This study aims to examine the relative contribution of religious identity, social support, social connectedness, and perceived discrimination on psychological well-being (PWB) among Middle Eastern (ME) migrants in Australia. This cross-sectional study was conducted within Queensland, Australia. A total of 382 first-generation young adult ME migrants, aged 20–39 years, filled out a self-administered questionnaire. The hypothesized model was tested using a 2-step process: measurement and structural model testing. First, confirmatory factor analysis was performed to test the fitness of the measurement model, and reliability and validity indices were calculated. Structural equations modeling was then applied to test the structural model. The mediation analyses were tested using a bootstrapping method. Social support had the largest total effect on PWB through both a direct and an indirect effect via perceived discrimination and social connectedness with ethnic community (SCETH). Religious identity demonstrated both a direct and an indirect effect on PWB through social support, perceived discrimination, SCETH, and social connectedness with mainstream community (SCMN). Perceived discrimination showed a direct and an indirect effect on PWB, mediated by SCMN. The SCETH and SCMN had only direct effects on PWB. Developing interventions that assist religious institutions/networks in offering support and/or strategies to provide support to ME migrants through religious organizations could be helpful in increasing their PWB. Protecting ME migrants against discrimination based on their religious affiliation is a main area of action. Interventions that promote ME migrants’ interaction with others could result in their better mental health outcomes.

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Summary There has been a proliferation of digital sexual health interventions targeting adolescents; however, limited evaluative reviews have compared the effectiveness of multiple digital tools for sexual health literacy and behaviour change. This study conducted a systematic literature review, screened 9881 records and analysed 61 studies. Findings suggest that websites and mobile phones dominate digital sexual health interventions, with a majority effectively delivering cognitive (e.g. awareness and attitudes about sexual and reproductive health) and behavioural outcomes (e.g. abstinence and use of contraception). The most popular sexual health promotion mechanisms were interactive websites, text messaging and phone calls, and online education programmes, followed by mobile applications—fewer studies in this review utilized social media, games and multimedia. Previous reviews focused on single outcome measures (e.g. sexually transmitted infection testing) to assess interventions’ effectiveness. The current review moves beyond single outcome measures to cover a wider range of behavioural and non-behavioural sexual health issues and contexts covered in the literature. Four main categories were analysed as outcomes: cognitive perceptions, promoting sexual health-related behaviours, promoting sexual health-related products and services, and impact (viral load). Seventy-nine per cent of interventions focused on preventive sexual health behaviours and products (e.g. condoms) and services (e.g. HIV testing). Overall, 75% of studies effectively changed sexual health behaviour and cognitive perceptions. However, the digital-only tools did not vary from the blended formats, in influence outcomes, even after categorizing them into behavioural or non-behavioural outcomes. Compared to previous systematic reviews, more studies from the last decade used rigorous research design in the form of randomized controlled trials, non-randomized control trials, and quasi-experiments and lasted longer.

Objective: A large proportion of hospitals’ private income is provided by insurance organisations. Hospitals in Iran face various problems in terms of insurance deductions from insurance organisations resulting from inefficient performance by both the hospitals and the insurers. These problems necessitate more specific cost control in this area. This research assesses the causes of insurance deductions by using the Failure Mode Effects Analysis (FMEA) technique, and addresses the issues resulting in deductions by providing some interventions through the Pareto technique. Design: The 10-step pattern of FMEA was implemented for assessing the main causes of insurance deduction in this study. Setting: Data was collected from deduced amounts by three main/largest contracting party insurance organisations (e.g. the Social Security Insurance Organisation, Medical Services Insurance Organisation and Armed Forces Medical Services Insurance Organisation of Namazi Hospital, a large healthcare provider in the South of Iran, in 2014. Findings: Sixty-five potential failure causes were identified, of which 26 were related to the anaesthesia unit, 23 were related to the surgery room unit and 16 were related to the hospitalisation unit. Deductions in the anaesthesia and hospitalisation units and the surgery room were reduced after intervention programs by 14.42%, 57.76%, and 51.52%, respectively. Conclusions: Using the FMEA technique in a large healthcare provider in Iran resulted in identifying the main causes of insurance deductions and provided intervention programs in order to increase the efficiency and productivity of healthcare services. Abbreviations: FMEA – Failure Mode Effects Analysis; RPN – Risk Priority Number.