BACKGROUND: Most individuals with severe mental illness (SMI) strongly prefer independent living over living in an institution. Independent Supported Housing (ISH) provides housing rehabilitation for persons with SMI in their accommodations. However, most individuals who need housing rehabilitation live in institutional housing settings (housing rehabilitation as usual: HAU). We investigated which housing rehabilitation setting is effective on which variable in the long term to support service users to form an informed preference for either housing rehabilitation setting.
METHODS: We conducted a two-year longitudinal observational non-inferiority study to test the effectiveness of ISH in improving participants\' social inclusion, quality of life, emotional social support, capabilities, symptom severity, functioning, service utilisation and costs. Participants were assessed at baseline and after six, twelve, and 24 months. Mixed effects models were computed to test between-group and within-group effects.
RESULTS: The study included 83 participants in ISH (n = 31) and HAU (n = 52) housing rehabilitation settings with a mean age of 36.2 years. Most participants were male (64%) and had a primary psychotic or schizophrenic (35%) or an affective diagnosis (24%). During the study, ISH participants significantly improved their quality of life (β = 0.54; 95% CI: 0.26 to 0.82), symptoms (β = -0.32; 95% CI: -0.60 to -0.03), and capabilities (β = 4.46; 95% CI: 0.14 to 8.77) and decreased psychiatric hospitalisations (p = 0.04). HAU participants improved their quality of life (β = 0.40; 95% CI: 0.12 to 0.69). Housing and rehabilitation support costs were almost half with ISH than with HAU.
CONCLUSIONS: ISH has been shown to be much less expensive than HAU and was associated with several improvements like reduced psychiatric hospitalisations and improved quality of life. Therefore, our findings strongly argue for a preference-driven provision of housing rehabilitation services and to end the institutionalisation of persons with SMI.
BACKGROUND: The study was registered on December 04, 2018, at ClinicalTrials.gov (NCT03815604).

In recent years, there has been significant growth in the development of Machine Learning (ML) models across various fields, such as image and sound recognition and natural language processing. They need to be trained with a large enough data set, ensuring predictions or results are as accurate as possible. When it comes to models for audio recognition, specifically the detection of car horns, the datasets are generally not built considering the specificities of the different scenarios that may exist in real traffic, being limited to collections of random horns, whose sources are sometimes collected from audio streaming sites. There are benefits associated with a ML model trained on data tailored for horn detection. One notable advantage is the potential implementation of horn detection in smartphones and smartwatches equipped with embedded models to aid hearing-impaired individuals while driving and alert them in potentially hazardous situations, thus promoting social inclusion. Given these considerations, we developed a dataset specifically for car horns. This dataset has 1,080 one-second-long .wav audio files categorized into two classes: horn and not horn. The data collection followed a carefully established protocol designed to encompass different scenarios in a real traffic environment, considering diverse relative positions between the involved vehicles. The protocol defines ten distinct scenarios, incorporating variables within the car receiving the horn, including the presence of internal conversations, music, open or closed windows, engine status (on or off), and whether the car is stationary or in motion. Additionally, there are variations in scenarios associated with the vehicle emitting the horn, such as its relative position-behind, alongside, or in front of the receiving vehicle-and the types of horns used, which may include a short honk, a prolonged one, or a rhythmic pattern of three quick honks. The data collection process started with simultaneous audio recordings on two smartphones positioned inside the receiving vehicle, capturing all scenarios in a single audio file on each device. A 400-meter route was defined in a controlled area, so the audio recordings could be carried out safely. For each established scenario, the route was covered with emissions of different types of horns in distinct positions between the vehicles, and then the route was restarted in the next scenario. After the collection phase, the data preprocessing involved manually cutting each horn sound in multiple one-second windowing profiles, saving them in PCM stereo .wav files with a 16-bit depth and a 44.1 kHz sampling rate. For each horn clipping, a corresponding non-horn clipping in close proximity was performed, ensuring a balanced model. This dataset was designed for utilization in various machine learning algorithms, whether for detecting horns with the binary labels, or classifying different patterns of horns by rearranging labels considering the file nomenclature. In technical validation, classifications were performed using a convolutional neural network trained with spectrograms from the dataset\'s audio, achieving an average accuracy of 89% across 100 trained models.

This study investigates the state of inclusivity in Ukrainian universities, focusing on the perceptions of university staff amid the country\'s ongoing sociopolitical transformations. Here we report on the perceptions of 820 staff members from various professional roles, including academic, management, and support positions, this research explored inclusivity through diverse lenses, encompassing work experience, interactions with students with disabilities, and self-identification with vulnerable groups. Most respondents assessed a moderate to high level of inclusivity, indicating a positive overall outlook on inclusive practices within these institutions. Notably, perceptions of inclusivity vary slightly across different professional roles, with academic staff expressing a marginally lower level of perceived inclusivity than their counterparts. However, these variations are not statistically significant, suggesting a uniform perception across staff categories. Furthermore, the study revealed that personal experience in working with students with disabilities does not substantially alter staff perceptions of inclusivity. Similarly, self-identification with vulnerable groups only marginally influences these perceptions. This suggests that while individual experiences and identities are factors in inclusivity perceptions, their impact is not profoundly different. This research contributes to understanding inclusivity in higher education, particularly within environments undergoing significant social and political changes.

In this paper, we examine the Moderating Role of Governance on the Relationships between social inclusion (SI), Information and communication technology infrastructure (ICT), and financial inclusion (FI) in 46 countries representing a global sample span from 2010 to 2020. We collect the data from the IMF\'s financial access survey and construct a multidimensional FI index. Based on the FI index, we divide the sample into two sub-samples (med-high level and low-level FI countries). For the empirics, we employed panel-corrected standard errors, fully modified ordinary least squares and dynamic ordinary least squares techniques. We find that SI is negatively related to FI. ICT infrastructure positively influences FI. Further, we find that governance with sound ICT infrastructure and socially inclusive communities enhances FI. The findings of sub-samples are similar to the full sample results except for a promoting effect of SI and governance in the case of med-high financially inclusive economies. Moreover, the Interaction term of governance and ICT infrastructure is insignificant in med-high financially inclusive economies and negatively significant in low financially inclusive economies. Our study reports novel findings which have significant implications for policymakers and financial institutions to effectively develop and implement new policies which strengthen the institutional base, develop digital banking infrastructure, enhance SI to boost up FI and ensure sustainable economic growth.

Participation in group activities such as choirs has been shown to have positive effects on emotional health and overall well-being. Inclusive choirs, which integrate individuals of various abilities and diverse backgrounds, provide a unique space for social interaction, emotional expression, and inclusion. This study aims to explore the impact of participation in an inclusive choir on the emotional health of its members, identifying both positive and negative emotional impacts as well as personal experiences derived from their participation. This longitudinal exploratory study combines participant observation, field notes, focus groups, and questionnaires to gain a deep understanding of the participant\'s emotional experiences through their narratives. The study was conducted in an inclusive choir located in a medium-sized city in Spain, which brings together people of various ages, genders, abilities, and cultural backgrounds. The results indicated that most participants experienced significant improvements in their emotional well-being, including increased self-esteem, a greater sense of belonging, and reduced symptoms of anxiety and depression. Participants also reported that the choir provided a safe space for emotional expression and the building of meaningful relationships. Participation in an inclusive choir can have a considerable positive impact on the emotional health of its members.

The present study aims to test a model in which basic psychological needs (BPN) satisfaction in physical-sport activity contexts is associated with self-determined motivation, which, in turn, would predict the social inclusion of people with intellectual disabilities. A total of 286 people with intellectual disabilities (53.5% men) who reported engaging in physical-sport activities responded to a validated questionnaire about the satisfaction of their BPN, motivation (using the Self-determination index [SDI]), and social inclusion. A Pearson\'s bivariate correlation and structural equation modeling were conducted. The resulting model was reanalyzed in a multigroup analysis to test its invariance across self and proxy reports. Positive associations were found between the satisfaction of the BPN and the SDI. However, the SDI and social inclusion were positively associated only in proxy reports (βself = 0.07 vs. βproxy = 0.30). The tested model established positive relationships between the BPN and SDI in autonomy (βself = 0.21 vs. βproxy = 0.18), competence (βself = 0.47 vs. βproxy = 0.53), and relatedness (βself = 0.21 vs. βproxy = 0.23). Further research is needed to understand the factors leading to discrepancies between participants and proxies when relating the SDI to social inclusion in the context of physical-sport activity. However, the results obtained suggest that it would be optimal to develop contexts of practice for people with intellectual disabilities in which the satisfaction of their BPN is favored and that this has a positive impact on their motivation and social inclusion.

UNASSIGNED: The murder of George Floyd in 2020 spurred an outpouring of calls for racial justice in the United States, including within academic medicine. In response, academic health centers announced new antiracism initiatives and expanded their administrative positions related to diversity, equity, and/or inclusion (DEI).
UNASSIGNED: To understand the experiences of DEI leaders at US allopathic medical schools and academic health centers, ie, the structure of their role, official and unofficial responsibilities, access to resources, institutional support, and challenges.
UNASSIGNED: This qualitative study used key informant interviews with participants who held formal DEI positions in their school of medicine, health system, or department. Interviews were conducted from December 2020 to September 2021. Transcripts were coded using a phenomenographic approach, with iterative concurrent analysis to identify thematic categories across participants. Data were analyzed from January to December 2021.
UNASSIGNED: Formal DEI role.
UNASSIGNED: Questions elicited reflection on the responsibilities of the role and the strengths and challenges of the unit or office.
UNASSIGNED: A total of 32 participants (18 of 30 [56%] cisgender women; 16 [50%] Black or African American, 6 [19%] Latinx or Hispanic, and 8 [25%] White) from 27 institutions with a mean (range) of 14 (3-43) years of experience in medical education were interviewed. More than half held a dean position (17 [53%]), and multiple participants held 2 or more titled DEI roles (4 [13%]). Two-thirds self-identified as underrepresented in medicine (20 [63%]) and one-third as first generation to attend college (11 [34%]). Key themes reflected ongoing challenges for DEI leaders, including (1) variability in roles, responsibilities, and access to resources, both across participants and institutions as well as within the same position over time; (2) mismatch between institutional investments and directives, including insufficient authority, support staff, and/or funding, and reduced efficacy due to lack of integration with other units within the school or health system; (3) lack of evidence-based practices, theories of change, or standards to guide their work; and (4) work experiences that drive and exhaust leaders. Multiple participants described burnout due to increasing demands that are not met with equivalent increase in institutional support.
UNASSIGNED: In this qualitative study, DEI leaders described multiple institutional challenges to their work. To effectively address stated goals of DEI, medical schools and academic centers need to provide leaders with concomitant resources and authority that facilitate change. Institutions need to acknowledge and implement strategies that integrate across units, beyond one leader and office. Policymakers, including professional organizations and accrediting bodies, should provide guidance, accountability mechanisms, and support for research to identify and disseminate evidence for best practices. Creating statements and positions, without mechanisms for change, perpetuates stagnation and injustice.

Celiac disease, an autoimmune disorder induced by the ingestion of gluten, affects approximately 1.4% of the population. Gluten damages the villi of the small intestine, producing symptoms such as abdominal pain, bloating and a subsequent loss of nutrient absorption, causing destabilization of the nutritional status. Moreover, gluten can trigger extra intestinal symptoms, such as asthma or dermatitis, but also mental disorders such as depression or anxiety. Moreover, people suffering from celiac disease sometimes feel misunderstood by society, mainly due to the lack of knowledge about the disease and the gluten-free diet. Thus, the treatment and follow-up of patients with celiac disease should be approached from different perspectives, such as the following: (1) a clinical perspective: symptomatology and dietary adherence monitorization; (2) nutritional assessment: dietary balance achievement; (3) psychological assistance: mental disorders avoidance; and (4) social inclusion: educating society about celiac disease in order to avoid isolation of those with celiac disease. The aim of this narrative review is to gain deep insight into the different strategies that currently exist in order to work on each of these perspectives and to clarify how the complete approach of celiac disease follow-up should be undertaken so that the optimum quality of life of this collective is reached.

The 16th European Network of Sport Education (ENSE) Forum was held in Rome, Italy at the University of Rome \'Foro Italico\' on 21 and 22 September 2023. The Forum was organised under the theme Sport Education for Sustainable Development: The Euro-Med Perspective and featured presentations and input from over 40 researchers, officials and policymakers. In this report, we highlight the key themes addressed at the Forum and highlight some of the notable contributions at the event.

UNASSIGNED: Participation in sports represents a potent means of empowerment and social inclusion. Nevertheless, women with physical impairments encounter specific challenges in accessing Para sports. The main aim of this study is to present the experiential participation and achievements in sports of women with physical impairments in Saudi Arabia.
UNASSIGNED: Twenty women athletes with physical impairments who engaged in competitive Para sports in Saudi Arabia were interviewed. Interpretive phenomenological analysis was employed to extract themes elucidating the experiences of women athletes with physical impairments in Para sports.
UNASSIGNED: Four dimensions were identified: (i) Exploring participation in sports; (ii) The positive impact of participation in sports; (iii) obstacles in participation in sport; and (iv) hopes and aspirations to improve participation in Para sports.
UNASSIGNED: In Saudi Arabia, participation in Para sports functions as a powerful tool for empowering and socially integrating women with physical impairments. However, these women encounter challenges in accessing sports. Achieving empowerment in Para sports necessitates the establishment of an inclusive ecosystem that celebrates diversity and equality. Collaborative efforts from governments, sports organizations, communities, and individuals are indispensable in creating an environment where women with impairments can flourish in sports.