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Appropriate paper-based technology (APT) is used to provide postural support for children with cerebral palsy (CP) in low-resourced settings. This pilot study aimed to evaluate the impact of APT on the children's and families' lives. A convenience sample of children with CP and their families participated. Inclusion was based on the Gross Motor Function Classification System levels IV and V. APT seating or standing frames were provided for six months. A mixed methods impact of APT devices on the children and families included the Family Impact Assistive Technology Scale for Adaptive Seating (FIATS-AS); the Child Engagement in Daily Life (CEDL) questionnaire; and a qualitative assessment from diary/log and semi-structured interviews. Ten children (median 3 years, range 9 months to 7 years). Baseline to follow-up median (IQR) FIATS-AS were: 22.7 (9.3) and 30.3 (10.2), respectively (p=.002). Similarly mean (SD) CEDL scores for "frequency" changed from 30.5 (13.2) to 42.08 (5.96) (p=.021) and children's enjoyment scores from 2.23 (0.93) to 2.91 (0.79) (p=.019). CEDL questionnaire for self-care was not discriminatory; seven families scored zero at both baseline and 6 months. Qualitative interviews revealed three key findings; that APT improved functional ability, involvement/interaction in daily-life situations, and a reduced family burden of care. APT devices used in Kenyan children with non-ambulant CP had a meaningful positive effect on both the children's and their families' lives. Assistive devices are often unobtainable for children with cerebral palsy (CP) in low-income countries. APT is a low cost and sustainable solution to make seating and standing devices for disabled children in Kenya. The regular use of a postural support device enhanced the children's motor skills, ability to function and participate in everyday activities, reduced the burden of care for the families and promoted the children's social interaction. The postural support devices were highly valued and utilised by the children and families in this study. [ABSTRACT FROM AUTHOR]

Objective: The primary aim of this study was to investigate the immediate and delayed effects of kinesiotape (KT) on postural control and patient-reported outcome measures under challenging conditions in individuals with anterior cruciate ligament reconstructions. Methods: Thirty-two anterior cruciate ligament-reconstructed patients for whom 6 months had passed since their operation were randomly assigned to either the KT (n = 16, aged 21.8 [5.5] y) or the placebo KT (n = 16, aged 24.0 [5.1] y) groups. Initially, both groups stood barefoot on a force platform while performing postural tasks in 4 randomized conditions (eyes open, eyes closed, cognitive task, and foam). Before the experiment, patients would bring the 4 conditions, which were written on folded papers, one by one, and in this way, the order of conditions for the examiners was determined. The patients' evaluations were conducted immediately and 48 hours after KT application. Postural control measures, with area and displacement of the center of pressure (CoP) in anterior--posterior and medial--lateral directions, and mean total velocity displacement of CoP (MVELO CoP) served as dependent variables. In addition, the International Knee Documentation Committee score was measured pretreatment and 48 hours posttreatment. Results: Significant group-by-time interactions were observed for displacement of COP in medial--lateral direction (P = .002) and MVELO CoP (P = .034). MVELO CoP significantly decreased (mean difference = 0.60, P = .009) immediately after KT application compared with preapplication measures. In the placebo group, a statistically significant decrease in MVELO CoP (mean difference = 0.869, P = .001) was observed at 48 hours post-KT compared with preapplication values. International Knee Documentation Committee scores significantly improved at 48 hours post-KT application in both groups (P < .05). Conclusions: Though observed at different time points, both KT (immediately after the intervention) and placebo KT (48 h after the intervention) were found to improve postural control measures. It appears that the changes in postural control may be more related to proprioceptive enhancement due to KT rather than the specific KT pattern. [ABSTRACT FROM AUTHOR]

Aims: Dehydration is one of the common complications of dysphagia and poses significant risks including hospitalization and mortality, but the relationship between dysphagia and dehydration has received little attention. This study aims to determine the prevalence and risk factors for dehydration of patients with dysphagia in eastern China, and to provide reference for early identification and prevention of dehydration. Methods: A descriptive, cross‐sectional design was conducted. Three hundred and thirty‐seven (n = 337) patients with dysphagia participated in the study between August and December 2022. Information relating to participants' demographic variables, nutrition, cognition, functional, hydration status and fluid intake was collected. Univariate analysis was used to examine related impact factors, and then binary logistic regression analysis was conducted to determine reliable impact factors. Results: Among 337 patients with dysphagia, the average age was 63.47 ± 16.96, most participants were male (72.1%) and married (91.7%). The prevalence of dehydration was calculated to be 43.9%, the mean plasma osmolality score was 293.53 mmol/L. Diseases with the highest prevalence were stroke (78.3%), followed by hypertension (63.5%). The risk for dehydration increased with older age, usage of more medicines such as diuretics and beta‐blockers, worse functional status and lower fluid intake. Conclusion: This study found a high percentage of dehydration in patients with dysphagia. Findings can provide a basis for targeted nursing interventions for clinical prevention and treatment of dehydration. Summary statement: What is already known about this topic? Dehydration is one of the adverse consequences of dysphagia, and it causes physical stress to sufferers and enormous costs to the health care system.Previous studies have identified that personal factors (age, gender, health condition etc.), living environment, and social support may affect dehydration What this paper adds? Results showed high percentages of dehydration among patients with dysphagia; older age, greater use of medicines such as diuretics and beta‐blockers, worse functional status and lower fluid intake played a crucial role in hospital patients with dysphagia, leading to dehydration. The implications of this paper: This paper reveals prevalence and risk factors associated with dehydration of patients with dysphagia in hospital.Findings could provide reference data for development of nursing preventive interventions, to reduce the incidence of dehydration and improve the health level of patients. [ABSTRACT FROM AUTHOR]

Background: A skin tear is a traumatic wound that occurs in up to one in five hospitalized patients. Nursing care includes application of a dressing to create a moist wound healing environment. Aim: To compare the effectiveness of two standard dressings (adhesive silicone foam vs. meshed silicone interface) to heal hospital‐acquired skin tear. Methods: An intention‐to‐treat pilot study was designed using a randomized, non‐inferiority trial in an Australian tertiary hospital setting. Consenting participants (n = 52) had acquired a skin tear within the previous 24 h and had agreed to a 3‐week follow‐up. Data were collected between 2014 and 2020. The primary outcome measure was wound healing at 21 days. Results: Baseline characteristics were similar in both arms. Per protocol, 86% of skin tears were fully healed at 3 weeks in the adhesive silicone foam group, compared to 59% in the meshed silicone interface group. Greater healing was observed across all skin tear categories in the adhesive silicone foam dressing group. In the intention‐to‐treat sample, healing was 69% and 42%, respectively. Conclusions: Results suggest the adhesive silicone foam dressing may be superior, as it produced clinically significant healing of skin tears at 3 weeks compared to the meshed silicone interface dressing. Accounting for potential loss to follow‐up, a sample of at least 103 participants per arm would be required to power a definitive study. Summary statement: What is already known about this topic? A skin tear is a traumatic wound that is commonly acquired during hospitalization that affects older adults in particular. In hospital settings, it may occur in up to one in five patients.A variety of skin tear dressings have been used in previous studies, with healing rates ranging from 34% to 97% at 21 days; however, evidence for the most effective dressing type is inconclusive.If treated inappropriately, or left untreated, minor skin tears can become chronic or complicated wounds, yet prevalence and treatment of hospital‐acquired injuries are under‐reported. What this paper adds? Based on our per‐protocol results, an adhesive silicone foam dressing may be superior, as it produced clinically significant healing of 86% of skin tears at 3 weeks compared to 59% with the meshed silicone interface dressing.Based on the methods and results from this pilot study, a future definitive trial would be feasible but would need to account for a relatively large loss to follow‐up rate. The implications of this paper: Using our intention‐to‐treat results, a future study would need a sample size of 103 per arm to be sufficiently powered, which may be impractical to achieve within a single hospital setting; thus, a multi‐site study would be advisable. [ABSTRACT FROM AUTHOR]

iPad® and paper versions of a receptive vocabulary assessment were administered to 4- to 6-year olds with a diagnosis of autism spectrum disorder (ASD). No differences were found between scores on the two assessments. Standardized testing for children with ASD can be challenging; however, testing using the iPad® may offer a different avenue as it provides visual input that appears to be motivating. Findings suggest iPad® assessments offer an efficient format for itinerant speech-language pathologists (SLPs) and SLPs providing telepractice when creating individualized evaluation plans. [ABSTRACT FROM AUTHOR]

Background: There is a lack of evidence relating to cognitive‐communication difficulties following traumatic brain injury (TBI) sustained in older adulthood. A prominent area in which post‐TBI cognitive‐communication difficulties manifest is at the level of social communication. An investigation of social communication focusing on comparison of those injured in older and younger adulthood is a practical starting point for age‐related cognitive‐communication outcome comparison. Aims: The overall objective of this study was to explore the social communication of individuals who sustained severe TBI in an early period of older adulthood (50–70 years) compared to younger adulthood (18–40 years), as informed by self and close other reports. Methods & Procedures: This exploratory controlled group comparison study involved analysis of self‐reported and close other reported La Trobe Communication Questionnaire data for 22 adults with severe TBI (11 older at injury; 11 younger at injury) and 22 control participants (11 older; 11 younger). TBI participants were matched for injury variables and participant groups were matched for sex, age and education. Outcomes & Results: The close others of the older and younger adults with TBI reported them to have significantly more frequent difficulty with social communication than the close others of age‐matched control groups. Older adults with TBI reported significantly more frequent difficulty with social communication than uninjured older adults. In contrast, younger adults with TBI and uninjured younger adults reported a similar frequency of difficulty with social communication. No age‐based difference in the frequency of social communication difficulty was evident when comparing the self or close other reports of older and younger adults with TBI. Awareness of social communication difficulty, as indexed by comparing self and close other perceptions, showed a different pattern across the TBI groups. The older TBI group rated themselves as having significantly less frequent social communication difficulty than was perceived by their close others. In contrast, no statistically significant difference was evident between the self and close other social communication ratings of the younger TBI group. Conclusions and Implications: Where possible clinicians need to work with close communication partners to understand the nature and degree of social communication difficulty following severe TBI. This may be especially important when working with people who sustain TBI in older adulthood if future research shows that this population have greater difficulty with self‐awareness of social communication difficulty. What this paper adds: What is already known on the subject: Cognitive‐communication difficulties are a common consequence of traumatic brain injury (TBI) that can have long‐term impact on everyday functioning. These challenges have primarily been investigated in individuals who sustained TBI in younger adulthood. What this paper adds to existing knowledge: Individuals who sustain severe TBI in early older adulthood have a higher frequency of reported social communication difficulty to non‐injured adults of a similar age, albeit they may underreport such difficulties potentially in the context of reduced self‐awareness. What are the potential or actual clinical implications of this work?: Social communication difficulty is an issue for people who sustain severe TBI in early older adulthood. However, a poorer overall social communication outcome in comparison to those injured in younger adulthood should not be assumed. Clinical service delivery for these challenges is most optimally delivered in a collaborative manner with the individual and their close others. Future research is required to investigate the identified trends from this study. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: People diagnosed with serious mental illness have a high risk of diabetes and are more likely to develop type 2 diabetes at ages below 60 years.Effective diabetes self‐care behaviours among people diagnosed with serious mental illness can improve glycaemic control and reduce vascular complications.Few studies have investigated diabetes self‐care behaviours and their associations with health literacy and self‐efficacy in people diagnosed with serious mental illness. What the paper adds to existing knowledge?: Diabetes self‐care behaviours in people diagnosed with serious mental illness were suboptimal; the least frequently performed self‐care activities were self‐monitoring of blood glucose.Factors associated with diabetes self‐care behaviours are gender, age, communicative and critical health literacy and self‐efficacy.Self‐efficacy is the strongest predictor of self‐care behaviours among people diagnosed with comorbid serious mental illness and type 2 diabetes. What are the implications of practice?: Mental health nurses should assess diabetes‐specific health literacy of people diagnosed with serious mental illness to ensure that they possess the knowledge and skills related to diabetes self‐care.When treating young people and those with newly diagnosed type 2 diabetes, nurses should incorporate strategies to minimise their perceptions of diabetes‐related distress and increase their confidence in managing comorbid diabetes. Introduction: People diagnosed with serious mental illness (SMI) experience greater challenges in managing their type 2 diabetes mellitus (T2DM) than do those diagnosed with T2DM alone. Aim: This study investigated diabetes self‐care activities and the factors associated with these activities in people diagnosed with SMI in a hospital setting. Methods: A cross‐sectional correlational study was conducted among 126 people diagnosed with comorbid SMI and T2DM in Taipei, Taiwan, between October 2020 and April 2021. Data were collected using self‐report questionnaires and a chart review. Three‐step hierarchical multiple regression analysis was used to identify factors associated with diabetes self‐care behaviours. Results: Diabetes self‐care behaviours in people diagnosed with SMI were suboptimal overall. Hierarchical multiple regression analyses revealed that age (β = 0.18, p =.037) and self‐efficacy (β = 0.27, p =.004) significantly associated with diabetes self‐care behaviours. Discussion: Self‐efficacy is the strongest predictor of self‐care behaviours among people diagnosed with comorbid SMI and T2DM. Implications for Practice: Mental health professionals should focus on enhancing confidence in managing comorbid diabetes in people diagnosed with comorbid SMI, especially young people and those with newly diagnosed T2DM. [ABSTRACT FROM AUTHOR]

Background: Cough is one of the most common presenting problems for patients in primary care and is largely managed in primary care clinical settings. Family physicians' familiarity with chronic cough guidelines and the extent to which these guidelines translate into everyday practice have not been well described. The objective of this study was to characterize current diagnosis, treatment, and referral practices among family physicians and to identify potentially impactful strategies to optimize chronic cough management in primary care. Methods: We conducted a cross-sectional survey of 5,000 family physicians to explore diagnosis, treatment, and referral practices related to chronic cough management in adults in primary care. Respondents completed the survey via paper or online. The outcome measures were self-reported numeric ratings and responses related to the survey elements. Results: 588 surveys were completed (11.8% response rate). About half (49.6%) of respondents defined chronic cough in a manner consistent with the American College of Chest Physicians (ACCP) chronic cough guidelines, with the rest differing in opinion primarily regarding duration of symptom presentation. Respondents reported trying to rule out most common causes of chronic cough themselves before referring (mean 3.41 on a 4-point scale where 4 is "describes me completely") and indicated a desire for more resources to help them manage and treat chronic cough. Years in practice and rural/urban setting influenced diagnosis and referral practices. Conclusions: Family physicians see chronic cough as a complicated condition that can be and is often diagnosed and treated entirely in a primary care setting. They also value the ability to refer in complex cases. Our results support that family physicians provide evidence-based management of chronic cough. [ABSTRACT FROM AUTHOR]

Purpose. This study aims to elucidate the gender gaps in the strategies for maintaining the social participation and interaction of older adults with people in a local community. Methods. The subjects were 130 older adults aged 65 years or older and independently living in their homes in Saitama, Saitama Prefecture, Japan. The authors conducted an anonymous questionnaire survey on paper and performed multiple regression analysis for men and women separately using the Lubben Social Network Scale-6 (LSNS-6) as the dependent variable. Results. Among the independent variables used for the analysis, those that significantly influenced LSNS-6 in men were social activities related to the daily life satisfaction of the elderly (SARDS). The independent variables that significantly influenced LSNS-6 in women were SARDS, sense of coherence-13 (SOC-13), and the number of family members living with the subjects. Discussion. Health promotion is not associated with interaction with people in men compared with women. [ABSTRACT FROM AUTHOR]

Background: Working in pediatric palliative care (PPC) impacts healthcare and allied professionals' work-related quality of life (QoL). Professionals who lack specific PPC training but who regularly provide services to the affected children have articulated their need for support from specialized PPC (SPPC) teams. Objectives: This study had two objectives: (1) to evaluate whether the availability of a SPPC team impacted the work-related QoL of professionals not specialized in PPC; and (2) to explore the work-related QoL of professionals working in PPC without specialized training. Design: Repeated cross-sectional comparative effectiveness design. Methods: One hospital with an established SPPC program and affiliated institutions provided the intervention group (IG). Three hospitals and affiliated institutions where generalist PPC was offered provided the comparison group (CG). Data were collected by paper-pencil questionnaire in 2021 and 2022. The Professional Quality of Life (ProQOL 5) questionnaire was used to assess work-related QoL, yielding separate scores for burnout (BO), secondary traumatic stress (STS) and compassion satisfaction (CS). A descriptive statistical analysis was performed and general estimation equations were modelled. To increase the comparability of the IG and CG, participants were matched by propensity scores. Results: The 301 participating non-PPC-specialized professionals had overall low to moderate levels of BO and STS and moderate to high levels of CS. However, none of these scores (BO: p = 0.36; STS: p = 0.20; CS: p = 0.65) correlated significantly with support from an SPPC team. Compared to nurses, physicians showed higher levels of BO (1.70; p = 0.02) and STS (2.69; p ⩽ 0.001). Conclusion: Although the study sample's overall work-related QoL was satisfactory, it showed a considerable proportion of moderate BO and STS, as well as moderate CS. To provide tailored support to professionals working in PPC, evidence regarding key SPPC support elements and their effectiveness is needed. Trial registration: ClinicalTrials.gov ID, NCT04236180. Plain language summary: Work-related quality of life in professionals involved in pediatric palliative care - Why was this study done? Caring for children suffering from life-limiting conditions and their families impacts professionals' work-related Quality of Life (QoL). Professionals without specific training often provide pediatric palliative care (PPC) to children and their families. - What did the researchers do? We aimed to determine whether the work-related the QoL of professionals without specialised PPC training would be positively influenced when they were supported by PPC specialists. We also wanted to explore what person-specific factors might correspond with higher or lower work-related QoL. Work-related QoL was analysed in relation to burnout (BO), secondary traumatic stress (STS), and compassion satisfaction (CS). These variables' levels were assessed with a questionnaire survey in 2021 and 2022. - What did the researchers find? The 301 participating professionals had overall low to moderate levels of BO and STS and moderate to high levels of CS. There was no substantial difference in work-related QoL in the professionals supported by PPC specialists compared to those who did not receive specialist support. Physicians showed higher levels of BO and STS than nurses. - What do the findings mean? Although the studied professionals' overall work-related QoL was satisfactory, there is a considerable proportion of moderate BO and STS scores in professionals working with children suffering from life-limiting conditions. Further research should explore the specific needs of professionals not specialised in PPC. [ABSTRACT FROM AUTHOR]

Background: Children with phonological impairment present with pattern‐based errors in their speech production. While some children have difficulties with speech perception and/or the establishment of robust underlying phonological representations, the nature of phonological impairment in children is still not well understood. Given that phonological and lexical development are closely linked, one way to better understand the nature of the problem in phonological impairment is to examine word learning abilities in children. Aims: To examine word learning and its relationship with speech perception, speech production and vocabulary knowledge in children aged 4–5 years. There were two variables of interest: speech production abilities ranging from phonological impairment to typical speech; and vocabulary abilities ranging from typical to above average ('lexically precocious'). Methods & Procedures: Participants were 49 Australian‐English‐speaking children aged 48–69 months. Children were each taught four novel non‐words (out of a selection of eight) through stories, and word learning was assessed at 1 week post‐initial exposure. Word learning was assessed using two measures: confrontation naming and story retell naming. Data were analysed by group using independent‐samples t‐tests and Mann–Whitney U‐tests, and continuously using multiple linear regression. Outcomes & Results: There was no significant difference in word learning ability of children with and without phonological impairment, but regardless of speech group, children with above average vocabulary had significantly better word learning abilities than children with average vocabulary. In multiple linear regression, vocabulary was the only significant predictor of variance in word learning ability. Conclusions & Implications: Children with phonological impairment can be lexically precocious and learn new words like their peers without phonological impairment. Contrary to expectations, vocabulary knowledge rather than expressive phonological ability explained variance in measures of word learning. These findings question an assumption that children with phonological impairment have underspecified phonological representations. They also highlight the heterogeneity among children with phonological impairment and the need to better understand the nature of their difficulty learning the phonological system of the ambient language. WHAT THIS PAPER ADDS: What is already known on the subject: There is limited research examining the word learning abilities of children with phonological impairment. Most previous research focuses on word properties such as phonotactic probability and neighbourhood density. Within the existing literature there are different reports and conclusions regarding the word learning abilities of children with phonological impairment and whether their word learning differs from that of children with typically developing speech. What this study adds to existing knowledge: This study found that vocabulary was the strongest predictor of word learning across children with and without phonological impairment. There was no significant difference in word learning ability between children with and without phonological impairment. However, children with lexically precocious vocabulary abilities were significantly better at word learning than children with average vocabulary abilities. What are the potential or actual clinical implications of this work?: Findings from this study support the importance of assessing and considering measures of word learning—including vocabulary—when working with children with phonological impairment. This study indicates that it is possible to use stories coupled with measures of confrontation naming and story retell to gain deeper insight into children's word learning abilities. [ABSTRACT FROM AUTHOR]

Persuasive gamified systems are effective tools for motivating behaviour change using various persuasive strategies. In line with the reinforcement theory, some persuasive gamified systems employ reward and punishment in their design to achieve the intended behavioural outcome. Research has argued both in favour and against using these strategies in behaviour change applications due to mixed results with respect to their effectiveness. However, there is a lack knowledge about how interventions using these strategies could motivate or demotivate behaviours. Therefore, this paper explores the mechanism through which Reward and Punishment motivate or demotivate behaviours with respect to their strengths and weaknesses. The results of large-scale exploratory studies (N = 1768) uncover important strengths and weaknesses that could facilitate or hinder the effectiveness of Reward and Punishment at motivating behaviour change. These include their ability to engage users and make behaviour fun, reinforce commitments to goals, and reveal some consequences of bad behaviour. We also compared the perceived effectiveness of reward and punishment quantitatively. [ABSTRACT FROM AUTHOR]

This paper sought to determine risk factors of occupational injury in the Irish dairy farming sector and to estimate the roles of both dairying expansion and the discipline of agricultural extension in influencing reducing injury occurrence. Data for this study was obtained via the Irish National Farm Survey (NFS). In total, 260 farm (83.6% of NFS dairy farm sample) workplace injury survey questionnaires were completed by NFS recorders by interviewing principal farm operators for year 2017. Injury survey data was analysed for 48 variables in conjunction with NFS core farm socio-economic, physical and financial data. Additionally, core data from 2010 for 78.5% of farms surveyed in 2017 was included in the study. Data were analysed using a three-step statistical testing process which met all Binary Logistic Regression assumptions. The study found that dairy farms had a higher farm workplace occupational injury level compared to a previous study. The study data indicates occurrence of elevated injury levels on farms which expanded and which were intensively managed from a milk production perspective. Farm expansion was associated with increased labor units used and increased investment per hectare. The study also found that use of extension services and farm discussion group participation were not associated with injury occurrence. This study demonstrates how a retrospective farm workplace occupational injury survey of Irish dairy farms, analysed in combination with farm business data can be used to identify injury risk factors, including those associated with production expansion. Irish dairy farms have a heightened farm workplace occupation injury level while dairy production expansion increased injury levels. Extension engagement did not influence on injury levels. Approaches to improve farm safety on dairy farms are outlined. [ABSTRACT FROM AUTHOR]

Background: Tele‐collaborative projects serve as invaluable platforms for students from diverse countries to engage in cross‐cultural communication and exchange cultural knowledge. These projects offer immense benefits in terms of fostering intercultural competence among participants. However, one challenge arises when participants engage in spoken communication rather than written. Those who may not share a common first language often rely on a lingua franca such as English for intercultural communication. In such spoken exchanges, varying levels of language proficiency can lead to communication errors that hinder the intercultural learning process and impede the development of intercultural competence in their fellow participants. Objectives: In the present trial study, our primary objective was to tackle the language‐related challenge associated with spoken communication head‐on. Our focus centred on addressing the discrepancies arising in spoken communication, and we aimed to mitigate these discrepancies by utilizing speech‐enabled corrective feedback technology. Methods: In a tele‐collaborative project involving 28 graduate students from the People's Republic of China and Republic of Kazakhstan, the participants engaged in spoken communication and cultural exchange in English via the internet. Given the emphasis on spoken communication and the recognition that English was not their first language, we implemented a speech‐enabled corrective feedback (SECF) technology to ensure effective communication in terms of pronunciation, grammar, and word choice. The SECF technology detected and provided instant feedback on any speech mistakes, enabling participants to make corrections accordingly. The main aim of our study was to explore the potential benefits of integrating SECF technology into a tele‐collaborative project for the development of participants' intercultural competence. Additionally, we sought to gather insights into the students' perceptions of the SECF support. Results and Conclusions: The results of our study revealed significant improvements in the participants' intercultural competence across dimensions such as knowledge, skills, attitude, and awareness. Furthermore, the participants expressed positive perceptions of the SECF technology. Drawing from our findings, we offer valuable implications and recommendations for educators and researchers in the field, enhancing their understanding of the role of SECF technology in supporting intercultural competence development in tele‐collaborative settings. Lay Description: What is currently known about the subject matter: Tele‐collaborative projects are widely utilized to enhance intercultural competence.Low language proficiency of participants often poses a significant challenge in tele‐collaborative projects. What this paper adds: The present study addressed the language barrier by incorporating speech‐enabled corrective feedback (SECF) technology to support our tele‐collaborative project.The study explored how our tele‐collaborative project, supported by SECF, facilitated the development of intercultural competence. The implications of study findings for practitioners: Scholars and practitioners should consider implementing SECF technology to address language‐related barriers in tele‐collaborative projects.Guidelines based on our study can be utilized to design tele‐collaborative projects with SECF support.Training on technology and constant support needs to be provided to participants. [ABSTRACT FROM AUTHOR]

Background: The global introduction of complex measures directed at the containment of the COVID‐19 spread has spurred a massive shift to distance learning among educational institutions. As far as such a learning mode is rather forced and, probably, only a few establishments faced no difficulties with it, the matter of assuring teaching activities' effectiveness in the practice of e‐learning is relevant. Objectives: The main purpose of this article was to assess the efficiency of online‐based tools and technologies in the context of distance education and develop a set of recommendations aimed at improving the effectiveness of online teaching. Methods: The research methodology was based on an empirical approach presupposing an exploratory questionnaire survey addressed to university students. As for the e‐learning platform used, the focus was set on Microsoft Teams. Results and Conclusions: In general, the conducted investigation unveiled that the perception of the role of the instructor differs among Western and Chinese students in terms of willingness to accept psychological help and the feeling of safety during online lessons. Given this, it is reasonable to pay more attention to the psychological well‐being of international students. The comprehensive analysis of survey outcomes allowed the development of a set of recommendations able to enhance the effectiveness of teaching in online settings. These encompass, for example, giving preference to small student group formations, setting greater emphasis on means increasing students' motivation to learn, involvement of instructors in the development and delivery of video lectures, the introduction of automated student assessment, use of multimedia information, and informing students about possible ways of interaction. Lay Description: What is already known about this topic: The comprehensive analysis of survey outcomes allowed developing a set of recommendations able to enhance the effectiveness of teaching in online settings.The most convenient digital features during e‐learning implementation were instant access to information and the availability of a shared chat room.Pre‐pandemic electronic learning was often criticized for insufficient student engagement and social interaction, leading to the need to increase student engagement through interactive online activities, virtual group projects, online discussion forums, and accessibility. What this paper adds: In general, the conducted investigation unveiled that perception of the role of instructor differs among Western and Chinese students in terms of willingness to accept psychological help and the feeling of safety during online lessons.It appeared that international students are more exposed to stress factors and are less likely to trust an educator to the degree allowing them to ask for help.It was possible to develop a set of recommendations aimed at improving the effectiveness of teaching activities during e‐learning through an in‐depth analysis of survey results. Implications for practice and/or policy: Several implications for future investigations can be identified, namely: conducting further studies on the psychological well‐being of international students in online learning, examining cross‐cultural differences, exploring the effectiveness of teaching practices, and addressing broader social issues and consequences.Further research should focus on institutions across China to generalize the results obtained and formulate more reliable inferences.Another limitation is related to the instructors themselves. This variation in specialization among participants could have had an impact on the study's results, but it was not possible to address this issue within the constraints of the current research design. [ABSTRACT FROM AUTHOR]

Aims: The study aimed to develop and evaluate the effects of a self‐determination theory‐based, nurse‐led, physical activity programme for postmenopausal women with rheumatoid arthritis. Methods: Between December 2019 and April 2020, this randomized controlled trial recruited 62 postmenopausal women with rheumatoid arthritis from a university‐affiliated hospital in South Korea. The intervention group participated in a self‐determination theory‐based, nurse‐led, physical activity programme that consisted of Tai Chi‐based physical activity, a supportive psychosocial strategy, and interactive counselling for 16 weeks, and the control group continued to undergo their usual care. Results: There were statistically significant group‐by‐time interactions in physical activity and perceived sarcopenia, which favoured the intervention group. Additionally, the intervention group showed significant improvements in the perceived therapeutic efficacy of physical activity, grip strength, walking speed, disease activity score, and health‐related quality of life. Conclusions: The programme developed in this study can be an effective and feasible approach for postmenopausal women with rheumatoid arthritis in improving physical activity, selected osteosarcopenic outcomes, and health‐related quality of life. Further research is required to investigate the long‐term effects of this theory‐based programme for postmenopausal women in diverse settings. Summary statement: What is already known about this topic? Tai Chi‐based physical activity has been known to be a component of self‐management for rheumatoid arthritis. What this paper adds? It highlights the efficacy of a theory‐based, nurse‐led, physical activity programme to improve the quality of life of postmenopausal women with rheumatoid arthritis.The evidenced‐based programme could be transferred to postmenopausal women with rheumatoid arthritis in clinical settings. The implications of this paper: The self‐determination theory‐based, nurse‐led, physical activity programme can improve physical and psychosocial outcomes in postmenopausal women with rheumatoid arthritis.Importantly, this nurse‐led and theory‐based programme is expected to be applicable to postmenopausal women with rheumatoid arthritis in clinical settings, including both hospitals and communities. [ABSTRACT FROM AUTHOR]

Background: Pain and anxiety management in patients undergoing medical and surgical procedures is an important competence area for nurses. Aim: This study aimed to determine and compare the effects of virtual reality and acupressure interventions on pain, anxiety, vital signs and comfort levels in the process of femoral catheter extraction for patients undergoing coronary angiography. Methods: The study was a single‐blind, three‐group, randomized controlled trial conducted in the cardiology clinics of a university hospital in 2021. A total of 153 patients (51 virtual reality, 51 acupressure, 51 control) participated in the study. Data were collected using a Visual Analogue Scale, the State–Trait Anxiety Inventory, a vital signs follow‐up form and the Perianesthesia Comfort Scale. Results: Both intervention groups had significantly lower pain and anxiety scores, as well as higher comfort scores, compared to the control group (p < 0.001). The virtual reality group had lower systolic blood pressure, respiratory rate and pulse rate than the control group (p < 0.05). The acupressure group had lower systolic and diastolic blood pressure and respiratory rate than the control group (p < 0.05). Conclusions: While neither intervention group was found to be superior to the other, both interventions improved vital signs and comfort levels by reducing pain and anxiety. Summary statement: What is already known about this topic? Uncontrolled pain and anxiety during medical and surgical procedures may increase the risk of complications and have negative effects on the pulmonary and cardiovascular systems, leading to changes in vital signs and compromising patients' hemodynamics.Virtual reality has demonstrated its potential to restore cognitive attention capacities, enabling patients to remain engaged and mentally focused during procedures, and thus reducing pain and anxiety.Acupressure, as a non‐pharmacological intervention, involves applying pressure to specific points on the body to alleviate pain and anxiety. It constitutes a safe, side‐effect‐free and cost‐effective option for improving patient outcomes.What this paper adds? This paper contributes to the knowledge of virtual reality and acupressure interventions as non‐pharmacological approaches that nurses can safely incorporate within their independent professional roles.The study evaluates the effects of traditional acupressure and technological virtual reality interventions on patients, comparing the two interventions for the first time to the best of our knowledge. Furthermore, to the best of our knowledge, these procedures were applied for the first time in femoral catheter extraction after coronary angiography.The implications of this paper: This study emphasizes the positive impacts of virtual reality and acupressure interventions administered by nurses for patients undergoing medical procedures.Overall, the findings suggest that non‐pharmacological techniques such as virtual reality and acupressure can contribute to a similar degree in improving patient outcomes during medical procedures. [ABSTRACT FROM AUTHOR]

Current advances in technology have enabled the development of a computer-based questionnaire that provides advantages over the paper-based mode of administration, such as automatic data entry, storage and calculations. However, before implementing a computer-based questionnaire, its equivalence with the original paper-based questionnaire must first be demonstrated. The purpose of this study was to evaluate the measurement equivalence of the computerized Diabetes- Specific Quality-of- Life questionnaire ( cD- QOL) with its original paper-based counterpart. A two-period crossover design was used in this study. The measurement equivalence was evaluated using quadratic weighted kappa coefficients, intraclass correlations and Cronbach's alpha comparisons. The cD- QOL was equivalent to its original paper-based counterpart. Participants preferred the cD- QOL over the paper-based questionnaire and reported that it was easy to use. [ABSTRACT FROM AUTHOR]

Abstract: There is little doubt surrounding the benefits of the Nutrition Care Process and International Dietetics and Nutrition Terminology (IDNT) to dietetics practice; however, evidence to support the most efficient method of incorporating these into practice is lacking. The main objective of our study was to compare the efficiency and effectiveness of an electronic and a manual paper-based system for capturing the Nutrition Care Process and IDNT in a single in-center hemodialysis unit. A cohort of 56 adult patients receiving maintenance hemodialysis were followed for 12 months. During the first 6 months, patients received the usual standard care, with documentation via a manual paper-based system. During the following 6-month period (Months 7 to 12), nutrition care was documented by an electronic system. Workload efficiency, number of IDNT codes used related to nutrition-related diagnoses, interventions, monitoring and evaluation using IDNT, nutritional status using the scored Patient-Generated Subjective Global Assessment Tool of Quality of Life were the main outcome measures. Compared with paper-based documentation of nutrition care, our study demonstrated that an electronic system improved the efficiency of total time spent by the dietitian by 13 minutes per consultation. There were also a greater number of nutrition-related diagnoses resolved using the electronic system compared with the paper-based documentation (P<0.001). In conclusion, the implementation of an electronic system compared with a paper-based system in a population receiving hemodialysis resulted in significant improvements in the efficiency of nutrition care and effectiveness related to patient outcomes. [Copyright &y& Elsevier]

Background Tobacco and non-tobacco-based waterpipe smoking has increased exponentially in many countries in recent decades, particularly among youth and young adults. Although tobacco smoking is banned in many indoor public places, waterpipe smoking, ostensibly non-tobacco, continues in Ontario and other jurisdictions where only tobacco smoking is prohibited. This study assessed air quality and exposure in waterpipe cafes using multiple methods and markers. Methods Indoor (n=12) and outdoor (n=5) air quality was assessed in Toronto, Canada waterpipe cafes from 30 August to 11 October 2012. Real-time measurements of air nicotine, fine particulate matter less than 2.5 microns in diameter (PM2.5) and ambient carbon monoxide (CO) were collected in 2 h sessions. Levels of CO in breath were collected in non-smoking field staff before entering and upon leaving venues. Observations of occupant behaviour, environmental changes and venue characteristics were also recorded. Results In indoor venues, mean values were 1419 mg/m3 for PM2.5, 17.7 ppm for ambient CO, and 3.3 mg/m3 for air nicotine. Levels increased with increasing number of active waterpipes. On outdoor patios, mean values were 80.5 mg/m3 for PM2.5, 0.5 ppm for ambient CO, and 0.6 mg/m3 for air nicotine. Air quality levels in indoor waterpipe cafes are hazardous for human health. Outdoor waterpipe cafes showed less harmful particulate levels than indoors, but mean PM2.5 levels (80.5 mg/m3) were still ‘poor'. Conclusions Staff and patrons of waterpipe cafes are exposed to air quality levels considered hazardous to human health. Results support eliminating waterpipe smoking in hospitality venues indoors and out. [ABSTRACT FROM AUTHOR]

Background: Preoperative education can improve postoperative quality of life in patients undergoing stoma surgery. However, the prevalence and when, where, and how preoperative education is implemented are unclear. Therefore, this study aimed to assess the current status of outpatient preoperative education for patients undergoing stoma surgery for rectal cancer as perceived by nurses. Additionally, it sought to identify the information provided by Japanese healthcare providers as a part of preoperative education. Methods: This cross-sectional study included 1,716 wound, ostomy, and continence nurses (WOCNs) in charge of stoma clinics at Japanese hospitals. Unsigned self-administered survey forms were mailed to the participants, and paper- or web-based responses were obtained. The main questions included: overview of the participants and their facilities, provision of outpatient preoperative education, status of implementation, and preoperative education components. To examine the factors associated with preoperative education, the independent variable was the presence or absence of preoperative education in the clinic, and the explanatory variables were the years of experience as a nurse, years of experience as a WOCN, type of hospital, number of beds, and number of intestinal stoma surgeries per year. Regression analysis was performed. Results: We received 773 valid responses (valid response rate: 45%). Duration of experience as a nurse and as a WOCN were 24.6 and 10.9 years, respectively. Outpatient preoperative education was provided by 24% of the participants. Most preoperative education sessions were conducted for patients or caregivers. Preoperative education took 31–60 min per patient, and one to five patients received preoperative education each month. Booklets, ostomy appliances, and stoma models/dolls were used as supplementary materials for preoperative education. The most frequently mentioned components of preoperative education were stoma care, daily life, social security, stoma clinic, traveling and going out, quality of life after stoma surgery, and precautions for medical treatment. In addition, education on the use of restrooms on the go, disaster preparedness, defecation disorders after restorative proctectomy, and complications after stoma closure were considered necessary. Conclusions: The implementation rate of outpatient preoperative education was low (24%). Future challenges include the development of specific educational content and procedures suitable for the Japanese medical environment and the establishment of preoperative medical care teams for stoma surgery to promote the provision of outpatient preoperative education. [ABSTRACT FROM AUTHOR]

This systematic review investigates the bidirectional relationship between alcohol consumption and disrupted circadian rhythms. The goal of this study was to identify (i) the types of circadian rhythm disruptors (i.e. social jet lag, extreme chronotypes, and night shift work) associated with altered alcohol use and (ii) whether sex differences in the consequences of circadian disruption exist. We conducted a search of PubMed, Embase, and PsycINFO exclusively on human research. We identified 177 articles that met the inclusion criteria. Our analyses revealed that social jet lag and the extreme chronotype referred to as eveningness were consistently associated with increased alcohol consumption. Relationships between night shift work and alcohol consumption were variable; half of articles reported no effect of night shift work on alcohol consumption. Both sexes were included as participants in the majority of the chronotype and social jet lag papers, with no sex difference apparent in alcohol consumption. The night shift research, however, contained fewer studies that included both sexes. Not all forms of circadian disruption are associated with comparable patterns of alcohol use. The most at-risk individuals for increased alcohol consumption are those with social jet lag or those of an eveningness chronotype. Direct testing of the associations in this review should be conducted to evaluate the relationships among circadian disruption, alcohol intake, and sex differences to provide insight into temporal risk factors associated with development of alcohol use disorder. [ABSTRACT FROM AUTHOR]

Background: Barriers exist for the provision of surgery for permanent contraception in the postpartum period. Prenatal counseling has been associated with increased rates of fulfillment of desired postpartum contraception in general, although it is unclear if there is impact on permanent contraception specifically. Thus, we aimed to investigate the association between initial timing for prenatal documentation of a contraceptive plan for permanent contraception and fulfillment of postpartum contraception for those receiving counseling. Methods: This is a planned secondary analysis of a multi-site cohort study of patients with documented desire for permanent contraception at the time of delivery at four hospitals located in Alabama, California, Illinois, and Ohio over a two-year study period. Our primary exposure was initial timing of documented plan for contraception (first, second, or third trimester, or during delivery hospitalization). We used univariate and multivariable logistic regression to analyze fulfillment of permanent contraception before hospital discharge, within 42 days of delivery, and within 365 days of delivery between patients with a documented plan for permanent contraception in the first or second trimester compared to the third trimester. Covariates included insurance status, age, parity, gestational age, mode of delivery, adequacy of prenatal care, race, ethnicity, marital status, and body mass index. Results: Of the 3103 patients with a documented expressed desire for permanent contraception at the time of delivery, 2083 (69.1%) had a documented plan for postpartum permanent contraception prenatally. After adjusting for covariates, patients with initial documented plan for permanent contraception in the first or second trimester had a higher odds of fulfillment by discharge (aOR 1.57, 95% C.I 1.24–2.00), 42 days (aOR 1.51, 95% C.I 1.20–1.91), and 365 days (aOR 1.40, 95% C.I 1.11–1.75), compared to patients who had their first documented plan in the third trimester. Conclusions: Patients who had a documented prenatal plan for permanent contraception in trimester one and two experienced higher likelihood of permanent contraception fulfillment compared to those with documentation in trimester three. Given the barriers to accessing permanent contraception, it is imperative that comprehensive, patient-centered counseling and documentation regarding future reproductive goals begin early prenatally. Plain language summary: Permanent contraception is a highly desired form of postpartum contraception in the United States, however there are several barriers to accessing it. In this paper, we investigate whether the timing of when a patient has a documented plan for postpartum contraception has an impact on if they achieve postpartum contraception. This is a cohort study from four hospitals in Illinois, Ohio, California, and Alabama for patients with a desire for postpartum permanent contraception documented in their medical record. We specifically investigated the trimester (first, second, or third) where a patient had a plan for permanent contraception first documented. We then used univariate and multivariate models to determine the relationship between the timing of a plan for permanent contraception and if a patient achieved the procedure at three time-points: hospital discharge, 42-days, and 365-days. Our findings showed that of the 3103 patients in our cohort, only 69.1% of them had a documented plan for postpartum contraception at any point before going to the hospital for their delivery admission. We additionally found that patients who had a documented plan for permanent contraception in the first or second trimester had a higher odds of receiving their postpartum contraception procedure compared to people who had their first documented plan in the third trimester. This showed us the importance of earlier counseling regarding contraception for pregnant patients. There are many barriers to accessing postpartum contraception, so having patient focused counseling about future goals around reproductive health early on in pregnancy is critical. [ABSTRACT FROM AUTHOR]

Introduction: Maternal glycemia is associated with pregnancy outcomes. Thus, supporting the self-management experiences and preferences of pregnant women with type 1 and type 2 diabetes is crucial to optimize glucose control and perinatal outcomes. Research design and methods: This paper describes the mixed methods integration of a sequential comparative case study. The objectives are threefold, as we integrated the quantitative and qualitative data within the overall mixed methods design: (1) to determine the predictors of glycemic control during pregnancy; (2) to understand the experience and diabetes self-management support needs during pregnancy among women with pre-existing diabetes; (3) to assess how self-management and support experiences helpe to explain glycemic control among women with pre-existing diabetes in pregnancy. The purpose of the mixing was to integrate the quantitative and qualitative data to develop rich descriptive cases of how diabetes self-management and support experiences and preferences in women with type 1 and type 2 diabetes during pregnancy help explain glucose control. A narrative approach was used to weave together the statistics and themes and the quantitative results were integrated visually alongside the qualitative themes to display the data integration. Results: The quantitative results found that women achieved "at target" glucose control (mean A1C of the cohort by the third visit: 6.36% [95% Confidence Interval 6.11%, 6.60%]). The qualitative findings revealed that feelings of fear resulted in an isolating and mentally exhausting pregnancy. The quantitative data also indicated that women reported high levels of self-efficacy that increased throughout pregnancy. Qualitative data revealed that women who had worked hard to optimize glycemia during pregnancy were confident in their self-management. However, they lacked support from their healthcare team, particularly around self-management of diabetes during labour and delivery. Conclusions: The achievement of optimal glycemia during pregnancy was motivated by fear of pregnancy complications and came at a cost to women's mental health. Mental health support, allowing women autonomy, and the provision of peer support may improve the experience of diabetes self-management during pregnancy. Future work should focus on developing, evaluating and implementing interventions that support these preferences. [ABSTRACT FROM AUTHOR]

The vulnerable children refer to the special group of children with deviation in the process of children's psychological development and personality formation due to growth dilemmas. This may incur a series of serious social and family problems. The vulnerable children mainly cover the children suffering from children's psychological problems, such as childhood autism, autism, social anxiety and hypersensitivity, fear, depression, and PTSD arising from other factors. At present, the research results at home and abroad mainly focus on the psychological dynamic correlation investigation and solution discussion of a certain kind of difficult factor in the children's psychological development based on statistical data by the experimental methods, such as scale and model, and there is a blind spot in the humanistic orientation theory construction of psychological treatment for vulnerable children, causing the social reflection on children's psychological predicament from the humanistic perspective cannot be performed in related researches and going against searching for universal and integral theoretical paradigm for solving related problems. Sophisticated technologies for the observations have emerged increasingly for enabling the psychological features of vulnerable children through developmental cognitive neuroscience experiments. This paper introduces humanistic art therapy theory, focuses on the construction of a theoretical paradigm, and verifies its effectiveness based on the experimental results on the psychological development of vulnerable children, with an efficient performance. This study mainly refers to children with difficulty in social inclusion and psychological development. The results showed that two kinds of art therapy can obviously improve the psychological disorders of vulnerable children. The goal was to enhance self-cognition, strengthen emotional interaction, and implement positive motivation. [ABSTRACT FROM AUTHOR]

Background: Prelinguistic communication complexity refers to the use of different communication forms such as eye gaze, gestures and vocalisations and the degree to which these forms are coordinated and how directed to a communication partner. To date, little is known about the relationship between prelinguistic communication complexity and expressive language in minimally verbal autistic children. Aims: To test the hypothesis that prelinguistic communication complexity predicts expressive language 12 months later in autistic children and explore whether there are any differences in specific prelinguistic intentional communicative behaviours that are related to later expressive language levels. Methods & Procedures: This longitudinal study examined 37 minimally verbal autistic children (29–71 months old). The Communication Complexity Scale (CCS) was used to measure participants' prelinguistic communication behaviours, which were extracted from a semi‐structured play interaction at Time 1. The Chinese Communicative Development Inventory (CCDI) was used to examine participants' expressive language at Time 1 and Time 2 (12 months later). According to Time 2 vocabulary size, participants were divided into two groups: Low CCDI, between 0 and 62 words, and High CCDI, more than 100 words. Linear regression was used to examine the relationship between early prelinguistic communication complexity and later expressive language. Binary logistic regression was used to determine which of the early communication behaviours were uniquely significantly related to later expressive language levels. Outcomes & Results: There was a significant positive relationship between prelinguistic communication complexity and expressive language 12 months later, even after controlling for age and concurrent language. Findings revealed a group difference in the frequency of gesture and vocalisation combinations between the Low and High CCDI groups at Time 1. Gesture‐vocalisation combinations also predicted better expressive language levels at Time 2. Conclusions & Implications: Our findings suggest that it may be beneficial to incorporate different complex communication behaviours into prelinguistic intervention targets for minimally verbal autistic children. The CCS hierarchies can be used as a reference for the intervention goals of minimally verbal autistic children. These findings highlight the importance of targeting gesture and vocalisation combinations when autistic children transition from single prelinguistic communication behaviours to multimodal behaviours. What this paper adds: What is already known on this subject: Children use eye gaze, gestures and vocalisations to communicate with others before they learn spoken language. There is strong evidence suggest that the frequency of prelinguistic communication predicts later linguistic achievements in autistic children. However, less is known about whether prelinguistic communication complexity also predicts later language and which specific behaviours are most predictive of language outcomes. What this study adds: Minimally verbal autistic children who exhibit more complex prelinguistic communication behaviours have better expressive language 12 months later. Gestures combined with vocalisations predict better expressive language in minimally verbal autistic children. What are the clinical implications of this work?: When identifying intervention targets for minimally verbal autistic children, the clinicians may reference the prelinguistic communication behaviours from the CCS. The gesture and vocalisation combinations are the key behaviours when targets transit from single form to two‐form behaviours. [ABSTRACT FROM AUTHOR]

Purpose: Prader-Willi syndrome (PWS) suffers from brain functional reorganization and developmental delays during childhood, but the underlying neurodevelopmental mechanism is unclear. This paper aims to investigate the intra- and internetwork functional connectivity (FC) changes, and their relationships with developmental delays in PWS children. Methods: Resting-state functional magnetic resonance imaging datasets of PWS children and healthy controls (HCs) were acquired. Independent component analysis was used to acquire core resting-state networks (RSNs). The intra- and internetwork FC patterns were then investigated. Results: In terms of intranetwork FC, children with PWS had lower FC in the dorsal attention network, the auditory network, the medial visual network (VN) and the sensorimotor network (SMN) than HCs (FWE-corrected, p < 0.05). In terms of internetwork FC, PWS children had decreased FC between the following pairs of regions: posterior default mode network (DMN) and anterior DMN; posterior DMN and SMN; SMN and posterior VN and salience network and medial VN (FDR-corrected, p < 0.05). Partial correlation analyses revealed that the intranetwork FC patterns were positively correlated with developmental quotients in PWS children, while the internetwork FC patterns were completely opposite (p < 0.05). Intranetwork FC patterns showed an area under the receiver operating characteristic curve of 0.947, with a sensitivity of 96.15% and a specificity of 81.25% for differentiating between PWS and HCs. Conclusion: Impaired intra- and internetwork FC patterns in PWS children are associated with developmental delays, which may result from neural pathway dysfunctions. Intranetwork FC reorganization patterns can discriminate PWS children from HCs. Registration number on the Chinese Clinical Trail Registry: ChiCTR2100046551. [ABSTRACT FROM AUTHOR]

Aims: This paper aims to assess kinematic parameters related to functional capacity, fatigue, and breathlessness during the 6-min walk test (6MWT) in patients with heart failure with preserved ejection fraction (HFpEF). Methods and results: A cross-sectional study was conducted in which adults 70 years or older with HFpEF were voluntarily recruited between April 2019 and March 2020. An inertial sensor was placed at the L3–L4 level and another on the sternum to assess kinematic parameters. The 6MWT was divided into two 3-min phases. Leg fatigue and breathlessness, assessed by the Borg scale, the heart rate (HR), and the oxygen saturation (SpO2), were measured at the beginning and the end of the 6MWT. The difference in kinematic parameters between the 6MWT two 3-min phases was also calculated. Bivariate Pearson correlations and subsequent multivariate linear regression analysis were performed. Seventy older adults with HFpEF (mean = 80.74 years old) were included. Kinematic parameters explained 81.00% of the functional capacity, 45.50% of the leg fatigue and 66.10% of the breathlessness variance. Moreover, kinematic parameters could explain 30.90% of the SpO2 variance at the end of the 6MWT. Kinematic parameters also explained 33.10% of the SpO2 difference between the beginning and end of 6MWT. Kinematic parameters explained neither the HR variance at the end of 6MWT nor the HR difference between the beginning and end. Conclusion: Gait kinematics from L3-L4 and sternum explain a part of the variance in subjective outcomes, assessed by the Borg scale, and objective outcomes such as functional capacity and SpO2. The kinematic assessment allows clinicians to quantify fatigue and breathlessness through objective parameters related to the patient's functional capacity. Registration: ClinicalTrials.gov NCT03909919. Graphical Abstract [ABSTRACT FROM AUTHOR]

Background Decisions about which antismoking advertisements should be aired are often guided by audience ratings of perceived effectiveness (PE). Given that the usefulness of PE measures depends on their ability to predict the likelihood that a message will have a positive impact on outcomes such as behaviour change, in the current study we used pre-exposure, postexposure and follow-up measures to test the association between PE and subsequent changes in quitting intentions and smoking behaviours. Methods Daily smokers (N=231; 18 years and older) completed baseline measures of quitting intentions before watching an antismoking advertisement. Immediately following exposure, intentions were measured again and PE was measured using six items that factored into two scales: ad-directed PE (ADPE) and personalised PE (PPE). A follow-up telephone survey conducted within 3 weeks of exposure measured behaviour change (reduced cigarette consumption or quit attempts). Results From pre-exposure to postexposure, 18% of smokers showed a positive change in their intentions. Controlling for baseline intentions, PPE independently predicted intention change (OR=2.57, p=0.004). At follow-up, 26% of smokers reported that they had changed their behaviour. PPE scores also predicted the likelihood of behaviour change (OR=1.93, p=0.009). Conclusions Audience ratings of PPE, but not ADPE, were found to predict subsequent intention and behaviour change. These findings increase confidence in the use of PE measures to pretest and evaluate antismoking television advertisements, particularly when these measures tap the extent to which a smoker has been personally affected by the message. [ABSTRACT FROM AUTHOR]

BACKGROUND: Obsessive-compulsive disorder (OCD) is a common, heritable neuropsychiatric disorder, hypothetically underpinned by dysfunction of brain cortical-striatal-thalamic-cortical (CSTC) circuits; however, the extent of brain functional abnormalities in individuals with OCD is unclear, and the genetic basis of this disorder is poorly understood. We determined the whole brain functional connectivity patterns in patients with OCD and their healthy first-degree relatives. METHODS: We used resting-state fMRI to measure functional connectivity strength in patients with OCD, their healthy first-degree relatives and healthy controls. Whole brain functional networks were constructed by measuring the temporal correlations of all brain voxel pairs and further analyzed using a graph theory approach. RESULTS: We enrolled 39 patients with OCD, 20 healthy first-degree relatives and 39 healthy controls in our study. Compared with healthy controls, patients with OCD showed increased functional connectivity primarily within the CSTC circuits and decreased functional connectivity in the occipital cortex, temporal cortex and cerebellum. Moreover, patients with OCD and their first-degree relatives exhibited overlapping increased functional connectivity strength in the bilateral caudate nucleus, left orbitofrontal cortex (OFC) and left middle temporal gyrus. LIMITATIONS: Potential confounding factors, such as medication use, heterogeneity in symptom clusters and comorbid disorders, may have impacted our findings. CONCLUSION: Our preliminary results suggest that patients with OCD have abnormal resting-state functional connectivity that is not limited to CSTC circuits and involves abnormalities in additional large-scale brain systems, especially the limbic system. Moreover, resting-state functional connectivity strength abnormalities in the left OFC, bilateral caudate nucleus and left middle temporal gyrus may be neuroimaging endophenotypes for OCD. [ABSTRACT FROM AUTHOR]

BACKGROUND: In a genome-wide association study of autism, zinc finger protein 804A (ZNF804A) single nucleotide polymorphisms (SNPs) were found to be nominally associated in verbally deficient individuals with autism. Zinc finger protein 804A copy number variations (CNVs) have also been observed in individuals with autism. In addition, ZNF804A is known to be involved in theory of mind (ToM) tasks, and ToM deficits are deemed responsible for the communication and social challenges faced by individuals with autism. We hypothesized that ZNF804A could be a risk gene for autism. METHODS: We examined the genetic association and CNVs of ZNF804A in 841 families in which 1 or more members had autism. We compared the expression of ZNF804A in the postmortem brains of individuals with autism (n = 8) and controls (n = 13). We also assessed in vitro the effect of ZNF804A silencing on the expression of several genes known to be involved in verbal efficiency and social cognition. RESULTS: We found that rs7603001 was nominally associated with autism (p = 0.018). The association was stronger (p = 0.008) in the families of individuals with autism who were verbally deficient (n = 761 families). We observed ZNF804A CNVs in 7 verbally deficient boys with autism. In ZNF804A knockdown cells, the expression of synaptosomal-associated protein, 25kDa (SNAP25) was reduced compared with controls (p = 0.009). The expression of ZNF804A (p = 0.009) and SNAP25 (p = 0.009) were reduced in the anterior cingulate gyrus (ACG) of individuals with autism. There was a strong positive correlation between the expression of ZNF804A and SNAP25 in the ACG (p < 0.001). LIMITATIONS: Study limitations include our small sample size of postmortem brains. CONCLUSION: Our results suggest that ZNF804A could be a potential candidate gene mediating the intermediate phenotypes associated with verbal traits in individuals with autism. [ABSTRACT FROM AUTHOR]

This paper aims to determine the role cognitive control awareness plays in university students through their scientific writing. Results show that through an assessment-centred instruction approach embedded in reflective learning, tertiary students at a faculty of sciences can achieve greater metacognitive awareness of their learning. Fourth-year students in a physical oceanography class displayed cognitive control over established activities designed to develop their discursive writing skills (writing components included objectives, subject content, methodologies, contextualization and environmental implications on local and global scales). Scientific writing was promoted through students managing their own learning processes and cognitive control through metacognitive awareness, i.e. through a constructivist scheme embedded in formative learning. In the POST test, students scored higher primarily in the categories of writing methodologies, and bibliographies. Teacher expertise, which was mainly provided through feedback and scaffolding for student autonomy was highly valued by the students, and included considering the effects of a teacher assessing their writing and providing strategies to write a better scientific paper [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study was to identify risk factors for cognitive impairment in advanced cancer patients and to develop predictive models based on these risk factors. Background: Cancer‐related cognitive impairment seriously affects the quality of life of advanced cancer patients. However, neural network models of cognitive impairment in patients with advanced cancer have not yet been identified. Design: A cross‐sectional design was used. Methods: This study collected 494 questionnaires between January and June 2022. Statistically significant clinical indicators were selected by univariate analysis, and the artificial neural network model and logistic regression model were used for multivariate analysis. The predicted value of the model was estimated using the area under the subject's working characteristic curve. Result: The artificial neural network and the logistic regression models suggested that cancer course, anxiety and age were the major risk factors for cognitive impairment in advanced cancer patients. All the indexes of artificial neural network model constructed in this study are better than those of the logistic model. Conclusion: The artificial neural network model can better predict the risk factors of cognitive impairment in patients with advanced cancer. Better prediction will enable nurses and other healthcare professionals to provide better targeted and timely support. Summary statement: What is already known about this topic?: Cancer‐related cognitive impairment has significantly affected the quality of life of patients with advanced cancer.Risk factors associated with cognitive impairment in patients with advanced cancer have not been adequately documented, and neural network models have not been identified. What this paper adds?: This study found that long a cancer course, anxiety and ageing were the most important risk factors for cognitive impairment in patients with advanced cancer.The artificial neural network showed good predictive indicators, indicating that it can be used to predict cognitive impairment in patients with advanced cancer. The implications of this paper: Neural network models can help nurses and other clinicians predict cognitive impairment in advanced cancer patients early which will allow provision of timely intervention. [ABSTRACT FROM AUTHOR]

Background: This research is inspired by the challenges encountered in interpreter training, changes in learning needs in the technological era, the educational paradigm shift caused by the COVID‐19 pandemic, the lack of studies on combining virtual reality (VR)_and mobile technologies, and literature gaps in the field of the incorporation of technology in interpreter education. Objectives: This research aims to develop a mobile‐based VR application for bi‐directional English‐Chinese and Chinese‐English interpreting learning named 'Virtual Interpreting Practice' (VIP) based on an interpreting competence model and to investigate its impact on students' self‐rated language and interpreting proficiency levels as well as their declarative knowledge and operative skills as reflected in different interpreting modes (sight and consecutive) and language directions (English‐Chinese and Chinese‐English). The VIP app contains learning resources, including 13 learning modules covering both interpreting modes, practical topics and contexts, video lectures and demonstrations, fully immersive VR and non‐VR practice, glossary lists, source texts, translated texts and an online feedback platform. Methods: Thirty‐one native Chinese‐speaking English as a second/foreign (ESL/EFL) undergraduate students used the app for self‐directed learning. The data were collected by the pre‐study and post‐study questionnaires as well as the pre‐test and post‐test. Results and Conclusions: The results indicate that the use of VIP significantly raised the students' self‐rated language and interpreting proficiency levels as well as their interpreting performance in both modes and language directions. While the students performed better in sight interpreting and Chinese‐English interpreting, they achieved a significantly higher improvement rate in consecutive interpreting and English‐Chinese interpreting. Lay Description: What is already known about this topic: A number of studies have demonstrated the use of virtual reality (VR) provides users with senses of multiple presence, enhances learner engagement and motivation, and facilitates collaborative, situated, immersive and experiential learning that is not often available in traditional learning environments.The increasing availability of VR has created new opportunities in the area of mobile‐assisted language learning (MALL), paving the way for a new research area called VR‐assisted language learning (VRALL).Using VRALL, numerous benefits in various language skills have been identified, such as listening, speaking, writing and vocabulary acquisition. What this paper adds: While blending VR and mobile technologies may play a more significant role in education settings and create more advantages, the impact of this combination for interpreting learning has remained an unexplored area in higher education. This paper has addressed the research gaps in which there is a lack of VR language learning apps that are bilingual, mobile‐based and specifically designed for interpreting practice in highly immersive learning environments.The results indicate that the use of VIP significantly raised the students' self‐rated language and interpreting proficiency levels as well as their interpreting performance in both sight and consecutive interpreting and language directions (English‐Chinese and Chinese‐English).While the students performed better in sight interpreting and Chinese‐English interpreting, they achieved a significantly higher improvement rate in consecutive interpreting and English‐Chinese interpreting. Implications for practice and/or policy: The results have implications for the roles of students and teachers. The app developed in this study shifts the teacher‐led approach to student‐centred learning. While it allows more learning autonomy, its effectiveness may largely depend on students' ability to self‐regulate and engage.It appears that the effectiveness of VRALL depends on a number of individual and contextual factors, e.g. the design and functionality of the apps, availability of the internet connection and smartphones as well as learning needs and motivation. [ABSTRACT FROM AUTHOR]

Background: The internet can provide evidence-based patient education to overcome time constraints of busy ambulatory practices. Health informationprescriptions (HIPs) can be effectivelyintegrated into clinic workflow, but compliance to visit health information sites such as Medline Plus is limited.Objective: Compare the efficacy of paper (pHIP)and email (eHIP) links to deliver HIPs; evaluate patient satisfaction with the HIP process and MedlinePlus information; assess reasons for noncompliance to HIPs.Method: Of 948 patients approached at two internal medicine clinics affiliated with an academic medical centre, 592 gave informed consent after meeting the inclusion criteria. In this randomised controlled trial, subjects were randomised to receive pHIP or eHIP for accessing an intermediate website that provided up to five MedlinePlus links for physician-selected HIP conditions. Patients accessing the intermediate website were surveyed by email to assess satisfaction with the health information.Survey non-responders were contacted by telephone to determine the reasons for no response.Results: One hundred and eighty-one patients accessed the website, with significantly more 'filling' eHIP than pHIP (38% vs 23%; P < 0.001). Most(82%) survey respondents found the website information useful, with 77% favouring email for future HIPs delivery. Lack of time, forgot, lost instructions or changed mind were reasons given for not accessing the websites.Conclusions: Delivery of MedlinePlus-based HIPs in clinic is more effective using email prescriptions than paper. Satisfaction with the HIP information was high, but overall response was low and deserves further investigation to improve compliance and related outcomes. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined the development of the paper-based Hajji Health Record (PHHR) instrument. Topics covered include the conduct of a survey among physicians in Alnoor Specialist Hospital in Saudi Arabia, the supportive effects of electronic health record system on health care and the need for standard-based health information technology to get quality of care.

In the present school-based study, a convenience sample of 477 students in grades 6-9 and second year in high school from a city and a smaller town recorded daily occurrence and intensity of headaches in a standard paper diary during a 3-week period. Total headache activity (headache sum), number of headache days, intensity level and duration for weekly headaches were estimated. Approximately 85% of the adolescents had experienced headache of any intensity level during the 3-week recording period. On the average, they reported 2.5 headache days per week and a mean intensity level for headache episodes of 1.7. Our estimates for headache of any intensity level (1-5) occurring at least once a week was surprisingly high (73.8%). For the highest intensity level across the whole 3-week period, almost identical proportions of mild and moderate headaches were reported by students (22.3-22.5%), while about twice as many (40.7%) had experienced severe headaches. Girls consistently reported more headaches than boys, in particular of the moderate and severe intensity types. Students in the city also reported more frequent and intense headaches than those in the town. Peak headache activity was observed at noon and in the afternoon and in the days from the middle of the week until weekend. The use of prospective recordings in diaries will further advance our knowledge on the prevalence and characteristics of recurrent headaches among children and adolescents in community samples. [ABSTRACT FROM AUTHOR]

Aim: Cognitive concerns are one of the most frequently reported symptoms by breast cancer survivors. This study aimed to evaluate perceived cognitive functioning in Portuguese women with breast cancer treated with chemotherapy. Methods: A cross‐sectional study enrolling 146 women (73 with breast cancer and 73 healthy) was conducted from August to October 2017, invited to participate through online dissemination. Participants completed self‐reported questionnaires to collect sociodemographic and clinical data and assess perceived cognitive functioning and psychological adjustment variables (anxiety and depression). Results: Compared to healthy women, women with breast cancer showed significantly lower scores on the Functional Assessment of Cancer Therapy‐Cognitive Function (FACT‐Cog) subscales and higher levels of depression. Both groups showed significant negative correlations between perceived cognitive functioning and anxiety and depression. Health status and depression seem to better explain perceived cognitive functioning, with health status adding significantly more explained variance beyond sociodemographic and psychological adjustment variables. Conclusion: The current findings provide evidence for the existence of more cognitive complaints among Portuguese women with breast cancer, compared to healthy individuals. Anxiety, depression, age and education also explain perceived cognitive functioning. Considering that health status and psychological adjustment seem to significantly explain perceived cognitive functioning, special attention should be given by health‐care professionals, including nurses, to designing clinical interventions for breast cancer patients to help manage cognitive impairment. Summary statement: What is already known about this topic? Cancer and associated treatments have diverse short‐ and long‐term side effects. Deficits in cognitive functions are one of the most frequently reported for breast cancer specifically due to chemotherapy.Subjective assessment of cognitive function is often neglected, although it might be clinically very useful and an important indicator of the impact of cognitive impairment on daily functioning.There is currently no Portuguese data on perceived cognitive impairment in cancer. What this paper adds? This Portuguese study shows that, compared to a matched healthy sample, breast cancer patients have significantly more cognitive complaints, as assessed by the FACT‐Cog scale.Furthermore, our findings showed that higher levels of anxiety and depression are associated with worse perceived cognitive functioning.Cognitive complaints in breast cancer patients are predicted by a complexity of factors, such as psychological adjustment, age, and education. The implications of this paper: Health‐care professionals, including nurses, should recognize cognitive complaints as legitimate in breast cancer patients.Findings may deepen nurses' knowledge about cognitive concerns in breast cancer patients, in order to improve the quality of care provided to this population.The results of the study highlight the importance of tackling this problem with specifically designed clinical interventions that target both the cognitive deficits and the psychological adjustment of patients, especially depressive symptomatology. [ABSTRACT FROM AUTHOR]

Background: Early and effective treatment for children with developmental language disorder (DLD) is important. Although a growing body of research shows the effects of interventions at the group level, clinicians observe large individual differences in language growth, and differences in outcomes across language domains. A systematic understanding of how child characteristics contribute to changes in language skills is still lacking. Aims: To assess changes in the language domains: expressive morphosyntax; receptive and expressive vocabulary; and comprehension, in children in special needs education for DLD. To explore if differences in language gains between children are related to child characteristics: language profile; severity of the disorder; being raised mono‐ or multilingually; and cognitive ability. Methods & Procedures: We extracted data from school records of 154 children (4–6 years old) in special needs education offering a language and communication‐stimulating educational environment, including speech and language therapy. Changes in language were measured by comparing the scores on standardized language tests at the beginning and the end of a school year. Next, we related language change to language profile (receptive–expressive versus expressive‐only disorders), severity (initial scores), growing up mono‐ and multilingually, and children's reported non‐verbal IQ scores. Outcomes & Results: Overall, the children showed significant improvements in expressive morphosyntax, expressive vocabulary and language comprehension. Baseline scores and gains were lowest for expressive morphosyntax. Differences in language gains between children with receptive–expressive disorders and expressive‐only disorders were not significant. There was more improvement in children with lower initial scores. There were no differences between mono‐ and multilingual children, except for expressive vocabulary. There was no evidence of a relation between non‐verbal IQ scores and language growth. Conclusions & Implications: Children with DLD in special needs education showed gains in language performance during one school year. There was, however, little change in morphosyntactic scores, which supports previous studies concluding that poor morphosyntax is a persistent characteristic of DLD. Our results indicate that it is important to include all children with DLD in intervention: children with receptive–expressive and expressive disorders; mono‐ and multilingual children, and children with high, average and low non‐verbal IQ scores. We did not find negative relations between these child factors and changes in language skills. WHAT THIS PAPER ADDS: What is already known on the subject: Intervention studies indicate that intervention can be effective, but not for all children with DLD, and not in all language domains. Longitudinal studies on language development show stable growth patterns in children with DLD at the group level. A systematic understanding of how child characteristics contribute to changes in language skills is still lacking. What this paper adds to existing knowledge: In this study, we report on the language gains of a cohort of 154 children with DLD (4–6 years old), in a special education setting for children with language disorders. Our sample includes children with receptive–expressive disorders and expressive‐only disorders, and monolingual as well as multilingual children. Our results show that children's language skills improved. The co‐normed tests we used revealed that the children had much lower growth in morphosyntax than in the other language domains. Language gains between children with receptive–expressive and expressive‐only language disorders did not differ, children with lower initial test scores showed more improvement than children with higher initial scores, multilingual children showed more gains in expressive vocabulary than monolingual children, and there was no effect of non‐verbal IQ on change in language scores. What are the potential or actual clinical implications of this work?: The results suggest that catching up on language is possible for children with DLD. It is important to include all children with DLD in intervention: mono‐ and multilingual children; children with receptive–expressive and expressive disorders; and children with high, average and low non‐verbal IQ scores. We did not find negative relations between these child factors and changes in language skills. The limited growth in morphosyntax compared with other linguistic areas warrants the attention of both practitioners and researchers, with a particular focus on the implementation of research findings in clinical practice. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Self‐management comprises five core skills: "Problem Solving, Decision‐Making, Resource Utilization, Forming a Patient/Healthcare Provider Partnership and Taking Action."Effective self‐management among patients diagnosed with anxiety can reduce the number of relapses and improve treatment outcomes.Knowledge of the impact of the family atmosphere, well‐being and illness symptoms on self‐management in patients diagnosed with anxiety disorders is limited. What does the paper add to the existing knowledge?: This is the first study in China to explore whether family atmosphere and well‐being of patients diagnosed with anxiety disorders affects self‐management.This paper adds to the list of factors influencing self‐management among patients diagnosed with anxiety disorders.SAS scores are a major factor influencing self‐management among patients diagnosed with anxiety disorders.The subjective well‐being of patients diagnosed with anxiety disorders can influence their self‐management behaviour.Patients who experienced family harmony had significantly higher self‐management scores than those who experienced family disharmony. What are the implications for practice?: Nurses should encourage patients diagnosed with anxiety disorders to manage their condition while receiving treatment at home.Nurses should focus on patients diagnosed with anxiety disorders who have significant anxiety symptoms and low well‐being.Nurses should emphasize the importance of the home environment in family self‐management and affirm that a good home environment promotes patient self‐management. Introduction: Better self‐management can improve treatment outcomes and reduce the number of relapses for patients diagnosed with anxiety disorders. However, the impact of well‐being and the home environment on self‐management among patients diagnosed with anxiety disorders is unclear in China. Aim: This study sought to determine the impact of the home environment, well‐being and illness symptoms on self‐management during home treatment for patients diagnosed with anxiety disorders. Method: This cross‐sectional study was conducted with patients diagnosed with anxiety disorders. Data were collected with SAS, Self‐Management Scale for People with Anxiety Disorders and Index of Well‐being. Frequency, percentage, analysis of variance, Kruskal–Wallis and multiple linear regression analyses were used. Results: Home environment (p <.001), self‐perceived quality of life (p =.015), well‐being index (p =.002) and SAS total score (p =.033) had a major impact on self‐management in patients diagnosed with anxiety disorders (n = 245). Discussion: Family disharmony, poor self‐perceived quality of life, high SAS scores and low levels of well‐being were significant influences on self‐management among people diagnosed with anxiety disorders. Implications for Practice: Nurses should focus on the self‐management of patients diagnosed with significant anxiety symptoms and low well‐being and value the importance of the home environment in facilitating self‐management among patients diagnosed with anxiety disorders. [ABSTRACT FROM AUTHOR]

Aims: To perform temporal validation of a risk prediction model for breast cancer‐related lymphoedema in the European population. Design: Temporal validation of a previously developed prediction model using a new retrospective cohort of women who had undergone axillary lymph node dissection between June 2018 and June 2020. Methods: We reviewed clinical records to identify women who did and did not develop lymphoedema within 2 years of surgery and to gather data regarding the variables included in the prediction model. The model was calibrated by calculating Spearman's correlation between observed and expected cases. Its accuracy in discriminating between patients who did versus did not develop lymphoedema was assessed by calculating the area under the receiver operating characteristic curve (AUC). Results: The validation cohort comprised 154 women, 41 of whom developed lymphoedema within 2 years of surgery. The value of Spearman's coefficient indicated a strong correlation between observed and expected cases. Sensitivity of the model was higher than in the derivation cohort, as was the value of the AUC. Conclusion: The model shows a good capacity to discriminate women at risk of lymphoedema and may therefore help in developing improved care pathways for individual patients. Implications for the Profession and/or Patient Care: Identifying risk factors for lymphoedema secondary to breast cancer treatment is vital given its impact on women's physical and emotional well‐being. Impact: What problem did the study address? Risk of BCRL. What were the main findings? The prediction model has a good capacity to discriminate women at risk of lymphoedema. Where and on whom will the research have an impact? In clinical practice with women at risk of BCRL. Reporting Method: STROBE checklist. What Does this Paper Contribute to the Wider Global Clinical Community?: It presents a validated risk prediction model for BCRL. No Patient or Public Contribution: There was no patient or public contribution in the conduct of this study. [ABSTRACT FROM AUTHOR]

Aim: This quasi‐experimental study aimed to explore effects of walking exercise on disease activity, sleep quality, and quality of life among individuals with systemic lupus erythematosus. Methods: After recruiting people with systemic lupus erythematosus from a hospital in Taiwan between October 2020 and June 2021, participants were free to opt to receive one walking exercise programme plus standard care for 3 months or to membership of a control group receiving routine care. Primary outcomes included Systemic Lupus Erythematosus Disease Activity Score, the Pittsburgh Sleep Quality Scale, and a quality‐of‐life scale for patients with systemic lupus erythematosus, namely, LupusQoL. These scales were administered first, at baseline and later, within 1 week following completion of the intervention. Between‐group effects were compared using generalized estimating equations with adjustment for baseline variables. Results: The experimental and control groups each included 40 participants. Multivariate analysis indicated that adding the walking exercise programme into routine care elevated sleep quality and LupusQoL (the latter in the subscales of physical health, planning, and intimate relationships), except for disease activity. Conclusion: Findings of this study supported the addition of walking exercise as part of routine care for people with systemic lupus erythematosus and may be a reference in the provision of adequate care for these patients. Summary statements: What is already known about this topic? Systemic lupus erythematosus is a lifelong autoimmune disease that affects any organs throughout the body, thus insidiously causing negative impacts on the affected patients.Today, use of exercise programmes such as walking exercise has been studied as a remedy for many medical conditions, but its effectiveness in minimizing the symptoms of distress among people with systemic lupus erythematosus is unknown. What this study adds? Participants with systemic lupus erythematosus who opt to receive the walking exercise programme for 3 months in addition to routine care experience improved sleep quality and quality of life compared with those receiving routine care alone. The implications of this paper: In accordance with the belief that "an ounce of prevention is worth a pound of cure," early implementation of an exercise programme should be considered in addition to routine care for patients with systemic lupus erythematosus.Evidence from this research could provide empirically informed and robust data for healthcare policymakers and in turn might help to reduce the incidence of morbidity among patients with systemic lupus erythematosus. [ABSTRACT FROM AUTHOR]

Background: Collaborative learning has become a crucial approach to promoting online in‐service teacher training. Appropriate peer recommendation for group composition is the basis to ensure productive learning outcomes of collaborative learning. However, there is a lack of understanding of the impact of peer recommendation on in‐service teachers' online training. Objectives: Therefore, based on the collaborative filtering approach, a peer recommendation mechanism for in‐service teachers was constructed in this study. We investigated the effects of the constructed mechanism on in‐service teachers' online learning performance, interactive knowledge construction behavioural patterns and social networks. Methods: In this study, 82 in‐service teachers were recruited to participate in the study. Participants under the experimental condition (n = 41) were invited to apply collaborative filtering‐based peer recommendation mechanism for grouping, while participants under the control condition (n = 41) were invited to use random grouping method. Participants' interaction data were collected from online collaborative discussion activities in a 5‐week asynchronous online course. The pre‐post knowledge test, content analysis, lag sequential analysis and social network analysis were used to analyse the differences between groups. Results and Conclusions: The following findings were revealed: (1) the experimental group performed better than the control group in terms of online learning performance; (2) interactive knowledge construction behavioural patterns generated in collaborative activities showed that the experimental group achieved deeper level of knowledge construction in collaboration than the control group; (3) social networks generated in collaborative activities showed that the experimental group had tighter interaction relationships than the control group. Therefore, the peer recommendation mechanism could be useful to improve peer recommendation for group composition and had positive effects on in‐service teachers' online training. Implications: This study can shed light on the construction of peer recommendation mechanism in recommending appropriate peers for in‐service teachers and different learners in online collaborative learning. Lay Description: What is currently known about this topic: Appropriate learning peers are conducive to promoting effective online collaborative learning. What this paper adds: This study constructed a collaborative filtering‐based peer recommendation mechanism for recommending appropriate learning peers to improve online collaborative learning of in‐service teachers. The implications of study findings for practitioners: The study findings provide insights into the construction of mechanisms for recommending learning peers in online teacher training and computer‐supported collaborative learning. [ABSTRACT FROM AUTHOR]

The use of standardized screening tools to identify trauma exposure and associated symptoms is commonly recommended as a key component in the development of trauma informed services and is seen as integral to facilitating access to evidence‐based therapies. However, there is limited evidence in the UK about the factors influencing the adoption of such tools into routine practice in children's social care. This paper presents the findings from a process evaluation of how practitioners implemented a screening tool for post‐traumatic stress disorder, anxiety and depression into their day‐to‐say practice and what worked or did not work during the process. The findings from this study highlight the potential benefits for both young people and practitioners, alongside some of the challenges involved. In particular, practitioners need to see the direct benefit for young people of being assessed. Additionally, practitioners value regular mentoring as they become more proficient in using standardized screening tools. [ABSTRACT FROM AUTHOR]

Background: Improvements in treatment of head‐and‐neck cancer (HNC) have resulted in improved long‐term survival rates so there is a growing interest in long‐term consequences. Objective: The aim was to perform a smartphone‐based assessment to analyse the upper airway dysfunction‐related symptoms in HNC 1 year after radiotherapy (RT) during social distancing due to COVID‐19. Methods & Procedures: Smartphone‐based assessment on upper airway function 1 year after RT was performed. Upper airway functions include perceived impact of voice on quality of life (Voice Handicap Index, VHI‐30), swallowing (Functional Oral Intake, FOIS; and Swallowing Quality of Life questionnaire, SWAL‐QOL) and sleep‐disordered breathing (Pittsburgh Sleep Quality Index, PSQI) assessments. Additionally, quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Outcomes & Results: The HNC group presented worse results in the VHI‐30 scale, in the three subscales (p < 0.001). Swallowing function also presented worse results in the HNC group, with a lower score in the FOIS questionnaire (p < 0.001) and a poorer score in the SWAL‐QOL (p < 0.001). Regarding to the sleep‐disordered breathing, the HNC group presented poorer scores in all subscales (p < 0.05). The HNC group also presented worse scores in quality of life. Conclusion: Our findings showed that HNC survivors presented a poorer upper airway function and a worse quality of life. This population needs to be systematically screened for those function impairments. WHAT THIS PAPER ADDS: What is already known on the subject: Head‐and‐neck cancer radiotherapy treatment is anatomically related to the upper airway, involved in several functions such as breathing, swallowing and speech that could be affected by the treatment. Public health restrictions caused by the COVID‐19 pandemic have made it difficult, and in many cases impossible, to see patients in person and complete assessments that are often crucial to improve their approach. Telephone interviews appear to be largely equivalent to face‐to‐face interviews, which could solve these problems. What this paper adds to existing knowledge: The aim of this study was to perform a smartphone‐based assessment to analyse the upper airway dysfunction‐related symptoms in head‐and‐neck cancer survivors 1 year after radiotherapy treatment. Our findings showed that head‐and‐neck cancer survivors who have been treated with radiotherapy presented a poorer upper airway function, with subjective speech and voice problems, swallowing and sleep‐disordered breathing compared to a control group matched for age and sex 1 year after the treatment. What are the potential or actual clinical implications of this work?: The results of this study will allow a better approach to treatment of head‐and‐neck cancer survivors. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine the effects of solution‐focussed education and counselling on problematic internet usage, sleep quality and school achievement. Methods: This randomized controlled trial was conducted between January ‐ December 2016 with 44 adolescents who participated in a solution‐focussed intervention to address their problematic internet usage and poor sleep quality. After the intervention, the teens were followed up for 6 months to measure problematic Internet usage, sleep quality and school achievement using the Internet Addiction Test, Pittsburg Sleep Quality Index, Parent–Child Internet Addiction Scale and the students' end‐of‐term school grades. Data were analysed in Statistical Package for the Social Sciences programme using Chi‐square test, Independent t test, Man–Whitney U test, Friedman test and Spearman correlation analysis. Results: The median Internet Addiction Test and Pittsburg Sleep Quality Index scores of the adolescents in the intervention group were significantly lower than those of the controls (P < 0.05), and there was a positive and moderate association between problematic Internet usage and sleep quality in both groups after the follow‐up (r = 0.537, P = 0.010; r = 0.576 P = 0.005). Conclusion: The education and counselling intervention decreased problematic Internet usage and increased sleep quality. There was also an improvement in school achievement, but the difference was not significant. Summary statement: What is already known about this topic? Problematic internet usage is a common public health problem among adolescents, and it affects their physical, social and academic lives.There are some studies in the literature on the prevalence and treatment of problematic internet usage, but there are few on preventing its occurrence.Strengths‐based approaches in adolescent interventions encourage active learning. What this paper adds? A solution‐focussed approach was used for the first time in adolescents to prevent and manage problematic internet usage and accompanying problems.A programme of solution‐focussed health education and counselling was found to be an effective intervention for preventing problematic internet usage and some accompanying problems in adolescents. The implications of this paper: For the prevention and management of problematic internet usage school nurses should screen young adolescents for Internet addiction symptoms and accompanying problems.Nurses must have the benefit of multiple approaches to systematize health care in fulfilling their school health responsibilities.Health education programmes administered by school nurses to address Internet addiction in students can be based on solution‐focussed approaches. [ABSTRACT FROM AUTHOR]

Objective: To examine implicit bias in employees at a cancer centre using an Australian race (Aboriginal–white) Implicit Association Test (IAT), in an attempt to understand a potential factor for inequitable outcomes of First Nations Australians cancer patients. Methods: All employees at an Australian cancer centre were invited to take part in a web-based, cross-sectional study using an Australian race IAT. The results were analysed using Welch t-tests, linear regression and ANOVA. Results: Overall, 538/2871 participants (19%) completed the IAT between January and June 2020. The mean IAT was 0.147 (s.d. 0.43, P < 0.001, 95% CI 0.11–0.18), and 60% had a preference for white over First Nations Australians. There was no significant mean difference in IAT scores between sub-groups of gender, age or clinical/non-clinical employees. 21% of employees (95% CI 17.65–24.53) had moderate to strong preference for white over First Nations Australians, compared to 7.1% with moderate to strong preference for First Nations over white Australians (95% CI 5.01–9.09). Conclusions: Inequitable cancer survival for First Nations patients has been well established and cancer is now the leading cause of mortality. This paper documents the presence of racial bias in employees at one cancer centre. We argue that this cannot be understood outside the history of colonialism and its effects on First Nations Australians, healthcare workers and our society. Further research is required to evaluate measures of racism, its effect on health care, and how to eliminate it. What is known about this topic? Australian cancer care providers deliver inequitable access and outcomes for First Nations Australians. Systemic and personal racism experienced by First Nations patients are thought to contribute to these inequities. What does this paper add? This paper documents the presence of cancer centre employee racial bias and reiterates the need for further research to document the effect of racism on cancer care outcomes for First Nations patients. What are the implications for practitioners? Healthcare practitioners, similar to other Australians, have implicit bias against First Nations Australians. Previous studies suggest that the presence of bias affects treatment options and outcomes for people of colour. In order to eliminate racism and associated inequities in cancer care services, multi-faceted anti-racism approaches are required. [ABSTRACT FROM AUTHOR]

Previous research has found that music brings back more vivid and emotional autobiographical memories than various other retrieval cues. However, such studies have often been low in ecological validity and constrained by relatively limited cue selection and predominantly young adult samples. Here, we compared music to food as cues for autobiographical memories in everyday life in young and older adults. In two separate four‐day periods, 39 younger (ages 18–34) and 39 older (ages 60–77) adults recorded their music‐ and food‐evoked autobiographical memories in paper diaries. Across both age groups, music triggered more frequent autobiographical memories, a greater proportion of involuntary memories, and memories rated as more personally important in comparison to food cues. Age differences impacted music‐ and food‐evoked memories similarly, with older adults consistently recalling older and less specific memories, which they rated as more positive, vivid, and rehearsed. However, young and older adults did not differ in the number or involuntary nature of their recorded memories. This work represents an important step in understanding the phenomenology of naturally occurring music‐evoked autobiographical memories across adulthood and provides new insights into how and why music may be a more effective trigger for personally valued memories than certain other everyday cues. [ABSTRACT FROM AUTHOR]

Aims and objectives: To detect the mediating effect of resilience on the relationship between perceived social support and burnout in Chinese palliative nurses. Background: Palliative nurses are a group that is vulnerable to burnout. Perceived social support may contribute to decreasing palliative nurses' burnout and facilitating their personal resilience, and resilience may be associated with lower levels of burnout. However, these relationships were unclear in the Chinese context. Design: A cross‐sectional design. Methods: The STROBE guideline was performed to report this study. A mixed sampling method including convenience sampling and stratified sampling was used to recruit participants, and a total of 319 palliative nurses completed the Nursing Burnout Scale, the Perceived Social Support Scale and the Connor–Davidson Resilience Scale from May 2021 to September 2021. Influencing factors were primarily identified using independent‐sample t tests and one‐way ANOVA. Bootstrap method was used to detect the mediating effect of resilience. Results: The level of burnout in palliative nurses (23.4 ± 7.68) was higher than that of general nurses in China. Education level, health condition and monthly income were influencing factors of burnout. Resilience was detected as a mediator in the relationships between perceived social support and dimensions of burnout. Conclusions: Chinese palliative nurses experience a relatively high level of burnout, which may be influenced by several sociodemographic variables. Resilience could mediate the effect of perceived social support on the dimensions of burnout. Problem‐oriented and palliative‐tailored strategies should be developed to further address burnout in Chinese palliative nurses. Relevance to clinical practice: Nurse managers and policy makers should support nurse ongoing education, adopt health‐promoting interventions and optimise salary systems. In addition, perceived social support resources and resilience training programmes are also warranted. Patient or public contribution: All participants were invited to complete the informed consent form and paper questionnaires. Human resource managers helped us collect some subjective data through the personnel management system. Nurse managers of palliative units conducted regular staff meetings to promote the data collection process. [ABSTRACT FROM AUTHOR]

Purpose: To extend knowledge about measurement equivalence of depression measures assessed by tablet and paper-pencil administration, the present study evaluated the effect of mode of administration (MoA) on scale and item level for the Patient Health Questionnaire (PHQ-9) and the Aachen Depression Item Bank (ADIB) in elderly patients.Methods: Primary care patients (N = 193, ≥60 years) were assessed following a crossover design in Leipzig, Germany. All participants filled out the PHQ-9 and the ADIB in both MoAs under study. Effects of MoA were analyzed by intra-class correlation, mixed-effects regression, and differential item functioning (DIF). Additionally, detection rates between both MoAs were compared using receiver operating characteristics analysis compared to a diagnostic interview (SCID-I, N = 163).Results: No effect of MoA was found in the PHQ-9 on scale score or item level. Two ADIB items showed DIF according to MoA. In terms of discriminatory power, MoA did not influence detection rates of both instruments.Conclusions: In summary, our findings suggest that no severe effect of mode of administration on self-report assessments of depression should be expected. It can be concluded that tablets provide a valid way to electronically assess depressive symptoms in elderly patients. Yet changes in item presentation can influence the psychometric properties and require equivalence testing using sophisticated analyses on item level such as DIF. [ABSTRACT FROM AUTHOR]