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Background: In the digital environment, users' academic reading behaviour has changed, working with many articles simultaneously to search, filter, scan, link, annotate and analyse content fragments. The semantic enhancement environment has been widely set with semantic technologies to offer additional and handy support for users and thus facilitate the reading process. Despite many efforts devoted to developing a semantic enhancement environment, less attention has been paid to its actual effects. Objectives: This study aims to explore the effects of a semantic enhancement environment. Methods: Elaborating on cognitive load theory and focusing on academic reading, this study compared users' cognitive load and reading effect under the semantic enhancement environment and plain text environment and verified the three hypotheses. Results and conclusions: Through experiments and statistical analysis, this study found that, under a semantic enhancement environment, users had their cognitive load reduced and their reading effect improved. Consequently, a semantic enhancement environment promotes academic reading. Takeaways: This study adds to previous literature on semantic publishing by empirically corroborating the conducive effects of semantic enhancement environment in academic reading. Additionally, it justifies semantic publishing and provides a reference for the future design of semantically enhanced reading environments. Lay Description: What is already known about this topic?: The effects of a semantic enhancement environment are open to discuss.Academic reading is fundamental to researches and hence needs promotion.Limited studies investigated the effects of a semantic enhancement environment on academic reading.Publishers require effective reading environment designs. What this paper adds?: This study constructed a semantic enhancement reading environment to conduct a reading experiment.The experiment tested cognitive load, by using WP scale, and reading effects, by answer time and answer score.Semantic enhancement environment reduces users' cognitive load, promotes users' reading effects, and bolsters users' understanding of academic reading materials, especially in microstructure content.The design of semantic enhancement reading environments needs to fully consider the features of reading materials and give users a controllable way of interaction. The implications of study findings for practitioners: Compared to plain text environment, semantic enhancement environment is preferred in academic reading.Publishers are encouraged to add semantic enhancements to their publications.This study discussed how to design an effective learning and reading environment from the perspectives of reading resources, media forms of resources, and interaction modes. [ABSTRACT FROM AUTHOR]

Background: This study examines the effect of a Theory of Mind (ToM) intervention on ToM abilities and social–emotional functioning in adolescents with developmental language disorder (DLD) or who are deaf/hard of hearing (D/HH). It emphasizes the importance of self‐reflection and measurement for personal growth. The research design incorporates both subjective and objective measures to evaluate the intervention's efficacy. Aims: To investigate the impact of the ToM intervention on ToM abilities and social–emotional functioning in adolescents with DLD or who are D/HH. It hypothesizes that participants in the intervention groups will show improved ToM and social–emotional functioning compared with those in the control groups. Methods & Procedures: Adolescents with DLD or who are D/HH were recruited through collaboration with educational institutions. The study utilized a pre‐/post‐test design, assigning participants to either the intervention or the control group. The ToM intervention involved targeted activities to enhance ToM abilities. ToM abilities and social–emotional functioning were assessed using standardized tests and self‐report questionnaires. Statistical analyses compared outcomes between the intervention and no intervention groups. Outcomes & Results: The findings reveal subjective improvements in social–emotional functioning among the D/HH intervention group. However, no significant effects on objective ToM measures were observed. These results highlight the need for further investigation and refinement of interventions in these areas. Future research should focus on improving intervention strategies and exploring additional objective measures to gain a comprehensive understanding of the intervention's impact on ToM and social–emotional functioning in this population. Conclusions & Implications: The ToM intervention shows subjective benefits in improving social–emotional functioning among D/HH adolescents. However, it does not yield significant effects on objective ToM measures. These findings emphasize the ongoing need to refine interventions targeting ToM abilities and social–emotional functioning in this population. Future studies should explore alternative strategies and incorporate additional objective measures to enhance understanding and outcomes. WHAT THIS PAPER ADDS: What is already known on this subject: Before this study, it was known that ToM interventions have the potential to enhance ToM abilities. However, the specific effects of such interventions on subjective and objective measures for ToM and social–emotional functioning in adolescents with DLD or who are D/HH remained unclear, necessitating further research. What this paper adds to the existing knowledge: This study adds to the existing knowledge by demonstrating subjective improvements in social–emotional functioning among adolescents who are D/HH and underwent a ToM intervention. However, no significant effects on objective ToM measures were observed. These findings highlight the need for refining interventions and exploring additional measures to better understand the intervention's impact. What are the potential or actual clinical implications of this work?: The subjective improvements in social–emotional functioning observed in this study have important clinical implications. They suggest that ToM interventions can positively impact the social well‐being of adolescents who are D/HH. However, the lack of significant effects on objective ToM measures emphasizes the need for further research and intervention refinement to address specific areas of improvement in this population. [ABSTRACT FROM AUTHOR]

Background: Pictures drawn by people with aphasia (PWA) are often more challenging to understand than those drawn by healthy people. There are two types of objects: those that tend to be drawn symbolically (symbolically drawn objects—SOs) and those that are likely to be drawn realistically (realistically drawn objects—ROs). Aims: To compare the identification rate and number of misunderstanding types between SOs and ROs drawn by PWA and healthy controls (HCs). To reveal trends in the misunderstandings of drawings by PWA, and to identify the language or cognitive abilities related to the identification rate of pictures drawn by PWA. Methods & Procedures: We designed a drawing task involving SOs and ROs. A total of 18 PWA and 30 HCs completed the task, and respondents identified the drawings. The identification rate and number of misunderstandings were analysed with two‐way analysis of variance (ANOVA) including group (PWA and HCs) and object type (SOs and ROs). The misunderstandings were divided into four categories varying in semantic and morphological similarity; these ratios were examined with a chi‐square test. The relationships of language and cognitive abilities with the identification rate were investigated with multiple regression analyses. Outcomes & Results: There was a significant effect of the interaction between group and object type on the identification rate (F(1.1387) = 3.90, Mean Squared Error (MSE) = 4139.67, p = 0.04): the identification rates for ROs were lower in the PWA than in the HCs. For the number of misunderstanding types, an interaction was observed between group and object type (F(1.56) = 8.26, MSE = 26.93, p < 0.01): the number of misunderstanding types for ROs in the PWA was greater than that in the HCs. The misunderstanding patterns differed between ROs and SOs (χ2(3) = 694.30, p < 0.001, V = 0.37). ROs were semantically related, whereas SOs were morphologically related. The identification rates of ROs and SOs were correlated only with Kanji writing scores (ROs: β = 3.66, p = 0.01; SOs: β = 6.57, p < 0.01). Conclusions & Implications: In drawings by the PWA, SOs had a higher identification rate, while ROs had a lower identification rate and a greater variety of misunderstandings. SOs may increase drawing motivation. Interventions to improve the identifiability of SOs and ROs should reflect each character. Identification rates were correlated only with Kanji writing scores. The PWA, whose native language was Japanese and had preserved Kanji writing abilities, and their communication abilities may be increased through drawing. WHAT THIS PAPER ADDS: What is already known on the subject: PWA often have impaired drawing abilities and draw pictures that third parties misinterpret. Some objects tend to be drawn symbolically, and some are drawn realistically. However, it is not clear whether there is a difference between these types of drawings depicted by PWA in identifiability and the tendency to be misunderstood by ordinary people. In addition, the relationships between language or cognitive abilities and the identification rate of drawn pictures are not clear. What this paper adds to the existing knowledge: The identification rate differed between SOs and ROs. In drawings by PWA, SOs had a higher identification rate, while ROs had a lower identification rate and the greatest variety of misunderstandings. Approximately half of the misunderstandings were related to the target object. SOs tended to be confused with morphologically related objects, while ROs tended to be confused with semantically related objects. Identification rates were correlated only with Kanji writing scores. What are the potential or actual clinical implications of this work?: To motivate PWA's drawing, it is suitable to begin with SOs. Examining drawing ability from the perspective of SOs and ROs increases the chance of identifying drawing ability. PWA whose native language is Japanese and have preserved Kanji writing abilities may be able to increase their communication abilities through drawing. [ABSTRACT FROM AUTHOR]

Background: Training parents to implement language and communication intervention strategies is an effective approach to promote language development for children with language delay. Aims: This study introduces an online parent training program conducted in Hubei province, China, which was designed to help parents of language‐delayed children with a diagnosis of autism spectrum disorder (ASD), developmental language disorder (DLD) or global developmental delay (GDD) apply language intervention strategies into daily interactions and promote their children's language development at home. Methods & Procedures: The Bethel Hearing and Speaking Training Center Family Training for Early Communication & Language Development (Bethel Family Training Program, BFT) (Bethel HSTC, 2020) was designed to improve the language and communication skills for children with language delay in a naturalistic way. The caregivers (including parents, grandparents and other main caregivers) participated in an 8‐h online program, including lectures on milestones in child language development, common misunderstandings of child language development, and three basic family language intervention strategies ('Looking together, playing together, and talking together') incorporating active learning through video analysis and discussion. Tongji Hospital in Hubei then continued with 3 months of online home intervention monitoring to all the caregivers via weekly online Q&As led by BFT certified speech therapists' team. The Gesell Developmental Schedules (GDS) was carried out before the online parent training program and after the 3‐month online home intervention monitoring. Outcomes & Results: 146 families whose children aged 12–68 months with language delay participated in the online training program. The results of the GDS assessments conducted before and after the program showed that not only did the developmental quotient (DQ) of language improve, but so did the DQ of social behaviour and adaptive behaviour (p < 0.001). There is no between‐group difference in the application of three strategies between the ASD group and the DLD or GDD group (p > 0.05). Furthermore, both caregivers' ability to apply 'looking together, playing together, talking together' strategies and the effective interaction time played important roles in improving the child's language abilities. Conclusion & Implications: The online parent training focusing on improving daily interaction with children through speech–language stimulation strategies promoted the development of language skills. It is an economic and practical approach for children with language delay who have limited access to local language intervention programs. WHAT THIS PAPER ADDS: What is already known on the subject: Parent‐implemented language intervention is an effective approach at improving children's language development. Telepractice is an appropriate model of service delivery for audiologists and speech–language therapists and may be the primary mode of service delivery or may supplement in‐person services. What this paper adds to the existing knowledge: This paper explores the effectiveness of an online parent training program and provides new evidence that online training on language support strategies (looking together, playing together, talking together) followed by home intervention monitoring works for Mandarin‐speaking children and it is equally effective for children with ASD and non‐ASD diagnosis. What are the potential or actual clinical implications of this work?: Developmental behavioural paediatricians and speech–language therapists in countries and areas that lack sufficient training resource for every child will have the option to deliver parent training and home intervention monitoring online, which will save time and cost considerably while offering convenience. [ABSTRACT FROM AUTHOR]

Purpose Although tablet computers offer advantages in data collection over traditional paper-and-pencil methods, little research has examined whether the 2 formats yield similar responses, especially with underserved populations. We compared the 2 survey formats and tested whether participants' responses to common health questionnaires or perceptions of usability differed by survey format. We also tested whether we could replicate established paper-and-pencil findings via tablet computer. Methods We recruited a sample of low-income community members living in the rural southern United States. Participants were 170 residents (black = 49%; white = 36%; other races and missing data = 15%) drawn from 2 counties meeting Florida's state statutory definition of rural with 100 persons or fewer per square mile. We randomly assigned participants to complete scales (Center for Epidemiologic Studies Depression Inventory and Regulatory Focus Questionnaire) along with survey format usability ratings via paper-and-pencil or tablet computer. All participants rated a series of previously validated posters using a tablet computer. Finally, participants completed comparisons of the survey formats and reported survey format preferences. Findings Participants preferred using the tablet computer and showed no significant differences between formats in mean responses, scale reliabilities, or in participants' usability ratings. Conclusions Overall, participants reported similar scales responses and usability ratings between formats. However, participants reported both preferring and enjoying responding via tablet computer more. Collectively, these findings are among the first data to show that tablet computers represent a suitable substitute among an underrepresented rural sample for paper-and-pencil methodology in survey research. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate a new prenatal education program evaluation tool, the UpStart Parent Survey – Prenatal, in terms of: (a) reliability and validity; (b) sensitivity to change over time; (c) whether results differed for mothers versus fathers; and (d) whether results differed when using an electronic tablet‐computer versus a paper survey. Design and Sample: Psychometric study. Participants were 277 expectant mothers (n = 161) and fathers (n = 106) enrolled in Childbirth Essentials, a 6‐week prenatal education program. Measures: The UpStart Parent Survey – Prenatal is a retrospective pretest/posttest survey with three scales: Parenting Knowledge, Parenting Experience, and Program Satisfaction, and three open‐ended questions. Results: The UpStart Parent Survey – Prenatal is sensitive to change and demonstrated significant positive differences in parenting knowledge and parenting experience. There was no difference in results whether the survey was completed by mothers or fathers. Results were similar whether paper or electronic formats were used. The survey was easy to complete. Conclusion: The UpStart Parent Survey – Prenatal holds promise as a reliable and valid evaluation tool to capture outcomes of brief prenatal education programs that target the general population of expectant parents. [ABSTRACT FROM AUTHOR]

Introduction: This study investigates the effectiveness of the segmentation principle from the cognitive theory of multimedia learning as well as the effectiveness of the generative learning strategy of summarization in immersive virtual reality (IVR) within a sample of preadolescents. Although previous research has supported the effectiveness of these instructional methods in multimedia learning, it remains unclear whether segmentation, summarization or the combination of both are superior to a stand‐alone IVR lesson in facilitating learning. Methods: To address this gap, 190 sixth to seventh grade students learned about the human body in an IVR lesson. Students were randomly assigned to one of four experimental conditions: (a) an IVR lesson divided into four segments (segmentation condition); (b) an IVR lesson, where students summarized after the entire lesson (summarizing condition); (c) an IVR lesson presented in four segments, where students summarized after each segment (combined condition); and (d) an IVR lesson without any manipulation (control condition). Results: Results indicated that, compared to the control condition, adding segmentation or summarization to an IVR lesson leads to better transfer, but not to acquiring more factual knowledge. Combining the two methods did not improve learning. Conclusion: The findings support the evidence that choosing appropriate instructional methods for IVR lessons can foster transfer. Lay Description: What is currently known about the subject matter: The use of immersive virtual reality (IVR) in classroom settings is increasing rapidlyThere are mixed results related to the efficiency of using IVR for learning facts and conceptsFew studies have investigated if efficient instructional design guidelines generalize to IVRFew studies have investigated the efficiency of IVR within a children sample What their paper adds: A class‐room investigation of the value of using different instructional design methods for designing IVR lessons within a children sampleResults indicated that, compared to the control condition, adding segmentation or summarization to an IVR lesson leads to better transferAdding segmentation or summarization did not lead to more factual knowledge Implications of study findings for practitioners: Choosing appropriate instructional methods for IVR lessons can foster transferStudents profit most from IVR lessons when they are given opportunities for refection during or following the immersive experience [ABSTRACT FROM AUTHOR]

Background: Information is available about what predicts Lidcombe Program treatment time, but nothing is known about what predicts treatment prognosis. Aims: To investigate the predictors of treatment dropout and treatment outcome for children who were treated for early stuttering with the Lidcombe Program (N = 277). Methods & Procedures: A total of 32 variables were used as predictors in regression analyses of short‐ and medium‐term Lidcombe Program outcome, and of treatment dropout. Outcomes & Results: Regression analyses associated children who have better language skills and easy temperament with better treatment outcome, although only a small portion of the variance of treatment outcome was accounted for by these variables. There was an association between treatment dropout and parental scores on a personality screening tool relating to their impulsivity. Conclusions & Implications: Variables identified as predictors of Lidcombe Program treatment outcome were statistically significant, but not clinically significant. They did not account for a clinically substantive portion of treatment outcomes. Findings about parental impulsivity and their relationship with intervention drop‐out require replication with prospective methods and comprehensive assessment of parent psychological status. This is particularly important because parents are involved in conducting all early interventions. What this paper addsWhat is already known on the subjectInformation is available about what predicts Lidcombe Program treatment time, but nothing is known about what predicts Lidcombe Program treatment outcome.What this paper adds to existing knowledgeThere are predictors of Lidcombe Program treatment outcome that are statistically significant, but none are clinically significant.What are the potential or actual clinical implications of this work?Clinicians can tell parents that nothing has been found that can assist with making prognostic indications about treatment outcome for their children. [ABSTRACT FROM AUTHOR]

Background: It is estimated that up to one in three lesbian, bisexual or queer (LBQ) women in Australia have children. In the past decade, it has become common for LBQ women to pursue pregnancy using clinic‐acquired donor sperm. Aims: The aims of this paper are to explore pathways to parenthood among Australian LBQ women in the context of increased access to fertility clinics and identify the type of clinical fertility services being used. Materials and method: This paper reports on female LBQ parents and expectant/prospective parents who participated in a 2016/2017 online survey of Australian lesbian, gay, bisexual, transgender and queer (LGBTQ) adults exploring reproductive choices, pathways to parenthood, conception method and use of clinical fertility services. Results: More than half the children reported on by current parents (52%) had been conceived using clinical fertility services. When asked what factors influenced a parent respondent's decision to use fertility services: 80% indicated access to donor sperm, 41% indicated fertility problems. Of respondents who had accessed donor sperm, over half (57%) had used in vitro fertilisation (IVF) services. Conclusions: These findings indicate that use of fertility clinics to access donor sperm is common for LBQ women, including those with no known fertility problems, and that most women who access donor sperm conceive using IVF rather than intrauterine insemination. More needs to be known about the context and reasons for this, including factors that influence LBQ women's decision making on their pathway to parenthood. [ABSTRACT FROM AUTHOR]

Background: Treatment of paediatric trauma requires specialized infrastructure, medical equipment, medical staff and ancillary support personnel that have been specifically trained for such tasks. Aims and Objectives: To examine the perceptions and attitudes of physicians and nurses in general and paediatric emergency departments (PEDs) on training, confidence, and management of paediatric trauma in order to facilitate the establishment of an optimal model for admitting and treating paediatric trauma patients. Design: Drawing on published literature and a previously conducted qualitative study that explored the provision of medical care to paediatric trauma patients, we conducted an attitude survey. Methods: A 26‐item paper‐based questionnaire was distributed by nurse managers to all staff working within general EDs and PEDs of 22 medical centres across Israel. Results: Of 843 physicians and nurses who completed the survey, 61.1% considered PEDs the most appropriate facility for treating both minor and severe paediatric trauma, 88.5% believed that minor paediatric trauma should be treated in designated paediatric trauma centres, and 53.6% deemed that paediatric emergency medicine specialists are the most suitable primary decision makers in paediatric trauma. PED teams expressed greater professional confidence for treating paediatric trauma and multiple casualty incident patients. Greater professional confidence was positively correlated with paediatric trauma training, greater exposure to paediatric trauma cases, and working in larger medical centres. Conclusions: The results of the current study suggest that PEDs are perceived to be more appropriate for dealing with paediatric trauma. Also, treatment of severe trauma may be more appropriate in centres that admit large numbers of paediatric trauma cases. Relevance to clinical practice: Emergency medicine teams should undergo training for dealing with paediatric trauma. Such training would develop their skills, increase their confidence, and enhance their emotional abilities to cope with paediatric trauma. [ABSTRACT FROM AUTHOR]

Prior studies have focused on general technology use and technology use in domain‐general applications and quantity of technology use. Recent evidence suggests that investigations should consider how technology is used in more contextually specific ways, including how technology is used for various cognitive tasks in specific classrooms. The purpose of this study was to examine the ways in which classroom content area and student goal orientation have a coordinated influence for how students used technology to support learning. The sample included high school students in a Midwestern state who were surveyed on their motivation and how they used technology to support learning. The study employed hierarchical linear modelling to examine how goal orientation and classroom content area predicted various levels of Bloom's Digital Taxonomy. Students who adopted mastery‐oriented goals were more likely to use technology for various cognitive tasks, especially those at higher levels of complexity. Lastly, the association between mastery goal orientation and some aspects of technology use was conditioned on content area, although effect sizes were small. This study showed that, overall, technology is used differentially across four core content areas. Students in mathematics classrooms used technology less, however much of technology use was evident at lower cognitive levels. Second, students' goal orientation, and in particular their mastery goals influence how technology is used across content areas, and this is marginally conditioned on content area. Technology use should match the instructional context to maximize technology use and students' goal orientation. Lay Description: What is already known about this topic: Computer technology tools support cognitive engagementTechnology tool availability differs by content areaStudent motivation is often positively related to increased technology use What this paper adds: Student technology use for various cognitive tasks differed by content areaStudents with mastery goals were more likely to use technology differentlyMotivational patterns' effect on technology use did not differ by content areaStudents in math used technology qualitatively less than other content areas Implications for practice and/or policy: Greater emphasis should be placed on choosing technology to match content areasTechnology should be appropriately chosen to maximize cognitive learning tasksTo support technology use, teachers should help student mastery learning goals [ABSTRACT FROM AUTHOR]

Child homicides are rare occurrences, but when they occur, they often cause significant outrage. This paper examines the role of varying degrees of intimacy between victims and perpetrators in determining characteristics in child homicide cases. Focusing on 533 cases of child homicide between 1985 and 2012 in Ontario, Canada, characteristics of intrafamilial and extrafamilial cases, biological and step/foster parents, and maternal and paternal perpetrators are compared. Results show that characteristics of the child homicide vary depending on the degree of intimacy between victims and perpetrators, including: perpetrator and victim age, weapon use, suicide following the offence, sexual violence and use of excessive force. These findings provide support for developmental victimology and a routine activities theoretical perspective. Suggestions for future research and policy implications are also discussed. 'Examines the role of varying degrees of intimacy between victims and perpetrators in determining characteristics in child homicide cases' Key Practitioner Messages: Younger children are at a greater risk of homicide from family members, while older children are at a greater risk of homicide from individuals outside the family.Developmental victimology and routine activities theory can contribute to a better understanding of the dynamics between victims and perpetrators in child homicide.Collaboration should take place between researchers, child death review committees, mental health services, social services and policymakers to improve child homicide prevention and intervention initiatives. [ABSTRACT FROM AUTHOR]

The present study investigates affective‐motivational, attention, and learning effects of unexplored emotional design manipulation: Contextual animation (animation of contextual elements) in multimedia learning game (MLGs) for children. Participants (N = 134; Mage = 9.25; Grades 3 and 4) learned either from an experimental version of the MLG with a high amount of contextual animation or from an identical MLG with no contextual animation (control). Children strongly preferred (χ2 = 87.04, p <.001) and found the experimental version more attractive (p <.001, d = −1.11). No significant differences in overall enjoyment and learning outcomes were found. Attention differences, measured by dwell times and fixation durations, were small and reached only borderline significance (p =.035; d = −0.39). The implication is that contextual animation in MLG for children increases such instructional materials' attractiveness without compromising cognitive processes needed for learning; however, it does not lead to their higher instructional efficiency. Lay Description: What is already known about this topic: Contextual animation is frequently used in multimedia learning games (MLGs) for children.Contextual animation is understood to be non‐expository picture motion, which can be added to already existing representational pictures that provide context for target instruction.It is not known whether or not contextual animation, which embellishes already existing representational contextual pictures, harms learning for children in the case of MLGs. What this paper adds: Children (Grades 3 and 4) strongly prefer the game with added contextual animation compared to the game without it.No between‐group differences in overall learning enjoyment and learning outcomes were found.Small attention‐allocation effects of borderline significance were detected. Implications for practice Adding contextual animation (i.e., added non‐expository picture motion) to multimedia learning games for children will increase the attractiveness of the materials and will not hamper learning. Investment into the production of costly contextual animation may be worthwhile in the case of instructional games intended for uncontrolled settings (e.g., at home or during leisure time). In formal contexts (e.g., school), it is less clear whether investment into contextual animation is needed, since children are extraneously motivated to learn and animation does not appear to enhance learning outcomes. [ABSTRACT FROM AUTHOR]

We used a randomized controlled trial to investigate if a mobile game, GraphoLearn (GL), could effectively support the learning of first graders (N = 70), who have severe difficulties in reading and spelling. We studied the effects of two versions of the game: GL Reading, which focused on training letter‐sound correspondence and word reading; and GL Spelling, which included additional training in phonological skills and spelling. During the spring of first grade, the children trained with tablet computers which they could carry with them during the six‐week intervention. The average exposure time to training was 5 hr 44 min. The results revealed no differences in the development of reading or spelling skills between GL players and the control group. However, pre‐training self‐efficacy moderated the effect among GL Reading players: children with high self‐efficacy developed more than the control group in word reading fluency, whereas children with low self‐efficacy developed less than the control group in spelling. Lay Description: What is already known: Serious games can support children's reading achievement, but less is known about their effects in mobile learning.GraphoLearn (GL) is a serious game designed to support reading acquisition, but previous studies suggest its effect on word‐level reading is limited.Explicit training of phonological skills and spelling could facilitate transfer to word reading.Self‐efficacy predicts persistence and effort in achievement situations but its role in mobile game‐based learning is not well known. What this paper adds: A randomized controlled trial was used to study if mobile game‐based learning supports children with reading difficulties.A new GL version, training phonological and spelling skills, had no effect on the development of reading and spelling skills.Children with high self‐efficacy benefited from training with the standard GL. Implications for practitioners: When using mobile games as support tools, close attention should be paid to learner characteristics and game design.Children with high self‐efficacy may be better able to regulate their behaviour during independent training with mobile games, leading to better learning outcomes. [ABSTRACT FROM AUTHOR]

Objective This study aims to ascertain if differences exist in the perception of the professional practice environment and personal well-being of nurses across different geographical areas in Queensland. Design This paper was performed on a prospective, self-report cross-sectional on-line survey. Setting The study was conducted among the nurses employed in public and private health care settings: acute hospitals, community health and aged care in Queensland, Australia. Participants Participants of this study were 1608 registered and enrolled nurses and assistants in nursing, current members of the Queensland Nurses Union in 2013 and who provided a workplace postcode. One thousand eight of these participants worked in major cities, while 382 in rural locations and 238 in remote areas. Interventions None. Main outcome measures Scores of well-being as determined by the following scales: the Depression, Anxiety and Stress Scale, the Professional Quality of Life Scale version 5, the Connor-Davidson Resilience Scale and of the Professional Practice Environment using the Practice Environment Scale - Nursing Work Index Revised. Results Nurses employed in major cities perceived 'nursing foundations for quality care' more favourably than those from other settings. Remote area nurses had lower levels of secondary traumatic stress than nurses in major cities and rural areas. There was no difference between nurses across their geographical locations for stress, anxiety, depression, compassion satisfaction, burnout, resilience and the four other measures of the Practice Environment Scale. Conclusions The study findings provide new data suggesting that, with the exception of secondary traumatic stress, the personal well-being of nurses does not differ across geographical settings. Similarly, with the exception of the subscale of 'nursing foundations for quality care' there was no difference in perceptions of the professional practice environment. As secondary traumatic stress is associated with burnout, this finding needs to be investigated further. [ABSTRACT FROM AUTHOR]

Poor diet quality (diet diversity and animal‐source food [ASF] consumption) during childhood negatively affects growth, development, behaviour and physiologic function in later life. Relatively less is known about the impact of poor diet on the growth of school‐age children compared to children <5 years of age, especially in low/middle‐income countries. A better understanding of delivery strategies for effective interventions to improve diet and hence growth in school‐age children is needed. A 36‐month longitudinal controlled impact evaluation in rural Nepal assessed the nutrition and growth of children <5 years of age in families assigned via community clusters to full package intervention (community development, training in nutrition [during pregnancy and for children <5 years] and livestock husbandry), partial package (training only) or control (no inputs). Concurrent data were collected prospectively (baseline plus additional four rounds) on school‐age children (5–8 years at baseline) in these households; the present study analysed findings in the cohort of school‐age children seen at all five study visits (n = 341). Diet quality improved more in the full package school‐age children compared to those in partial package or control households. full package children consumed more ASF (β +0.40 [CI 0.07,0.73], p < 0.05), more diverse diets (β +0.93 [CI 0.55,1.31], p < 0.001) and had better head circumference z‐scores (β +0.21 [CI 0.07,0.35], p < 0.01) than control children. In conclusion, a multi‐sectoral community development intervention was associated with improvements in diet and growth of school‐age children in rural Nepal even though the intervention focused on the diet of children <5 years of age. The diet and growth of school‐age children can be favourably influenced by community‐level interventions, even indirectly. Key messages: Relatively less is known about the factors that influence diet quality and growth in school‐age children compared to younger children, especially in low‐ and middle‐income countries.Better diet quality and growth were found among school‐age children whose families participated in an impact study multi‐sectoral intervention compared to children in control families or those whose families only received nutrition training.Diet and growth of school‐age children can be favourably influenced by community‐level interventions. [ABSTRACT FROM AUTHOR]

Although sucrose is widely administered to hospitalized infants for single painful procedures, total sucrose volume during the entire neonatal intensive care unit (NICU) stay and associated adverse events are unknown. In a longitudinal observation study, we aimed to quantify and contextualize sucrose administration during the NICU stay. Specifically, we investigated the frequency, nature, and severity of painful procedures; proportion of procedures where neonates received sucrose; total volume of sucrose administered for painful procedures; and incidence and type of adverse events. Neonates <32 weeks gestational age at birth and <10 days of life were recruited from four Canadian tertiary NICUs. Daily chart reviews of documented painful procedures, sucrose administration, and any associated adverse events were undertaken. One hundred sixty‐eight neonates underwent a total of 9093 skin‐breaking procedures (mean 54.1 [±65.2] procedures/neonate or 1.1 [±0.9] procedures/day/neonate) during an average NICU stay of 45.9 (±31.4) days. Pain severity was recorded for 5399/9093 (59.4%) of the painful procedures; the majority (5051 [93.5%]) were heel lances of moderate pain intensity. Sucrose was administered for 7839/9093 (86.2%) of painful procedures. The total average sucrose volume was 5.5 (±5.4) mL/neonate or 0.11 (±0.08) mL/neonate/day. Infants experienced an average of 7.9 (±12.7) minor adverse events associated with pain and/or sucrose administration that resolved without intervention. The total number of painful procedures, sucrose volume, and incidence of adverse events throughout the NICU stay were described addressing an important knowledge gap in neonatal pain. These data provide a baseline for examining the association between total sucrose volume during NICU stay and research on longer‐term behavioral and neurodevelopmental outcomes. [ABSTRACT FROM AUTHOR]

Background and Objective The aim of this study is to analyze the relationship between the subgingival colonization by Candida albicans and other yeasts with the severity of chronic periodontitis ( CP). Material and Methods After sample size calculation, 40 patients with CP and 20 healthy subjects ( HS) were included in the study. Cases of slight-moderate ( MCP, n = 23) and severe CP ( SCP, n = 17) were defined according to the Centers for Disease Control/American Association of Periodontology classification. Subgingival samples were acquired using sterile paper-points from the sulcus or the deepest periodontal pocket of each healthy and subject with CP, respectively, and were cultured aerobically on three selective media. Yeast colonies that grew on the surface of plates were later identified by biochemical reactions. Statistical tests were used to analyze the association between subgingival yeast colonization (number of yeast-positive individuals and colony forming units ( CFU) per subject) and periodontal disease status, considering statistical significance when P < 0.05. Results Although several yeast species were found ( C. parapisilosis, Rhodotorula sp., C. dubliniensis and C. tropicalis), only C. albicans was present in all the patients with yeast-positive CP. Twelve patients (30%) with CP presented yeasts in the subgingival biofilm while only three patients (15%) in the HS group were positive for these microorganisms. No statistical difference was found between the CP and HS groups ( P = 0.084). However, when the CP group was divided on the basis of severity, statistical differences were observed between the SCP and MCP groups (47% vs. 17%, P = 0.043), and between the SCP and HS groups (47% vs. 15%, P = 0.033). No statistical difference was observed between the MCP and HS groups (17% vs. 15%, P = 0.832). High densities of yeasts were found only in patients with MCP and SCP (mean and range 61.25 (0-100) CFU/plate and mean and range 51 (0-101) CFU/plate, respectively). Conclusion In this group of patients, subgingival colonization of some yeasts, especially C. albicans, was associated with the severity of CP. [ABSTRACT FROM AUTHOR]

Prenatal iron supplementation improves children's health and cognitive performance, but few studies explore behavioural development. This study assessed the effects of adjusting prenatal iron supplementation to maternal iron stores during early pregnancy on children's behavioural problems. Randomized controlled trial conducted in Tarragona (Spain) involving 230 nonanaemic pregnant women and their children after a 4‐year follow‐up. Based on haemoglobin (Hb) levels before gestational week (GW) 12, women receive different iron doses: those with Hb = 110–130 g/L were randomized to receive 80 or 40 mg/day and those with Hb > 130 g/L were randomized to receive 20 or 40 mg/day. Maternal iron stores at GW12 were classified using serum ferritin (SF) as low (SF < 15 µg/L), normal (SF = 15–65 µg/L), and normal‐high (SF > 65 µg/L). Children's behaviour was assessed by parents using the Child Behaviour Checklist for ages 1.5–5 years and the Behaviour Rating Inventory of Executive Function‐Preschool Version, and by teachers using the Teacher's Report Form for ages 1.5–5 years. Multivariable regression models were performed. Taking 80 mg/day of iron improved child behaviour when women had low iron stores but worsened it when mothers had normal–high iron stores, except for depressive and attention/hyperactivity problems. Taking 20 mg/day of iron improved behaviour only in those children whose mothers had SF > 65 µg/L in early pregnancy. Additionally, executive functioning improved at high doses of prenatal iron when maternal baseline SF < 15 µg/L. Adjusting prenatal iron supplementation to both maternal baseline Hb levels and iron stores reduces behavioural problems in 4‐year‐old children. Key messages: Prenatal iron supplementation succeeds in improving maternal haematological outcomes and cognitive performance of children, but few studies have focused on behavioural development.Prenatal iron supplementation adjusted to maternal iron stores reduces behavioural problems in 4‐year‐old children.Maternal iron stores early in pregnancy should be measured in addition to haemoglobin concentration.These findings contribute greatly to the advancement of public health by giving physicians the tools to prescribe the most appropriate dose of iron supplementation to contribute to better child development. [ABSTRACT FROM AUTHOR]

Formula fed infants experience gastrointestinal infections at higher rates than breastfed infants, due in part to bacteria in powdered infant formula (PIF) and bacterial contamination of infant feeding equipment. The United Kingdom National Health Service (UK NHS) has adopted the World Health Organization recommendation that water used to reconstitute PIF is ≥70°C to eliminate bacteria. We used community science methods to co‐design an at home experiment and online questionnaire ('research diary') to explore the safety of PIF preparation compared to UK NHS guidelines. 200 UK‐based parents of infants aged ≤12 months were recruited; 151 provided data on PIF preparation, and 143 were included in the analysis of water temperatures used to reconstitute PIF. Only 14.9% (n = 11) of 74 PIF preparation machines produced a water temperature of ≥70°C compared with 78.3% (n = 54) of 69 kettle users (p < 0.001). The mean temperature of water dispensed by PIF preparation machines was 9°C lower than kettles (Machine M = 65.78°C, Kettle M = 75.29°C). Many parents did not always fully follow NHS safer PIF preparation guidance, and parents did not appear to understand the potential risks of PIF bacterial contamination. Parents should be advised that the water dispensed by PIF preparation machines may be below 70°C, and could result in bacteria remaining in infant formula, potentially leading to gastrointestinal infections. PIF labelling should advise that water used to prepare PIF should be ≥70°C and highight the risks of not using sufficiently hot water, per WHO Europe advice. There is an urgent need for stronger consumer protections regarding PIF preparation devices. Key points: Only 14.9% (n = 11) of 74 PIF preparation machines produced a water temperature of ≥70°C compared with 78.3% (n = 54) of 69 kettle users (p < 0.001).The mean temperature of water dispensed by PIF preparation machines was 9°C lower than kettles (Machine M = 65.78°C, Kettle M = 75.29°C).Most parents routinely washed and sterilised bottles and teats.Many parents did not always fully follow NHS safer PIF preparation guidance, including 21.8% washing their hands half the time or less, and 14.6% regularly pre‐preparing bottles.Most parents did not appear to understand the risks of PIF bacterial contamination. [ABSTRACT FROM AUTHOR]

Resistance exercise training is effective to counteract the adverse effects of androgen deprivation therapy (ADT) on body composition, muscle mass and leg strength in prostate cancer patients (PCa). However, it is unknown whether these effects can be autonomously maintained after cessation of the supervised program. Sixty‐eight PCa patients on ADT were included. The exercise intervention group (EX, n = 37) performed 20 weeks of supervised resistance exercise training. Thereafter, patients were advised to autonomously continue exercise training. The control group (CON, n = 31) only received usual care. Outcome measures were compared between baseline and after 1 year. Changes during the intervention (baseline vs. 20 weeks) and follow‐up period (20 weeks vs. 1 year) were descriptively explored. In EX, 83% reported to have continued exercise training themselves. After 1 year, fat mass gains were attenuated in EX compared to CON (1.2 ± 2.6 and 2.8 ± 1.9 kg, respectively; time × treatment effect p = 0.032). The fat percentage increased, and lean mass and quadriceps muscle cross‐sectional area decreased over time, with no differences between groups (overall 1.6 ± 2.1%, −0.7 ± 2.3 kg and −2.2 ± 2.9 cm2, respectively; time effects, all p < 0.05). For muscle strength, an increase of ∼5% in EX was observed, significantly different from the ∼10% decrease in CON (p < 0.001). Subsequent analyses showed that the initial exercise training‐obtained gains in lean mass, muscle mass and strength in EX compared to CON, declined during the follow‐up period. In conclusion, PCa patients on ADT are not capable to autonomously maintain the exercise‐obtained gains of a 20‐week supervised training program over a subsequent 1‐year period. Highlights: ADT for prostate cancer results in many side effects, including muscle mass lossA supervised resistance exercise training program can counteract many side effectsAfter cessation of the supervised program, exercise benefits are not effectively preservedMore focus on sustainability of exercise programs during ADT is required [ABSTRACT FROM AUTHOR]

Household Risk Perception (HRP) and Self‐Efficacy in Environmental Risk Reduction (SEERR) instruments were developed for a public health nurse‐delivered intervention designed to reduce home‐based, environmental health risks among rural, low‐income families. The purpose of this study was to test both instruments in a second low‐income population that differed geographically and economically from the original sample. Participants (N = 199) were recruited from the Women, Infants, and Children (WIC) program. Paper and pencil surveys were collected at WIC sites by research‐trained student nurses. Exploratory principal components analysis (PCA) was conducted, and comparisons were made to the original PCA for the purpose of data reduction. Instruments showed satisfactory Cronbach alpha values for all components. HRP components were reduced from five to four, which explained 70% of variance. The components were labeled sensed risks, unseen risks, severity of risks, and knowledge. In contrast to the original testing, environmental tobacco smoke (ETS) items was not a separate component of the HRP. The SEERR analysis demonstrated four components explaining 71% of variance, with similar patterns of items as in the first study, including a component on ETS, but some differences in item location. Although low‐income populations constituted both samples, differences in demographics and risk exposures may have played a role in component and item locations. Findings provided justification for changing or reducing items, and for tailoring the instruments to population‐level risks and behaviors. Although analytic refinement will continue, both instruments advance the measurement of environmental health risk perception and self‐efficacy. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The present study examined the processes by which children acquire pro-environmental behaviours in different cultures. Our focus was on parental influence. Several studies have been conducted on adults' environmental behaviours; however, we know little about how children's environmental attitudes and behaviours are formed. We conducted a questionnaire survey with elementary school children and one of their parents in Germany and Japan. Two hundred and twenty-one pairs participated in Germany and 365 in Japan. The results of structural equation modelling showed that parents' behaviours affected children's environmental behaviours directly and also via the subjective norm (the children's experienced expectations of their parents). A comparison of the two countries revealed that hypothesized cultural differences between the impact of personal norms and subjective norms were clearer for adults. The results also showed that the effects of subjective norms were stronger for children, indicating that children are more likely to be influenced by expectations of others. The results of the study suggest that for promoting children's environmental behaviours, showing the behaviours in daily life would be most effective. [ABSTRACT FROM AUTHOR]

Background Maternal depression is associated with poor child development and growth in low-income countries. This paper evaluates the effect of a community-based trial providing psychosocial stimulation and food supplements to severely malnourished children on maternal depressive symptoms in Bangladesh. Methods Severely underweight (weight-for-age Z-score < −3) hospitalized children aged 6-24 months ( n = 507), were randomly assigned to: psychosocial stimulation ( PS), food supplementation ( FS), PS+ FS, clinic control ( CC) and hospital control ( CH) at discharge. PS included play sessions with children and parental counselling to mothers during fortnightly follow-up visit at community clinics, conducted by trained play leaders for 6 months. FS involved cereal-based supplements (150-300 kcal/day) for 3 months. All groups received medical care, micronutrient supplements and growth monitoring. We used Bayley scales, Home Observation for Measurement of Environment ( HOME) inventory and a parenting questionnaire to assess child development, home stimulation and mothers' child-rearing practices, respectively. We assessed mothers' depressive symptoms using a modified version of Centre for Epidemiologic Studies Depression Scale at baseline and at 6 months post intervention. Results Maternal depressive symptoms were significantly lower in the CH group at baseline ( P = 0.014). After 6 months of intervention there was no significant effect of intervention after adjusting for baseline scores and all possible confounders. Maternal depressive symptoms were higher among poorer ( P = 0.06), older ( P = 0.057) and less educated ( P = 0.019) mothers, who were housewives ( P = 0.053), and whose husbands had more unstable jobs ( P = 0.058). At 6 months post intervention, children's cognitive ( P = 0.045) and motor ( P = 0.075) development, HOME ( P = 0.012) and mother's parenting score ( P = 0.057) were higher among mothers with lower depressive symptoms. Conclusion The study did not show a significant effect of the intervention on the level of maternal depressive symptoms. Interventions with higher intensity and/or of longer duration focusing directly on maternal psychosocial functioning are probably needed to reduce maternal depressive symptoms. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to identify a new barrier to the use of the Mini‐Nutrition Assessment Short‐Form (MNA‐SF), which is a malnutrition assessment tool for the risk assessment of sarcopenia in a nourished population. Methods: The MNA‐SF was completed, and individuals with a score of > 11 were considered nourished in this cross‐sectional feasibility study of a registry. Sarcopenia was assessed in 766 healthy, nourished adults (33.4% men, 64.9 ± 7.1 years) based on the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Results: The MNA‐SF scores for non‐sarcopenia, pre‐, confirmed, and severe sarcopenia were 13.59 ± 0.69, 13.73 ± 0.60, 12.64 ± 0.74, and 12.5 ± 0.71, respectively. The higher MNA‐SF score association with pre‐sarcopenia [odds ratio (OR): 1.41, 95% confidence interval (CI): 1.06–1.86, P = 0.02], confirmed sarcopenia (OR = 0.25, 95% CI: 0.13–0.49, P < 0.001), and severe sarcopenia (OR = 0.20, 95% CI: 0.09–0.46, P < 0.001) was as significant as in the MNA‐SF categories. Individuals with a score = 13 (compared with 14), had a higher risk of confirmed sarcopenia (OR = 10.07, 95% CI: 1.92–52.71, P = 006) and severe sarcopenia (OR = 12.09, 95% CI: 1.24–117.50, P = 0.032). Individuals with a score of 12 had a higher risk of confirmed sarcopenia (OR = 30.94, 95% CI: 4.25–103.02, P < 0.001) and severe sarcopenia (OR = 35.90, 95% CI: 4.25–303.07, P = 0.001) compared with subjects with a score of 14. The models also showed that MNA‐SF < 13 could predict sarcopenia. Conclusion: There was a significant association between MNA‐SF and confirmed and severe sarcopenia in nourished people. Sarcopenia assessment in people with MNA‐SF < 13 can be beneficial. Developing a tool to identify the risk of malnutrition and sarcopenia at the same time based on MNA‐SF can be considered. [ABSTRACT FROM AUTHOR]

Purpose The Department of Veterans Affairs (VA) and the Indian Health Service (IHS) signed a Memo of Understanding in 2010 to strengthen their partnership in improving health care services for Native veterans, who are disproportionately rural. This paper describes the demographic and service use profile of rural Native veterans who access VA health care. Methods Data were abstracted from the 2008 Veteran Health Administration (VHA) medical dataset, and the characteristics of rural Native veterans were compared to rural non-Native veterans. Findings Rural Native veterans were more rural (41% vs 35%) and more highly rural (8% vs 2%) compared to non-Native veterans. Rural Native veterans were younger, more likely to be female, and earned about the same median income compared to rural non-Native veterans. Although rural Native veterans had fewer diagnoses on average, they were more likely to have served in combat areas and to have higher levels of service-connected disability compared to other rural veterans. Conclusions Demographic and service-related characteristics of rural Native veterans who accessed VA care differ from those of rural non-Native veterans. Identifying specific health care and service use characteristics will assist in the development of appropriate policy and programs to serve rural Native veterans. [ABSTRACT FROM AUTHOR]

Aims To update the existing scientific evidence on the efficacy of local antimicrobials as adjuncts to subgingival debridement in the treatment of chronic periodontitis. Material and Methods Fifty-six papers were selected, reporting data from 52 different investigations. All the studies reported changes in probing pocket depth ( PPD) and clinical attachment level ( CAL) and most in plaque index (PlI) and/or bleeding on probing ( BOP). Meta-analyses were performed with the data retrieved from the studies fulfilling the inclusion criteria. Results The overall effect of the subgingival application of antimicrobials was statistically significant ( p = 0.000) for both changes in PPD and CAL with a weighted mean difference ( WMD) of −0.407 and −0.310 mm respectively. No significant differences occurred for changes in BOP and PlI. Subgingival application of tetracycline fibres, sustained released doxycycline and minocycline demonstrated a significant benefit in PPD reduction ( WMD between 0.5 and 0.7 mm). The rest of the tested outcomes demonstrated a high heterogeneity. The local application of chlorhexidine and metronidazole showed a minimal effect when compared with placebo ( WMD between 0.1 and 0.4 mm). Conclusions The scientific evidence supports the adjunctive use of local antimicrobials to debridement in deep or recurrent periodontal sites, mostly when using vehicles with proven sustained release of the antimicrobial. [ABSTRACT FROM AUTHOR]

In this paper, we examined how identification with urban districts as a common ingroup identity and perceived ingroup prototypicality influence the attitudes of residents toward other ethnic groups in their neighborhood. The overall conclusion of two field studies (N = 214 and N = 98) is that for majority-group members, there may be a positive relation between identification with an overarching identity and outgroup attitudes but only when they perceive their ingroup as low in prototypicality for the overarching group (Study 1 and 2). Conversely, for minority-group members, there may be a positive relation between identification and outgroup attitudes but only when they perceive their ingroup as high in prototypicality for the overarching group (Study 2). Outgroup prototypicality did not moderate the relation between identification and outgroup attitudes. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

BACKGROUND: Mississippi (MS) Delta adults and youth report obesity rates far exceeding those of the state and nation. State law requires in-school physical activity and nutrition practices to address childhood obesity but does not require evaluation of outcomes, specifically the impact on weight-related outcomes. This paper offers 3 things: (1) describes the weight status of elementary school-age children in the MS Delta; (2) explains the importance of including waist-to-height ratio (WHtR) values when reporting body mass index (BMI); and (3) provides impetus for policy that requires weight-related health risk, as measured by WHtR, to be assessed regularly as a means to evaluate school health policy. METHODS: We took anthropometric measures in a cross-sectional investigation of 1136 children from 11 public elementary schools in the MS Delta. Measures included BMI, waist circumference (WC) and WHtR. RESULTS: The prevalence of overweight and obesity (BMI ≥85th percentile) was 47.1% (18.3% overweight and 28.8% obese). In this sample, 59.9% and 42.0% were 'at risk' for weight-related chronic disease based on WC (≥75th percentile) and WHtR (>0.5), respectively. The differences in these proportions were statistically significant. The predominantly black districts reported higher on all of the weight-related measures. CONCLUSIONS: Investigators recommend the assessment of health policy include measures of health risk in addition to BMI, namely WHtR as it accounts for growth in both WC and height over age. Furthermore, WHtR is a more accurate indicator of fat distribution and health risk than WC alone. [ABSTRACT FROM AUTHOR]

Measures of self-forgiveness that merely focus on the outcome of positive self-regard risk neglecting the process through which offenders restore it. They may thus tap pseudo self-forgiveness where offenders downplay their responsibility for the wrongdoing. For genuine self-forgiveness, the process should instead involve an attenuation of the negative link between responsibility acceptance and positive self-regard. In this paper, we examine how acts of value reaffirmation facilitate genuine self-forgiveness. In Study 1, a role-play experiment (N = 90), participants either confessed their wrongdoing to the victim or not. Although responsibility acceptance was strongly negatively related to reported self-forgiveness (i.e., self-regard), this relationship was tempered when participants confessed their wrongdoing to the victim and, through this, reaffirmed the violated values. In Study 2, a longitudinal study referring to self-reported transgressions (N = 74), responsibility acceptance was negatively related to self-forgiveness measures as well as self-esteem when offenders showed little value reaffirmation, but not when they more strongly reaffirmed the violated values. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: This paper examines differences in drinking and binge drinking between Mexican Americans living along the U.S.-Mexico border and those living in 2 metropolitan areas away from the border (Houston, Texas and Los Angeles, California). Methods: Respondents in the non-border area (Houston and Los Angeles) constitute a multistage probability sample ( N = 1,288), who were interviewed as part of the 2006 Hispanic Americans Baseline Alcohol Survey (HABLAS). Respondents in the border area ( N = 1,307) constitute a household probability sample of Mexican Americans living on the U.S.-Mexico border. In both surveys, data were collected during computer-assisted interviews conducted in respondents' homes. The HABLAS and the border sample response rates were 76 and 67%, respectively. Results: There were no differences between border and non-border Mexican American men in the proportion of drinkers, the proportion who binge drink at least once a year, and volume of alcohol consumption. However, within each location, there were significant differences in drinking by age, indicating that younger men drank more than men who were older. Border women showed significant differences across age-groups in the proportion of drinkers, in binge drinking, and volume of alcohol consumption, which were not seen among non-border women. Conclusions: Women's drinking seems to be more affected than men's by their residence on or off the U.S.-Mexico border. This is seen most clearly among young women 18 to 29 years old, and it is associated with an increased proportion of drinkers, a higher volume of drinking, and an increased proportion of women who report binge drinking. Increased drinking in this group of younger women seems to be associated with drinking in Mexico. [ABSTRACT FROM AUTHOR]

Background Present day service systems evolved from the traditional model of disability intervention where the child with the disability and the family were viewed as pathological entities that needed to be fixed rather than supported. Scholars have increasingly called for a greater focus on the family in service delivery, but few studies have empirically examined the practical reality of such a shift. The present paper examines the disability-related formal service supports within the family quality of life (FQOL) framework in a sample of predominantly low-income, minority families in the USA. Methods Cross-sectional data collected from a convenience sample of 149 families using the Family Quality of Life Survey (FQOLS-2006) was analysed at the univariate, bivariate and multivariate levels. Results Over half of the families indicated that they needed more help from the service system, and the largest barrier to accessing services was a lack of information. Almost all families viewed service support as very important to their overall FQOL; however, only half of them were satisfied with the formal support that they were receiving. Less than half of the families reported having many service support opportunities and high attainment of service support, although most took high initiative in pursuing formal supports. The path model illustrated the complex inter-relationships between the six dimensions of service support. Conclusions Findings underscore the need for resources to empower families and the value of using the FQOLS-2006 to ascertain the service support needs and strengths of families. [ABSTRACT FROM AUTHOR]

Background The Taiwanese government launched a new programme in November 2004 to support adults with intellectual disabilities living in smaller facilities. This paper aims to evaluate the service outcomes of this new residential scheme over 2 years including those residents who moved from an institution and those who moved from their family. Methods A one-group repeated-measures analysis was conducted for five interviews after the adults with intellectual disabilities entered the new environment. Forty-nine adults were initially studied (T1) and 29 adults remained in the homes until the end of the study (T5). Results This study found significant improvements over the 2 years in the residents' quality of life and family contact. The results also highlight a decrease in maladaptive behaviour among the residents moving from institution and an increase in choice making and family contact among the residents moving from family. No significant changes in adaptive behaviour and community inclusion were found. Conclusion Results revealed that further policy changes and financial support including service quality assurance are required in order to improve service outcomes for adults living in the new residential scheme. [ABSTRACT FROM AUTHOR]

The southeastern region of Kenya is prone to aflatoxin outbreaks, yet maternal and infant aflatoxin intake levels remain unclear. We determined dietary aflatoxin exposure of 170 lactating mothers breastfeeding children aged 6 months and below in a descriptive cross‐sectional study involving aflatoxin analysis of maize‐based cooked food samples (n = 48). Their socioeconomic characteristics, food consumption patterns and postharvest handling of maize were determined. Aflatoxins were determined using high‐performance liquid chromatography and enzyme‐linked immunosorbent assay. Statistical analysis was conducted using Statistical Package Software for Social Sciences (SPSS version 27) and Palisade's @Risk software. About 46% of the mothers were from low‐income households, and 48.2% had not attained the basic level of education. A generally low dietary diversity was reported among 54.1% of lactating mothers. Food consumption pattern was skewed towards starchy staples. Approximately 50% never treated their maize, and at least 20% stored their maize in containers that promote aflatoxin contamination. Aflatoxin was detected in 85.4% of food samples. The mean of total aflatoxin was 97.8 μg/kg (standard deviation [SD], 57.7), while aflatoxin B1 was 9.0 μg/kg (SD, 7.7). The mean dietary intake of total aflatoxin and aflatoxin B1 was 7.6 μg/kg/b.w.t/day (SD, 7.5) and 0.6 (SD, 0.6), respectively. Dietary aflatoxin exposure of lactating mothers was high (margin of exposure < 10,000). Sociodemographic characteristics, food consumption patterns and postharvest handling of maize variably influenced dietary aflatoxin exposure of the mothers. The high prevalence and presence of aflatoxin in foods of lactating mothers are a public health concern and calls for the need to devise easy‐to‐use household food safety and monitoring measures in the study area. Key messages: A high prevalence of aflatoxin (84.4%) and high dietary aflatoxin exposure were reported among lactating mothers in the study.The mean concentration of 90% of maize‐based cooked food samples exceeded the 2 and 10 µg/kg set limits for aflatoxin B1 and total aflatoxin, respectively.Household size, education, socioeconomic status and limited food consumption patterns were potential determinants of dietary aflatoxin exposure in lactating mothers. Within dietary diversity, the type of food constituting a diverse diet played an important role.Postharvest handling of maize could be one of the factors contributing to dietary aflatoxin exposure in the study area.The reported results call for the need to devise easy‐to‐use household food safety and monitoring measures in the study area. [ABSTRACT FROM AUTHOR]

Introduction: Hospitalization due to cardiac conditions is increasing worldwide, and follow‐up after hospitalization usually occurs in a different healthcare setting than the one providing treatment during hospitalization. This leads to a risk of fragmented care and increases the need for coordination and continuity of care after hospitalization. Furthermore, international reports highlight the importance of improving continuity of care and state that it is an essential indicator of the quality of care. Patients' perceptions of continuity of care can be evaluated using the Patient Continuity of Care Questionnaire (PCCQ). However, the original version is extensive and may prove burdensome to complete; therefore, we aimed to develop and evaluate a short version of the PCCQ. Methods: This was a psychometric validation study. Content validity was evaluated among user groups, including patients (n = 7), healthcare personnel (n = 15), and researchers (n = 7). Based on the results of the content validity and conceptual discussions among the authors, 12 items were included in the short version. Data from patients were collected using a consecutive sampling procedure involving patients 6 weeks after hospitalization due to cardiac conditions. Rasch analysis was used to evaluate the psychometric properties of the short version of the PCCQ. Results: A total of 1000 patients were included [mean age 72 (SD = 10), 66% males]. The PCCQ‐12 presented a satisfactory overall model fit and a person separation index of 0.79 (Cronbach's α:.91, ordinal α:.94). However, three items presented individual item misfits. No evidence of multidimensionality was found, meaning that a total score can be calculated. A total of four items presented evidence of response dependence but, according to the analysis, this did not seem to affect the measurement properties or reliability of the PCCQ‐12. We found that the first two response options were disordered in all items. However, the reliability remained the same when these response options were amended. In future research, the benefits of the four response options could be evaluated. Conclusion: The PCCQ‐12 has sound psychometric properties and is ready to be used in clinical and research settings to measure patients' perceptions of continuity of care after hospitalization. Patient or Public Contribution: Patients, healthcare personnel and researchers were involved in the study because they were invited to select items relevant to the short version of the questionnaire. [ABSTRACT FROM AUTHOR]

Background: Cannabis use is increasing among Andalusian adolescents, causing health, social and financial problems. School nurses visit schools and provide health promotion to adolescents in Andalusia. In order to better tailor health promotion programs, it is important to understand the sociodemographic and motivational factors related to cannabis use in Andalusian adolescents. Design/Methods: In this cross‐sectional study, 369 students (aged 15–18 years) from secondary schools in Andalusia were involved. An anonymous questionnaire based on the I‐Change Model was self‐administered during school hours. Cannabis users were compared with non‐cannabis users regarding sociodemographic and motivational factors. Contingency tables, mean comparison tests, and logistic regression analyses were conducted. Results: The prevalence of cannabis use in the last year was 21.6%. Non‐cannabis users had a few positive beliefs toward cannabis use (e.g. the ability to relax or medical benefits), as well as users. Users recognized some disadvantages of cannabis use but played down their importance and mentioned more advantages. Moreover, social influence, especially from peers, plays a critical role in cannabis use. Specific social situations and moods seemed to be special risk factors for cannabis use, such as being at a celebration or feeling good. Results of regression analysis showed that cannabis use is mainly associated with age, low family function, low family affluence, high pocket money, perceiving few disadvantages of cannabis use, much social modeling of cannabis use, social norm and pressure favoring cannabis, low self‐efficacy to resist using cannabis and positive intentions to use cannabis. Conclusions: Based on our results, prevention programmes lead by nurses can be tailored to the factors important to prevent cannabis use, focusing on outlining the disadvantages of cannabis use, alternatives for using cannabis when feeling good, increasing salience of healthy social influences and reinforcing self‐efficacy to resist temptations to use cannabis are recommended. Clinical Relevance: Nurses need to know the sociodemographic factors and motivations associated with the use of cannabis in adolescents in order to establish effective preventive interventions at school. [ABSTRACT FROM AUTHOR]

In health care, high-fidelity simulation has been shown to result in increased student learning outcomes when compared to low-fidelity simulation. With educational facilities investing significant amounts of money into purchasing high-fidelity simulators, it is imperative to identify if the midlevel simulator, which is less costly, will result in the same learning outcomes. In this study, we examined the effect of midlevel-fidelity simulation versus low-fidelity simulation on Bachelor of Science in Nursing nursing students' knowledge, self-confidence, and skill performance. A quasi-experimental design examined the effects of midlevel-fidelity simulation ( n = 37) versus low-fidelity simulation (case study) ( n = 37) in junior-level nursing students. There was a significant difference for both groups in knowledge and skill performance (measured with a mini Objective Structured Clinical Examination), but not between the groups. Unexpectedly, the case-study group had a higher level of self-confidence (self-reported). The results of this study indicate that further research is needed to support faculties' selection of learning strategies with the lowest cost and highest effectiveness in achieving the desired learning outcomes. [ABSTRACT FROM AUTHOR]

Purpose: More than 86% patients experience moderate to severe pain after thoracoscopic surgery. A combination of diverse nonpharmacological pain relief methods is a developing trend for pain management. The purpose of this study was to explore the effect of acupressure in reducing pain after thoracoscopic surgery. Design: A Randomized controlled study with purpose sampling was used for this study. Patients who underwent thoracoscopic surgery at a medical center in central Taiwan were enrolled. Study data was collected from September 2020 to April 2021 after the approval of the institutional review board. A total of 100 participants were randomized into two groups (49 and 51 in the experimental and control groups, respectively). Methods: Participants in the experimental group received acupressure at the Neiguan (PC6) and Shenmen (HT7) acupoints thrice a day for 2 days, whereas those in the control group received routine treatment and did not receive acupressure. The measurement included questionnaires for the collection of general information, physiological information, and disease rating scale. The Visual Analogue Scale‐Pain (VAS‐P) was used to measure the severity of pain. SPSS statistical software was used for data analysis. Independent sample t‐test and chi‐squared test were used for descriptive statistics, and paired t‐test and linear mixed model were used to examine the effect of acupressure in alleviating pain. Findings: After acupressure intervention, the pain score of the experimental group was lower than that of the control group, and this difference was significant β = 17.76, p < 0.001 on day 1 after intervention; β = 19.80, p < 0.001 on day 2 after intervention. The postoperative pain score in the experimental group on day 2 after intervention was significantly lower than that in the control group (t = 2.039, p = 0.044). After the subjects received acupressure, pain index significantly decreased after considering the interaction between time and group (p < 0.001). Regardless of the type of surgery, there were significant differences in pain index when the interaction between time and group was considered (p < 0.001). Conclusions: This study provided an experimental basis that acupressure can help in pain management in patients after thoracoscopic surgery, and the pain relief results become more significant as the duration of intervention increases. Clinical relevance: Acupressure is effective in relieving postoperative pain in any type of thoracoscopic surgery. Nurses can use acupressure to help control pain in patients after thoracoscopic surgery. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effectiveness of a professional identity promotion strategy (PIPS) on nursing students' professional identity and resilience. Methods: This study was a quasi‐experimental study with a random cluster sample of 103 sophomore undergraduate nursing students. One hundred students answered the questionnaires at both baseline and follow‐up (51 of 53 in the intervention group and 49 of 50 in the control group). Intervention and control groups underwent 5 months PIPS and standard professional education from May 2 to September 27, respectively. Participants completed the professional identity questionnaire for nursing students (PIQNS) and Connor–Davidson resilience scale (CD‐RISC). Data were collected at baseline (T0), after the intervention (T1) and 3 months after the intervention (T2), and analyzed using the Chi‐squared test, Fisher's exact test, and repeated‐measures analysis of variance. Results: There were no significant differences between the two groups (p >.05) regarding demographic questions, professional identity, or resilience at baseline (p >.05). Significant differences were found in professional identity between groups (p <.001), measurement times (p =.026), and in the interaction between groups and measurement times (p =.018) from T0 to T2. Significant differences were found in resilience between groups (p <.001), measurement times (p =.007), and in the interaction between groups and measurement times (p =.035) from T0 to T2. Conclusions: The PIPS program improved nursing students' professional identity and resilience. Further long‐term effectiveness of the program needs to be tested with implementation through various forms of mobile technology. [ABSTRACT FROM AUTHOR]

Purpose: To test the effects of a Vitality Acupunch exercise program on the functional fitness and the ability to perform the activities of daily living (ADL) among older adults with probable sarcopenia in residential facilities. Design: This was a cluster‐randomized controlled trial. A total of 12 long‐term care facilities randomly assigned to the intervention and control groups with 1:1 allocation ratio. Among them, 114 older adults with probable sarcopenia participated at baseline and were allocated to either the intervention or control group according to the facility where they resided in. Of these, 103 older adults completed the study. Methods: The intervention group (n = 52) underwent the Vitality Acupunch exercise program three times a week, each lasting 40 min, for 6 months while the control group (n = 51) performed its routine daily activities. Findings: The functional fitness and ADL of the intervention group significantly improved at each time point (all p < 0.001), while the control group showed a significant decreasing trend. Except the lower limb muscular endurance, the functional fitness and ADL of the intervention group significantly improved compared to the control group at T1, and the improvements were still significant at T2. Conclusions: Functional fitness and the ability to perform ADL in older adults with probable sarcopenia were significantly improved after receiving the Vitality Acupunch exercises. Clinical relevance: An exercise that integrates the meridian theory and exercise concepts effectively improves functional fitness in probable sarcopenic older adults. Clinical trial registration: Clinicaltrials.gov (NCT04504786). The trial was first posted on August 7, 2020. This part of the data was collected from August 2020 to March 2021. [ABSTRACT FROM AUTHOR]

Despite a plethora of studies that demonstrate the positive impact of strategic human resource management on firm performance, existing knowledge of the processes through which such gains can be achieved remains limited. This study aims to extend our knowledge by investigating the mechanism through which a teamwork-oriented executive strategic human resource management system impacts organizational ambidexterity. Specifically, by integrating the resource-based view and information-processing theory, we examine the mediating role of top management team effectiveness and the moderating role of knowledge-sharing intensity from middle managers to top management teams. Drawing on a multiple-source and multiple-respondent survey from 144 manufacturing firms in China, we show that top management team effectiveness partially mediates the effect of the executive strategic human resource management system on organizational ambidexterity. Moreover, knowledge-sharing intensity from middle managers to top management teams strengthens the effect of the executive strategic human resource management system on organizational ambidexterity. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Child undernutrition in Cambodia is a persistent public health problem requiring low‐cost and scalable solutions. Rising cellphone use in low‐resource settings represents an opportunity to replace in‐person counselling visits with phone calls; however, questions remain on relative effectiveness. Our objective was to evaluate the impact of two options for delivering a World Vision infant and young child feeding (IYCF) counselling programme: (1) traditional Positive Deviance/Hearth (PDH) programme with in‐person visits or (2) PDH with Interactive Voice Calling (PDH‐IVC) which integrates phone calls to replace 62.5% of face‐to‐face interaction between caregivers and volunteers, compared to the standard of care (SOC). We conducted a longitudinal cluster‐randomised controlled trial in 361 children 6–23 months. We used an adjusted difference‐in‐difference approach using baseline, midline (3 months) and endline (12 months) surveys to evaluate the impact on child growth among the three groups. At baseline, nearly a third of children were underweight, and over half were food insecure. At midline the PDH group and the PDH‐IVC groups had improved weight‐for‐age z‐scores (0.13 DID, p = 0.011; 0.13 DID, p = 0.02, respectively) and weight‐for‐height z‐score (0.16 DID, p = 0.038; 0.24 DID, p = 0.002), relative to SOC. There were no differences in child height‐for‐age z‐scores. At endline, the impact was sustained only in the PDH‐IVC group for weight‐for‐age z‐score (0.14 DID, p = 0.049), and the prevalence of underweight declined by 12.8 percentage points (p = 0.036), relative to SOC. Integration of phone‐based IYCF counselling is a potentially promising solution to reduce the burden of in‐person visits; however, the modest improvements suggest the need to combine it with other strategies to improve child nutrition. [ABSTRACT FROM AUTHOR]

Maternal depression has been associated with adverse child growth and development; less is known about its relation to children's diet. In a cross‐sectional study embedded at endline of a longitudinal community development intervention, mothers of 629 children (age 23–66 months) in rural Nepal responded to household and children's diet questionnaires and were screened for depression. Child anthropometry and development (Ages and Stages Questionnaire) were assessed. Regression models examined children's diet, growth and development, adjusting for household, child and maternal characteristics. The prevalence of maternal depression was 21%. Maternal depression was associated with 11% lower likelihood that the child consumed one additional food group [Poisson regression, adjusted relative risk (aRR) 0.89, 95% confidence intervals (95% CI 0.81, 0.99), p = 0.024] and 13% lower likelihood that the child consumed one additional animal source food (ASF) [aRR 0.87, (95% CI 0.76, 1.01), p = 0.061] compared with children of nondepressed mothers. However, maternal depression was not associated with either child anthropometry or development: these outcomes were strongly associated with better home child‐rearing quality. Stunting also related to child age and intervention group; child development related to mother's education and household wealth. This study suggests a correlation between maternal depression and child dietary diversity. This association could be due to unmeasured confounders, and therefore, further research is warranted. Understanding the relationship of depression to child outcomes—and the role of other potentially compensatory household factors—could help address some of the earliest, modifiable influences in a child's life and contribute to innovative approaches to improve child well‐being. [ABSTRACT FROM AUTHOR]

Background: Consistent practice, an agreed clinical practice based on evidence, has been considered as a base for effective provision of quality and safety of care. As a result, patients have an equal quality of care regardless of the organisation or worker. However, despite the international guidelines, pressure ulcer prevention practices vary in long‐term older people care. Aim: To develop, implement and evaluate the impact of renewed, consistent practice for pressure ulcer prevention, in long‐term older people care. Design: A quasi‐experimental intervention study. Methods: Two long‐term older people care facilities chosen with convenience sampling were randomly allocated to intervention or comparison group. Registered and practical nurses, in total 141/112, participated in the study. The renewed consistent practice based on international guidelines for pressure ulcer prevention was developed and implemented using the Operational Model for Evidence‐Based Practices (OMEBP). Frequencies and agreement of PU prevention practices in line with international guidelines in the care facilities were measured using the PUPreP instrument. Results: In the intervention facility, improvement in line with international guidelines was seen in the frequency of PU prevention practices in risk assessment, nutrition, pressure‐relieving devices and documentation. Furthermore, improvement was seen in the intervention facility in all six areas of agreement on practices. Conclusions: The results of this study support the implementation of PU prevention guidelines in long‐term older people care (LOPC) and more widely in healthcare settings for older people to promote consistent practice, and safety and equal quality of care. [ABSTRACT FROM AUTHOR]

Aim: Long‐term care needs are important for older adults with dementia in the West, but they have not received enough attention from China. This study evaluated the psychometric properties of a long‐term care needs instrument for older Chinese adults with dementia. Methods: A total of 1,212 older adults with dementia were recruited from five Chinese cities to complete a 30‐item long‐term care needs questionnaire. The reliability and validity of the questionnaire was evaluated using multiple assessments, including a content validity assessment, Cronbach's alpha, an item‐to‐total correlation test, and exploratory factor analysis. Results: The questionnaire was divided into four sub‐sections: life care services (eight items), basic and specialist care services (12 items), mental comfort psychological services (four items), and homecare support services (six items). Cronbach's alpha was.93 for the whole questionnaire and ranged from.83 to.92 for the four sub‐questionnaires. The item‐to‐total correlation coefficients for the four sub‐questionnaires were between.68 and.88, and the test–retest correlation coefficient was.88. Conclusion: Our results validated the reliability and validity of a questionnaire designed to measure the quality of long‐term care services for older Chinese adults with dementia. [ABSTRACT FROM AUTHOR]

Background: Engaging youth in research provides substantial benefits to research about youth‐related needs, concerns and interventions. However, researchers require training and capacity development to work in this manner. Methods: A capacity‐building intervention, INNOVATE Research, was co‐designed with youth and adult researchers and delivered to researchers in three major academic research institutions across Canada. Fifty‐seven attendees participated in this research project evaluating youth engagement practices, attitudes, perceived barriers, and perceived capacity development needs before attending the intervention and six months later. Results: The intervention attracted researchers across various career levels, roles and disciplines. Participants were highly satisfied with the workshop activities. Follow‐up assessments revealed significant increases in self‐efficacy six months after the workshop (P =.035). Among possible barriers to youth engagement, four barriers significantly declined at follow‐up. The barriers that decreased were largely related to practical knowledge about how to engage youth in research. Significantly more participants had integrated youth engagement into their teaching activities six months after the workshop compared to those who were doing so before the workshop (P =.007). A large proportion (71.9%) of participants expressed the need for a strengthened network of youth‐engaged researchers; other future capacity‐building approaches were also endorsed. Conclusions: The INNOVATE Research project provided improvements in youth engagement attitudes and practices among researchers, while lifting barriers. Future capacity‐building work should continue to enhance the capacity of researchers to engage youth in research. Researchers notably pointed to the need to establish a network of youth‐engaged researchers to provide ongoing, sustainable gains in youth engagement. [ABSTRACT FROM AUTHOR]

Women's delay in seeking medical advice for abnormal vaginal discharge can cause serious effects such as infertility, ectopic pregnancy, and advanced cervical cancer. Family healthcare workers are in a unique position to help in the promotion of vaginal health. A nonrandomized controlled trial was conducted among a sample of family healthcare workers in the intervention (n = 37) and a control (n = 37) group to assess the effectiveness of an educational intervention, which was a 2‐day intensive workshop combining reading materials. Data were analyzed using SPSS software (version 20), and the effectiveness of the intervention was determined using a mixed between‐within subjects analysis of variance. The total knowledge and attitude scores were significantly greater for family healthcare workers in the intervention group immediately and at 3 and 6 months after the educational intervention, compared to the control group. A substantial main effect was observed concerning the time, showing an increase in family healthcare workers' knowledge and attitude scores across the four time periods. A statistically significant difference in the median overall health education competency score across the two groups was also observed. The mean score differences in all sub‐competencies in health education were significantly higher among the intervention group, compared to the control group between second postintervention and the baseline. The educational intervention had revealed successful and sustainable improvements in family healthcare workers' knowledge, attitude on vaginal discharge, and health education competency. This can be implemented as an in‐service program for family healthcare workers to improve health education practices. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to examine the frailty transition patterns of older adults recruited from both community and residential care settings within a 5‐year period, and to identify the physical and psychosocial factors associated with the transitions. Design: This study is a secondary data analysis of a longitudinal study for tracking the change of health status of older adults 60 years of age or older. Participants who had undergone at least two assessments during 2013–2017 were selected for analysis. Guided by the Gobben's Frailty Model, biopsychosocial predictors were comprehensively identified from the literature, and their relationship to frailty state transition was explored. Methods: We compared the baseline characteristics of participants at the frail, pre‐frail, and robust states (categorized using the Fried Frailty Index). A generalized estimating equation was used to identify factors associated with an improvement or a deterioration in frailty. The probability of transitions between frailty states was calculated. Findings: Among the 306 participants, 19% (n = 59) improved and 30% (n = 92) declined in frailty within the project period. Sleep difficulties (odds ratio [OR] = 1.76; 95% confidence interval [CI]: 1.07–2.90; p =.027), better cognitive status (OR = 0.80–0.84; 95% CI: 0.66–0.98 and 0.73–2.73; p =.031 and.018), good nutritional status (OR = 0.74; 95% CI: 0.59–0.91; p =.005), slow mobility (OR = 1.03–1.13; 95% CI: 1.00–1.05 and 1.03–1.25; p =.047 and.014), hearing impairment (OR = 2.83; 95% CI: 1.00–8.01; p =.05), better quality of health—physical domain (OR = 0.95; 95% CI: 0.92–0.99; p =.006), and better functional ability (OR = 0.85–0.97; 95% CI: 0.79–0.92 and 0.96–0.99; p <.001 and p =.003) were significant associated factors in the worsening group. More physical activity (OR = 1.01; 95% CI: 1.00–1.01 and 1.01–1.02; p =.026 and p <.001), hearing impairment (OR = 0.26; 95% CI: 0.08–0.86; p =.028), and slow mobility (OR = 0.93; 95% CI: 0.87–1.00; p =.037) were significant associated factors in the improvement group. Conclusions: Frailty is a crucial global public health issue. This study provides evidence for nurses to holistically consider the associated factors and to design effective interventions to combat frailty in our ageing society. Clinical Relevance: Frailty is a transient state that can be reversed. Professional nurses working in both community and residential care settings should be able to identify older adults at risk and improve their health conditions appropriately. [ABSTRACT FROM AUTHOR]

Background: Visitation is one of the most critical needs of patients in intensive care units (ICUs). Clinicians should enable a more flexible visitation policy to prevent the adverse effects of a restricted approach. Aim and objectives: This study aimed at investigating the relationship between increasing visitation time and patients' physiological parameters in intensive units. Additionally, nurses' beliefs and attitudes towards visiting is examined in this research. Design Parallel randomized clinical trial. Methods: This study was conducted in four general medical ICUs in Iran. In total, 60 patients and 57 nurses participated in this study. The patients' physiological parameters were measured at particular times in both groups. Moreover, the nurses responded to the questionnaire on beliefs and attitudes towards visitation in intensive units before and after the intervention. Results: Among all the physiological parameters, systolic and diastolic blood pressure and heart rate had a significant decrease within the normal range 10 and 30 minutes after visiting in the intervention group (P <.05), and nurses' beliefs and attitudes score were at the middle of the survey scoring range (0‐120). However, no significant difference was found between nurses' belief and attitude score and intervention in any groups (P >.05). Conclusion: The findings indicate that increasing visitation times can lead to a positive effect on the stability and balance of patients' physiological parameters. Relevance to clinical practice: A more flexible visiting policy can provide a therapeutic environment where not only patients' physiological disorders are minimised as much as possible but also a higher level of patients' health and satisfaction are reached. [ABSTRACT FROM AUTHOR]

Purpose: Technology‐based systems like telemedicine are frequently being implemented into healthcare settings, impacting clinician practices. Little is known about factors influencing acute telemedicine uptake, if factors differ across time, or between nurses and non‐nurses. Design: A mixed‐methods, pre‐post design with implementation of a new acute stroke telemedicine service. Methods: A survey based on an extended Technology Acceptance Model (TAM) was administered to clinicians involved in acute stroke care at 16 regional hospitals (2014–2017). Open‐ended questions postimplementation (at 6 months) included strengths of the program and areas to improve. Subsequently, a secondary analysis of nurses' semistructured interviews at the first telemedicine site (2010–2011) was completed to provide greater explanatory detail. Findings: Surveys were completed by nurses (preimplementation n = 77, postimplementation n = 92) and non‐nurses (pre n = 90, post n = 44). Preimplementation, perceived usefulness was the only significant predictor of intending to use telemedicine for nurses, while perceived ease of use and social influence were significant for non‐nurses. Postimplementation, perceived usefulness was significant for both groups, as was facilitating conditions for nurses. Specific examples aligned to TAM categories from our detailed interviews (n = 11 nurses) included perceived usefulness (improved clinical support and patient care), perceived ease of use (technical, clinical aspects), facilitating conditions (setting, education, confidence), and social influence (working relationships). Conclusions: Important factors for acute stroke telemedicine varied between nurses and non‐nurses, and changed after implementation. The benefits of telemedicine should be emphasized to nurses. Preimplementation, more non‐nurses wanted systems to be easy. Support in clinical, technical, and relationship aspects of telemedicine consultations is required. Clinical Relevance: Nurses are influential in implementing acute telemedicine, which is complex, with clinical and technical aspects entwined. Evidence‐based implementation strategies must be tailored over time, and between nurses and non‐nurses, to ensure initial uptake and ongoing use. [ABSTRACT FROM AUTHOR]