sample health education plan

Planning and Conducting Health Education for Community Members

Health education is any combination of learning experiences designed to help individuals and communities improve their environmental health literacy. The goals of health education are to increase awareness of local environmental conditions, potential exposures, and the impacts of exposures on individual and public health. Health education can also prepare community members to receive and better understand the findings of your public health work.

Some health education takes the form of shorter, one-on-one, or small group conversations with community members, state, territorial, local, and tribal (STLT) partners, and stakeholders. In the beginning of your public health work, you may need to constantly educate community members about exposure sources and exposure pathways –that is, how they may encounter harmful substances.

Later in your public health work, you may want to do a full community workshop or participate in existing community events to increase understanding about specific exposures related to the chemical of concern. Be sure to address how the harmful substance may be encountered, levels of exposure, and ways community members can prevent, reduce, or eliminate exposure. There may be other concerns that are not chemical-specific, such as environmental odors and community stress.

Health education is a professional discipline with unique graduate-level training and credentialing. Health educators are critical partners that advise in the development and implementation of health education programs. Public health work benefits from the skills that a health educator can provide. (See resource: What Is a Health Education Specialist? external icon ) If you don’t have this training, see what you can do to build your skills and improve your one-on-one and small group educational conversations. Health educators may also work with other public health professionals such as health communication specialists. Health communication specialists develop communication strategies to inform and influence individual and community decisions that enhance health.

• Assess individual and community needs for health education. (See activity: Developing a Community Profile )
• Ask community members about factors that directly or indirectly increase the degree of exposure to environmental contamination. Factors may include community members accessing a hazardous site or the presence of lead in house paint, soil, or water.
• Develop a health education plan.
• Listen for opportunities to provide health education throughout your community engagement work.

Despite nearby mines being shut down, a tribal nation continued to face risks of exposure to uranium and radon. To help the community better understand how to reduce the risk of exposure, a group of federal and tribal agencies developed a uranium education workshop. The agencies established a vision and a set of strategies to ensure the workshop was technically-sound and culturally appropriate.

The agencies ensured that they

• Offered the workshop in English and tribal languages,
• Developed materials at the average US reading level for broad accessibility,
• Invited all local tribal families to participate, and
• Piloted the workshop with three communities before finalizing the content.

Before the first pilot workshop, the agencies sought feedback on content, tone, and complexity from community health representatives from the tribe’s department of health. The community health representatives provided many suggestions to tailor the presentation for tribal community audiences.

The workshop content was further refined after each pilot presentation. Working with local professionals and offering workshops as pilot sessions enabled the agencies to tailor content to the needs, preferences, and beliefs of local community members.

CDC’s National Center for Environmental Health (NCEH) and ATSDR have many existing materials to help educate community members about specific chemicals. ATSDR’s Toxicological  Profiles and Tox FAQs provide a comprehensive summary and interpretation of available toxicological and epidemiological information on a substance. ATSDR’s Choose Safe Places for Early Care and Education Program  provides a framework and practices to make sure early care and education sites are located away from chemical hazards. Consider leveraging or adapting these resources, as well as the following chemical-specific websites and interventions, when developing health education activities for your community, such as

• NCEH’s Childhood Lead Poisoning Prevention Program Website
• ATSDR’s soilSHOP Toolkit —A toolkit to help people learn if their soil is contaminated with lead
• ATSDR’s Don’t Mess with Mercury  — Mercury spill prevention materials for schools

Per-and Polyfluoroalkyl Substances (PFAS):

• ATSDR’s PFAS Website

As noted above there may be other concerns that are not chemical-specific, such as environmental odors and community stress. Some helpful resources to address these concerns can be found here:

• ATSDR Environmental Odors
• ATSDR Community Stress Resource Center

Develop health education materials that are culturally appropriate, with community input.

Be aware that your health education messages may be received by the community differently than you intend. Consider testing your messages with community counterparts before you use them widely. Be aware of community beliefs about health and the environment, so that you can develop culturally appropriate health education materials. Your awareness will help you design, plan, and implement activities that are protective of health and respectful of community beliefs. (See callout box: Cultural Awareness )

Avoid stigmatizing (devaluing) communities living in “contaminated” areas [ ATSDR 2020 ].

• CDC Learning Connection  (CDC). A source for information about public health training.
• Characteristics of an Effective Health Education Curriculum  (CDC). A list of characteristics that you can use to develop an effective health education curriculum.
• Community Environmental Health Education Presentations  (ATSDR). A collection of presentations designed for health educators to use in face-to-face sessions with community members to increase environmental health literacy.
• Promoting Environmental Health in Communities (ATSDR). A guide that includes talking points, PowerPoint presentations, and covers the basic concepts of the environment, toxicology, and health.
• What is a Health Education Specialist? external icon (Society for Public Health Education – SOPHE): A description of a health education specialist including areas of responsibility and competency.

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Planning and Implementing an Effective Health Education Curriculum

This is an excerpt from lesson planning for skills-based health education with web resource by sarah benes & holly alperin..

To ensure that your students develop the skills and knowledge needed to lead healthy lives, you must plan and implement an effective health education curriculum. This takes, among other things, planning for and consideration of developmental levels, student and community needs, and where your curriculum fits within the bigger picture of the district. (That is, have students had health education before your class? Will they have it after?) As discussed in chapter 1, a skills-based approach uses the skills of the National Health Education Standards as the foundation of the curriculum and integrates topic areas such as nutrition, alcohol and other drugs, and interpersonal relationships to help students develop the skills and acquire the knowledge necessary for maintaining or enhancing their health. This chapter provides strategies and tools for designing a skills-based health education curriculum.

Before we dive into specifics of curriculum design, let's take a moment to think about how well-designed learning experiences influence student outcomes. We will explore two scenarios that could play out in your classroom. In the first, you go into class having an idea of what you would like students to learn (although you have no specifically designed behavioral outcomes). You have thought about the information you want students to know and you design and teach your lessons in an engaging way to make sure they learn this new information. You create an assessment (near the end of the unit) to measure whether or not students can restate what they've just learned based on what you were able to cover in the lessons. Perhaps the assessment asks students to create a poster, make a presentation, or take a test. When students turn in their projects or their tests, you notice that they were able to include a lot of information on the topics discussed and their test scores reflect knowledge acquisition. Based on this information, you feel that students have retained information from the unit, and you hope that they will be able to use that information to make healthy choices.

Now we want you to consider a second scenario and notice the differences in both student output and transferability of learning. In this scenario, your curriculum and student learning experiences are predetermined. The learning experiences are created to support skill development while integrating the functional information and topics necessary for developing skills. You begin your unit by considering what your students need to know and be able to do. You consider the needs of your school, district, and community using data from a variety of resources - from state standards to school-based surveys. For example, suppose you have outlined your scope and sequence and are brainstorming topics to cover in the Analyzing Influences unit. While looking at Youth Risk Behavior Survey (YRBS) data, you notice an increase in alcohol use among high school students. Based on a local survey conducted by guidance counselors, you also know that students are experiencing high levels of stress and are using alcohol as a way to deal with their stress. Finally, you know from conversations with the parent - teacher organization that parents are concerned about the online activity of students. Using all of these data, you find it important to focus your unit on analyzing the influences of stress in students' lives by identifying stressors, including technology, and discussing healthy ways of managing stress without turning to alcohol or other unhealthy options. You use this information to develop your unit objectives.

Next, you create an assessment that will provide an opportunity for students to demonstrate their skill proficiency and the extent to which they have met the unit objectives. After creating the assessment, you design your lessons in such a way that students will acquire the knowledge and develop the ability to apply the skill in a health-enhancing way and demonstrate their learning through the assessment. All the while, you make sure that you are teaching in a way that is both engaging and meaningful to students. By the end of the unit, students are able to demonstrate to you how to apply the skill while also using the information taught to them. You now have greater levels of confidence in your students' ability to use the information learned and apply the skill developed in a health-enhancing way. You also feel confident that students will be able to analyze other influences in their lives that might lead to unhealthy behaviors.

These two scenarios have fundamental differences. In the first, students are able to tell you what they have learned and have built up a knowledge base of health-related information. While some of the information will resonate with students, behavior change theory suggests that they are unlikely to retain that information over the long term, nor will they necessarily use that information in their daily lives to make health-enhancing choices. Knowledge is a precondition for behavior change; it sets the stage, but on its own will not lead to change (Bandura, 2004). Initially, the information might become a topic of conversation and even spark interest in learning about something else, but the information alone does not ensure that students have the ability to apply that information in ways that support or maintain their health.

In contrast, in the second scenario, the unit is designed to give students opportunities to develop the skill and apply the information learned during the unit. Through this experience, the students must use health-related information to support their application of the skill, with the information itself secondary to skill development. The assessment designed before the lesson planning and implementation helps to ensure that learning activities included in the unit align with and contribute to students' ability to meet the unit objectives. Not only does this help guide your teaching, but also it helps to set clear expectations for students - they know where they will end up before they even start! Also, as students progress through the lessons, they build on their ability to apply the skill so as they approach the assessment they are prepared to demonstrate the skill and apply the information in a meaningful way. After completing the unit, students have the ability to perform the skill, apply the newly learned information, and transfer learning to their daily lives.

This chapter provides you with strategies and ideas to set up your health education classroom (and curriculum) in a way that more closely mirrors the second scenario. We believe that students who participate in meaningful, well-designed learning experiences that focus on skill development are more likely to leave their health classrooms prepared to handle the challenges they will experience in everyday life.

Learn more about Lesson Planning for Skills-Based Health Education .

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Effective Tips for writing a good Patient Teaching/Education Plan

How do I write a teaching plan for nursing? If this question bothers you, then you are in luck. Patient education is critical in aiding positive patient outcomes and ensuring maximum independence. Nurses play a significant role in patient education by utilizing nursing teaching plans to provide the necessary information to patients to manage their health conditions. A detail-oriented nursing education plan informs patients, improves their understanding of their medical condition, and helps them make the best decisions about their health. As a nursing student, you must learn how to write a teaching plan so that you can communicate well with patients about their medical issues.

In this guide, we will define a nursing teaching plan, show you the steps for creating a teaching plan for a patient, and give tips for writing an impactful teaching plan.

What is a Teaching Plan in Nursing?

A nurse-teaching or patient education plan guides patients about a particular medical issue. In other words, it is a way for nurses to teach patients about their illnesses so that they can know how to take medication and manage their disease.

These plans are necessary for informing patients without medical backgrounds what to do when they are not close to their doctors. They identify a patient's current needs and acknowledge the possible risks. The goal is to achieve long-lasting behavioural changes by providing relevant knowledge to allow patients to make autonomous decisions about their health.

Nurse teaching plans are vital in patient education as they are used to achieve the best care plan for patients. Usually, both nurses and nursing students use these teaching plans to learn more about a particular illness. They can make better decisions concerning a diagnosis, impending surgery, medications, and treatment options.

A well-thought-out patient teaching plan is an effective way for nurses to teach patients instead of communicating information without a plan.

What Should A Nursing Teaching Plan Include

A good teaching plan must include the following:

• Purpose of the lesson.
• The overall goal of the lesson.
• Objectives for achieving the goals.
• Lesson outline.
• Instrumental methods that show how you plan to teach the lesson.
• Timeline for achieving the objective.
• Instrumental resources for achieving the identified objectives.
• How do you evaluate whether the objectives are working?

These are all crucial elements that will help

How to Create a Nursing Teaching Plan

Research shows that a well-thought-out teaching plan significantly improves patient outcomes and saves lives. For this reason, you must learn how to create an effective teaching plan. The following are the steps for creating an effective teaching plan for nursing.

Come up with the Goals of the Teaching Plan

Figuring out how to write a patient teaching plan is challenging, so setting a goal to guide you through every step is necessary. Remember, a lesson plan outlines teaching goals, learning objectives, and how you intend to accomplish them.

An effective and productive nursing teaching plan differs from one in which everything goes well but in which both the teacher and student gain something from it.

Start by deciding what medical issues, such as surgery or treatment ideas, will be the basis for the teaching plan. Then, decide what you want the nursing plan to fulfill.

For example, if you are teaching a diabetic patient, the goal would be to inform them how they would be taking regular insulin injections. Ensure the goals are measurable, realistic, achievable, and relevant to the patient's medical condition.

Find Out What Works Best

Ask the patient how they learn best so that you can match their style. If you don’t know how to go about this, consider asking, "The last time you learned about something new easily, how was it taught?" If they prefer visuals or jotting things down, make sure you make it possible for them. This is necessary for delivering medical information in a way that the patient can understand.

The most common way to teach patients is using visual components and auditorily. Thus, it's best to include images, graphs, and diagrams in your nursing if they prefer visuals. If they prefer auditory, it's best to read to them out loud or provide a recording device they can use whenever.

Assess Patient's Knowledge

Apart from knowing how patients learn best, it's important that you also assess their medical knowledge. This will then help you know how to write a nursing teaching plan that works well. If they don't understand medical concepts, you may have to find more information in the teaching plan to make it easy for them to grasp what you intend to teach them. You can achieve this by asking the following questions:

• Have you had any health-related issues related to your current condition?
• Do you truly understand your current health condition?
• Have you ever been given a teaching plan before?
• On a scale of 1-10, Please rate your medical condition.

The answers to these questions will help you judge a patient's knowledge of medical concepts. Nurses play a big role in identifying and addressing patients' knowledge deficits, which any of the following could cause:

• Limited access to education - Some patients may need help obtaining educational resources or internet access to understand even the simplest terms.
• Health illiteracy - Not being health literate could make it difficult for one to understand medical terminologies. The reading level for all material should be between 3rd and 5th grade.
• Poor communication - When key information is miscommunicated, patients will miss what they should know.
• Cognitive impairment - those with cognitive impairment, such as intellectual disability, will struggle to process information. Your target should be between 3-5 pieces of information at a time.
• Emotional distress - patients experiencing high emotional stress, such as anxiety, may be unable to focus or understand information when it is shared.
• Language barrier - Nurses and patients will experience difficulty communicating. Patients will also have difficulty understanding important information. If your patient’s primary language differs from English, find an interpreter to translate the resources for effective learning.

As a nurse, you should know all the causes of knowledge deficit to communicate well with the patients. Knowledge deficit refers to a lack of the necessary information to understand and process an illness and treatment options, thus impeding a patient's ability to make informed decisions aligning with their health.

Also, ensure you know all the patient's needs and concerns before teaching them. This means you should be aware of all their issues and key details of the after-care plan.

For example, a patient may have been given prescription medication by their therapist to take at home.

At the same time, they may be required to do some exercises according to their physical therapist. Therefore, it's imperative that you keenly evaluate theory ability to understand what you will be teaching them.

Please note that some patients may struggle to understand even the simplest information because of a mental issue. So, it's best to know this before you begin teaching them.

Create an Outline

Now that you have figured out the patient's learning style and knowledge of medical concepts, you need to develop an outline of what information you will deliver. Use either an online template or create one. Include the following in the outline:

• Short and long-term goals that you would want the patient to achieve.
• Patient medical information.
• Strategies for achieving the goals.

Include the patient through every step by sharing information to make them feel they are in control of their health.

Write Clear Instructions

Write down clearly what you expect the patients to do. Explain when, where, and how you want the patient to complete the task.

Don't beat around the bush. Make sure every information you are sharing is as specific as possible. For instance, if your teaching plan is about chemotherapy treatment, include details of when they should come, how many times they should come in a month, and the side effects of the treatment. Other information you should add:

• Predicted outcomes
• Alternative strategies
• Resources for medical help
• Medications
• Exercise strategies
• Nutrition information

 All this information is necessary to understand the patient's medical condition comprehensively.

Provide information in Small Chunks.

It’s essential to share information with patients in a way that they can understand. For this reason, sharing information in smaller, more manageable, and meaningful chunks is necessary so that you don’t overwhelm them. Therefore, it breaks down complex phrases and sentences into smaller sections that are easy to process.

Before moving to the next section, ensure the previous one is easy to digest. In addition, make it easy for patients to ask for information about what they do not understand and provide clarification when needed.

Create a Glossary of the Medical Terms

Patient information must be written and communicated in a way that is easy for patients to understand. Medical terms refer to words and phrases that are used specifically in healthcare. Including a glossary list ensures that patients can refer to terms they do not understand. A glossary of terms is crucial to the success of the nursing teaching plan because some medical terms are extremely complex, especially for patients without any medical background.

Provide Relevant Copies of the Material

Increase your chances of success by providing relevant material and the teaching plan. This could be information about health facilities pamphlets, contact information for emergency clinics, and information about specialists.

Also, customize and print the resources instead of just handing the patient a stack of papers. The teaching plan should address their plans.

Additionally, before being discharged, repeat the plan with the patients to ensure they understand it. Some of these resources are valuable in multiple languages, so you can find the one suitable for your patients to make it easier for them to understand the information.

Evaluate the Outcome of the Teaching Plan

Check-in with the patient occasionally to know how well they follow the teaching plan. If they are having difficulties, offer to show them again or adjust the mode of information delivery.

Also, consider reviewing the teaching plan once more to know whether information could confuse the patient. If there are, consider simplifying the questions.

You may be forced to reteach the information once more through different methods. So, modify the nursing education plan until the main objective is achieved, which is learning.

Use the following steps to evaluate the patient outcomes:

• Use a teach-back strategy- Ask the patient to explain what they have learned in their own words. The aim is not to test them but to know whether they described the information in a way that meets their learning needs. Use the following questions to implement the teach-back strategy:
• “How you will….”
• “What are you going to do if…."
• “How would you explain….”
• As they answer, encourage accurate responses and respectfully clarify any gaps.
• Encourage return demonstration. Evaluate how well they can demonstrate through kill performance. As they do this, gently correct any mishaps.
• Measure a change in patient outcomes- Measure how they adhere to the self-management plan through tools such as questionnaires, symptom logs, etc. Likewise, consider checking readmission rates and verify whether they have adhered to the treatment by checking lab reports.

Tips for Success

The following are some tips to increase your chance of success when using a nursing teaching plan to educate your patients.

Anticipate Questions

Before you begin teaching the patients, you must anticipate any questions or concerns they might have. This will help you act on them and prepare adequately for the lesson.

For instance, if you teach a parent of a child with high blood pressure, you might anticipate a question like, why does a young child have high blood pressure?

Prepare a teaching plan that addresses the fact that high blood pressure in children is a common result of kidney problems.

Involve the patient's Family.

Patients’ family involvement in a patient education plan is critical as it impacts the quality of care and patient outcomes. It also improves their mental health and motivates them to follow the teaching plan.

Family involvement will ensure that the patients get the help they need to follow through with the teaching plan. If they cannot come, arrange to speak to them by phone or email.

Stimulate Patient’s Interest

Patient interest is necessary for them to learn and follow through with the teaching plan. The best way to stimulate this interest is by first building a rapport, asking questions, being respectful, and considering their concerns. i

f your patient prefers detailed information about a particular concept, provide it to them. If they prefer facts, ensure that you also offer them.

Final Word 

Creating an impressive nursing teaching plan is necessary to ensure patients take a proactive role in their health. For this reason, you must know how to write it well. Including clear objectives and implementing the appropriate teaching methods will ensure that patients learn everything they need. The above tips will help you create an impactful nursing teaching plan.

Are you struggling to figure out how to write a teaching plan for a patient? Whether it is a Flyer, Poster, or Word document, you can get assignment help here at Nursemygrade.com.

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The current status of health care indices and functional independence among older adults: data from HelpAge international-jordan study

• Original Article
• Open access
• Published: 30 May 2024
• Volume 36 , article number  124 , ( 2024 )

Cite this article

You have full access to this open access article

• Mohammad Abufaraj 1 , 2 ,
• Lana Alhalaseh 3 ,
• Mohammed Q. Al-sabbagh 4 ,
• Zaid Eyadat 2 ,
• Walid Al Khatib 2 ,
• Osama A Samara 5 ,
• Immanuel Azaad Moonesar 6 ,
• Lee Smith 7 &
• Raeda Al qutob 8  

1 Altmetric

Health services should anticipate the changing pattern of illnesses associated with population aging to promote healthy aging.

We aimed to evaluate health indices and chronic illnesses and their relationship with functional independence in community Syrian refugees & Jordanian elderly.

A stratified sample of 1,718 community older adults aged ≥ 60-year-old from four major Jordanian governorates was interviewed in this cross-sectional study. Katz Index of Independence in Activities of Daily Living was utilized to assess functional status. Data were analyzed using STATA 15.

Despite the similarities in baseline function, Syrian refugees had more multimorbidities but less active health insurance, accessibility to healthcare services and availability of medications and medical devices than Jordanians. Two-thirds had multimorbidities; with heart diseases, musculoskeletal conditions, hypertension, and diabetes being the most commonly reported chronic illnesses. Females had significantly more multimorbidities, and functional dependence, yet less education, income and accessibility to healthcare services. The mean Katz Index score was 4.99 ± 1.61. Significant predictors of functional dependence included increasing age, lower level of education, and some chronic illnesses.

National inclusive plans to support vulnerable older adults especially refugees and older women, provide health insurance, enhance access to health care facilities, and manage chronic medical illnesses comprehensively are urgently needed to improve independence of community-living older adults and to promote healthy aging.

Avoid common mistakes on your manuscript.

Introduction

The global population is rapidly aging in both developing and developed countries due to improvements in healthcare, reduction in mortality rates, urbanization and a subsequent demographic transition [ 1 ]. With aging, the prevalence of chronic illnesses and multimorbidity is increasing in parallel with rising social and healthcare demands and expenditures on one hand and decreasing functional independence and survival on the other hand, which may become an important public policy problem [ 2 , 3 , 4 , 5 ].

The most important consideration for an older person is likely to be their functionality rather than the presence or absence of diseases [ 2 ]. The World Health Organization, therefore, has advocated for “Healthy aging” which is “the process of developing and maintaining the functional ability that enables wellbeing in older age” [ 6 ]. Functional ability is measured by the capacity to meet basic life demands and perform needed life roles that include Basic and Instrumental Activities of Daily Living (ADLs and IADLs; respectively) [ 6 ]. It is negatively affected by the accumulation of health deficits and chronic illnesses that are translated as multimorbidities [ 3 ].

The Hashemite Kingdom of Jordan is an upper-middle-income country with a population of 11.1 million and an estimated life expectancy at birth of 73.3 years [ 7 , 8 ]. It hosts the second-highest share of refugees per capita in the world where more than 1.3 million Syrian refugees have fled the war and are registered with the United Nations High Commissioner for Refugees (UNHCR) which works closely with the Government of Jordan and other partners, like HelpAge International, to provide protection and assistance to refugees and Jordanians affected by the refugee influx [ 9 ]. They aim to improve the lives of older women and men in low- and middle-income countries, especially those in crisis-prone areas by responding to humanitarian crises, advancing gender equality and advocating for the rights of older people through challenging ageism.

Due to the refugees’ influx, the development of health policies in Jordan has been challenging, especially for this vulnerable group of older adults which lacks the necessary data that help frame such inclusive policies. Previous research in Jordan highlighted the need for high-quality, nationwide studies to address the patterns of chronic illnesses, functional status and health indices among older adults in order to have customized policies in place [ 7 ].

Therefore, this study aimed to explore health indices including the patterns of chronic illnesses and multimorbidity and their relationship with ADLs in community older adults, including Syrian refugees and Jordanians living in northern Jordan, with particular emphasis on gender differences in an attempt to help phrase healthcare strategies tailored to these specific needs.

Study design

This is a cross-sectional survey-based study conducted by the Center for Strategic Studies at the University of Jordan in collaboration with HelpAge International-Jordan. Using a two-stage stratified-cluster sampling design, 15 field supervisors and 45 data collectors interviewed 1718 participants representing Jordanian and Syrian adults from both genders, aged ≥ 60 years. The samples were captured from the four major governorates (Amman, Zarqa, Irbid and Mafraq) hosting Syrian refugees, excluding those residing in refugees’ camps.

The latest Jordan Population and Housing Census 2015 was used as a sampling frame for Jordanians.

A sample of 860 households was randomly drawn to represent the Jordanian population in the four targeted governorates. It was designed in a probability proportional to size (PPS) way to provide valid and reliable survey estimates across the four governorates - rural and urban areas. Furthermore, each governorate was subdivided into area units called census blocks, which were the Primary Sampling Units (PSU-Blocks) for this survey (on average, a PSU comprises 50–70 households). The PSU-Blocks were then regrouped to form clusters. From each PSU, eight households were randomly drawn with an equal probability systematic selection. A household was defined as a group of people living in the same dwelling space who eat meals together, acknowledging the authority of a man or a woman as the household head. After the household selection and obtaining the permission of household residents to participate in the survey, all the eligible household members (has to be over 60 years old) were entered into the CSPRO program, which ran a random selection to choose one member from each household.

The sample size from each governorate was proportionate to the population’s size (see the Supplementary Table S1 ).

To update the sampling frame for Syrians, a pre-listing of households took place, where Syrian households were visited and entered into a listing frame (the same listing questionnaire was used). This sampling frame enabled weight calculation and the selection of the final Syrian sample. This was followed by determining the sampling blocks (PSU), which were 108, then 8 households were randomly selected from each block to fulfill the pre-calculated sample size of 858.

Measurement instrument

The study instrument was designed by HelpAge International, supported by a steering committee that included statisticians, geriatric consultants, and other experts in the field. Survey items included sociodemographic variables: age, gender, marital status, monthly income in Jordanian Dinar (JOD, 1 JOD = 1.41 USD), Nationality (Jordanian or Syrian), region of residence (Amman, Al-Zarqa, Irbid, and Mafraq), and the level of education (Illiterate, less than secondary, and secondary and/or higher education). The interviewers asked about age-related health indices: living alone, needing assistance in their daily life, having chronic medical illnesses (self-report), having active health insurance, accessibility to healthcare services, access to medications, and availability of blood pressure or blood sugar measuring devices in patients with hypertension and diabetes, respectively.

Chronic illnesses are then grouped into major categories that included: heart diseases (including heart failure, angina and valvular heart disease), hypertension, dyslipidemia, lung diseases (including asthma, bronchitis and interstitial lung diseases), gastrointestinal and liver diseases, diabetes mellitus, thyroid diseases, musculoskeletal conditions (including arthritides and back pain), neurological diseases (including stroke, headaches, and seizures), kidney (including urinary tract) diseases, neoplasms and cancers, hematological diseases, and ophthalmic and dermatological diseases (requiring repeated prescriptions). Multimorbidity is defined as having at least two concurrent chronic illnesses [ 10 ].

Katz Index of Independence in Activities of Daily Living (ADLs) was utilized to evaluate the functional status of the participants [ 11 ]. It assesses six basic ADLs (Bathing, Dressing, Toileting, Transferring, Continence, and Feeding) with two-option responses for each item (dependent = 0, independent = 1), yielding a total score of 6. The higher the score, the higher the independence in ADLs.

Data analysis

Data were analyzed using STATA (Stata Statistical Software: Release 16. College Station, TX: StataCorp LLC). First, gender differences in demographic variables, healthcare indices and chronic illnesses were evaluated using chi-square test. Then, women and men were stratified into two groups based on their perception of needing assistance in their daily life, and differences between each stratum were assessed using chi-square test. Statistically significant results were regarded if the p -value was < 0.05.

A linear regression analysis was used to assess the impact of sociodemographic variables and chronic illnesses on the Katz Index of Independence in ADLs score. Variables were first evaluated using univariate linear regression analysis, and the variables that were significant to the outcome were included in the final multivariable linear regression model to estimate the beta coefficient (β) and 95% confidence interval (CI).

Sample characteristics

Overall, 1,718 participants completed the interview. The sample was equally distributed between Jordanians (50.1%) and Syrian refugees (49.9%) and between men and women. Table  1 shows that one thousand (58.2%) participants were between 60 and 70 years old, living in the capital Amman (39.1%), married (61.6%), had secondary education or less (44.1%), and reported a household income of ≤ 200 JOD (66.0%). The mean Katz Index score was 4.99 ± 1.61.

Independent sample t-test showed that participants who declared their need for assistance with their daily life ( n  = 493) had significantly lower mean Katz Index scores (3.86 ± 1.98) compared to those who did not perceive a need for assistance (5.44 ± 1.16), P  < 0.001.

There were significant gender differences in reported and measured (Katz Index) functional dependence, marital status, educational level, the status of living alone and household income ( P  < 0.05).

Gender differences in healthcare among jordanians & Syrian refugees

Table  2 shows that women from both Jordanian and Syrian nationalities had significantly more multimorbidity ( P  < 0.001), and higher need for chronic medications ( P  < 0.001) compared to men. Nonetheless, they had less access to healthcare than men. Syrian refugees, of both genders, had significantly less favorable healthcare indices compared to their Jordanian counterparts. These include less healthcare insurance (14.3% vs. 85.7%, P  < 0.001), less access to healthcare (36.3% vs. 63.7%, P  < 0.001), more multimorbidity (51.2% vs. 48.1%, P  = 0.027) and less availability of medications for chronic illnesses (39.3% vs. 60.7%, P  < 0.001) as well as the devices to monitor their diabetes and hypertension ( P  < 0.001).

Table  3 shows the prevalence of chronic illnesses among the participants. Hypertension was the most common chronic illness reported by participants while neoplasms were the least common. Male sex was significantly associated with heart disease, whereas female sex was more significantly associated with hypertension, diabetes, thyroid diseases and musculoskeletal conditions.

Predictors of independence in ADL

Overall, 649 participants (37.75%) reported being dependent in at least one ADL, with transferring (24.33%) and bathing (23.75%) having the highest dependency rates (Supplementary Table-2). Table  4 shows the Multivariable-adjusted linear regression analysis evaluating the impact of different factors on Independence in Activities of Daily Living measured by Katz Index. Increasing level of education was a positive predictor of higher ADLs, with a dose-response relationship (“Less than secondary” vs. “Illiterate”) and (“secondary & higher” vs. “Illiterate”). Increasing age was significantly associated with dependence in ADLs, so were the following chronic illnesses: heart diseases, diabetes, musculoskeletal conditions, neurological diseases and kidney diseases. Gender was not found a significant predictor of dependence in ADLs.

In this representative sample of older adults living in northern Jordan, Syrian refugees had less favorable healthcare indices than their Jordanian counterparts despite the similarities in their baseline function. Two-thirds had multimorbidities; with heart diseases, musculoskeletal conditions, hypertension, and diabetes being the most commonly reported chronic illnesses. Female gender was significantly associated with more multimorbidities and functional dependence, yet less education, income and accessibility to healthcare services. Significant predictors of functional dependence included increasing age, level of education, and some chronic illnesses.

Our results showed that 37% of the participants had a limitation in at least one ADL as measured by the Katz Index score, which is higher than the reported prevalence in some studies in China (26.6%) [ 12 ], Malaysia (14%) [ 13 ] and across the European Union where prevalence rates ranged from 8 to 28% [ 14 ]. On the other hand, similar rates of functional dependence were seen in Spain [ 14 ], and higher rates were seen in India [ 15 ]. Alhalaseh showed that less than 10% of Jordanian older adults were dependent in at least one ADL, yet when Instrumental Activities of Daily Living (IADLs) were included, 33.8% were dependent in at least one IADL/ADL [ 16 ]. These high rates of dependence in ADLs might be related to many factors; firstly, more than 64% of the study participants had multimorbidity which is much higher than the reported global (51.0%) [ 4 ] and previous national numbers (32.9%) [ 16 ] in samples representing the same age groups. Multimorbidity is known to be associated with functional decline [ 4 ]. Secondly, compared to the previous study done in Jordan, this cohort had lower levels of education and less monthly income. In fact, half of the cohort is comprised of refugees, of which 85% had less than a secondary level of education. Research findings reiterate the higher rates of multimorbidity in groups with fewer educational qualifications and lower household income [ 4 , 5 , 17 , 18 ]. It is argued that higher levels of education are associated with the adoption of healthier lifestyles that help maintain functional status [ 19 ] and are linked with the development of many brain circuits that protect cognitive and functional abilities in the elderly [ 19 , 20 , 21 ].

To complicate things more, it was found that Syrian refugees had significantly less active health care insurance and accessibility to health services compared to Jordanians. In comparison, the overall national health insurance coverage in Jordan is 86% [ 22 ].

Therefore, screening programs targeting populations with lower socioeconomic status and educational levels are essential anticipatory proactive measures that may help minimize dependence in ADLs. This necessitates providing active health insurance and improving accessibility to primary care which is the foundation of successful screening programs. Additionally, focusing on the wider context of multimorbidity, rather than single diseases, as most clinical practice guidelines recommend, leads to a better understanding of the impact of chronic diseases on older adults from a patient-centered perspective [ 7 ]. Advocating for geriatric training of primary care providers is expected to enhance their understanding of multimorbidity as a geriatric concept.

Not unexpectedly, it was found that women had a significantly higher prevalence of functional dependence and multimorbidity but less accessibility to healthcare. This gender preponderance is corroborated by research studies, and it indicates an association that could be related to biological, sociocultural, environmental, or economic factors [ 4 , 18 , 23 ]. In our cohort, women were significantly more illiterate than men. They also had a significantly lower monthly income and lived alone more frequently than men. Targeting these vulnerable older women and improving their accessibility to healthcare is of paramount priority to help manage their multimorbidity, hence improving functional dependence.

Interestingly, three out of the four most commonly reported chronic illnesses in our sample were significant predictors of lower Katz Index of Independence in ADLs score, namely: heart diseases, musculoskeletal conditions, and diabetes. These results highlight one of the major challenges facing healthcare in the aging populations where the focus of healthcare practices should shift from managing diseases and pathologies to managing patients to encourage independence and healthy aging [ 3 ]. Moreover, this indicates a pressing need for further research investigating the interplay of chronic diseases, multimorbidities and functional independence among vulnerable older adults to facilitate framing national guidelines and policies that are inclusive [ 7 ].

While more than two-thirds of the study participants were independent in ADLs, the results showed that older adults have a high level of multimorbidities and functional dependence and low accessibility to healthcare and health insurance coverage, especially among older adults’ refugees. Female gender was significantly associated with more multimorbidities, and functional dependence, yet less education, income and accessibility to healthcare services.

Healthcare providers and policymakers should understand the predictors of poor functional status especially among the vulnerable groups of older women and refugees. Geriatric training should also be advocated to improve the awareness of healthcare providers about the complex needs of older adults. For national plans to be inclusive, they should prioritize health insurance, enhance access to healthcare facilities, and manage chronic medical illnesses comprehensively especially among vulnerable older adults’ refugees and women.

Limitations of this study

Our study has several limitations worth mentioning. Firstly, its cross-sectional nature makes it unsuitable for drawing cause-effect relationships. Secondly, relying on the self-reported prevalence of diseases and symptoms might be less accurate than using medical records as it is subjected to recall and social desirability biases. Thirdly, mental health issues that include depression and other mood and memory disorders were not enquired about which negatively affects the prevalence of multimorbidity and chronic illnesses and overlooks an integral pillar in functional dependence.

Finally, the association reported in this study may be influenced by residual and unmeasured confounding, which we could not account for. The major strength of our study is, however, the representative sampling technique and the validated, culturally adopted data collection instrument. Moreover, the inclusion of Syrian refugees residing in Jordan, and outside refugee camps, gives contemporary insight into the status of health indices of vulnerable elderly people living currently in Jordan.

Data availability

The data that support the findings of this study are available from The Center for Strategic Studies. Restrictions apply to the availability of these data, which were used under license for this study. Data are available from the corresponding author upon reasonable request and with the permission of The Center for Strategic Studies.

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Acknowledgements

We thank the expert rosters from the Economic and Social Council and The Center for Strategic Studies at the University of Jordan for their valuable participation and input in the project. We would like to acknowledge and thank the HelpAge International/ Jordan for their efforts in promoting the right of all older people to lead dignified, healthy, and secure lives.

The authors received no specific funding for this work.

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Division of Geriatrics, Department of Family and Community Medicine, School of Medicine, The University of Jordan, Amman, Jordan

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School of Medicine, the University of Jordan, Amman, Jordan

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Health Administration & Policy, Mohammed Bin Rashid School of Government, Dubai, United Arab Emirates

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Abufaraj, M., Alhalaseh, L., Al-sabbagh, M.Q. et al. The current status of health care indices and functional independence among older adults: data from HelpAge international-jordan study. Aging Clin Exp Res 36 , 124 (2024). https://doi.org/10.1007/s40520-024-02738-2

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Leaky Gut Diet: The Best Anti-Inflammatory Foods To Eat For Gut Health, According To Dietitians

Plus, how to relieve your symptoms.

If you’ve never heard of leaky gut syndrome before, you’re not alone. It’s not currently recognized as an official medical diagnosis, so it’s still pretty new to health practitioners and the general public, says Brigitte Zeitlin, MPH, RD, and founder of BZ Nutrition. “Leaky gut may not be a classical medical analysis, but studies have shown it to be [linked to] chronic inflammation, insulin resistance , weight gain, and obesity,” she says.

Leaky gut occurs when there is damage to the intestinal lining, which then allows bacteria into the bloodstream, says Zeitlin (more on that soon). If you're having ongoing tummy issues and suspect it may be leaky gut, chat with a healthcare provider. In the meantime, here's what you need to know about leaky gut, what causes it, and the best anti-inflammatory foods that may help.

Meet the experts: Brigitte Zeitlin, RD , a New York-based registered dietitian and the founder of BZ Nutrition. Chrissy Arsenault, RDN , is a registered dietitian at Trainer Academy in Colorado.

What is leaky gut syndrome?

Although it’s not a medical diagnosis and experts have mixed opinions on the term, leaky gut typically refers to intestinal hyperpermeability (when gaps in your intestinal wall start to loosen) and the cluster of symptoms associated with it. “With this condition, the intestinal lining becomes more permeable, giving bacteria, toxins, and undigested food particles the ability to pass through the gut lining into the bloodstream,” says Colorado-based dietitian Chrissy Arsenault, RDN.

Leaky gut can cause digestive issues like gas, bloating, constipation , and loose stools, Zeitlin says—but gastrointestinal symptoms aren’t the only signs that point to a leaky gut. You may also notice sudden food intolerances, seasonal allergies , skin conditions like eczema or acne, chronic fatigue, joint pain, difficulty losing weight, fatigue, and even mood changes, she says.

If you have any of these symptoms, talk to your doctor about what might be going on in your gut—especially if you have candida overgrowth (a fungal infection) or small intestinal bacterial overgrowth (SIBO), the presence of excessive bacteria in the small intestine.

What causes leaky gut?

Although the causes aren't entirely clear, it is believed that acute issues like infections or stress can cause inflammation in the gut lining, says Arsenault. This could be as simple as eating food you’re allergic to or something like undergoing chemotherapy or radiation, which puts stress on your physiological and physical well-being. Along with stress, an unhealthy diet may also compromise the gut lining, a recent study suggests.

Prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, or alcohol may also affect the gut over time as well as environmental toxins like cigarette smoke, pesticides, or pollution, Arsenault says. People with chronic conditions like an autoimmune disease, celiac disease, diabetes , and Crohn’s disease may be more at risk to leaky gut than the average patient, she adds.

Foods To Eat

If you suspect you have leaky gut, try to make room in your diet for foods that are quality sources of fiber and fat, says Zeitlin. “Aim to have six to eight cups of whole fresh fruits and veggies daily, one serving of whole grains, and include quality fats daily, like two to four tablespoons of olive oil in your salad or veggie sauté, plus two tablespoons of nuts or seeds daily, and avocado,” she recommends.

• Vegetables: Brussels sprouts, cabbage, kale, broccoli, mushrooms, zucchini, arugula, ginger, spinach, and carrots
• Whole grains: brown rice, corn, oats, buckwheat, and amaranth
• Probiotic foods: yogurt, kefir, kimchi, and sauerkraut
• Fermented foods: sourdough bread, apple cider vinegar, sauerkraut, kefir, and miso
• Fruits: bananas, strawberries, coconut, pineapple, raspberries, kiwi, mandarin, lemon, limes, passionfruit, papaya, blueberries, grapes, and oranges
• Nuts: a lmonds, pine nuts, peanuts, and cashews
• Seeds: flax seeds, sunflower seeds, chia seeds, and hemp seeds
• Fish: omega-3-rich fish like salmon, herring, and tuna
• Meat: lean cuts of chicken, beef, turkey, lamb, and eggs
• Herbs and spices: all are recommended

Foods To Avoid Or Limit

Before you start tossing everything in your pantry, you may want to try cutting back on common inflammatory foods like gluten and dairy first, Zeitlin says. Consider a two-week-long elimination diet and keep a food journal to track how your digestion feels after eating meals. “After two weeks, add small amounts of food back into your diet for two to three days and see how you feel,” Zeitlin suggests. “What you have identified as a trigger, you will want to keep out of your diet long-term.”

• Highly processed foods: fried foods, sugary cereals, potato chips, and candy
• Refined carbs: pizza, waffles, pastries, baked goods, bagels, crackers, pancakes, cookies, cakes, pies, and muffins
• Artificial sweeteners: aspartame, sucralose, and saccharin
• Dairy products: milk, cheese, ice cream, and custard
• Wheat-based products: bread, pasta, cereals, wheat flour, energy bars, soup, and batter-fried foods
• Refined oils: canola, sunflower, soybean, and safflower oils
• Sauces: salad dressings, soy, hoisin, and teriyaki sauce, as well as ketchup
• Beverages: alcoholic drinks, caffeinated drinks, and coffee

7-Day Leaky Gut Diet Plan

Here are some of the best foods to eat for gut health, according to Zeitlin.

• Breakfast: Two scrambled eggs with a piece of sourdough bread with four ounces of plain, unsweetened kefir
• Lunch: Fresh garden salad with grilled chicken and 2 tablespoons of olive oil
• Dinner: Baked salmon with roasted broccoli
• Snack: Three dates with almond butter
• Breakfast: Half of an avocado (sliced) on a piece of sourdough bread with 4 ounces of plain, unsweetened kefir
• Lunch: Lentil soup
• Dinner: Sautéed shrimp with zucchini noodles and pesto sauce Snack: Hummus and crudité
• Breakfast: Spinach and blueberry smoothie with 1 tablespoon of ground flax seeds
• Lunch: Fresh garden salad with edamame
• Dinner: Grilled chicken with baked carrot fries
• Snack: Bananas and almond butter
• Breakfast: Coconut yogurt with ½ cup of berries and 1 tablespoon of nuts, 1 tablespoon of ground flax seed
• Lunch: Fresh garden salad with avocado and tuna
• Dinner: Turkey burger with roasted veggie medley
• Snack: Pistachios and kombucha
• Breakfast: Spinach and egg scramble with 1 cup of raspberries
• Lunch: Quinoa salad with vegetables and roasted turkey breast
• Dinner: Vegetable stir-fry with edamame
• Snack: Smoothie with plain, unsweetened Greek yogurt, frozen berries, and protein powder
• Breakfast: Avocado toast with hard-boiled egg
• Lunch: Tuna plate with sliced cucumbers
• Dinner: Turkey meatballs with zucchini noodles and pesto sauce
• Snack: Overnight oats
• Breakfast: Veggie frittata with mushrooms, broccoli, and cheddar cheese
• Lunch: Chopped salad with chickpeas, olives, and parmesan
• Dinner: Veggie curry with coconut quinoa
• Snack: Apples with almond butter

How To Improve Gut Health

While a healthy gut generally relies on a consistent and healthy diet, improving your nutrition is not the only way to strengthen your gut health. For example, taking a daily probiotic may help you maintain a healthy gut balance in addition to your new diet, Zeitlin says. A daily turmeric supplement may also help reduce inflammation in the gastrointestinal system, she adds. A once-a-day multivitamin could also be beneficial in keeping your immune system strong as you navigate your gut health.

Make sure you’re also getting seven to eight hours of sleep per night, as quality sleep is essential for healing your gut, Zeitlin says. “Create an evening routine that helps you de-stress, gets you off screens for at least two hours before bedtime, and aim to go to bed at the same time every night,” she says. “Add calming activities into your routine, like walking, yoga, minimal exercise, time with friends, meditation , journaling, listening to music—anything that you know feels good and relaxing for you,” Zeitlin shares.

In addition to eating balanced, satiating meals, drink plenty of water, prioritize movement, and consider an anti-inflammatory diet (and stick to it). You’ll be on your way to better gut health in no time.

Meguire Hennes is a freelance lifestyle journalist specializing in fashion news, celebrity style, dating, and wellness (her Libra moon won’t let her settle on one beat). She received a B.A. in fashion studies from Montclair State University, and her words can be found in Bustle, The Zoe Report, Elite Daily, Byrdie, and more. When she’s not debunking a new TikTok wellness trend or praising Zendaya’s latest red carpet look, you can find her in yoga class, reading a cutesy romance novel, or playing Scrabble with her puppy in her lap. 

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Veterinary Diagnostic Laboratory

H5N1 Highly Pathogenic Avian Influenza in Cats

Situational Overview

The current strain of H5N1 highly pathogenic avian influenza (HPAI) circulating in the United States emerged in U.S. poultry in February 2022. HPAI has affected domestic birds , wild birds , and several species of mammals including big cats, bears, coyotes, foxes, opossums, otters, seals, skunks, and squirrels. In Michigan, H5N1 HPAI infections have been confirmed in wild mammals such as red fox, opossum, raccoons, and coyotes since the outbreak began in 2022. Infection can cause illness, severe disease, and even death especially in young wild animals.

Most recently, infections of dairy cattle have been confirmed in herds in several states including here in Michigan. On and around affected dairies, sick and dead wild mammals and domestic cats have been widely reported, presumably linked to exposure to infected raw milk which often contains high levels of virus. As part of the effort to track the virus, the United States Department of Agriculture (USDA) is covering the testing costs of sick and dead cats and wildlife near H5N1 positive premises, as well as cats with neurologic signs testing negative for rabies.

What do we know about HPAI in cats?

According to the U.S. Centers for Disease Control and Prevention (CDC), detections of H5N1 HPAI infections in cats have been reported during outbreaks in the early 2000’s in Thailand and Germany, and Poland and South Korea in 2023. The source of previous HPAI infection in cats is unclear in many cases.

Because finding HPAI in dairy cattle is unusual and there is still much to be learned, animal health experts are also learning about the increased risk to cats through infections in cattle. According to the USDA, cats appear to be highly susceptible to the currently circulating strain of H5N1 HPAI. Increased vigilance is needed to both protect cats from infection and to better understand virus transmission between animal species.

What should pet owners do?

• Limit contact between pets and wild birds as well as ill livestock and environments that could be contaminated with the virus.
• Consider changing clothing and shoes after interacting with animals or birds with unknown health status, and before interacting with personal pets.
• Wash your hands thoroughly after touching or interacting with animals outside your household.
• Avoid contact with sick or dead wildlife.
• Contact your veterinarian immediately if your pet has decreased energy and appetite progressing to neurologic signs (lack of coordination, inability to stand, tremors, seizures). Respiratory signs (nasal discharge, coughing, sneezing) may or may not be present.

What should veterinarians do?

• Follow CDC recommendations for veterinarians evaluating and handling cats potentially infected with H5N1 HPAI.
• Use your clinic’s isolation and patient handling protocols for suspected infectious and/or zoonotic disease cases.
• Contact the MSU Veterinary Diagnostic Laboratory at 517-353-1683 to discuss possible testing options . The Laboratory can coordinate with your state animal health official to facilitate a diagnostic plan.

Anyone who suspects the presence of HPAI or any other reportable disease in domestic animals in Michigan should contact the Michigan Department of Agriculture and Rural Development immediately at 800-292-3939 (daytime) or 517-373-0440 (after-hours).

Page posted May 24, 2024

Hochul pushes to ban smartphones in NY schools. Will it help address mental health crisis?

Gov. Kathy Hochul on Thursday revealed her push to ban students from bringing smartphones into New York schools amid ongoing efforts to address intersecting educational and youth mental health crises.

The Democratic governor has plans to introduce a bill banning schoolchildren from carrying smartphones on school grounds. She aimed to approve it during the 2025 legislative session that begins in January, which tees up politically charged debate between educators, lawmakers and major tech companies in coming months over the issue.

The governor's office has yet to release many details about the proposal, but Hochul told media outlets she would be open to allowing "flip phones" in schools that would let children text and make calls.

The comments come during an 11th-hour push by state lawmakers to ban internet companies from exploiting personal data and using addictive social media features in ways that harm youth mental health and development in New York. That effort aims to approve those two bills before the current legislative session ends in early June.

What Hochul says about smartphone ban

Each New York school district has various policies regarding smartphone use by students, Hochul said Thursday during an appearance on MSNBC . But she asserted "a majority are allowing it" in the face of parental concerns about losing the ability to connect with kids amid fears of school shootings.

"Why are young people on their devices all day long during school hours? How are they learning?," Hochul asked, addressing the smartphone ban, first reported by The Guardian .

"I'm okay if you have a flip phone," Hochul added on MSNBC, noting that allowing the outdated technology should assuage parental concerns while ensuring children aren't "in the world of social media throughout the day." It remains unclear how Hochul would propose enforcing the ban.

NY education: Should NYS try to protect kids from addictive social media? Supreme Court case looms

What are other schools, states doing about smartphones in schools?

School smartphone bans have been debated intermittently since the devices first hit markets about two decades ago. But efforts to limit use of the devices on school grounds has gained worldwide attention in the past year, as research mounted on the harmful effects to children's education and mental health.

Guidance recommending a school cellphone ban  took effect in England  last fall, following examples in other European countries. Stateside, Florida last year adopted a statewide ban on cellphones during instructional time, with some districts going further and banning their use at lunch and breaks, too.

National debate on cellphones: Schools don't want kids on cellphones. Is banning them the solution?

How NY plans to stop data collection, addictive social media feeds

Hochul's comments come as lawmakers debated the current session bills, including the Stop Addictive Feeds Exploitation for Kids Act, would require social media companies to restrict key addictive features on their platforms.

Currently, platforms supplement the content that users view from the accounts they follow by serving them content from accounts they do not follow or subscribe to. This content is curated using algorithms that gather and display content based on a variety of factors. However, algorithmic feeds have been shown to be addictive because they prioritize content that keeps users on the platform longer, the governor has noted.

NY mental health: Youth mental health a 'hidden crisis' after COVID: Monroe County report

The other bill, called the New York Child Data Protection Act, would prohibit all online sites from collecting, using, sharing, or selling personal data of anyone under the age of 18, unless they receive informed consent or unless doing so is strictly necessary for the purpose of the website.

For users under 13, that informed consent must come from a parent. The bill authorizes the Attorney General’s Office to enforce the law and may enjoin, seek damages, or civil penalties of up to $5,000 per violation.

These two bills have been a top end-of-session priority for Hochul in recent weeks, as she aimed to overcome lobbying pushback from tech giants, including Meta, the parent company of Facebook, and Google, that have combined spent hundreds of thousands of dollars since last fall seeking to influence New York lawmakers and regulators, state records show.

USA TODAY contributed to this report .

Wes Streeting destroys arguments against Labour's private schools plan on BBC Question Time

Shadow Health Secretary Wes Streeting took on critics of Labour's plan to axe tax perks enjoyed by independent schools in a brutal takedown on BBC Question Time

• 07:55, 31 May 2024

Wes Streeting has destroyed arguments against Labour's private schools plan in a brutal takedown on BBC Question Time.

The Shadow Health Secretary took on critics of his party's plan to axe tax perks enjoyed by independent schools. It wants to remove their exemption from paying 20% VAT and use the cash raised to improve state schools instead.

A member of the BBC Question time audience asked Mr Streeting if it was "morally right to impose a tax on parents' aspirations for their children". He replied simply "yes" and said there are "difficult choices to be made".

In a takedown of criticism of the plan, Mr Streeting continued: "There's lots of opposition from independent schools who are now pleading poverty and saying that people will be priced out, so I took the liberty of looking at this school's fees and how they've changed since 2020. They've gone up from £8,717 per term, to £10,303 pounds per term, an increase of 18%.

"School fees in this country - independent school fees - have risen well above inflation every year since before 2010. So I say respectfully, not to the parents, I know that parents are worried about this, I accept that, but I say to the head teachers of these sorts of schools pleading poverty, I'm sorry, but you're going to have to cut your cloth accordingly, like state schools have had to for more than 14 years.

"And we make no apology for putting the education and ambitions and opportunities of kids from working class backgrounds like mine who attend [state schools] - the 93% of kids - above the schools that educate the 7% because we want to extend opportunity and aspiration and ambition, and that is not simply the preserve of the wealthy. And those are the sorts of fairer choices a Labour government would make unapologetically."

Shadow Education Secretary Bridget Phillipson earlier this week said she did not accept that private schools would be forced to close as a result of Labour's proposed 20% VAT charge on fees. "If you look at the work that the Institute for Fiscal Studies did ... they concluded that Labour's policy would raise £1.3-1.5billion net and we would invest that directly into our state schools - we would make sure we've got 6,500 more teachers," she told Sky News.

Asked whether there was a risk the policy would cause private school s to close, she said: "Firstly, I don't accept that we will see that kind of change - that wasn't the conclusion that the Institute for Fiscal Studies reached - but secondly, in our state schools we're actually facing a situation at the moment where we've got falling rolls, so fewer young people coming through our schools, so we're actually going to be in the position in the years to come of state schools facing those kinds of pressures about whether they've got enough students within their classrooms."

Ms Phillipson added that private schools could learn from state schools and how they've had to manage a really tight budget in recent years "whereas private schools have whacked up fees way beyond inflation, putting themselves out of the reach of many middle-class parents who might have, in the past, considered sending their children to private school".

MORE ON Labour Party Wes Streeting Question Time Education Schools Politics General election

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Top Proxy Adviser ISS Recommends Against Tesla CEO Musk's 'Excessive' $56 Billion Pay

Top Proxy Adviser ISS Recommends Against Tesla CEO Musk's 'Excessive' $56 Billion Pay

FILE PHOTO: Elon Musk, Chief Executive Officer of SpaceX and Tesla and owner of Twitter, gestures as he attends the Viva Technology conference dedicated to innovation and startups at the Porte de Versailles exhibition centre in Paris, France, June 16, 2023. REUTERS/Gonzalo Fuentes/File Photo

By Ross Kerber

(Reuters) -Top proxy advisory firm ISS recommended Tesla shareholders vote against ratifying CEO Elon Musk's $56 billion pay package, calling the compensation excessive in a rejection of the plan set by the electric vehicle maker's board.

In a report sent by a representative late on Thursday, Institutional Shareholder Services (ISS) also recommended a vote against Tesla director James Murdoch, but backed votes for director Kimbal Musk, Elon Musk's brother, and for the company's proposed move to change its state of incorporation to Texas from Delaware.

Tesla did not immediately respond to a request for comment.

The report by ISS follows a similar recommendation for a vote against Musk's pay package by proxy advisory firm Glass Lewis last week.

The massive compensation arrangement, the biggest for a corporate CEO in America, set rewards based on Tesla's market value and operational milestones. But in January a Delaware judge voided the plan and Tesla subsequently sought to move its state of incorporation to Texas from Delaware.

Unusually, Tesla put the 2018 pay plan up for a re-ratification vote at its upcoming annual meeting on June 13.

While the recommendations from the big proxy advisory firms play a role in focusing attention on certain issues at corporate annual meetings, their exact influence on votes is up for debate and criticism.

A recent University of Utah study found their recommendations can have a significant impact on votes but also found the firms themselves may only be channeling the views of investors, their customers.

Tesla responded to Glass Lewis' recommendations in a securities filing earlier this week, saying Musk is creating wealth for Tesla stockholders and has "skin in the game."

In recommending votes against Musk's pay, ISS wrote that "although the structure of the grant's performance hurdles arguably contributed to, as well as reflect, the company's significant financial growth during the performance period, the total award value remains excessive, even given the company's success."

"In addition, the grant, in many ways, failed to achieve the board's other original objectives of focusing CEO Musk on the interests of Tesla shareholders, as opposed to other business endeavors, and aligning his financial interests more closely with those of Tesla stockholders," ISS' report said.

Other concerns include "a lack of clarity on the board's plan" for Musk's future pay, ISS wrote.

ISS recommended a vote against director and audit committee member Murdoch "given concerns about the risk oversight function of the board."

ISS wrote that while it had concerns about the process used by the Tesla board to decide to move to Texas, it is "not readily apparent that the rights of shareholders would be materially harmed as a result of the proposed reincorporation."

(Reporting by Ross Kerber and by Hyunjoo Jin; Editing by Peter Henderson and Muralikumar Anantharaman)

Copyright 2024 Thomson Reuters .

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