170. https://doi.org/10.1007/s13668-017-0202-1 Hoppu, U., Prinz, M., Ojansivu, P., Laaksonen, O., & Sandell, M. A. (2015). Impact of sensory- based food education in kindergarten on willingness to eat vegetables and berries. Food and Nutrition Research, 59, 1–8. https://doi.org/10.3402/fnr.v59.28795 Jarpe-Ratner, E., Folkens, S., Sharma, S., Daro, D., & Edens, N. K. (2016). An Experiential Cooking and Nutrition Education Program Increases Cooking Self-Efficacy and Vegetable Consumption in Children in Grades 3–8. Journal of Nutrition Education and Behavior, 48(10), 697-705.e1. https://doi.org/10.1016/j.jneb.2016.07.021 Jones, A. M., & Zidenberg-Cherr, S. (2015). Exploring Nutrition Education Resources and Barriers, and Nutrition Knowledge in Teachers in California. Journal of Nutrition Education and Behavior, 47(2), 162–169. https://doi.org/10.1016/j.jneb.2014.06.011 Jung, T., Huang, J., Eagan, L., & Oldenburg, D. (2019). Influence of school-based nutrition education program on healthy eating literacy and healthy food choice among primary school children. International Journal of Health Promotion and Education, 57(2), 67–81. https://doi.org/10.1080/14635240.2018.1552177 Lwin, M. O., Malik, S., Ridwan, H., & Sum Au, C. S. (2017). Media exposure and parental mediation on fast-food consumption among children in metropolitan and suburban Indonesian. Asia Pacific Journal of Clinical Nutrition, 26(5), 899–905. https://doi.org/10.6133/apjcn.122016.04 Mc Kenna, & L, M. (2010). Policy Options to Support Healthy Eating in Schools. Canadian Journal of Public Health, 101(2), S14–S18. https://doi.org/10.1007/BF03405619 Menkes, R. PERATURAN MENTERI KESEHATAN REPUBLIK INDONESIA NOMOR 41 TAHUN 2014. , Menteri Kesehatan Republik Indonesia § (2014). Mitsopoulou, A. V., Magriplis, E., Dimakopoulos, I., Karageorgou, D., Bakogianni, I., Micha, R., ... Zampelas, A. (2019). Association of meal and snack patterns with micronutrient intakes among Greek children and adolescents: data from the Hellenic National Nutrition and Health Survey. Journal of Human Nutrition and Dietetics, 32(4), 455–467. https://doi.org/10.1111/jhn.12639 Moffitt, A. (2019). Early Childhood Educators and the Development of Family Literacy Programs: A Qualitative Case Study. ProQuest Dissertations and Theses, 96. Retrieved from http://proxy.mul.missouri.edu/login?url=https://search.proquest.com/docview/2242479347 ?accountid=14576%0Ahttps://library.missouri.edu/findit?genre=dissertations+%26+theses &title=Early+Childhood+Educators+and+the+Development+of+Family+Literacy+Progra ms%3A+ Mustonen, S., & Tuorila, H. (2010). Sensory education decreases food neophobia score and encourages trying unfamiliar foods in 8-12-year-old children. Food Quality and Preference, 21(4), 353–360. https://doi.org/10.1016/j.foodqual.2009.09.001 Myszkowska-Ryciak, J., & Harton, A. (2019). Eating healthy, growing healthy: Outcome evaluation of the nutrition education program optimizing the nutritional value of preschool menus, Poland. Nutrients, 11(10), 1–17. https://doi.org/10.3390/nu11102438 Nekitsing, C., Hetherington, M. M., & Blundell-Birtill, P. (2018). Developing Healthy Food Preferences in Preschool Children Through Taste Exposure, Sensory Learning, and Nutrition Education. Current Obesity Reports, 7(1), 60–67. https://doi.org/10.1007/s13679- 018-0297-8 Noura, M. S. pd. (2018). Child nutrition programs in kindergarten schools implemented by the governmental sector and global nutrition consulting companies: A systematic review. Current Research in Nutrition and Food Science, 6(3), 656–663. https://doi.org/10.12944/CRNFSJ.6.3.07 Oh, S. M., Yu, Y. L., Choi, H. I., & Kim, K. W. (2012). Implementation and Evaluation of Nutrition Education Programs Focusing on Increasing Vegetables, Fruits and Dairy Foods Consumption for Preschool Children. 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Augmented reality (AR) and virtual reality (VR) technologies have demonstrated immense potential to transform fields like education and healthcare through immersive and interactive virtual environments (Bower et al., 2014; Dhar et al., 2023; Moro et al., 2021)). However, high costs of proprietary headsets and content platforms have inhibited widespread adoption of these technologies in resource-constrained contexts, especially in developing countries (Karre et al., 2019). Augmented reality (AR) and virtual reality (VR) have the potential to transform how we approach education and healthcare, enhancing access and outcomes especially in developing countries. AR/VR furthers United Nations (UN) Sustainable Development Goals (SDGs) 3 and 4 through inclusive, equitable education and healthcare (United Nations, 2016). VR can simulate immersive learning environments, providing hands-on medical training to healthcare workers in regions with limited resources. By using VR for anatomy and surgery education, healthcare professionals can gain experience without risk to patients. This improves local healthcare capacity and retention of health workers in remote areas. Similarly, AR and VR can enable experiential learning for students without access to labs or materials (Sinou et al., 2023). This facilitates authentic learning for financially or geographically constrained students (van der Meer et al., 2023). AR/VR health interventions can also improve patient diagnosis and care (Sureja et al., 2023). AR glasses for doctors could display patient vitals or past records during examinations to improve diagnostic capabilities. Remote consultations can connect rural healthcare workers with urban specialists via AR assistive tools during complex treatments. AR/VR distraction therapy has also proven effective during painful procedures for children and the elderly (Vaillant-Ciszewicz et al., 2022). Such solutions enhance community health literacy and comfort with medical services, a key challenge in developing contexts. This presentation proposes a practical methodology for opportunities to expand access to AR/VR healthcare and education tools in low-resource settings through three pathways - utilising low-cost VR headsets, employing inclusive user interface design, and using participatory methodologies during content development. The Educational Design Research (EDR) methodology will guide the project through four main phases (McKenney and Reeves, 2020; Kartoğlu et al., 2020): Analysis and Exploration Phase Conduct a literature review on AR/VR adoption in healthcare education. Engage stakeholders (educators, students, industry partners) through focus groups and interviews. Analyze existing curricula, learning objectives, and assessment practices in healthcare education programs across Australasia. Design and Development Phase Develop design principles and guidelines for creating effective AR/VR experiences in healthcare education. Collaborate with interdisciplinary teams to design and prototype AR/VR experiences aligned with learning objectives and assessment practices. Conduct iterative cycles of prototyping, testing, and refinement with stakeholder feedback. Implementation and Evaluation Phase Implement the developed AR/VR experiences in selected healthcare education programs across Australasia. Evaluate the effectiveness through mixed methods, including quantitative measures of learning outcomes, engagement, and skill development, as well as qualitative analysis of user experiences. Conduct formative evaluations for improvement and refinement. Reflection and Dissemination Phase Analyze and synthesize findings from the implementation and evaluation phases. Refine the design principles and guidelines based on research findings. Develop a comprehensive framework and guidelines for effective AR/VR implementation in healthcare education across Australasia. Disseminate research findings, framework, and guidelines through publications, conferences, workshops, and online resources. The project will apply the principles of EDR, such as interdisciplinary collaboration, contextual adaptation, and iterative refinement, to develop a robust and contextualized solution for AR/VR adoption in healthcare education programs across Australasia. References Bower, M., Howe, C., McCredie, N., Robinson, A., & Grover, D. (2014). Augmented Reality in education – cases, places and potentials. Educational Media International, 51(1), 1–15. https://doi.org/10.1080/09523987.2014.889400 Dhar, E., Upadhyay, U., Huang, Y., Uddin, M., Manias, G., Kyriazis, D., Wajid, U., AlShawaf, H., & Syed Abdul, S. (2023). A scoping review to assess the effects of virtual reality in medical education and clinical care. DIGITAL HEALTH, 9, 20552076231158022. https://doi.org/10.1177/20552076231158022 Kartoğlu, Ü., Siagian, R. C., & Reeves, T. C. (2020). Creating a "Good Clinical Practices Inspection" Authentic Online Learning Environment through Educational Design Research. TechTrends : for leaders in education & training, 1-12. https://doi.org/10.1007/s11528-020-00509-0 Karre, S. A., Mathur, N., & Reddy Y. R. (2019). Usability evaluation of VR products in industry. https://doi.org/10.1145/3297280.3297462 McKenney, S., & Reeves, T. C. (2020). Educational design research: Portraying, conducting, and enhancing productive scholarship. Medical Education, 55(1), 82–92. https://doi.org/10.1111/medu.14280 Moro, C., Birt, J., Stromberga, Z., Phelps, C., Clark, J., Glasziou, P., & Scott, A. M. (2021). Virtual and Augmented Reality Enhancements to Medical and Science Student Physiology and Anatomy Test Performance: A Systematic Review and Meta-Analysis. 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