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Objective. To perform a bibliometric analysis of scientific production related to gut microbiota and Parkinson's disease between 2011 and 2020. Methods. A descriptive, retrospective, cross-sectional, and bibliometric study was carried out. The Scopus database was used as a source to evaluate the worldwide scientific production on intestinal microbiota and its relationship with Parkinson's disease. Data were extracted from Scopus using a formula developed with thesaurus terms MeSH (Medline) and Emtree (Embase). Results. A total of 591 documents were found. The retrieved manuscripts received an average of 41.9 citations per document. Four of the 10 most productive authors were Italian. The University of Helsinki (Finland) was the institution with the highest scientific production (19 papers) and the highest impact (5921 citations). In terms of productivity and impact, Movement Disorders ranked first with 38 papers and 2782 citations, and those papers published in Q1 quartile journals exceeded the sum of the remaining quartiles. Papers with international collaboration were the most cited. Keyword analysis showed that the terms Parkinson Disease, Disease, and Intestine Flora were the most frequent. Conclusion. The number of papers on Parkinson's disease and gut microbiota has been increasing; however, high-quality journals maintain the same high publication rate. International collaboration from high-income countries played an important role in the impact generated by the publications. [ABSTRACT FROM AUTHOR]

Background. China will inevitably enter a medium, severe, or deep aging society in the future, and the number of elderly people living alone is also increasing. Mental health is a major issue for older people living alone. With the deepening of aging, social participation has become an important way to promote mental health and improve the quality of life of the elderly. Methods. This study uses data from Chinese Longitudinal Health Longevity Survey (CLHLS). Based on the CLHLS data of 2018, this paper uses multiple ordered logistic models to measure the mental health level of elderly people living alone through two dimensions of depression and anxiety and carries out a heterogeneity analysis on the mental health level of elderly people living alone. Results. The analysis of 2477 elderly people living alone shows that the increase of social participation in simple communication can reduce the degree of depression and anxiety of elderly people living alone, and the decrease of social participation in self-recreation can reduce the degree of depression and anxiety of elderly people living alone. In addition, the heterogeneity analysis found that the heterogeneity of social participation was more significant among the elderly living alone with different genders, ages, places of residence, and self-care abilities. Limitations. This study has some limitations, and CES-D-10 is a screening tool and cannot fully determine the presence of depression in high-rise older adults living alone. Conclusions. In the future, primary healthcare-targeted interventions can be provided according to the different degrees of depression and anxiety of elderly people living alone. [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]

Objective. The extent, range, and nature of available research in the field of herbal therapies for osteoarthritis (OA) have not been systematically analyzed. This study aimed to map the literature available on herbal therapies for OA and identify global hotspots and trends in this field. Methods. Studies on herbal therapies for OA published between 2004 and 2022 were searched from the Web of Science Core Collection. Microsoft Excel, SPSS Statistics, and CiteSpace software were used to analyze and visualize the quantity and citations of publications, and the research hotspots and trends in research on herbal therapies for OA. Results. A total of 1649 publications mainly from 76 countries/regions and 270 institutions were included in this study. From 2004 to 2022, there is an upward trend in the publications of herbal therapies for OA. China ranked first in the number of publications (n = 568, 34.45%), followed by the USA (n = 353, 21.41%), South Korea (n = 187, 11.34%), Germany (n = 85, 5.15%), and England (n = 79, 4.79%). Kyung Hee University (n = 46), Xianxiang Liu (n = 25), and Evidence-Based Complementary and Alternative Medicine (n = 74) were the most prolific affiliation, author, and journal, respectively. Felson DT (n = 185) and Arthritis and Rheumatism (n = 1173) held the record for the most cited papers by an author and journal, respectively. Currently, the hot keywords in the field of herbal therapies for OA include knee OA, traditional Chinese medicine (TCM), differentiation, rosa canina, inflammation, oxidative stress, stem cell, and regenerative medicine. The emerging research trends in herbal therapies for OA are herbal medicinal product, chronic knee pain, mesenchymal stem cell, and clinical pharmacology. Conclusions. Research on herbal therapies for OA is flourishing, but communication among countries/regions should be strengthened. Current research on herbal therapies for OA mainly focuses on knee OA, TCM, differentiation, rosa canina, inflammation, oxidative stress, stem cell, and regenerative medicine. The research frontiers are herbal medicinal product, chronic knee pain, mesenchymal stem cell, and clinical pharmacology. [ABSTRACT FROM AUTHOR]

Nurses' turnover intention has increased since the COVID-19 pandemic. Emotional labor is reportedly high among nurses in Korea, and a positive psychological capital can help reduce turnover intention. This cross-sectional study investigated the factors influencing turnover intention in nurses during the COVID-19 pandemic. Survey data were collected from 155 nurses caring for patients with COVID-19 at a university hospital in South Korea in March 2022. Self-reported and paper-based questionnaires on emotional labor, positive psychological capital, and turnover intention were employed. The mean values for emotional labor, positive psychological capital, and turnover intention were 54.52/80, 58.03/90, and 38.92/50, respectively, and 77.8% of nurses reported planning to quit working. Turnover intention correlated with emotional labor (r = 0.17; p = 0.041) and had no significant relationship with positive psychological capital. Sex (β = 0.24; p = 0.003) and emotional labor (β = 0.18; p = 0.019) affected turnover intention, with 9% explanatory power. Female nurses caring for patients with COVID-19 had a higher turnover intention than male nurses. Finally, the higher the emotional labor of nurses caring for patients with COVID-19, the higher the turnover intention. To reduce the turnover intention of nurses, hospitals need to help them enhance their emotional labor and positive psychological capital by establishing measures such as emotional coaching programs or psychological capital interventions. [ABSTRACT FROM AUTHOR]

Background. Research has shown that pressure in the vaginal birth process aids the infant's neurophysiological adaption to extrauterine life, including their ability to regulate their responses to diverse sensory stimuli. As pressure is absent in elective caesarean section births, we hypothesised that these children may be at higher risk for developing sensory hyperreactivity (SHR), a sensory modulation difficulty which negatively impacts on the child's engagement in their occupations. This paper reports on a study which investigated associations between birth method and SHR. Method. In this cross-sectional study, 91 children aged three and four years from various language, cultural, and socioeconomic groups were recruited and categorised based on birth method (caesarean section or vaginal birth). Caregivers of each child completed the Short Sensory Profile-2 and a demographic questionnaire. The prevalence of SHR between the birth method groups was compared. Results. The prevalence of SHR was greater in the vaginal birth group (29%) than the caesarean section group (9%). Mothers in the vaginal birth group were younger (p ≤ 0.001), of lower-income level (p = 0.003), and more likely to be single (p = 0.037). During data collection with the vaginal birth group, comprehensibility of certain items in the Short Sensory Profile-2 proved challenging for many caregivers. Conclusion. The statistically significant higher prevalence of SHR in the vaginal birth group supported a null hypothesis. However, the results are questioned due to the challenges related to data collection. Given this, the study supports the need for further investigation of how sociocultural and socioeconomic factors influence the assessment of SHR in the South African context. [ABSTRACT FROM AUTHOR]

Background. Several studies identified that emotional intelligence skills are important indicators for nurse engagement and performance. Issues related to nursing performance in healthcare organizations have been gaining greater attention because they influence the effectiveness of improvement approaches to maintain high-quality care. This study aimed to investigate the relationships between emotional intelligence and nurses' work performance and work engagement. Methods. A quantitative, descriptive, correlational design was used to evaluate the relationships between the study variables. Data were gathered from 150 nurses working at Madinah Cardiac Center, Saudi Arabia. Three scales were used to measure the study variables which were Emotional Intelligence Scale, Job Performance Scale, and Utrecht Work Engagement Scale in addition to demographics. SPSS was used to analyze data. Results. The results of this study showed that emotional intelligence has a total mean of 3.77 (SD = 0.598), nurses' performance 3.65 (SD = 0.503), and work engagement 4.29 (SD = 1.04). The results also showed that there is a positive and significant relationship between emotional intelligence and nurses' work performance (R2 = 0.657, p < 0.001). Also, it was found that emotional intelligence has a positive and significant relationship with nurses' work engagement (R2 = 0.621, p < 0.001). Conclusions. This paper highlights the influence of emotional intelligence in nurses' improved performance and engagement in work. The field of nursing is associated with care and compassion; thus, it needs a high level of emotional intelligence. Nurses need to enhance their emotional intelligence skills by attending workshops. Nurse leaders also have a role in that by building a culture for nurses that is driven by applying emotional intelligence in the workplaces. [ABSTRACT FROM AUTHOR]

Aim. The objective was to investigate the impact of structural empowerment and demographic factors on the psychological empowerment of nurses. Background. The empowerment of nurses plays a crucial role in improving patient care and achieving successful healthcare outcomes. When nurses feel empowered in their work environment, they tend to remain dedicated to their jobs and experience higher levels of job satisfaction and engagement. Methods. This cross-sectional study utilized a convenience sample of 287 nurses recruited from various hospital units, resulting in a response rate of 94.7%. Data were collected through a paper survey consisting of three sections: structural empowerment, psychological empowerment, and demographics. Results. The first hierarchical regression explains 57.0% variance in nurses' psychological empowerment (F = 78.52, p < 0.001). Age (β = 0.37, p < 0.01) and structural empowerment (β = 0.69, p < 0.001) have a positive influence on nurses' psychological empowerment. Conversely, having a bachelor's degree (β = −0.16, p < 0.01) had a negative impact psychological empowerment. The second hierarchical regression clarifies the specific aspects of structural empowerment that influences positively on nurses' psychological empowerment: access to opportunities (β = 0.13, p < 0.01), support (β = 0.13, p < 0.01), resources (β = 0.35, p < 0.001), and informal power (β = 0.12, p < 0.01). Conclusion. This study emphasizes the importance of considering demographic variables, such as age and education, in conjunction with structural empowerment to effectively enhance nurses' psychological empowerment. Implications for Nursing Management. Nursing managers should tailor their empowerment strategies based on the demographic characteristics of their nurses. It is essential to focus on providing nurses with access to opportunities, support, resources, and informal power. These insights provide valuable guidance for nursing managers to enhance nurses' psychological well-being, job satisfaction, and overall quality of life. Ultimately, this contributes to positive outcomes for patients, nursing staff, and healthcare organizations. [ABSTRACT FROM AUTHOR]

Although individual factors play a vital role in determining professional autonomy, their specific impact during the coronavirus disease 2019 (COVID-19) pandemic has not been studied. This study aimed to compare nurses' professional autonomy when caring for patients with COVID-19 and for other patients and explore factors related to autonomy when caring for these patients. A paper-based questionnaire survey was conducted from June to August 2022 among nurses working at a university hospital in Japan. The survey included demographic factors (10 items, including, age, section, years of nursing experience, position, educational background, ladder level, and having certified nurse specialists or certified nurse qualifications) and individual experience factors (4 items: number of COVID-19 patients experienced, frequency and contents of searching for the latest information about COVID-19, frequency of using scientific sources, and frequency of training/study sessions on COVID-19 attended at the hospital). Additionally, basic knowledge of COVID-19 was evaluated. The scale for nurses' professional autonomy was developed based on a previous study. A paired t-test and stepwise multiple linear regression were used for the analyses. Overall, 241 nurses participated in the survey. The average length of nursing experience was 10.3 ± 9.2 years. The total scores for nurses' professional autonomy in all 5 factors 27 items were significantly lower (t = −12.1, p < 0.001) when caring for COVID-19 patients than when caring for other patients. Specifically, Factor 1 (Cognition) exhibited the most decreased scores when caring for COVID-19 patients than when caring for other patients. Factor 4 (Abstract judgment) differed the least between caring for COVID-19 and for other patients, but the average score was the lowest. More years of nursing experience (β = 0.208, p = 0.001) and a higher number of patients with COVID-19 cared for (β = 0.140, p = 0.026) were associated with higher autonomy scores. In conclusion, to enhance professional autonomy during an unprecedented pandemic, nurses must enhance cognition and abstract judgment. In the event of a future pandemic, nurses need to create an environment in which they routinely access and utilize the latest information and scientific evidence to provide high-quality nursing care based on their professional judgment and competence. [ABSTRACT FROM AUTHOR]

This study seeks to assess the health, social and economic outcomes associated with rough sleeping among women and compare those outcomes with those of (1) men sleeping rough, and (2) women experiencing other forms of homelessness (such as being housed in temporary supported accommodation due to family and domestic violence). The paper analyses survey data using the Vulnerability Index‐Service Prioritization Decision Analysis Tool (VI‐SPDAT) collected from 2735 women experiencing homelessness and 3124 men sleeping rough in Australian cities from 2010 to 2017. We find that women sleeping rough report poorer physical and mental health outcomes and greater problematic drug and or alcohol use relative to both men sleeping rough and women experiencing other types of homelessness (all p < 0.5). Women sleeping rough report significantly higher levels of crisis service utilisation (Β = 17.9, SE = 3.9, p < 0.001) and interactions with police in the previous 6 months (Β = 1.9, SE = 0.3, p < 0.001) than women experiencing homelessness not sleeping rough. Women sleeping rough also report greater healthcare utilisation, and, therefore, healthcare costs, than women experiencing homelessness not sleeping rough and men sleeping rough (all p < 0.05). From a policy perspective, the evidence presented in this paper supports a social determinants approach that moves from addressing symptoms of poor health outcomes associated with homelessness to preventing and ending homelessness with a particular focus on the life trajectories of women. Integrated services and homelessness strategies need to be developed through a gender lens, providing women sleeping rough with tailored permanent housing with wrap‐around supportive housing to address poor health outcomes. [ABSTRACT FROM AUTHOR]

Background. Despite the growing prevalence of Parkinson's disease (PD) and the need to plan for future health service provision, little is known in the Irish context about PD patients' experiences of service access/use. Methods. A cross-sectional survey, with multiple formats, i.e., online, pen-and-paper, and telephone. Data were collected from May 2020 to July 2021 using a multipronged recruitment strategy. The survey was completed by people with PD alone or with the support of a carer/support person. Results. A total of 1402 responses were included. Over half (53%) were male. Approx. 10% were diagnosed with young-onset PD. A minority (6%) reported attending only their GP to manage their PD, with the rest attending a generic or specialist outpatient clinic. Almost 1-in-5 reported it took more than 12 months to obtain the diagnosis. Most were diagnosed by neurologists (84%), followed by GPs (8%) and geriatricians (7%); 1% indicated "other." Of those diagnosed privately, 37% of these patients subsequently switched to the public system for ongoing management. The majority (97%) reported currently taking PD medications, but just 52% believed these were working effectively. Access to the range of health and social care professionals, including PD nurse specialists and clinical therapies is universally poor. Conclusions. A number of significant gaps in PD care are discussed, which require urgent attention. A reconfigured model of PD care is necessary to accommodate the growing need for specialist, integrated care at the population level. Specifically, more PD nurse specialists are needed within the public health system. [ABSTRACT FROM AUTHOR]

A strong First Nations health workforce is necessary to meet community needs, health rights, and health equity. This paper reports the findings from a national survey of Australia's First Nations people employed in health services to identify enablers and barriers to career development, including variations by geographic location and organisation type. A cross-sectional online survey was undertaken across professions, roles, and jurisdictions. The survey was developed collaboratively by Aboriginal and non-Aboriginal academics and Aboriginal leaders. To recruit participants, the survey was promoted by key professional organisations, First Nations peak bodies and affiliates, and national forums. In addition to descriptive statistics, logistic regression was used to identify predictors of satisfaction with career development and whether this varied by geographic location or organisation type. Of the 332 participants currently employed in health services, 50% worked in regional and remote areas and 15% in Aboriginal Community-Controlled Health Organisations (ACCHOs) with the remainder in government and private health services. All enablers identified were associated with satisfaction with career development and did not vary by location or organisation type. "Racism from colleagues" and "lack of cultural awareness," "not feeling supported by their manager," "not having role models or mentors," and "inflexible human resource policies" predicted lower satisfaction with career development only for those employed in government/other services. First Nations people leading career development were strongly supported. The implications for all workplaces are that offering even a few career development opportunities, together with supporting leadership by Aboriginal and Torres Strait Islander staff, can make a major difference to satisfaction and retention. Concurrently, attention should be given to building managerial cultural capabilities and skills in supporting First Nations' staff career development, building cultural safety, providing formal mentors and addressing discriminatory and inflexible human resources policies. [ABSTRACT FROM AUTHOR]

Aim. This paper aimed to examine the current state of nurse safety behavior, and the effect of work engagement on it, and to explore the mediating effect of self-efficacy between work engagement and nurse safety behavior in specialized cancer hospitals. Background. Nurse safety behavior affects the quality of care and outcomes for patients with cancer. The research proves that self-efficacy is associated with work engagement, but the relationship between self-efficacy, work engagement, and nurse safety behavior needs to be clarified. Methods. This study used a convenience sampling method to survey 957 nurses from January to February 2023. The survey included tertiary specialized cancer hospitals in five provinces in China. Sociodemography information, the Work Engagement Scale, the Self-Efficacy Scale, and the Nurse Safety Behavior Scale were used for the survey. A Questionnaire Star program collected all the data automatically. The Statistical Package for the Social Sciences version 24 was employed for Pearson correlation and multiple regression analysis to examine the association between work engagement, self-efficacy, and nurse safety behavior. Structural equation models were built using Analysis of Moment Structures version 24.0 software. Results. The results showed that the nurse safety behavior was at a high level in specialized cancer hospitals. There was a significant positive relationship between the variables work engagement, self-efficacy, and nurse safety behavior with coefficients ranging from 0.244 to 0.564. The results of structural equation modeling revealed that self-efficacy partially mediated the effect between work engagement and nurse safety behavior, accounting for 25.3% of the total effect. Conclusion. Self-efficacy mediates the relationship between work engagement and nurse safety behavior, and by increasing self-efficacy, nurse safety behavior can be improved, thus ensuring patient safety. Implications for Nursing Management. Managers should promote high work engagement and nurse safety behaviors by fostering nurses' self-efficacy. [ABSTRACT FROM AUTHOR]

Introduction: Systemic barriers impacting smoking cessation in pregnant women may include nicotine replacement therapy (NRT) access and training. Aim: Assess general practitioner (GP) and obstetrician's agreement with system-based changes to improve the management of smoking in pregnancy; compare group responses. Methods: National cross-sectional survey with two samples: (1) online survey emailed to a random sample of 500 GPs from Royal Australian College of General Practitioners (RACGP); (2) paper survey posted to 5571 GPs and obstetricians from Royal Australia and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). Percentages agreeing that specified changes would improve the management of smoking in pregnancy were calculated. Pairwise comparisons used Kruskal–Wallis tests (RACGP/RANZCOG GPs/obstetricians). Results: N = 378 participated. Response rates 8.4% (N = 42; online survey) and 6% (N = 335; paper survey), respectively. Total percentages agreeing with system-based changes: 79% training, 64% oral NRT subsidy, 62% Medicare item for smoking cessation, 54% improved access to NRT patches. Within RANZCOG, more GPs (73.1%) agreed that oral NRT should be subsidised (P = 0.001) than obstetricians (53.7%). Conclusion: GPs and obstetricians agreed that system changes would improve their management of smoking in pregnancy. Oral NRT subsidy was the only pairwise group difference. Subsequently, oral NRT has been subsidised; in time, this may influence prescribing and quit rates. [ABSTRACT FROM AUTHOR]

Objective. This study aims to explore the mediation role of perceived stress between nonrestorative sleep (NRS) and emotional distress, as well as the moderation role of resilience among NRS, perceived stress, and emotional distress in university students. Method. We recruited 851 students from the Be Resilient to Nursing Career program (BRNC, registration number: NFYKDX002) in June 2022. Nonrestorative sleep scale (NRSS), 10-item perceived stress scale (PSS-10), 10-item Kessler psychological distress scale (K10), and 10-item Connor–Davidson resilience scale (CD-RISC-10) were administered through a paper questionnaire. Latent profile analysis and moderated mediation analysis were performed. Results. Three profiles of perceived stress were identified: high ability-low stress (24.5%), middle ability-high stress (65.0%), and low ability-middle stress (10.5%). The mediation role of perceived stress between NRS and emotional distress was significant (SE = 0.025; 95% confidence interval = −0.369, −0.269). The moderation role of resilience among NRS, perceived stress, and emotional distress was not significant. Conclusion. Heterogeneity exists in freshmen students' perceived stress. Perceived stress plays a significant mediating role between NRS and emotional distress, while resilience cannot significantly moderate the associations among NRS, perceived stress, and emotional distress. The trial is registered with ChiCTR2000038693. [ABSTRACT FROM AUTHOR]

This paper is focused on the experimental study and numerical simulation of isolated spread concrete foundation slab with a large width-to-height ratio (in short ISCFS-LWR) to investigate the failure modes and uplift bearing capacity, as well as the design method of uplift capacity. First, a total of 16 isolated spread concrete foundation slabs with the width-to-height ratio varied from 1.5 to 4 and the hypotenuse slope varied from 10° to 30° were tested under uplift load. Based on the test results, effects of the width-to-height ratio and the hypotenuse slope on uplift bearing capacity of ISCFS-LWR were analyzed and discussed. Then, several numerical models were built using the finite element software ABAQUS and the results of numerical analysis agreed well with the test results. Furthermore, the cross-sectional performance of ISCFS-LWR was studied, and the coefficients of internal force arm were also evaluated further using previous validated numerical models. To obtain the suggested design method of uplift capacity for the foundation slab, effective width correction coefficient k and slope correction coefficient j were introduced to propose a design formula. Finally, the proposed design method was applied to a practical engineering, and the economic indicators obtained from the suggested design method were compared with that from the original design method. The results of this paper showed that the correction coefficient jsks based on numerical analysis agreed well with the recommended correction coefficient jk, and the error was between 1% and 3.4%, by which the reasonability of the proposed design method of uplift capacity for ISCFS-LWR has been proved. It can also be found that the economic benefits of the practical engineering in this paper were obvious due to the suggested design method, and this paper can provide a reference for other engineering practices and the further research work on ISCFS-LWR. [ABSTRACT FROM AUTHOR]

Aim: This paper aimed to investigate the relationship between social support and quality of life for nurses in infectious disease departments in China, as well as the function of psychological resilience in mediating this relationship. Background: Nurses in infectious disease departments play a critical role in the prevention and control of infectious diseases and in public health care services in general, and their quality of life can affect the quality of clinical nursing work they do. However, there are few studies on the relationship between nurses' social support networks and their quality of life. Methods: A cross‐sectional study was conducted using a sample of 866 clinical nurses from the infectious disease departments of 10 general hospitals in China. Data were collected using a questionnaire survey from January to May 2021. The mediating influence of psychological resilience on social support and quality of life was investigated using structural equation modelling. Results: The score of quality of life was (36.36 ± 7.64). Quality of life was positively correlated with social support and psychological resilience (r1 = 0.521, r2 = 0.583; p <.01), and psychological resilience was positively correlated with social support (r = 0.426; p <.01) as well. The mediating effect of psychological resilience between social support and quality of life was 0.233, accounting for 37% of the total effect. Conclusion: The quality of life of nurses working in infectious disease departments is in the middle level. Psychological resilience is a mediating variable between social support and quality of life. Implications for Nursing Management: Managers can improve the quality of life of nurses by both increasing social support and strengthening psychological resilience. Managers should pay attention to the degree of social support provided to nurses and take proactive measures to build psychological resilience so that nurses can effectively manage stress and negative emotions from work and life in order improve their quality of life. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to understand the current situation and multiple factors affecting the core competence specializing in the maternal, neonatal and under‐five nursing in China. Background: Highly skilled nurses and midwives are essential worldwide for achieving the Sustainable Development Goals, especially in low‐ and middle‐income countries like China, due to the overwhelming COVID‐19 crisis. Method: The 890 nurses and midwives from 12 hospitals were investigated in this cross‐sectional study, with two questionnaires: the sociodemographic information and competency inventory for the registered nurses. Results: The participants reported a mean total score of 193.78 (±42.19) out of 220 and lowest in critical thinking and research ability (3.01 ± 0.82). The professional title, level, marital status, relationship quality, highest qualification, experience in specialist nurse training, participation in scientific research projects and publishing papers were the influencing factors (P <.05). Conclusions: The respondents' core competence needs improvement, especially critical regarding thinking and research ability. In addition, marriage and good or excellent relationship quality are factors that can potentially improve competence. Implications for Nursing Management: Targeted interventions for higher core nursing competence need to be implemented, especially focusing on nurses' marital status and emotional support from partners. [ABSTRACT FROM AUTHOR]

The role of formal volunteering in mental health promotion among older adults in China has been widely discussed during recent decades. However, the relationship connecting mental health with cross‐level interaction (i.e., average levels of participation in the community vs. individual participation) is still unclear. This paper examined the effects of cross‐level formal volunteering on depressive symptoms among older adults living in China. Using two waves of the China Longitudinal Aging Social Survey, a sample of 3128 Chinese older adults was surveyed in 2014 and 2016. Depressive symptoms were measured using the abbreviated CES‐D‐9. Individual fixed‐effects ordinary least squares regression models assessed the associations between individual‐ and community‐level formal volunteering and depressive symptoms in urban and rural areas separately. We found that in the urban sample, formal volunteering activities were negatively associated with depressive symptoms at the individual level (β = −0.49, SE = 0.22, p < 0.05). Higher community‐level formal volunteering was positively associated with depressive symptoms (β = 2.82, SE = 1.42, p < 0.05). When adding interactions between individual and community levels, engagement in individual‐level formal volunteering was associated with lower rates of depressive symptoms as community volunteering participation levels increased (β = −3.07, SE = 1.07, p < 0.01). High community‐level volunteering participation was detrimental for non‐volunteers. In rural areas, neither community‐ nor individual‐level formal volunteering was associated with changes in depressive symptoms. The current findings demonstrate formal volunteering may not always benefit mental health for all. The effects may depend on the community context and individual choices. Social policies aimed to promote mental health through formal volunteering need to be tailored according to the specific community social environment. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe the prevalence, severity, coping strategies and precipitating factors of food insecurity in university students in a large multi‐campus Australian university during the COVID‐19 lockdown in 2020, in context of providing information to inform institutional support. This was a cross‐sectional analysis which was part of a larger university‐led research project, the Thrive@Home study conducted at Monash University during the COVID‐19 pandemic. The main outcome measures included: Sociodemographic characteristics, PROMIS anxiety, PROMIS depression and the six‐item US Department of Agriculture Household Food Security Survey Module. All variables were reported according to the four levels of food security status (high (H), marginal (M), low (L) and very low (VL)). Chi‐squared tests were used to compare all categorical variables including demographic, mental health and food security status. A multivariable regression was conducted between food security status and mental health variables. Overall, n = 1315 students were included in the analysis. Of which, 5% were classified as having VL food security, 13% L, 14% M and 68% H. As food security worsened the likelihood of being unemployed looking for work, living alone and deteriorating physical health, diet quality and mental health increased. As food security status deteriorated the prevalence of needing to ask family or friends for food, shopping at multiple outlets for discounts, accessing emergency food relief, subsidised meals and financial assistance from organisations increased (p < 0.002). In regression models adjusting for covariates, depression (b (95%CI): VL = 7.2(4.1–10.3), L = 3.7(1.7–5.7), M = 2.0(0.1–3.8)) and anxiety (VL = 7.4(4.5–10.4), L = 3.5(1.5–5.4) and M = 2.0(0.3–3.8)) were positively associated with worsening food security. Food insecurity during COVID‐19 was associated with worsening mental health. This paper provides targets for future university‐led initiatives to promote student food security and supporting better access to physical and mental health services. [ABSTRACT FROM AUTHOR]

Patient satisfaction is a critical component of quality of care assessment in the pursuit of universal health coverage to end the tuberculosis epidemic and other diseases. This study aimed to review the level of satisfaction of tuberculosis patients and related factors. Articles were accessed from Web of Science, EMBASE, PubMed and Google Scholar. Twenty‐six papers fulfilled the eligibility criteria from 13 countries. The percentage of satisfied tuberculosis patients ranged from 53.5% to 97.0% in the five African countries, 67.8 to 97.2% in India, South‐East Asia, 82.0% in Pakistan, East‐Mediterranean and 92.9% in Armenia, the European region. Accessibility, healthcare cost, treatment duration and taking supervised‐directly observed treatment were healthcare service‐related determinants. Technical competency, interpersonal relationships, confidentiality, time spent with healthcare providers, time spent waiting for care and counselling and health education were health worker‐related determinants. Patient‐related variables that determine satisfaction were gender, age, ethnicity, place of residence, marital status, educational status, income and health status. Developing and/or approaching an internationally‐agreed tool to measure tuberculosis patient satisfaction in healthcare settings will improve the availability of high‐quality and comparable data to verify actual variation across and within a country. A multidimensional approach considering clients, health workers and healthcare settings is required to holistically address satisfaction issues of tuberculosis patients to gradually realise universal health coverage. [ABSTRACT FROM AUTHOR]

Chronic pain is common in older people. However, little is known about how pain is experienced in residents of retirement villages ('villages'), and how pain intensity and associations are experienced in relation to characteristics of residents and village living. We thus aimed to examine pain levels, prevalence and associated factors in village residents. The current paper is a cross‐sectional analysis of baseline data from the 'Older People in Retirement Villages' study in Auckland, New Zealand. Between July 2016 and August 2018, 578 village residents were interviewed face‐to‐face by gerontology nurse specialists, using interRAI Community Health Assessment (CHA) and customised survey. We used a validated pain scale and multivariable logistic regression analyses adjusted for pre‐specified confounders. Residents' median age was 82 years; 420 (73%) were female; 270 (47%) exhibited/reported daily pain, and in 11% this was severe. After controlling for confounders, daily pain was positively associated with self‐reported arthritis (OR = 3.88, 95% CI = 2.57–5.87), poor/fair self‐reported health (OR = 3.19, 95% CI = 1.29–7.93), having no health clinic on‐site (OR = 1.76, 95% CI = 1.10–2.83), and minimal fatigue (diminished energy but completes normal day‐to‐day activities) (OR = 1.77, 95% CI = 1.11–2.81). Similar associations were observed for levels of pain. We conclude that levels of pain and prevalence of daily pain are high in village residents. Self‐reported arthritis, self‐reported poor/fair health, no health clinic on‐site and minimal fatigue are all independently associated with a higher risk of daily pain and with levels of pain. This study suggests potential opportunities for villages to better provide on‐site support to decrease prevalence and severity of pain for their residents, and thus potentially increase wellbeing and quality‐of‐life, though as we cannot prove causality, more research is needed. [ABSTRACT FROM AUTHOR]

Various barriers make recruiting a difficult task for researchers, especially when recruiting people living with HIV (PLWH) or conducting longitudinal studies. Effective recruitment is crucial to the validity of studies, and in this regard, social media can come to aid, although researchers usually rely on paid advertisements. This paper describes the free social media strategies used for participant recruitment in two studies carried out with PLWH in Spain and Latin America. Study 1 was a cross‐sectional study on the validation of two stigma scales with a 1‐month retest. Study 2 was a longitudinal study exploring the mental health of newly diagnosed PLWH, with a second assessment after 6 months. Facebook posts, Twitter mentions, and discussion forums were used in both studies. Study 2 also recruited participants through a healthcare centre. In Study 1, 5‐month recruitment yielded a sample of 458 PLWH, averaging 91.6 surveys/month and a 43% retention rate. In study 2, recruitment took 16 months, yielding a final sample of 145 newly diagnosed PLWH, 92 from the healthcare centre (5.75 surveys/month) and 53 from social media (3.31 surveys/month), with 95% and 60% retention rates, respectively. Participants in Study 2 did not differ in sociodemographic characteristics by recruitment method, except for the region of origin and financial difficulty (more diverse origin and greater difficulty emerged in social media participants). Greater psychological distress and lower personal and social resources were also found in social media participants. These data indicate that free social media recruitment is a feasible and effective tool for the recruitment of Spanish‐speaking PLWH, although it is best used in combination with traditional methods for newly diagnosed PLWH and longitudinal studies. [ABSTRACT FROM AUTHOR]

Aim: We aim to investigate the interplay between moral distress and moral injury among nurses working in palliative and oncology wards and to assess its impact on nursing leadership. Background: The past 2 years have been particularly challenging for nurses and nursing leaders in Croatia. The coronavirus disease pandemic and the subsequent earthquakes in the country significantly impacted the work of nurses. Moral distress has been well‐known to nursing professionals, but recent studies warn about cofounding it with moral injury and their possible intercorrelation, deserving more attention from an empirical perspective. Methods: We conducted quantitative cross‐sectional research in palliative and oncology wards in 11 Croatian health care facilities on 162 nurses, using a questionnaire and paper/pencil method over 6 months (1 January 2021 to 1 July 2021). The questionnaire consisted of three parts: sociodemographic data, a Measure of moral distress for health care professionals and Moral injury symptoms scale for health care professionals. The research protocol was approved by the Ethics committee of the Catholic University of Croatia under no. 1‐21‐04. Results: The findings of our study demonstrated that the current average levels of moral distress might be characterized as low, but the moral injury symptoms are severe. The results of our study bring interesting novel insights, such as the strong correlation between moral distress and moral injury, but also in terms of nurses' decision to leave or consider leaving their position. The nurses who experience higher levels of moral distress experience severe symptoms of moral injury, while nurses who score higher in moral distress and moral injury have left, considered or consider leaving their positions. Conclusions: This study highlighted the need to pay attention to the emerging phenomenon of moral injury that has been unaddressed and overshadowed by moral distress, their intercorrelation, and the importance of addressing them timely and adequately within health care organizations with their leadership and management. Implications for Nursing Management: These findings provide a significant insight that may assist nursing managers and leaders to act and respond in time to develop various prevention and mitigation measures and help resolve situations leading to moral distress or moral injury. [ABSTRACT FROM AUTHOR]

Purpose: To find out whether psychological capital has a mediating role in the relationship between job satisfaction and turnover intention on nurses. Design and Methods: This study is a cross‐sectional descriptive study. 466 nurses participated in this study. Data were collected via paper‐and‐pencil format using Minnesota Satisfaction Questionnaire, Psychological Capital Questionnaire and Turnover Intention Scale. Conclusions: Our findings revealed effects of poor psychological capital among nurses. The effect of psychological capital was statistically significant and it partially mediated job satisfaction and turnover intention. Practice Implications: Initiative sand training programs should be planned to improve nurses' attitudes towards psychological capital levels. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to evaluate the validity and reliability of the Turkish version of the social cyberloafing (SC) scale as an important predictor of the mental health of healthcare employees. Methods: The data for this descriptive cross‐sectional study was obtained from 202 Turkish healthcare employees. We followed Dima's 6‐step protocol for validation. Findings: The one‐dimensional structure of the scale was found to be homogenous (H = 0.54) and reliable (α = 0.87). The CFA demonstrated that the 7‐item and one‐factor construct was a valid instrument to measure the SC (GFI = 0.98, CFI = 0.98, TLI = 0.95, SRMR = 0.03, RMSEA = 0.09). Practical Implications: These results demonstrated that the Turkish version of the SC scale is an accurate measurement tool. [ABSTRACT FROM AUTHOR]

Purpose. To evaluate risk factors associated with keratoconus in a monocentric cross-sectional case-control study. Methods. This observational study occurred from June 2019 to February 2021 in a university hospital (France). The case group consisted of 195 patients with keratoconus in at least one eye who were followed up by a corneal specialist. The control group consisted of 195 patients without any evidence of keratoconus on slit-lamp examination and corneal topography, who were matched 1 : 1 to controls by age and sex. Data were collected by a self-completed paper questionnaire before the consultation, and a multivariate logistic regression was performed. Results. Multivariate analysis revealed significant associations of keratoconus with family history (odds ratio [OR] = 22.2, p < 0.001), rubbing eyes (OR = 10.9, p < 0.001), allergy (any kind) (OR = 3.80, p < 0.001), smoking exposure (OR = 2.08, p = 0.017), and dry eyes (OR = 1.77, p = 0.045 f). The worst eye was associated with the more rubbed eye (p < 0.001) and the more pressed eye during the night according to sleeping position (p < 0.041). Conclusion. This study confirmed the association between keratoconus and eye rubbing, family history, and allergy. It highlighted the role of pressure on the eyes during sleep. Other less known risk factors such as dry eyes and smoking exposure should be explored in future studies. [ABSTRACT FROM AUTHOR]

With the development of the Internet era, the application of smartphones in life is quite useful, and the penetration rate of smartphones will be further increased in the future, making teenagers increasingly dependent on mobile phones. Teenagers are under great academic pressure, and excessive reliance on mobile phones will inevitably affect the formation of normal values. Teenagers, as a special group, deserve our attention. Mobile phone dependence has become a social problem. In this paper, the Pittsburgh Sleep Quality Index was used to evaluate the sleep quality of adolescents, and the factors affecting the sleep quality of adolescents were explored from three dimensions of behaviour, physiology, and emotion based on the sleep quality model. In this study, structural equation modelling was used to test the multiple mediating effects and analyze the relationship between mobile phone anxiety and sleep quality. Through the analysis of the internal mechanism of the two, the results show that the average score of adolescents' anxiety about mobile phone use is 32.87, and the standard deviation is 10.67. The difference between mobile phone anxiety and sleep quality was statistically significant (P < 0.001); good sleep quality can alleviate the prediction effect of mobile phone anxiety on anxiety and provide reference for promoting the physical and mental health development of adolescents. [ABSTRACT FROM AUTHOR]

Medical imaging feature analysis is the basis of medical image processing and analysis. The solution of this problem not only directly affects the successful application of computer graphics and image technology in medicine but also has important theoretical and practical significance. In this paper, the imaging characteristics and clinical significance are discussed by studying the comprehensive evaluation of aortic valve and root before aortic valve replacement. In recent years, preoperative comprehensive evaluation of the aortic valve and root has been gradually carried out. Compared with traditional methods, minimally invasive surgery brings more accurate diagnosis to patients, quick recovery and discharge after surgery, and less pain. This study retrospectively includes patients with severe aortic stenosis who underwent TAVR with routine computed tomography. Based on CT images, the determination and grouping of bicuspid aortic valve and tricuspid aortic valve were completed. Thirteen cross-sectional levels of the aorta-iliac-femoral vascular access were completed. The results showed that 3 people had stroke (17.6%) and 5 people had myocardial infarction (29.4%) during the follow-up period. Atrial fibrillation occurred in 5 patients (29.4%), permanent pacemaker implantation was performed in 1 patient (5.9%), and acute kidney injury occurred in 7 patients (41.2%). No patient died due to surgery-related causes, and the analysis of imaging features and clinical significance in the preoperative comprehensive evaluation of the aortic valve and root played a crucial role. In the training stage, the principal component analysis method was used to train the shape, and the model of the shape intensity of the aortic valve and the shape change of each principal component was obtained. The most probable aortic valve region in the target image was obtained by matching the similarity of all atlases, and the correct aortic valve segmentation was obtained by using the first level set of shape intensity. The experimental part verified the accuracy of the algorithm. [ABSTRACT FROM AUTHOR]

Aims: To explore and collate solutions for occupational violence from emergency department (ED) staff. Background: Despite publications highlighting the progressively worsening issue of occupational violence in EDs and its detrimental impacts, few strategies aimed to reduce or manage it have been discussed in the literature. Methods: This was a cross‐sectional study involving ED staff. Participants completed an electronic survey that prompted interventions for occupational violence. Free‐text data were analysed and logically categorized using validated techniques. Results: Participants (N = 81) suggested 24 interventions: 12 were classified as prevention strategies, 10 as response strategies and two as recovery strategies. Prevention and response strategies for occupational violence targeted key participants: patients, staff and ED environment. Recovery strategies centred around staff management of the personal impacts of incidences of occupational violence and on systems in place to support them after occupational violence incidents. Conclusion: Solutions to occupational violence should be multifaceted encompassing prevention, response and recovery for patients, staff and the ED environment. Implications for Nursing Management: No single, universal intervention can be endorsed to reduce or mitigate the impacts of occupational violence in EDs. However, a combination of the interventions (strategies) discussed in this paper can be recommended. [ABSTRACT FROM AUTHOR]

While much attention has been given to loneliness as a public health and societal problem less consideration has been given to men's experiences, particularly in later life, and there is a limited evidence based on what works with supporting older men to counteract the impact of loneliness on their mental and social wellbeing. In this paper, we focus on the experiences of older men living alone in the community. Between 2017–2018 72 men residing in England (65–95 years) took part in the study and shared their accounts of experiencing and addressing loneliness on an everyday basis. We generated qualitative data through semi‐structured interviews. Interview data were analysed thematically using the framework analysis approach. We present and discuss findings on the difficulties older men experience in responding to and discussing loneliness and the range of coping practices men applied within their home environments. Three core themes are presented: 1. Maintaining silence around loneliness and distress; 2. Getting on with it versus feeling stuck in loneliness and, 3. Temporary remedies and distractions from loneliness from within the home. Across men's accounts, 'the home' is constructed as a space of biographical connections with others as well as a restrictive environment of separation from others. In relation to help‐seeking and efforts to break silence surrounding loneliness, the findings speak to the ways in which masculinities and social expectations attached to male roles complicate older men's varying attempts at help‐seeking and underpin some of their everyday methods of coping with loneliness. The findings reiterate the importance of targeted individual support for older men, particularly for those feeling frozen in loneliness. Facilitators of group‐based support for older men need to recognise the different and potentially conflicting positions older male service users may adopt in relation to help‐seeking that are configured around masculine ideals but in diverging ways. [ABSTRACT FROM AUTHOR]

The current researchers carried out a large online survey on 18 March 2020 and unintentionally provided a 'snap shot' of how the British population was responding in the early stages of the Covid‐19 pandemic. This paper aims to investigate the relationship between loneliness and mental health at the early stages of the global crisis. This cross‐sectional study was carried out using Prolific, an online participant recruitment platform that allowed 1608 responses in just 2 hr. Participants completed measures of Personal Well‐being, Psychological Distress, Flourishing and Loneliness. Numerous associations between loneliness and mental health were found. A multiple regression found that 43% of the variance in loneliness can be accounted for by age, psychological distress and flourishing. Responses were also categorised into three groups: the non‐lonely (n = 311), averagely lonely (n = 1054) and the severely lonely (n = 243), with analysis indicating that poorer well‐being was associated with increased loneliness. Due to the cross sectional nature of this research, determining the direction of causality is not possible. It remains uncertain whether increased loneliness negatively impacted on mental health, whether poor mental health lead to increased loneliness, or both in fact. Current findings suggest that severely lonely individuals may be particularly vulnerable to psychological distress and that individuals with poor mental health may be especially prone to loneliness. Individuals experiencing loneliness and/or poor mental health will almost certainly need additional support during and beyond the pandemic. [ABSTRACT FROM AUTHOR]

Health systems rely on the unpaid work of family caregivers. Nevertheless, demographic changes suggest a shortage of caregivers in the near future, which can constrain the long‐term care policy in many countries. In order to find ways to support family caregivers, a primary effort would be to estimate how much their work is worth. This paper estimates the economic value of long‐term family caregivers and how these costs would be shared by the health system, the social insurances and the cared‐for person in the absence of informal caregivers. We use data of 717 family caregivers of persons with spinal cord injury (SCI) in Switzerland. We implemented the proxy‐good method and estimated the market value of their work if performed by professional caregivers. Our results show that family caregivers in the sample spent an average of 27 hr per week caring for a relative for almost 12 years. This work, if undertaken by professional home care, has a market value of CHF 62,732 (EUR 56,455) per year. In the absence of family caregivers, these costs should be financed by the health insurances (47%), by the cared‐for person (24%) and by the social insurances (29%). It is in the best interest of the cared‐for person and of the healthcare and social systems to keep a sustained supply of family caregivers. One option is finding ways to recognise and compensate them for their work and make it less cumbersome. [ABSTRACT FROM AUTHOR]

One of the key issues in the alcohol and other drug (AOD) treatment sector concerns the reported difficulties that clients have in accessing treatment. This paper draws on qualitative interview data collected from clients undergoing treatment (n = 20) and stakeholders (n = 15) of five specialist non‐government AOD treatment services in New South Wales, Australia, to offer an in‐depth perspective about treatment entry experiences. We identified four key themes of positive treatment entry experiences: the presence of high‐quality online information which enabled clients to best match themselves to treatment; flexible and simple intake procedures with skilled and welcoming staff; the presence and quality of social and other resources (such as families, peers and private health insurance) which enabled quicker access; and prior experience in the treatment system which helped clients to gain important knowledge and skills to improve future access. We discuss implications of these findings, including that waiting lists significantly exacerbate inequity, but that this could be ameliorated by providing peer‐support to those trying to gain entry, especially clients who do not have family and friends for help during this period. The findings also point to the way that client self‐determination is central to all positive treatment entry experiences, and that supporting clients to find 'the right fit' in relation to treatment options improves their experiences. [ABSTRACT FROM AUTHOR]

Purpose. The aim of the study was to evaluate general physical activity (PA) level on the basis of leisure time and transportation physical activity (LTPA and TPA), assess the percentage of persons not meeting PA recommendations by the World Health Organisation (WHO), and evaluate the relationship between selected sociodemographic factors and physical inactivity. Methods. The paper is based on data (n = 7,347) retrieved from five large-scale surveys (2014-2018) used to collect information on the PA of Polish society. In order to meet the aim of the paper, we selected a sample of 2,023 Poles aged ≥ 60 years old. In each wave, the Polish long version of the International Physical Activity Questionnaire was used. Mann–Whitney U and Kruskal-Wallis tests were used to investigate the differences between the types and volume of PA and sociodemographic variables. Relationships between physical inactivity and analysed variables were evaluated using log-linear analysis. To capture relationships between physical inactivity and a set of explanatory variables, a predictive model was built. Results. The total average energy expenditure amounted to 1879.5 ± 2352.5 MET-min/week, including LTPA (938.5 ± 1491.9 MET-min/week) and TPA (944.8 ± 1322.4 MET-min/week). Over the course of the last two years of the study, the average value of MET-min/week increased significantly (p < 0.05); however, prohealth WHO norms are not met by nearly 40% of Poles. Sex determines the volume of LTPA and TPA (p < 0.05) but does not determine the inactivity of seniors. Place of residence and education differentiate participation in LTPA and TPA. The lower the education level and the smaller the place of residence, the greater the inactivity. Conclusions. The target for future interventions should be people aged 60+ living in villages and small towns (especially those with primary education). It is necessary to undertake educational and motivational programmes promoting PA. It is essential to develop detailed recommendations and to create a friendly and supportive environment. [ABSTRACT FROM AUTHOR]

This paper reports and discusses the weekly Clapping for Carers – described as 'front‐line heroes' that took place across the United Kingdom during the first national lockdown of the coronavirus pandemic. Data are drawn from a UK‐wide online survey of health and social care workers, completed in May to July 2020. The survey received 3,425 responses of which 2,541 were analysed; free‐text comments were categorised. One question asked specifically: 'Do you think the "Clap for Carers" was a helpful response from the public?', and 815 comments were provided. Responses were extracted from these 815 free‐text comments and categorised as follows: unequivocally Yes, predominantly Yes, mixed feelings, predominantly No and unequivocally No. Most comments revealed mixed feelings about the helpfulness of Clapping with only a minority being entirely supportive. The free‐text comments offer some explanations for these views with many feeling that Clapping distracted from the severity of the pandemic and the inadequate resources. The free‐text comments reveal workforce concerns that the support demonstrated for the frontline workforce in Clapping might be transitory and that it may not translate into workforce improvements and political commitment to further funding of health and social care. Some saw the value of Clapping as illustrative of community cohesion. There was little mention of Clapping for heroes, and where it was the notion of heroism was rejected. The demonstration of public support in Clapping for Carers may have directly benefitted the public, but only indirectly the workforce. Future recruitment data may help discern if public support has translated into a desire to join the workforce. [ABSTRACT FROM AUTHOR]

Background. Dietary diversification is considered the proxy indicator of dietary quality and nutrient adequacy during pregnancy. Pregnant women have been considered susceptible to malnutrition because of their increased nutrient demands and thus consuming a variety of foods in their diet plays a lion's role in ensuring adequate nutrient intake. So understanding bottleneck factors associated with dietary diversity practice is very crucial to encouraging adequate dietary diversity practice. Therefore, this paper aimed to assess determinants of dietary diversity practice among pregnant women in the Gurage zone, Southwest Ethiopia. Methods. A community-based cross-sectional analytical study was conducted among 726 pregnant women, 13 key informants, and 27 focus group discussion discussants in the Gurage zone, southwest Ethiopia, from 1 September to 1 November 2021. A face-to-face interviewer-administered questionnaire was used to collect the data. According to the Minimum Dietary Diversity Score for Women (MDD-W) tool, women who consumed more than or equal to 5 of 10 food groups in the previous 24 hours had a diverse diet. Epi data version 3.1 was used for data entry, while SPSSversion 26 was used for analysis. To determine factors associated with dietary diversity, bivariate and multivariable logistic regression models were used to obtain crude odds ratio (COR), adjusted odds ratios (AOR), and 95 percent confidence intervals (CIs). Statistical significance was determined using adjusted odds ratios (AORs) with 95 percent confidence intervals (CIs) and p values less than 0.05. In narrative form, qualitative results were triangulated with quantitative data. Results. The overall prevalence of the adequate dietary diversity practice was found to be 42.1% with 95% CI (48.4–46.1%) and the mean dietary diversity score was 5.30 ± 1.49 standard deviation (SD). Multivariable analysis revealed that primary school level [AOR = 6.471 (2.905, 12.415)], secondary school level (9–12) [AOR = 7.169 (4.001, 12.846)], college and above level [AOR = 32.27 (15.044, 69.221)], women with higher empowerment [AOR = 3.497 (2.301, 5.315)], women with a favorable attitude toward dietary diversity [AOR = 1.665 (1.095, 2.529)], women from wealthier households [AOR = 2.025 (1.252, 3.278)], and having well-secured food status [AOR = 3.216 (1.003, 10.308)] were variables that influence dietary diversity practice. Three FGD and 13 key informant interviews were conducted, and the results of qualitative data generated three major themes. Conclusion. The overall prevalence of adequate dietary diversity practice was found to be low in this study when compared to studies conducted in Ethiopia. Maternal educations, mothers' attitudes toward dietary diversity, women empowerment, food security status, and wealth index level of the household were determinant factors that influence dietary diversity practice in this study. Therefore, programs aimed to improve pregnant women's dietary diversity practice should focus on improving the socioeconomic status and creating a congenial environment to promote women's empowerment. [ABSTRACT FROM AUTHOR]

Background: People around the world look hesitant to get the coronavirus disease‐2019 (COVID‐19) vaccine. Identifying factors behind people's hesitancy is of great importance. Aim: This paper aimed at examining the predictors of the intention to get the COVID‐19 vaccine in a sample of 281 Jordanians. Methods: A cross‐sectional online survey was employed to collect data on the intention to vaccination, knowledge and attitudes toward COVID‐19, the perception of measures taken by the government to control COVID‐19, self‐rated health, and perceived susceptibility and severity of COVID‐19. Results: The subjects were hesitant to get the vaccine. Intention to get the vaccine was predicted by being male, working in the education field, and having a poor perception of health, better perception of the adequacy of governmental measures, positive attitudes towards COVID‐19, and higher levels of perceived susceptibility to the disease. These predictor variables accounted for 25.5% of the total variance. Conclusion: This study demonstrated that this sample of Jordanian people had some hesitancy to take the COVID‐19 vaccine; variables in the study partially explained that. Several implications have been discussed, including further research is needed to fully understand the relationships between different variables and the intention to get the vaccine. [ABSTRACT FROM AUTHOR]

Undernutrition is an inadequate supply of energy and nutrients. Periodontal diseases (PDs) are defined as a broad form of chronic inflammatory disease of the gingiva, bone, and ligaments supporting the teeth. This study aimed to reveal the relationship between undernutrition, using body mass index (BMI) and serum albumin level (Alb), and PDs in a sample of Yemeni population. A cross-sectional study was conducted at dental teaching clinics at the Faculty of Dentistry, Sana'a University. Of 1920 patients who attended clinics, only 229 matched the study criteria. Oral examination was performed to assess the periodontal clinical parameter measurements. BMI and Alb were measured. Participants of both genders were involved, with a slight increase in males (n = 134, 58.5%), and most of the study sample was in the age group of 18–35 years (n = 209, 91.3%). Regarding habits, only 18.2% (n = 43) of patients were smokers and about half of the participants (n = 136, 59.4%) were khat chewers. Most cases had mild undernutrition according to BMI (n = 139, 60.7%) and normal Alb level (n = 213, 93%). Regarding the periodontal diagnosis, most of the participants were diagnosed with gingivitis (n = 186, 81.2%). BMI and albumin level were nonsignificantly associated with PDs. PDs were statistically significant with the participant's age, gender, level of education, and smoking (P > 0.05). However, BMI, khat chewing, and albumin level were nonsignificant factors of periodontal diseases among Yemeni participants (P > 0.05). In both genders, variables such as age of the patients, smoking, khat chewing, and PDs were nonsignificantly associated with BMI. This study showed that the majority of the participants had been diagnosed with gingivitis, but there was not an association between PDs and undernutrition. This paper is presented on research square URL // https://www.researchsquare.com/article/rs-429796/v1 with DOI 10.21203/rs.3.rs-429796/v1. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the relationship between work engagement and inclusive leadership in Chinese hospital head nurses. Besides, it explored the effect of the mediating role of inclusive leadership in the relationship between work engagement and innovative behaviour among Chinese hospital head nurses. Background: Head nurses are essential in the group of registered nurses who are to pass the Chinese licensure examination for nurses. Their work engagement and innovative behaviour are beneficial to improve the quality, efficiency and competitiveness of nursing services. However, little is known about the mediating role of inclusive leadership in the relationship between work engagement and innovative behaviour. Methods: In April 2018, a total of 374 Chinese head nurses were surveyed with a Work Engagement Scale, an Inclusive Leadership Scale and an Innovative Behavior Scale. Because the data were normally distributed in our study, Pearson's correlation coefficient (r) was used to conduct the correlation analysis of study variables. Multiple linear regression analysis was used to explore the factors of innovative behaviour. Model 4 of Hayes's (2013) PROCESS macro and Bootstrap method was used to examine the mediating role of inclusive leadership. Result: Inclusive leadership was significantly and positively correlated to innovative behaviour and work engagement (p < 0.01). Moreover, work engagement was correlated with innovative behaviour (p < 0.01). In addition, hospital level, publishing papers, work engagement and inclusive leadership were the factors of head nurses' innovative behaviour (p < 0.01). Inclusive leadership partially mediated the relationship between work engagement and innovative behaviour, accordingly. Conclusion: Work engagement affects innovative behaviour among Chinese head nurses, and inclusive leadership is a mediator in the relationship. We should take measures to improve the leaders' level of inclusive leadership, in order to strengthen head nurses' innovative behaviour. Implications for nursing management: According to the results of the study, the leaders of head nurses should pay attention to improve head nurses' innovative behaviour, inclusive leadership, work engagement, and the quality and competitiveness of nursing. [ABSTRACT FROM AUTHOR]

Background. A lot of effort is being done in the electronic medical record (EMR) system. However, it has not been implemented and used at the expected scale for maximal effectiveness. There is limited evidence on the factors affecting the utilization of EMR in this particular context, which are critical for targeted strategies. Objective. To assess the magnitude and factors affecting the utilization of EMR among health professionals in eastern Ethiopia. Methods. An institutional-based cross-sectional study was conducted among randomly selected 412 health professionals from Harari and Dire Dawa, eastern Ethiopia, using a pretested self-administered questionnaire. The tool was developed from previous literature, and a pilot survey was done before the actual study. Bivariable and multivariable binary logistic regression were done to assess the relationship between an independent variable with EMR use. Crude and an adjusted odds ratio with a 95% confidence interval were reported. A P value of less than 0.05 was used to declare a statistically significant association. Results. A total of 412 health professionals with a mean age of 29 years (±6.4 years) were included. A total of 229 (55.6%) and 300 (72.8%) of them had good knowledge and attitude towards the EMR, while 279 (67.7%) used the service (54% used it on a daily basis). About 272 (66%) of the respondents reported that they prefer EMRs to paper-based systems. Health professionals with more than five years of experience had two times higher odds of using the service (AOR = 2.22 ; 95% CI; 1.12-4.42) than early-career workers. Health professionals trained in EMR would use the service more (AOR = 5.88 ; 95% CI; 2.93-11.88) compared to those who did not take the training. In addition, having good knowledge (AOR = 1.52 ; 95% CI; 0.92-1.5) and a good attitude towards the EMR system (AOR = 2.4 ; 95% CI; 1.35-4.31) showed to use EMR as compared to counterparts. Conclusions. The utilization of EMR was found to be optimal. Age, work experience, knowledge, attitude, and training of professionals were positively associated with the use of the service in their facility. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to describe the prevalence and reasons for non‐nursing tasks as perceived by nurses. Background: Four types of non‐nursing tasks have been identified to date: (a) auxiliary; (b) administrative, (c) expected by allied health care professionals; and (d) medical. However, no studies on a large scale have been performed with the aim of identifying the prevalence of all of these non‐nursing tasks, and factors promoting or hindering their occurrence, given that they represent a clear waste of nurses' time. Methods: A cross‐sectional study in 2017, following The Strengthening the Reporting of Observational studies. All active nurses registered in an Italian provincial Nursing Board (=1331) willing to participate were involved. A questionnaire survey exploring the nature of the nursing tasks performed in daily practice and the underlying reasons was administered via paper/pencil and e‐mail. Results: A total of 733 nurses participated of which 94.5% performed at least one type of non‐nursing task, mainly administrative and auxiliary. Auxiliary tasks are less likely among nurses working in a community (odds ratio [OR] 0.43, 95% CI 0.29–0.63, p <.01) or in a residential (OR 0.41, 95% CI 0.23–0.72, p <.01) setting, in critical (OR 0.29, 95% CI 0.16–0.54, p <.01) or surgical (OR 0.37, 95% CI 0.19–0.75, p <.01) hospital settings, and when they deal with unexpected clinical events (OR 0.58, 95% CI 0.44–0.77, p <.01). Greater adequacy of nursing resources decreases the occurrence of auxiliary tasks (OR 0.98, 95% CI 0.97–0.99, p <.01), whereas the need to compensate for a lack of resources (OR 1.44, 95% CI 1.07–1.93, p <.01) increases it. Conclusions: Around one‐third of shift time is devoted to non‐nursing tasks; working in a hospital, in medical units, with lack of resources and with patients with predictable clinical conditions might increase the occurrence of auxiliary tasks. Implications for nursing management: Strategies to increase the time available for nursing care should consider the type of tasks performed by nurses, their antecedents and the value added to care in terms of patient' benefits. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this paper was to investigate the relationship between high‐involvement human resource management, autonomy, affective organisational commitment and innovative behaviours of nursing staff who care for elderly clients. Background: Nursing teams are increasingly required to demonstrate innovative behaviours that enhance care quality. Nursing leaders need to create environments where nursing staff have sufficient autonomy and feel a sense of commitment to support these behaviours. The appropriate implementation of these processes and practices may lead to greater involvement. Methods: A cross‐sectional survey‐based research design was employed to explore the experiences of involvement practices, autonomy, affective organisational commitment and innovative behaviours of 567 nursing staff workers from four elderly care organisations in the Netherlands. Results: The results demonstrate that a bundle of high‐involvement practices positively influences innovative behaviour and that affective commitment and autonomy fully mediate this relationship. Conclusions: The study highlights the role of autonomy and commitment as routes towards translating involvement practices into nurses' innovativeness. Implications for Nursing Management: To create an innovative environment, leaders need to create a positive climate by providing nurses with opportunities to enhance their competence, relatedness and autonomy through active involvement. Leaders should, therefore, encourage involvement as a mechanism to promote innovation. [ABSTRACT FROM AUTHOR]

Background: Nursing students' and educators' experiences with e‐learning during the Coronavirus disease 2019 (COVID‐19) pandemic are unknown in most countries. Aim: To (1) describe and compare Egyptian nursing students' and educators' experiences with e‐learning during the COVID‐19 pandemic and (2) elicit participants' preferences for responding to online versus paper questionnaires. Methods: This is a cross‐sectional online survey of nursing students (undergraduate and postgraduate; n =580) and nursing educators (n = 95) in one faculty of nursing in Egypt. The survey assessed participants'characteristics, preferences for online versus paper surveys, and 11 dimensionsrelated to the e‐learning experience, such as perceived competency, satisfaction, cognitive presence, and the preferred platforms for e‐learning. Results: About 91% of students and 80% of educators received either no or inadequate training on e‐learning before the pandemic. Students' and educators' experiences significantly differed (p‐value < 0.001) in most of the examined dimensions, with educators having better experiences. About 71% of the students and 76% of the educators preferred responding to online surveys. The Strengths, Weaknesses, Opportunities, and Threats (SWOT analysis) of e‐learning were mapped. Conclusion: Students are in more need of training on e‐learning than educators, and this training is a must before any attempt to undertake online exams. The online survey is a preferred methodology among Egyptian nursing educators and students. The provided SWOT analysis may help administrators best implement and support e‐learning during infection outbreaks. [ABSTRACT FROM AUTHOR]

Despite a growing burden of stroke in low‐middle‐income countries, research on patient's experiences and access to rehabilitation services remains limited. This study explores the experiences of stroke patients in relation to access and use of stroke rehabilitation services, coping strategies and strategies to improve care in Ghana. A cross‐sectional study was conducted. A total of 136 adult stroke patients hospitalised and subsequently discharged in three major referral hospitals in Ghana participated in the study. A paper‐based questionnaire was used to collect data. Data were inputted into STATA version 12, cleaned and analysed using descriptive statistics and Chi‐Square tests. Findings showed that stroke patients experience stroke differently. Early detection (awareness) of stroke symptoms at onset was low (29.4%). Hypertension was the major (58.1%) predisposing risk factor for stroke, followed by diabetes (14.7%). Multiple barriers impede access to outpatient rehabilitation services: high cost of medications (43.4%), transportation constraints (10.3%), long waiting time (6.6%), forgetfulness about appointment (4.4%), limited education on rehabilitation (20.6%), lack of community support (12.5%) and ineffective communication with healthcare providers (5.2%). Recommended strategies to improve access to rehabilitation care included public education on stroke and its associated risk, reduction in the cost of drugs and increased stroke rehabilitation funding by the NHIS, especially for physiotherapy consultation and training support to caregivers on patient care. Given the difference in stroke experience and barriers in accessing rehabilitation care, multi‐level health policy and service delivery reforms are needed to improve access to rehabilitation care, including national public awareness campaigns on early signs of stroke and subsidised cost of stroke rehabilitation. [ABSTRACT FROM AUTHOR]

Cancer patients undergoing chemotherapy experience a range of treatment-related problems, and variations in prevalence exist between treatment centres. A scoping review was undertaken to map reported rates of problem prevalence in the literature. This will inform development of a patient-reported outcome measure ( PROM) to monitor prevalence and severity of problems over time and assist service providers optimise supportive care provision. Two databases ( Embase and Medline) were searched from 2002 to 2013. Fifty one published papers and conference abstracts reporting problem prevalence rates were identified. The papers reported 98 different problems, from which a typology of 27 problem domains was developed, including both physical symptoms and psychosocial issues. The problem domains most often studied were nausea, vomiting and fatigue. This review reflects the chemotherapy-associated problems to which researchers attach the most importance. The range in reported prevalence across studies was very broad (e.g. nausea: 9-74%), with even less frequently studied problems showing high prevalence in some studies (e.g. gynaecological problems: up to 94%). The wide variation in prevalence and range of problems experienced raises challenges for PROM development. Patients should therefore be involved in consensus exercises to assist selection of items to ensure any instrument is complete and robust. [ABSTRACT FROM AUTHOR]

Objective: To trial collecting patient‐reported outcome measures (PROMs) to assess psychosocial outcomes in men with prostate cancer (PC). Methods: A cross‐sectional postal survey was sent to three groups of 160 men with PC (6, 12 and 24 months post‐initial treatment; ntotal = 480), through the South Australian Prostate Cancer Clinical Outcomes Collaborative (SAPCCOC) registry (2017). Outcomes were as follows: response rate, completeness, general and disease‐specific quality of life, distress, insomnia, fear of recurrence, decisional difficulties and unmet need. Results: A response rate of 57–61% (n = 284) was achieved across groups. Data completeness was over 90% for 88% of survey items, with lower response (76–78%) for EPIC‐26 urinary and sexual functioning subscales, sexual aid use (78%) and physical activity (68%). In general, higher socio‐economic indicators were associated with higher completion of these measures (absolute difference 12–26%, p < 0.05). Lower unmet need on the sexuality domain (SCNS‐SF34) was associated with lower completion of the EPIC‐26 sexual functioning subscale [M (SD) = 12.4 (21.6); M (SD) = 26.3 (27.3), p <.001]. Worse leaking urine was associated with lower completion of urinary pad/diaper use question (EPIC‐26) [M (SD) = 65.9 (26.5), M (SD) = 77.3 (23.9), p <.01]. Conclusion: Assessment of psychosocial PROMs through a PC registry is feasible and offers insight beyond global quality of life assessment, to facilitate targeting and improvements in services and treatments. [ABSTRACT FROM AUTHOR]

Background. Despite substantial progress in the treatment of hepatitis C through the use of direct-acting antivirals which have been shown to cure the disease, complementary and alternative medicines (CAM) are popular among patients as a substitute or complement of allopathic medicines. This study aimed to explore the perspectives of patients and CAM practitioners on the use of CAM for the treatment of hepatitis C in Pakistan. Methods. A cross-sectional design was adopted. Participants (CAM practitioners and patients) were recruited from the capital and two provinces: Khyber Pakhtunkhwa and Punjab of Pakistan. A survey using paper-based questionnaires, each specific for patients and CAM practitioners, was conducted to gather information pertaining to demography, disease status, treatment history, and participants' perspectives (about the disease, reasons to switch to CAM, and referring source). Results. A total of 417 respondents (n = 284 patients, n = 133 practitioners) were recruited. Of the total patients, 170 (59.9%) had started CAM during the previous three months. There were 168 (59.2%) of the total patients who had used allopathic treatments for hepatitis C prior to their use of CAM. The confidence in CAM (24.6%), high cost (19%), and unbearable side effects (52.1%) of allopathic medicines were the main reasons to switch to CAM treatment. Majority (49.3%) of the patients were referred to CAM on the recommendations of relatives or care givers (17.3%) whereas only 9.5% were referred by health care professionals. Out of 133 practitioners, 48 (36.1%) were practicing herbal medicines. From practitioners' perspectives, club-moss (Lycopodium clavatum) was the best treatment option for hepatitis C. The majority, 73 (54.9%), of the patients had chosen to use CAM because of the side effects of allopathic medicines. Patients who had previous "good experience" with CAM were the most common referral source (56.4%) for CAM use in hepatitis C. Conclusions. Patients' beliefs in CAM, side effects of allopathic therapy, high cost of allopathic medicines, and referrals from previous CAM users are key factors in the switching of hepatitis C patients to CAM. [ABSTRACT FROM AUTHOR]

Background and Objective. Anxiety is an emotional and behavioral disorder that may disturb the student's quality of learning and its outcome. This study is aimed at assessing the prevalence and associated factors among pharmacy students at a university in Saudi Arabia. Methods. We used a cross-sectional design, and data collection was carried out over a period of two months from September 2018 to November 2018 using paper-based self-administered questionnaires. The General Anxiety Disorder-7 (GAD-7) scale was used to measure and classify anxiety among the study participants. Results. The prevalence of anxiety among pharmacy students was 49% (83 students); 44 students (25.9%) had mild anxiety, while 24 (14.1%) students had moderate anxiety, and 15 (8.8%) severe anxiety. There were statistically significant differences in anxiety scores according to faculty type (p = 0.2) and nutritional status (p = 0.4). Conclusion. The findings of this study revealed that half of the pharmacy students suffered from anxiety incidence during their studies at the university. However, the majority of them are experiencing mild to moderate. This may have a significant impact on academic performance and necessitates special attention. [ABSTRACT FROM AUTHOR]

Aim: To assess the perception of the nursing profession in Armenia from the perspective of multiple stakeholders, including nurses and the general public. Background: Nurses' role perception is a complex phenomenon defined by multiple stakeholders. Methods: The assessment used a convergent parallel mixed‐methods design, with a dominant qualitative status. We conducted the qualitative phase through focus group discussions and in‐depth interviews with 235 people and collected quantitative data in a cross‐sectional telephone survey with 389 participants. Results: The nursing profession has been influenced by medical hierarchy and subordination, and none of the participants recognized nursing as an autonomous health care profession. The quantitative survey findings were largely consistent with the qualitative results. Our findings highlighted empathy and compassion as inherent qualities of nurses in Armenia. Conclusion: To change opinions about the nursing profession and highlight nurses' meaningful contribution to the provision of health care services, it is important to develop a national definition of nursing and introduce higher educational opportunities for nurses in Armenia. Implications for nursing management: The paper highlights the importance of quality education for preparing highly competent nurse managers who can become role models in promoting nurses' roles in health care systems and improving the professional and public image of nursing. [ABSTRACT FROM AUTHOR]