Search

Context: Girls' high school volleyball is a popular sport with a high rate of overuse injuries and sport specialization. Health professionals perceive that high school athletes are reluctant to follow treatment plans involving sport activity reduction. This study's purpose was to describe high school girls' volleyball athletes' self-reported shoulder and knee pain, the likelihood of adhering to medical advice, and the association of factors that influence the likelihood of reporting overuse injuries and sport specialization. Study Design: Cross-sectional. Methods: Participants completed an online survey (demographics, sport participation measures, shoulder and knee pain information, medical adherence likelihood [4-point Likert: not at all likely to extremely likely], and factors influencing overuse injury reporting intentions). A 2 × 2 chi-square analysis compared factors that influence athletes' intentions to "not report an overuse injury" (eg, I thought my coach would get mad; yes/no) and sport specialization (nonhighly specialized/highly specialized athletes). Results: There were 150 participants (highly specialized = 56%, grade: ninth = 33%, 10th = 28%, 11th = 22%, 12th = 17%). At least 60% reported shoulder and knee pain related to an overuse mechanism. Most reportedly did not seek rehabilitation led by a medical provider (shoulder pain = 66%, knee pain = 60%). Only 11% of athletes reported they were "extremely likely" to rest from sporting activity during the regular season if advised by a medical professional. Highly specialized athletes were more likely to report the pursuit of a college scholarship as a factor that influences their intention to report an overuse injury compared to nonhighly specialized athletes (13% vs 3%, respectively, P =.04). Conclusions: Most girls' volleyball athletes did not treat their pain with guided rehabilitation, which may increase their risk of a worse overuse injury or even acute injury. Clinicians, athletes, parents, and coaches need to work together to create a sport culture that empowers athletes to discuss their pain and overuse injuries with medical professionals. [ABSTRACT FROM AUTHOR]

Talent transfer has enabled elite athletes to be successful in another sport, with great potential in para-sport. Previous research suggests that similarities between donor and recipient sports may facilitate talent transfer; however, this remains unclear in para-sport. This study investigated patterns between donor and recipient sports' characteristics, identifying the impact on talent transfer in para-sport. An Australian case study utilizing secondary data of 38 Australian Paralympians who competed at the Paralympic Games from 2000 through 2020 was analyzed. Results demonstrated that similarities between sports were not significantly associated with successful talent transfers between Paralympic sports. Understanding patterns associated with successful Paralympic talent transfers offers a foundation of knowledge for designing and developing future talent-transfer pathways and research. Based on this study, it is recommended that sport administrators and practitioners explore greater opportunity for talent transfer in para-sport, rather than limiting talent-transfer opportunities based on athletes' donor sports. [ABSTRACT FROM AUTHOR]

Context: Psychological difficulties can adversely affect rehabilitation outcomes and make return to sport more difficult . Identifying psychological difficulties is possible with valid and reliable measurement tools. The purpose of this study is to translate and culturally adapt the Reinjury Anxiety Inventory (RIAI), the Sport Injury Rehabilitation Adherence Scale (SIRAS), and the Athletic Injury Self-Efficacy Questionnaire (AISEQ) into Turkish and evaluate the psychometric properties of the Turkish versions. Design: Cross-sectional study . Methods.· The instruments were forward- and back-translated, culturally adapted, and validated on 248 athletes and 34 physical therapists. The physical therapists of the athletes completed the SIRAS to evaluate the athletes. Statistical analysis included reliability tests (Cronbach alpha and test-retest), exploratory factor analysis, confirmatory factor analysis, and correlational analysis . Floor and ceiling effects (< 15%) were also assessed. Results : Confirmatory factor analyses revealed a satisfactory model fit for the RIAI and the AISEQ, and exploratory factor analysis revealed the 1 -factor structure for the SIRAS as in the original. All 3 instruments displayed adequate internal consistency (Cronbach alpha coefficients ranged from .84 to .88) and test-retest reliability (coefficients ranged from .81 to .93). Convergent validity of the instruments was supported by significant correlations between the AISEQ and both the RIAI and the SIRAS. Conclusions : Our results suggest that the Turkish versions of the instruments were valid, consistent, and reliable in athletes who have serious injuries. Scores on these instruments could be useful for evaluating the contributions of psychological factors to return to sport following serious injuries. Clinicians are encouraged to use RIAI-Turkish (RIAI-TR), SIRAS-Turkish (SIRAS- TR), and AISEQ-Turkish (AISEQ-TR) together to make decisions about the treatment and rehabilitation plans of injured athletes. [ABSTRACT FROM AUTHOR]

Context: Wheelchair Power Soccer (WPS) is the only team sport that allows the participation of people with severe physical disabilities who require the daily use of motorized wheelchairs. These individuals may live with chronic pain due to the characteristics of the disabilities and treatments, interfering with their health and limiting their participation in sports. Objectives: To investigate the prevalence of musculoskeletal pain and its relationship with mood in WPS players and to analyze the incidence of traumatic injuries during a championship. Methods: A prospective, longitudinal study was carried out on 30 WPS athletes (93.33% male) with a mean (SD) (range) age of 22.37 (9.79) (47) years. Data collection was performed during a South American WPS Championship lasting 3 days, with: investigation of the presence of musculoskeletal pain and mood through a questionnaire; investigation of the occurrence of traumatic injuries through match observation; and confirmation of the occurrence of traumatic injuries through access to medical department records. Results: About 30% (n = 9/30) of the sample presented some pain on the day of evaluation, with an intensity of 5.67 (3.35) (10) points on the visual analog scale. The most common regions of pain were the lower back (13.3%, n = 4/30), thoracic (10%; n = 3/30), and cervical (10%; n = 3/30) areas of the spine. A total of 46.7% (n = 14/30) reported pain in the month before data collection but of less intensity (2.56 [4] [10] points), the most common regions being the lower limbs (20%; n = 6/30) and cervical spine (20%; n = 6/30). Among the between-group comparisons (ie, participants with pain vs without pain), no relationship was observed between mood state and pain. No traumatic injuries were identified during the competition. Conclusion: The presence of musculoskeletal pain was common in WPS players, but it was not related to mood. As no traumatic injuries were observed during the championship, this modality seems to be safe for people with physical disabilities in general. [ABSTRACT FROM AUTHOR]

Objective: To rate athletes' functional ability and return to sport (RTS) success at the end of their individual, formal, medically prescribed rehabilitation after anterior anterior cruciate ligament (ACL) reconstruction. Methods: In our prospective multicenter cohort study, 88 (42 females) adults aged 18-35 years after acute unilateral ACL rupture and subsequent hamstring grafting were included. All patients were prospectively monitored during their rehabilitation and RTS process until the end of their formal rehabilitation and RTS release. As outcome measures, functional hop and jump tests (front hop, balance hops, and drop jump screening test) and self-report outcomes (Knee Injury and Osteoarthritis Outcome Score, ACL-RTS after injury) were assessed. Literature-based cut-off values were selected to rate each performance as fulfilled or not. Results: At 7.5 months (SD 2.3 months) after surgery, the percentage of participants meeting the functional thresholds ranged from 4% (Knee Injury and Osteoarthritis Outcome Score SPORT) and over 44% (ACL-RTS after injury sum score) to 59% (Knee Injury and Osteoarthritis Outcome Score activities of all daily living) in the self-report and from 29% (Balance side hop) to 69% (normalized knee separation distance) in performance testing. Only 4% fulfilled all the cut-offs, while 45% returned to the same type and level of sport. Participants who successfully returned to their previous sport (type and level) were more likely to be "over-cut-off-performers." Conclusions: The low share of the athletes who fulfilled the functional RTS criteria highlights the importance of continuing the rehabilitation measures after the formal completion to assess the need for and success of, inter alia, secondary-preventive therapies. [ABSTRACT FROM AUTHOR]

Context: The purpose of this study was to compare short-term clinical outcomes between meniscus procedures performed with anterior cruciate ligament reconstruction (ACLR), ACLR (ACLR-only), ACLR with meniscectomy/resection (ACLR-resect), and ACLR with meniscal repair (ACLR-repair) for bone patellar tendon bone grafts (BPTB) and hamstring tendon grafts, separately. Design: This was a cross-sectional study conducted in a controlled laboratory setting as part of a large point-of-care collaborative research program. Methods: This study included 314 participants (168 females; mean [SD]: age, 19.7 [4.8]) with primary unilateral ACLR with a BPTB or hamstring tendon. Patients were divided into 3 groups depending on meniscal procedure (ACLR-only, ACLR-resect, and ACLR-repair). Postsurgical testing included: isokinetic assessment of knee extension and flexion, single-leg hop tests, and patient-reported outcomes. Multivariate analysis of covariance compared differences between meniscal procedures on the battery of tests, and for each statistically significant variable an analysis of covariance assessed the effect of meniscal procedure within each graft type. Chi-square analysis assessed the influence of meniscal procedure on tests' pass rates defined as 90% of limb symmetry index. Results: BPTB: ACLR-only had greater hamstring strength than ACLR-resect (P = .05) and ACLR-repair (P = .005). ACLR-only had the highest proportion of participants to pass the hamstring strength test (P=.02). amstring tendon: ACLR-only (P=.03) and ACLR-resect (P=.003) had higher International Knee Documentation Committee scale scores than ACLR-repair. There was a significant difference in the proportion of participants who scored >90% limb symmetry index on the timed hop test (P = .05). Conclusions: The influence of meniscal repair on clinical outcomes is dependent on the graft choice. Following an ACLR with BPTB and a meniscal procedure, hamstring function should be more closely monitored for optimal short-term recovery. [ABSTRACT FROM AUTHOR]

Context: Soft tissue mobilization is frequently employed for delayed onset muscle soreness (DOMS) management. Foam roller and percussive massage are 2 popular soft tissue mobilization methods preferred by various professionals. However, their effects on DOMS symptoms are controversial and there are no studies comparing these 2 methods. The aim of the present study was to compare the acute effects of soft tissue mobilization with a foam roller or a percussive massage device on DOMS in young male recreational athletes. Design: A parallel, single-blinded, randomized controlled trial. Methods: Thirty-six participants (median [interquartile range 25/75]; age: 20.0 [19.3/21.0] y) were randomly allocated to percussive massage group (n = 12), foam roller group (n = 12), and control group (n = 12). First, a fatigue protocol targeting quadriceps femoris was performed. Then, participants received soft tissue mobilization with foam roller/percussive massage or rested for 10 minutes according to their groups. Pain and fatigue were evaluated by a visual analog scale, and the skin surface temperature of over the quadriceps femoris was measured with thermal camera imaging. Evaluations were performed at baseline, following fatigue protocol, at 24th hour, and at 48th hour. Changes from the baseline at 24th and 48th hours were compared between groups. Results: No significant between-group differences were observed at the assessments performed at 24th or 48th hour regarding the changes from baseline in pain (P value for 24th hour = .905, P value for 48th hour = .733), fatigue (P value for 24th hour = .895, P value for 48th hour = .606), or skin surface temperature measurements (P values for 24th hour = between .300 and .925, P values for 48th hour = between .311 and .750). Conclusions: Soft tissue mobilizations applied with foam roller or percussive massage device do not seem to be superior to passive resting in alleviating DOMS symptoms in recreational athletes. [ABSTRACT FROM AUTHOR]

Summary: We found that a standardized order set after hip fracture increased initiation of anti-osteoporosis medication and increased persistence at 1 year, but did not reduce secondary fractures. Background: A treatment gap exists after osteoporosis-related fractures. Introducing standardized care can improve treatment. We evaluated the impact of a hip fracture order set (OS) on anti-osteoporosis medication (AOM) initiation, persistence, and secondary fracture prevention. Methods: In 2015, one hospital in Manitoba, Canada, introduced a hip fracture OS including recommendations for the initiation of AOM (OS group). A control group was identified from the other hospitals in the same region. A retrospective cohort study was conducted using linked administrative health data. All individuals 50 + years with surgical treatment for low-energy hip fracture between 2010 and 2019 were included and followed for AOM initiation, medication persistence at 1 year, and secondary fractures. Between-group differences for each year were assessed using chi-square tests. Logistic regression models tested the impact of socio-demographic and clinical factors on initiation, persistence of AOM. Cox regression tested the risk of secondary fracture. Results: No baseline differences between OS group (813 patients) and control group (2150 patients) were observed in demographics, socioeconomic factors, or comorbidities. An increase in post-fracture AOM initiation was seen with OS introduction (OS group year before 16.7% versus year after 48.6%, p < 0.001). No change was seen in the control group. Persistence on AOM also increased (OS group year before 17.7% versus year after 28.4%, p < 0.001). No difference in secondary fractures was observed (OS group 19.8% versus control group 18.8%, p = 0.38). Conclusion: Introduction of a hip fracture OS significantly increased AOM initiation and persistence at 1-year post-fracture. There was no significant difference in secondary fractures. [ABSTRACT FROM AUTHOR]

Purpose: Disability in activities of daily living (ADL) is a common unmet need among people with advanced respiratory disease. Rehabilitation could help prolong independence, but indicators for timely intervention in this population are lacking. This study aimed to identify trajectories of disability in ADLs over time, and predicting factors, in advanced respiratory disease. Method: Multi-site prospective cohort study in people with advanced non-small cell lung cancer (NSCLC), chronic obstructive pulmonary disease (COPD) or interstitial lung disease (ILD), recruited from hospital or community services, throughout England. Disability in basic (Barthel Index) and instrumental (Lawton–Brody IADL Scale) ADLs were assessed monthly over six months. Visual graphical analysis determined individual trajectories. Multivariate logistic regression examined predictors of increasing disability in basic and instrumental ADLs. Findings: Between March 2020 and January 2021, we recruited participants with a diagnosis of NSCLC (n = 110), COPD (n = 72), and ILD (n = 19). 151 participants completed ≥3 timepoints and were included in the longitudinal analysis. Mobility limitation was an independent predictor of increasing disability in instrumental ADLs (odds ratio, 1⋅41 [CI: 1⋅14–1⋅74], p = 0⋅002). Conclusion: Mobility limitation could be used as a simple referral criterion across people with advanced respiratory disease to ensure timely rehabilitation that targets independence in ADLs. IMPLICATION FOR REHABILITATION: To our knowledge this is the first prospective cohort study of trajectories of disability in activities of daily living (ADL) in advanced respiratory disease, including recruitment during the Covid-19 pandemic. It adds to existing evidence by identifying individual variability in trajectories of ADL disability which are undetected at group level. The identification of mobility limitation as a predictor of increasing ADL disability, while controlling for malignant or non-malignant respiratory disease, is novel and has practical utility. Our findings have implications for clinical care, as early identification of functional decline through use of mobility limitation tools could flag early referral to rehabilitation services, potentially preventing or delaying forthcoming functional decline and avoiding reactive crisis management. Mobility limitation is a predictor of increasing disability in activities of daily living in advanced disease, which could be used to flag early referral to rehabilitation services, to help prevent or delay forthcoming functional decline and avoid reactive crisis management [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effects of mirror therapy (MT) and therapeutic exercise (TE) with the unaffected hand, on pain, sensitivity and functionality in individuals with unilateral carpal tunnel syndrome (CTS). Material and methods: A randomized controlled trial was carried out. Thirty-nine adults with unilateral CTS were included and randomly allocated to a six-week training programme based on MT (n = 20) or TE (n = 19). Visual Analogue Scale, Semmes-Weinstein monofilament test, Two-point discrimination (2PD), Disabilities of the Arm, Shoulder and Hand (DASH) and Boston Carpal Tunnel Questionnaire (BCTQ) were assessed before (T0) and after the intervention (T1), and at one-month follow-up (T2). Results: At T1, MT and TE showed significant improvements in pain (p = 0.001 and p = 0.03, respectively), however, only MT maintained the achieved effects at T2 (p = 0.01). In addition, 2PD significantly improved in MT in the first (p = 0.04) and fourth fingers (p = 0.02) at T1. The DASH score decreased at T1 in MT (p < 0.001) and TE (p = 0.01). Additionally, the BCTQ score improved in MT (p < 0.001), and TE (p < 0.001) at T1. The effects were maintained at T2 for DASH and BCTQ scores. Conclusions: Training of the unaffected hand resulted in a significant improvement of the affected hand in both groups; nevertheless, MT achieved a longer duration of the effects. IMPLICATIONS FOR REHABILITATION: Training of the unaffected hand may improve pain, sensitivity and functionality in people with unilateral tunnel carpal syndrome. Mirror therapy achieved longer duration of the effects on pain and hand functionality. Our research may inform clinical decision-making and guide the development of therapeutic interventions for patients with carpal tunnel syndrome. [ABSTRACT FROM AUTHOR]

Parental phubbing refers to the phenomenon where parents ignore their children due to mobile phone use during parent-child interactions. This study examined the longitudinal mediating role of basic psychological need satisfaction in the relations between parental phubbing and adolescents' core self-evaluation. We recruited 629 adolescents (M age = 15.20 years, SD age = 1.62 years) to participate in our longitudinal survey. Longitudinal mediation analyses revealed that parental phubbing negatively predicted adolescents' core self-evaluation by diminishing their basic psychological need satisfaction. Additionally, longitudinal network analyses identified two significant parental phubbing behaviors that impact adolescents' core self-evaluation: parents keeping mobile phones in hand during interactions with their adolescents and checking mobile phone information during mealtime. Our work provides a novel understanding on how parental phubbing decreases adolescent core self-evaluation. [ABSTRACT FROM AUTHOR]

Guided by the stress process perspective, this study examined if combat exposure was indirectly associated with marital satisfaction through work performance stress. Additionally, we tested whether unit cohesion served as a moderator of this indirect effect. Data were drawn from 1,122 married Soldiers who participated in the All-Army Study component of the Army STARRS study, a probabilistic sample of Army Soldiers. Indicative of stress proliferation and spillover, our results showed that combat exposure may negatively impact marital satisfaction through work performance stress, but the pathways of this indirect effect varied as a function of unit cohesion. Consistent with the stress buffering hypothesis, unit cohesion buffered the positive association between combat exposure and work performance stress for Soldiers reporting higher levels unit cohesion, such that this association was no longer statistically significant. However, for Soldiers reporting higher levels of unit cohesion, the negative association between work performance stress and martial satisfaction was exacerbated but was not statistically significant for those reporting lower levels of unit cohesion. The results underscore the importance of understanding the contextual nature of relational resources within the stress process framework. [ABSTRACT FROM AUTHOR]

We aimed to analyze the effects of exclusive breastfeeding duration on the occurrence and course of pneumonia in infants aged up to 6 months. Prospective case-control study. This study was conducted from August 2020 to August 2022 at a maternity and child health hospital in China. A total of 218 infants up to 6 months of age with pneumonia were included in the analyses. Health data were obtained using a hospitalization information system or an interview-based questionnaire. Univariate and multivariate logistic regression analyses were performed to analyze the data. The incidence of pneumonia, hospitalization duration, and costs to participants were significantly affected by the duration of exclusive breastfeeding (p < 0.01). The incidence of pneumonia among participants with different exclusive breastfeeding durations also differed significantly (p < 0.01). The shorter the duration of exclusive breastfeeding, the higher the incidence of pneumonia among infants. We found that the longer the exclusive breastfeeding duration in infants up to 6 months of age, the lower the recurrence of pneumonia, the shorter the hospital stay, and the lower the hospital costs. The rate of exclusive breastfeeding for infants up to 6 months of age should be increased as much as possible to reduce the occurrence of pneumonia and hospital costs. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to determine the effect of moderately strenuous aerobic exercise training on heart rate variability (HRV) and heart rate turbulence (HRT) in patients with an implantable cardioverter defibrillator (ICD). Methods: Patients were randomized to a 24-week home-based aerobic exercise (EX) training program (n = 84) or to usual care (UC) (n = 76). All subjects underwent 24-h Holter monitoring at baseline, 8 and 24 weeks. Generalized estimating equations were used to test the effects of exercise on HRV and HRT outcomes. Results: The study group was comprised of n = 160 patients (124 M, 36 F, age 54.9 ± 12.2 years) with an ICD for primary (43%) or secondary prevention (57%). Compared to UC, EX was associated with a significant improvement in parasympathetic HRV for root mean square of successive differences (rMSSD; p =.05) at 8 weeks and global HRV for standard deviation of all normal (N-N) intervals (SDNN; p =.05) and standard deviation of 5-min averages N-N intervals (SDANN; p =.03) at 24 weeks. When stratified by adherence, those who were ≥80% adherent (minutes/week) had significant improvements in parasympathetic HRV (rMSSD, pNN50) and global HRV (SDNN, SDANN) at 8 weeks, and a further significant improvement in global HRV (SDNN, SDANN, SDNN index) at 24 weeks. Neither HRT nor ventricular ectopy changed with exercise training. Conclusion: Moderately strenuous aerobic exercise improved parasympathetic and global HRV indices following an ICD, with greater adherence associated with greater improvements. Clinical trial registration: Clinicaltrials.gov: NCT 00522340. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the comparability of frailty assessment tools – the electronic frailty index (eFI), retrospective electronic frailty index (reFI), and clinical frailty scale (CFS) – in older residents of care facilities. Methods: Data from 813 individuals aged 65 or older, with frailty and co-morbidities, collected between 2022 and 2023, were analysed using various statistical methods. Results: The results showed significant differences in frailty classification among the tools: 78.3% were identified as moderately to severely frail by eFI, 59.6% by reFI, and 92.1% by CFS. Statistical tests confirmed significant differences (p <.05) in their assessments, indicating variability in measurement methods. Discussion: This study advances the understanding of frailty assessment within aged-care settings, highlighting the differences in the efficacy of these assessment tools. It underscores the challenges in frailty assessments and emphasizes the need for continuous refinement of assessment methods to address the diverse facets of frailty in aged care. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to determine the effects of caffeine consumption and sleep on post-spinal headache after spinal anesthesia. Background: Post-spinal headache is among the most well-known and common complications of spinal anesthesia. Although caffeine consumption is recommended to prevent headache after spinal anesthesia, caffeine does not prevent headache and causes sleep-related problems. No study in the literature found a correlation between sleep and caffeine consumption after spinal anesthesia and post-spinal headache. Methods: The research is a descriptive and cross-sectional study. The study sample comprised 425 patients who underwent elective surgery in a research hospital. The research data were collected by face-to-face interviews between April 2021 and December 2023. The "Sociodemographic and Clinical Characteristics Form," "Richard-Campbell Sleep Scale," "Insomnia Severity Index," and "Visual Analog Scale" were used in data collection. Factors affecting post-spinal headache were determined using binary logistic regression analysis. Results: According to the binary logistic regression, the insomnia severity score (OR = 1.234; p <.001), sleep quality score (OR =.992; p <.01), postoperative sleep duration (OR =.619; p <.05), and not consuming coffee (OR =.035; p <.001) are statistically significant predictors of post-spinal headache and explain 57.7% of the variance. A one-unit increase in patients' insomnia severity increased the probability of experiencing a post-spinal headache by 23.4%. With a one-unit increase in sleep quality, there was an 8% decrease in the probability of experiencing spinal headache, and a 3.81% decrease in the probability of experiencing post-spinal headache with an increase in sleep duration after surgery. The probability of experiencing post-spinal headache was 0.35 times higher in individuals who did not consume caffeine after surgery than in those who consumed it. Conclusion: The present study demonstrated that insomnia severity and sleep quality were more effective than caffeine consumption in preventing post-spinal headache. Insomnia and decreased sleep quality may cause a significant burden in developing post-spinal headache in patients and may cause post-spinal headache to be observed more frequently. Therefore, the use of caffeine in preventing or reducing post-spinal headache may adversely affect the duration and quality of sleep and increase the severity of insomnia. [ABSTRACT FROM AUTHOR]

Background: This study aims to determine the effect of virtual reality glasses application on pain, anxiety, and patient satisfaction during a transrectal prostate biopsy. Materials and Methods: The study was conducted with pre-tests, post-tests, and a control group, using a randomized controlled experimental research design. A total of 70 patients (35 in the intervention group and 35 in the control group) were included in the study. The intervention group watched a video with virtual reality glasses during the biopsy process. A Descriptive Information Form, State-Trait Anxiety Inventory (STAI-I, STAI-II), Scale of Patient Perception of Hospital Experience with Nursing Care (PPHEN), and Visual Analog Scale for Pain (VAS) were used for data collection. To evaluate the data, numbers, percentages, mean, standard deviation, chi-square, paired sample t test, independent samples t test, regression analysis, and Cronbach's alpha Reliability Coefficient were used. Results: There was no significant difference between the groups in terms of descriptive and clinical characteristics (p >.05). The mean VAS and STAI post-test scores of the patients in the intervention group were lower than the control group, and the difference between them was statistically significant (p <.05). The mean PPHEN post-test scores of the patients in the intervention group were significantly higher than those in the control group (p <.05). Conclusion: The application of virtual reality glasses during a transrectal prostate biopsy significantly reduced the level of pain and anxiety and increased patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most frequent female malignancy in the UK. Around 20% of cases are linked to weight gain, excess weight and health behaviours. We designed a weight gain prevention, health behaviour intervention for young women at increased risk. Methods: The study comprised a single arm observational study over 2 months testing acceptability and usability of the intervention: online group welcome event, app and private Facebook group. Females aged 18–35 years at moderate or high risk of breast cancer (>17% lifetime risk) were recruited via invite letters and social media posts. The app included behaviour change techniques and education content. Online questionnaires were completed at baseline, as well as at 1 and 2 months. We also assessed feasibility of study procedures. Results: Both recruitment methods were successful. Thirty‐five women were recruited, 26% via social media posts. Median age was 33 (interquartile range = 28.2–34.5) years, the majority (94.1%) were of White ethnicity. Thirty‐four participants were included in the analyses, of which 94% downloaded the app. Median self‐monitoring logs per participant during the study period was 10.0 (interquartile range = 4.8–28.8). App quality mean (SD) score was 3.7 (0.6) at 1 and 2 months (scale: 1–5). Eighty‐nine per cent rated the app at average or above at 1 month and 75.0% at 2 months. Nineteen women (55.9%) joined the Facebook group and there were 61 comments and 83 reactions and votes from participants during the study period. Conclusions: This first iteration of the app and intervention was well received and is suitable to progress to the next stage of refining and further testing. Highlights: The newly developed intervention that focused on weight gain prevention and health behaviour change was tested in young women at increased risk of breast cancer and was well‐received by the target population.Both recruitment methods, by mailshot and social media, were successful.The study was unable to recruit and ethnically diverse population.Future research should retest the intervention in a larger population, after making refinements. [ABSTRACT FROM AUTHOR]

The college transition is a time of great emotional lability, and sharing emotional experiences with parents can be beneficial for first-year students. Guided by the social sharing of emotions framework and the cultural theory on self-construal, this study investigated the developmental course of freshmen's emotional disclosure with parents during the first semester and the mediating role of independence-orientation in two Asian contexts—Beijing (China) and Singapore. Using experience sampling method (online diary), 205 Chinese freshmen (Mage = 19.43) and 291 Singapore freshmen (Mage = 19.44) reported on four facets of emotional disclosure with parents (frequency, intimacy, negativity, and positivity) across four timepoints and their independence–interdependence orientation (Time 1). Latent growth curve modeling comparing the two Asian samples revealed that frequency increased for Chinese students and decreased for Singapore students. Intimacy indicated upward trajectories for both Asian samples, whereas negativity and positivity showed downward trajectories but were less pronounced for Chinese students. Mediated latent growth curve modeling revealed that the cultures predicted independence-orientation, which in turn negatively predicted increase in frequency for the Singapore sample and positively predicted decrease for the Chinese sample. Independence-orientation negatively predicted increase in intimacy, positively predicted decline in negativity, and negatively predicted decline in positivity. In sum, we found complex and differentiated trajectories for the four facets of emotional disclosure in two Asian samples and the mediating role of independence-orientation in explaining cultural differences in the trajectories, which have implications for understanding emotional disclosure to parents during the developmental phase of the college transition in Asian contexts. Public Significance Statement: Chinese and Singapore freshmen's emotional disclosure with parents is a sophisticated and multifaceted developmental process. Although Beijing (China) and Singapore are traditionally interdependence-oriented Asian societies, first-year students across these two Asian cultures have varying experiences in how they manage emotions with parents during the developmentally significant phase of the college transition. Independence-orientation can account for cross-cultural differences in the trajectories of emotional disclosure with parents among first-year Asian college students. [ABSTRACT FROM AUTHOR]

Given the importance of self-esteem for promoting adolescents' social, psychological, and academic adjustment and the growing importance of social identities during adolescence, this five-wave study examined whether an identity-based self-affirmation intervention attenuated declines in adolescent self-esteem following the high school transition. A sample of ninth graders in the United States (N = 388; Mage = 14.05; 60.6% female; 35.8% male; 3.6% nonbinary, trans, or identifying with another gender; 46% White, 19% Black, 17% Asian, 6% Arab, Middle Eastern, North African, 6% Biracial/Multiethnic, 3% Latinx/Hispanic, and 3% another race/ethnicity) was recruited for the study. Following completion of a baseline online survey assessing self-esteem, participants were assigned to one of three conditions and corresponding writing exercises: identity-based self-affirmation, values-based self-affirmation, or control. Participants completed the same writing exercise during the first three waves of the study, and they completed measures of self-esteem at all five waves. Results indicated that participants in the self-affirmation conditions, but not the control condition, were protected from declining self-esteem across 1 year. Public Significance Statement: Self-esteem is a psychological phenomenon that predicts a host of important outcomes for youth but typically stagnates or even declines during adolescence. The present study developed an identity-based and values-based self-affirmation intervention to mitigate declines in ninth graders' self-esteem across 1 year. Results revealed that adolescents in the control condition exhibited declines in self-esteem, whereas those in the identity-based or values-based self-affirmation conditions were buffered from deteriorating self-esteem. The findings suggest that providing adolescents with opportunities to reflect on values and social identities of personal importance could have cascading effects on psychological adjustment following the high school transition. [ABSTRACT FROM AUTHOR]

People see some impossible events as more impossible than others. For example, walking through a solid wall seems more impossible if it is made of stone rather than wood. Across four experiments, we investigated how children and adults assess the relative impossibility of events, contrasting two kinds of information they may use: perceptual information and causal knowledge. In each experiment, participants were told about a wizard who could magically transform target objects into other things. Participants then assessed which of the two transformation spells would be easier or harder, a spell transforming a target object into a perceptual match (i.e., a similar-looking thing) or one transforming it into a causal match (e.g., an item made of similar materials). In Experiments 1–3, children aged 4–7 mainly thought that transformations into the perceptual match would be easier, though this tendency varied with age. Adults were overall split when choosing which spell would be easier. In Experiment 1, this was because of variations in their judgments across different pairs of spells; in Experiments 2 and 4, the split resulted because different subsets of adults preferred either the perceptual or causal match. Overall, these findings show that children, and many adults, use perceptual reasoning to assess relative impossibility. Public Significance Statement: Besides differentiating possible events from ones that are impossible, people see some events as more impossible than others. We investigated how children and adults make these judgments by asking them about magical transformations. One way that people might assess the relative impossibility of magic is by drawing on their causal knowledge. However, we find that young children, and even many adults, instead make these judgments using shallow perceptual information. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate nnU-net's performance in automatically segmenting and volumetrically measuring ocular adnexal lymphoma (OAL) on multi-sequence MRI. Methods: We collected T1-weighted (T1), T2-weighted and T1-weighted contrast-enhanced images with/without fat saturation (T2_FS/T2_nFS, T1c_FS/T1c_nFS) of OAL from four institutions. Two radiologists manually annotated lesions as the ground truth using ITK-SNAP. A deep learning framework, nnU-net, was developed and trained using two models. Model 1 was trained on T1, T2, and T1c, while Model 2 was trained exclusively on T1 and T2. A 5-fold cross-validation was utilized in the training process. Segmentation performance was evaluated using the Dice similarity coefficient (DSC), sensitivity, and positive prediction value (PPV). Volumetric assessment was performed using Bland-Altman plots and Lin's concordance correlation coefficient (CCC). Results: A total of 147 patients from one center were selected as training set and 33 patients from three centers were regarded as test set. For both Model 1 and 2, nnU-net demonstrated outstanding segmentation performance on T2_FS with DSC of 0.80–0.82, PPV of 84.5–86.1%, and sensitivity of 77.6–81.2%, respectively. Model 2 failed to detect 19 cases of T1c, whereas the DSC, PPV, and sensitivity for T1_nFS were 0.59, 91.2%, and 51.4%, respectively. Bland–Altman plots revealed minor tumor volume differences with 0.22–1.24 cm3 between nnU-net prediction and ground truth on T2_FS. The CCC were 0.96 and 0.93 in Model 1 and 2 for T2_FS images, respectively. Conclusion: The nnU-net offered excellent performance in automated segmentation and volumetric assessment in MRI of OAL, particularly on T2_FS images. [ABSTRACT FROM AUTHOR]

Objective: The 48‐week, phase 2 SLEek study (NCT03978520) evaluated the efficacy and safety of upadacitinib (JAK inhibitor) and elsubrutinib (BTK inhibitor) alone or in combination (ABBV‐599) in adults with moderately to severely active systemic lupus erythematosus (SLE). Methods: Patients were randomized 1:1:1:1:1 to elsubrutinib 60 mg and upadacitinib 30 mg once daily (ABBV‐599 high dose), elsubrutinib 60 mg and upadacitinib 15 mg once daily (ABBV‐599 low dose), elsubrutinib 60 mg once daily (QD), upadacitinib 30 mg QD, or placebo QD. The primary endpoint was the proportion of patients achieving both Systemic Lupus Erythematosus Responder Index 4 (SRI‐4) and glucocorticoid dose ≤10 mg QD at week 24. Additional assessments through week 48 included British Isles Lupus Assessment Group‐Based Composite Lupus Assessment (BICLA) and Lupus Low Disease Activity State (LLDAS) responses, number of flares, time to first flare, and adverse events. Results: The study enrolled 341 patients. The ABBV‐599 low dose and elsubrutinib arms were discontinued after a planned interim analysis showed lack of efficacy (no safety concerns). More patients achieved the primary endpoint with upadacitinib (54.8%; P = 0.028) and ABBV‐599 high dose (48.5%; P = 0.081) versus placebo (37.3%). SRI‐4, BICLA, and LLDAS response rates were higher for both upadacitinib and ABBV‐599 high dose versus placebo at weeks 24 and 48. Flares were reduced, and time to first flare through week 48 was substantially delayed with both upadacitinib and ABBV‐599 high dose versus placebo. No new safety signals were observed beyond those previously reported for upadacitinib or elsubrutinib. Conclusion: Upadacitinib 30 mg alone or in combination with elsubrutinib (ABBV‐599 high dose) demonstrated significant improvements in SLE disease activity and reduced flares and were well tolerated through 48 weeks. [ABSTRACT FROM AUTHOR]

Migration-related risk factors may impact the association between coping strategies, resilience, and identity development, one of the fundamental developmental tasks in adolescence. We examined the relationship between resilience and coping strategies in immigrant and non-immigrant adolescents' identity development. On a sample of Turkish adolescents (n = 399, 50.9% girls), we conducted six hierarchical regression models to predict identity dimensions from resilience and coping strategies. For both immigrants and non-immigrants, seeking social support predicted a more mature and successful identity while avoidance predicted less reconsideration of commitment. For non-immigrants, seeking social support and avoidance was associated with in-depth exploration whereas for immigrants, only seeking social support was linked to in-depth exploration. Additionally, resilience predicted a successful identity for immigrants. Results were discussed considering migration-related difficulties [ABSTRACT FROM AUTHOR]

Multiple studies have explored the factor structure of working memory (WM) tasks, yet few have done so controlling for both the domain and category of the memory items in a single study. In the current pre-registered study, we conducted a large-scale latent variable analysis using variant forms of n-back and backward recall tasks to test whether they measured a single underlying construct, or were distinguished by stimuli-, domain-, or paradigm-specific factors. Exploratory analyses investigated how the resulting WM factor(s) were linked to fluid intelligence. Participants (N = 703) completed a fluid reasoning test and multiple n-back and backward recall tasks containing memoranda that varied across (spatial or verbal material) and within (verbal digits or letters) domain, allowing the variance specific to task content and paradigm to be assessed. Two distinct but related backward recall and n-back constructs best captured the data, in comparison to other plausible model constructions (single WM factor, two-factor domain, and three-factor materials models). Common variance associated with WM was a stronger predictor of fluid reasoning than a residual n-back factor, but the backward recall factor predicted fluid reasoning as strongly as the common WM factor. These data emphasise the distinctiveness between backward recall and n-back tasks. [ABSTRACT FROM AUTHOR]

Transgender individuals face challenges to identity as they transition from their sex assigned at birth to their affirmed gender. Memories may support a sense of self through the recall of events with more phenomenological detail than others, making them feel closer to the current self. Autobiographical memories of 90 transgender and 90 cisgender adults were compared on self-reported memory phenomenology. Memory phenomenology was more variable in transgender individuals, with a larger difference between phenomenological ratings of recent and distant memories. Memory phenomenology specifically varied in relation to the timing of coming out to a parent. High points reported after this time were rated with higher phenomenological quality and these ratings were linked to positive well-being. Results affirm the relevance of phenomenological continuity to the identity of transgender individuals, suggesting that events from before coming out are recalled with less phenomenological quality than events after coming out. [ABSTRACT FROM AUTHOR]

Purpose: To identify the qualifications, professional roles and service practices of nurses, occupational therapists (OTs) and speech-language pathologists (SLPs) in the management of adults with oropharyngeal dysphagia (OD) in the Nordic countries. Methods: A web-based survey was developed that consisted of 50 questions on respondent demographics, education, experience, roles and service practices provided for adults with OD. The survey was distributed to practicing nurses, OTs, and SLPs in five Nordic countries via professional associations, social media, online networks and snowballing. Results: Data from 396 nurses, OTs and SLPs whom provided services for adults with OD revealed that the majority of respondents worked in acute care and inpatient rehabilitation facilities. Most respondents had minimal undergraduate education and practical clinical training in OD. Notable variances in roles and service practices in OD between professions and countries were found. OTs were the primary service provider for OD management in Denmark, while SLPs had this role in the other Nordic countries. Nurses were mainly involved in screening and some compensatory treatments in most Nordic countries. Limited use of evidence-based screening, non-instrumental or instrumental clinical assessments and rehabilitative therapeutic methods was evident. Conclusions: Study results highlight challenges in education and training of professionals responsible for the management of adults with OD in the Nordic countries. Increased use of evidence-based assessment and exercise-based treatments to improve swallowing are warranted. Adherence to European and international clinical practice guidelines for the management of adults with OD is recommended. [ABSTRACT FROM AUTHOR]

Purpose: National surveys of speech-language pathologists' (SLP) practices play an important role in professional development, and previous research show that many challenges faced by the profession are similar across the globe. This study aims to describe Swedish SLP assessment practices, examine factors that may affect this practice, and discuss the results in the light of international studies. Methods: Data from 584 SLPs were collected through an online questionnaire with multiple choice and open-ended questions. A mixed-method design was deployed where a deductive qualitative analysis of free-text responses complemented quantitative data. Results: In line with previous results from English-speaking countries, both standardized discrete skill tests and contextualized assessments were used by the respondents but fewer used language sample analysis and dynamic assessment procedures, despite international recommendations. There were few differences based on experience, work setting, proportion of multilingual assessments and socio-economic status of the health catchment area. Main challenges reported were lack of time and difficulty prioritizing, and assessment and/or diagnosis of multilingual/L2 children, which is similar to challenges faced by SLPs in other countries. Swedish SLPs also reported lack of national clinical guidelines as a main challenge. Factors contributing to better assessments included experience, and the combination of many sources of information, including professional and interprofessional discussions. Conclusions: The accumulated evidence from this and previous studies show that to address challenges and build on strengths, changes on a systemic level are needed. This includes more time and resources for continuing education and implementation of recommended assessment methods, as well as professional and interprofessional collaborations. [ABSTRACT FROM AUTHOR]

This cross-cultural study examines the differences in TikTok use among users from the United States, Spain, and Chile. A survey, in English, European Spanish, and Latin American Spanish respectively, was administered to 556 TikTok users across the three countries. These users shared similar demographic characteristics, and multigroup measurement models were established to support cross-country measurement invariance. Our results show that Chilean TikTokers are the least engaged on the platform, but have more followers on average than their American and Spanish counterparts. Additionally, users' motivations for and uses of TikTok are associated with their countries' national cultural values. For instance, TikTok users in Chile and Spain, which are collectivistic societies, view the platform as a socialisation tool more than users in the individualistic United States. Lastly, Chileans, who have a high uncertainty avoidance level, tend to avoid self-expression and archiving on TikTok compared to Americans, who have a low uncertainty avoidance level. [ABSTRACT FROM AUTHOR]

'Phubbing' refers to the phenomenon where people ignore social partners in a face-to-face situation by focusing on their phones. Narcissism, a personality trait characterised by entitled self-importance, has strong influences on interpersonal relationships. As the mechanism through which narcissism may affect the development of phubbing is unclear and most relevant studies have been conducted in Western countries, we proposed and empirically tested a theoretical model that links narcissism to phubbing in China. Chinese participants (N = 322; 181 women and 141 men) completed a survey in the Chinese language. Path analyses largely confirmed the proposed hypothetical model. The main findings showed that vulnerable narcissism directly predicted more phubbing behaviour and also indirectly via increased social anxiety, preference for online social interaction (POSI), social media use (SMU) for mood regulation, and compulsive SMU. Also, grandiose narcissism indirectly predicted less phubbing behaviour via reduced social anxiety, POSI, SMU for mood regulation, and compulsive SMU. The findings, therefore, elucidate the mechanisms by which the two subtypes of narcissism differentially predispose people to phubbing in China, with vulnerable narcissism predisposing people to more phubbing and grandiose narcissism to less phubbing. Implications and limitations of the study are discussed. [ABSTRACT FROM AUTHOR]

Data visualisation software provides the ability to create highly customisable choropleth maps. This presents an abundance of design choices. The colour legend, one particular aspect of choropleth map design, has the potential to effectively convey data points' absolute magnitudes (how large or small they are). Colour legends present the mapping between a specific range of colours and a specific range of numerical values. In this experiment, we demonstrate that manipulating this range affects interpretations of the plotted values' absolute magnitudes. Participants (N = 100) judged the urgency of addressing pollution levels as greater when the colour legend's upper bound was equal to the maximum plotted value, compared to when it was significantly larger than the maximum plotted value. This provides insight into the cognitive processing of plotted data in choropleth maps that are designed to promote inferences about overall magnitude. [ABSTRACT FROM AUTHOR]

In recent years, information security has gained significant academic attention. The present research sought to examine shifts in undergraduates' Information Security Awareness (ISA) as they advanced in their academic pursuits. Comprising two distinct phases, the initial phase involved adapting the Human Aspects of Information Security Questionnaire (HAIS-Q) to fit the context of Chinese tertiary institutions, a process overseen by five eminent ISA specialists. The adapted instrument was then piloted with 647 students, utilising snowball and criterion sampling techniques. Construct validity was established through exploratory factor analysis, and the questionnaire's reliability was ascertained via Cronbach's alpha. The subsequent primary survey engaged 5148 undergraduates from three Chinese academic institutions to further validate the instrument and investigate its relevance to student cohorts. Distinctively, participants exhibited pronounced proficiency in the Attitude component, yet lagged in Behavioural aspects. Analytical outcomes highlighted discernible interactions between gender, academic progression, and the Knowledge, Attitude, and Behaviour (KAB) facets. Notably, female respondents consistently outperformed their male counterparts. However, a marked decline in ISA cognisance and comportment was observed as students ascended academically. The HAIS-Q stands as a reliable tool for evaluating ISA in tertiary education, offering fresh insights to the scholarly discourse on educational information security. [ABSTRACT FROM AUTHOR]

Purpose: Quadriceps tendon disruption post-total knee arthroplasty (TKA) is rare. Existing reconstruction procedures use allografts or synthetic meshes with varied success. This study evaluates outcomes with autogenous peroneal tendon grafts, a cost-effective alternative, compared to synthetic polypropylene mesh for quadriceps reconstruction. Methods: 16 patients who underwent extensor mechanism reconstruction between 2017 and 2021were retrospectively analysed. Parameters evaluated included type of reconstruction, extensor lag, IKDC (International Knee Documentation Committee) Score and AOFAS-Hindfoot-score (American Orthopaedic Foot and Ankle Society). Results: At final follow-up, extensor lag for peroneal autograft group was 6.6° ± 1.5 and for synthetic polypropylene mesh group, 7.2° ± 0.7. Both groups improved in IKDC score (p < 0.01) AOFAS-Hindfoot-score was comparable for peroneal autograft patients with opposite side (p = 0.15). Conclusions: Autogenous peroneal tendon graft for quadriceps reconstruction could be viable, cost-effective alternative to allografts or synthetic meshes, with good clinical outcomes. Graphical abstract depicting the harvesting of the peronei grafts and their passage through the quadriceps tendon. Sonographic image showing the preoperative presence of a gap in the quadriceps tendon which is reconstructed post-operatively [ABSTRACT FROM AUTHOR]

Background: People in agriculture face unique stressors and occupational hazards, and relatively little is known about substance use in this population. The purpose of this study was to describe substance use among farmers in Illinois. Methods: We conducted a mail survey of Illinois farmers that included the Brief ASSIST to assess substance use for lifetime and past three-month use of ten different substances. The survey also included questions about farming characteristics, mental health, stress, coping, social support, and demographic characteristics. We used chi-square and non-parametric tests to assess group differences. Results: Alcohol, tobacco, cannabis, and sedatives were most reported as used for a lifetime and in the past three months. About three-quarters of the sample had recently used alcohol. Recent tobacco use was associated with not being married, less education, and less concern about climate-related farm stress. Recent sedative use was associated with greater concern about isolation-related farm stress. People who reported multiple substance use were at a greater risk for suicide and were more likely to meet the criteria for generalized anxiety disorder. None of the participants reported recent use of cocaine, heroin, inhalants, or hallucinogens. Conclusion: Specific social and cultural aspects of farming and farm communities may contribute to substance use among people working in agriculture. Future research can help to better understand this intersection and make recommendations for programs and resources to promote adaptive coping strategies. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the effect of neuromuscular electrical stimulation on the frontal ankle motor control in individuals with chronic ankle instability during drop landing. Design: This was a randomized, controlled, double-blind trial. Thirtysix individuals with chronic ankle instability were randomly assigned to each group. Participants received 6-wk neuromuscular electrical stimulation intervention and sham stimulation in the neuromuscular electrical stimulation and control groups, respectively. Data were collected at week0 and week6. A mixed-effects model and analysis of covariance were employed to investigate the between-group differences in continuous and discrete outcome variables at week6, with the outcome variables at week0 as covariates. Results: Compared to control group, neuromuscular electrical stimulation group exhibited a 2.66° (2.45, 2.86) reduction in frontal ankle inversion angle, a 47.41°/sec (−16.05, −78.77) decrease in peak ankle inversion angular velocity, and a 0.43 Nm/kg (0.18, 0.68) increase in peak ankle eversion moment during drop landing at week6. Conclusions: Applying 6-wk neuromuscular electrical stimulation to the fibularis longus resulted in decreased ankle inversion angle and ankle inversion angular velocity and increased peak ankle eversion moment during drop landing. Consequently, neuromuscular electrical stimulation could be considered an effective modality for individuals with chronic ankle instability to enhance the frontal ankle movement patterns and overall ankle motor control. [ABSTRACT FROM AUTHOR]

Objective: The main objective of this study was to investigate the effect of a self-regulated dual task on muscle endurance within a single rehabilitation session in patients recovering from an elbow fracture. Design: This is a cross-sectional study of individuals recovering from elbow fractures (N = 20). Muscle endurance was tested using elastic bands at Borg’s CR10 intensity 3—during four conditions: singletask and dual-task for elbow flexion and extension. Results: The cognitive condition significantly influenced muscle endurance ( P < 0.001), while the type of elbow exercise (flexion or extension) did not show significant differences ( P = 0.592). The perceived difficulty of the tasks showed a significant interaction effect ( P = 0.032). The dual-task condition showed an average increase of about 15 repetitions. A moderate negative correlation was found between the differences in repetitions and the perceived difficulty of the flexion exercise (r = 0.677, P = 0.001). Conclusions: Dual-task with self-regulation enhances muscle endurance among patients recovering from an elbow fracture. However, the improvements seem to depend on the perceived difficulty of the cognitive task. Future randomized controlled trials are required to understand the therapeutic implications of dual-tasking. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to determine whether a health service system is an independent influencing factor of having pressure injury problems in individuals with chronic spinal cord injury living in three countries Design: This is a cross-sectional study. Methods: Data from the International Spinal Cord Injury Community Survey were analyzed. The pressure injury problems were assessed using the Spinal Cord Injury Secondary Condition Scales (dichotomized to “having problem” and “not having problem”). Health service systems were categorized as an inpatient-oriented spinal cord injury–specialized system and a primary care–oriented system. A directed acyclic graph was applied to create a multivariable logistic regression model to determine the independent influencing factors of pressure injury problems. Results: Of 790 included participants, 277 (35%) had pressure injury problems. Being recruited from countries with inpatient-oriented spinal cord injury–specialized systems (model 1) and visiting rehabilitation medicine/spinal cord injury physicians at least once a year (model 2) is an independent negative correlating factor of pressure injury problems (odds ratio = 0.569 [95% confidence interval = 0.374–0.866] and 0.591 [95% confidence interval = 0.405–0.864], respectively). Conclusions: Spinal cord injury–specialized health service systems might be a protective factor of pressure injury problems in middle-income country contexts. This result suggests the importance of having spinal cord injury–specialized services in middle-income countries to reduce the prevalence of pressure injury problems. [ABSTRACT FROM AUTHOR]

Background Encapsulated pancreatic fluid collection (PFC) is a requisite for endoscopic drainage procedures. The 4-week threshold for defining walled-off necrosis does not capture the dynamic process of encapsulation. We aim to investigate the changes in the wall characteristics of PFC in acute necrotizing pancreatitis (ANP) by comparing baseline contrast-enhanced computed tomography (CECT) with follow-up CT scans. Methods This retrospective study comprised consecutive patients with ANP who underwent a baseline CECT within first 2 weeks and follow-up CECT in the third to fifth weeks of illness. Presence, extent, and encapsulation thickness (defined as enhancing wall around the collection) on baseline CECT were compared with follow-up CT (done in the third–fifth weeks of illness). Results Thirty patients (19 males and 11 females; mean age 41.5 ± 13.5 years) were included in the study. The mean time to first CECT was 10 ± 3.6 days. There were 58 collections. The most common site was the lesser sac (n = 29), followed by the left pararenal space (n = 15). At baseline CT, 52 (89.7%) collections had varying degree of encapsulation (15.3%, complete encapsulation). Complete encapsulation was seen in 52 and 82.6% collections in third and fourth week, respectively. All collections in fifth week and beyond were encapsulated. The wall was thicker on follow-up CECT scans (p < 0.01). The mean wall thickness was not significantly associated with the degree of encapsulation (p = 0.417). There was no significant association between the site and degree of encapsulation (p = 0.546). Conclusion Encapsulation is dynamic and collections may get "walled off" before 4 weeks. Walled-off collections should be defined based on imaging rather than a fixed 4-week revised Atlanta classification threshold. [ABSTRACT FROM AUTHOR]

Objective: In high-risk agricultural environments, tasks, weather, and work conditions vary throughout the year. Also, injuries peak during certain periods. The primary objective of this study was to examine operator- and farm-level characteristics as risk factors for injuries within each of the four seasons. The secondary objective was to examine seasonal differences in the incident location and primary cause of these injuries. Method: We analyzed data from the 2018 and 2020 Farm and Ranch Health and Safety Surveys (FRHSS), conducted in seven U.S. states by the Central States Center for Agricultural Safety and Health (CS-CASH), which were collected using a stratified random sampling approach to ensure representativeness. The survey data were merged with operation-level data from the Farm Market iD database. We employed Generalized Estimating Equations (GEE) to examine the association of seasonal injuries with individual and operation-level characteristics. The chi-square test of independence was used to assess the association between injury incident location and season, as well as injury cause and season. Pairwise Z-tests of proportions were conducted to evaluate the differences in the proportions of injuries due to specific combinations of injury location and cause across each pair of seasons. Results: Surveys conducted in 2018 and 2020 yielded a combined response rate of 15.9%, with 5,428 responses and 7,915 unique operators. Of these, 903 operators reported at least one injury during the past 12 months. Seasonally, most injuries occurred in spring (34.2%), followed by summer (24.7%). Male operators had higher injury odds in the spring (adjusted OR = 1.42) and summer (aOR = 2.41). Those managing both a farm and a ranch reported increased injury risks in winter (aOR = 1.73) and spring (aOR = 1.48). Operators in cow-calf operations faced higher springtime injury risks (aOR = 1.45). High stress and exhaustion were consistent risk factors across all seasons. The highest proportion of injury incidents occurred in the farmyard (43.6%), and livestock were the most common cause of injury (24.9%). Conclusion: Results highlight the need for season-specific prevention and intervention strategies, considering farmers' and ranchers' risk characteristics, injury locations, and causes. These findings can inform targeted measures for high-risk populations at optimal times and locations. [ABSTRACT FROM AUTHOR]

Objectives: Adolescents are at-risk of fatal and non-fatal injuries in the farm environment. School-based agricultural safety and farm injury prevention education is likely to be more effective when utilizing co-designed and gamification principles; however, this needs to be tested. This study examined data from a pilot evaluation of a co-designed farm injury prevention gamified educational resource for adolescents. Methods: Online, anonymous surveys were conducted with students studying agriculture in regional Australia who had previously participated in the co-design process to develop "Calm Your Farm". Three courses were developed (vehicles, workshop, and water safety) and before and after playing each of the courses for the first time, students completed survey questions regarding self-reported knowledge on the course topic, and assessment of content, design, ease of play, and how much they learned. Survey data were analyzed using descriptive statistics, chi square tests of association, and independent sample t tests. Results: We analyzed 66 responses (66.7% male; 60.6% aged 13 years). Staged course release meant all respondents assessed the vehicle and workshop courses, while 58% assessed the water safety course. Vehicle and workshop courses were rated 7.64 out of a possible 10 (SD = 1.85) and 7.65 (SD = 1.78), respectively, for the information presented, slightly higher than water safety (7.47 [SD = 1.91]). Statistically significant improvements in self-reported knowledge post play were seen among boys for the water safety course (63% said knowledge improved; X2 = 4.98; p =.026) and 13-year-olds for vehicles (35%; X2 = 4.31; p =.038) and workshop safety (50%; X2 = 4.29; p =.038). Respondents indicated being more likely to replay the game at school (M = 6.62 [SD = 2.96]) than at home (M = 5.57 [SD = 3.07]). Of respondents, 61% (n = 40) agreed that "Calm Your Farm" taught them more about farm safety and was more fun than other farm safety education previously received. Tractor safety (62%), chemical safety (58%), and firearm safety (58%) were the most popular topics suggested to be added to the game. Conclusion: The co-design and gamification approach taken with "Calm Your Farm" appeared to be successful in improving self-reported knowledge around farm injury prevention and was perceived by 62% of the respondents as being fun and educational. Future expansion should incorporate student suggested topics. [ABSTRACT FROM AUTHOR]

Objectives: The objective of the current study is to describe mental health among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people who work in agriculture in the U.S. Methods: This study uses a survey of LGBTQ+ adults who work in agriculture in the U.S. (N = 148), including questions about LGBTQ+ identity, farming background, depression symptoms (PHQ-8) and diagnosis, anxiety symptoms (GAD-7) and diagnosis, suicide risk, and stress. Data were analyzed using SPSS, including descriptive statistics, chi-square tests, and Mann-Whitney U tests. Results: Over one-third (36.1%) had probable depression (PHQ-8 ≥ 10), and 71.9% were experiencing mild to severe depression symptoms. Nearly half (46.2%) had probable anxiety disorder (GAD-7 ≥ 8), and 69.7% experienced mild to severe anxiety symptoms. Over half (51.7%) were at significant risk for suicide. Greater proportions of men had probable anxiety disorder, probable depression, and suicide risk compared to non-men. Greater proportions gay participants had probable depression, as did beef producers. Perceived stress was higher for men, lesbian and gay participants, transgender participants, and those in beef production. Resilient coping was highest among participants who were genderqueer or genderfluid, bisexual, and those in field crop production. Conclusion: LGBTQ+ farmers in the current sample experienced depression and anxiety at higher rates than general farming or general LGBTQ+ samples, although suicide risk was lower than for general LGBTQ+ samples. Future research should explore how working in agriculture may be protective against suicide risk for LGBTQ+ farmers, as well as how specific farm stressors are related to LGBTQ+ farmer mental health. [ABSTRACT FROM AUTHOR]

This study used the Actor-Partner Interdependence Model to examine how parents' adult attachment influences their their own and the partners' co-parenting and parent-child relationships. Participants were from a cross-sectional sample of 1313 Chinese heterosexual married couples (fathers' Mage = 39.74, SD = 5.61; mothers' Mage = 37.55, SD = 5.04) whose biological children were pupils (Mage = 10.25, SD = 2.35). Results revealed that: (a) Couple members' actor effects from adult attachment avoidance to positive and negative co-parenting and parent-child closeness and conflict were found both significant; (b) The actor effects from adult attachment anxiety to negative co-parenting and parent-child conflict were found significant, whereas only partner effect from attachment avoidance to positive co-parenting and from attachment anxiety to parent-child conflict were significant. The results highlight the negative effects of parents' attachment avoidance and anxiety on their partners' parenting function. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM) is an important public health issue owing to its rising global prevalence. Phthalates cause various health problems and are currently regulated in developed countries. However, studies on the impacts of low-level phthalate exposure under these regulations on T2DM are limited. This study investigated the impacts of combined and single exposures to phthalates and their alternatives on the prevalence of T2DM in 3,005 adults in the United States. The results indicated a positive joint effect of phthalate mixtures on the prevalence of T2DM. The joint effect was primarily attributed to Di-2-ethylhexyl phthalate (DEHP) metabolites, whereas the contributions of others were limited. This study suggests that, despite the stringent regulations on phthalates, low levels of phthalates, including DEHP, still have joint effects on T2DM. The findings highlight the importance of regulating hazardous phthalates and the need for safer alternatives to reduce public health risks. [ABSTRACT FROM AUTHOR]

This study tried to understand the association between exposure to indoor air pollution and angina among the aging population in India. We utilized the data from the Longitudinal Ageing Study in India (LASI) Wave–1 (2017–2018), with a sample of 62,846 aging adults. We applied Chi-square and multivariate logistic regression models. The odds of angina were higher among individuals living in households that used solid fuels for cooking (aOR = 1.15, 99% CI- 1.09-1.20), had someone smoked inside the house (aOR = 1.12, 99% CI- 1.07-1.18), and households that used of incenses inside the home (aOR = 1.11, 99% CI- 1.05-1.18). In addition, it was also found that work-limiting impairment, unhealthy behaviors, and poor health status increased the odds of angina. These results indicate the need to reduce in-house air pollution by promoting clean fuel usage and changing attitudes and practices. Other implications are discussed. [ABSTRACT FROM AUTHOR]

The Screen for Child Anxiety Related Emotional Disorders: Parent Version (SCARED-P) was originally developed for use in middle childhood and adolescence. The present study examined the psychometric properties and validity of the SCARED-P in an early childhood sample (predominantly aged 4–7 years). The 41-item version of the SCARED-P was administered to the parents of 233 children (mean age = 6.31 years, SD = 1.08; females = 34.3%). Confirmatory factor analysis provided mixed support for the original five-factor model of the SCARED-P. The SCARED-P demonstrated good to excellent internal consistency (total α =.94, subscale α =.68–.89), and good construct validity with the Child Behavior Checklist, Strengths and Difficulties Questionnaire, and the Developmental and Well-being Assessment. These findings indicate overall initial support for the SCARED-P's utility as a measure of anxiety in early childhood, but further psychometric and validation studies are needed in larger community-based samples of young children. [ABSTRACT FROM AUTHOR]

The Stress Appraisal Measure (SAM) captures six different types of cognitive appraisals in anticipation of an upcoming stressful situation. The goal of this article was to examine the factorial structure and the validity of the scale in the French language while accounting for existing limitations in the literature. These include factorial structure instability and low internal consistency for specific subscales across multiple validation studies in other languages. In the first study (N = 425), the results from an exploratory factor analysis reliably suggested the removal of five items, the bridging of the threat and challenge subscales as one, and a new general five-factor structure. The new structure and its construct, convergent, and discriminant validity were confirmed in a second study (N = 308). We discuss the relevance of this five-factor scale for the studies focused on individual differences in stress and appraisals. [ABSTRACT FROM AUTHOR]

This study explored the delivery of Bernard's Discrimination Model (DM) in a post-masters agency setting and what supervisors did under varying conditions as they applied the model. Researchers examined the relationship between the frequency of application for the four DM foci and three supervision roles. Utilization of supervision interventions related to DM was also explored. Sixty-six (66) master's-level mental health clinicians [half fully licensed, half provisionally licensed] were assessed using a multi-rater observational approach. Results revealed that clinical supervisors worked with the majority of clinicians on the focus of skills, and supervisors spent most of their time within the teaching and counseling roles. General patterns of use by supervisory interventions were that Interpersonal Process Recall (IPR) and micro-training were utilized the most frequently, with structuring and role play utilized less so. Chi-square analyses indicated significant differences in expected use of interventions by foci and roles. Implications are included. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the effectiveness of an eight-session universal parent training program for working parents using a parallel cluster randomized controlled trial design. The program was facilitated by preschool-based social workers in preschools. Method: Participants included 242 parents of children attending 16 preschools under the Pilot Scheme on Social Work Service for Pre-Primary Institutions, with 150 (seven preschools) randomly allocated to the intervention group and 92 (nine preschools) to the waitlist control group, with no blinding. Participants completed questionnaires on their parenting stress, parenting practices and emotion coaching (primary outcomes), and children's behavior problems (secondary outcomes). The study was registered with the ISRCTN registry (39415). Results: Mixed effects regression analysis (intention-to-treat) with preschool as a random factor indicated a significant decrease in over-reactivity, and an improvement in emotion coaching. Conclusions: The results provided promising research on the effectiveness of a preschool-based parenting program for working parents. [ABSTRACT FROM AUTHOR]

Background: Four-factor prothrombin complex concentrate (4F-PCC) is indicated for vitamin K antagonist (VKA) reversal but is associated with thrombotic events (TE). In 2018, the institution revised 4F-PCC dosing for VKA reversal from INR and weight-based dosing to a fixed-dose of 1500 units. Objective: The purpose of this study was to compare hemostatic efficacy and TE rate of fixed-dose 4PCC to weight-based dosing. Methods: This was a retrospective, single-center, quasi-experimental study of adult patients who received 4F-PCC for VKA reversal from January 2014 through May 2016 (INR and weight-based dosing) or April through October 2018 (fixed-dosing). The primary endpoint was hemostatic efficacy, defined by achieving an INR of ≤1.4, or an INR of ≤1.7 with evidence of hemostasis. The key secondary endpoint was TE within 14 days of 4F-PCC administration. Data were analyzed using descriptive statistics, chi-squared for nominal data and Mann-Whitney U for ordinal and continuous data. Results: The study included 163 patients who received weight-based dosing and 45 who received fixed-dose 4F-PCC. Hemostatic efficacy was 76.9% of patients in the weight-based group and 77.4% of patients in the fixed-dose group (P =.229). TE occurred in 13.5% of the weight-based vs 6.7% of the fixed-dose group (P =.181). Conclusion: This study found no difference in hemostatic efficacy with fixed-dose 4F-PCC for VKA reversal compared to INR and weight-based dosing. The occurrence of TE was reduced by 50% with the 4F-PCC fixed-dose strategy; however, this difference was not statistically significant. Further randomized studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Purpose: The Joint Commission standards for titrated infusions require specification of maximum rates of infusion. This practice has led to the development of protocolized maximum doses that can be overridden by provider order ("soft maximums") and to dose caps that cannot be superseded ("hard maximums"). The purpose of this study was to determine the prevalence of and attitudes towards dose capping of norepinephrine. Methods: A 20-item cross-sectional survey assessing norepinephrine dose capping practices, perceptions of norepinephrine protocols, and respondent and practice site demographics was distributed electronically to the mailing list of an international medical podcast. Responses were stratified according to use of weight-based dosing (WBD) or non-WBD of norepinephrine. The primary objective was to characterize norepinephrine dosing practices including protocolized maximum doses and/or dose capping. Categorical and continuous variables were compared using the Chi-square test and Mann-Whitney U test, respectively, with P <.05 indicating statistical significance. Results: The survey was completed by 586 physicians, nurses, pharmacists, and advanced practice providers. WBD was used by 51% and non-WBD by 47%. A standardized titration protocol was reported by 65% and dose capping was reported by 19%. The protocolized maximum dose ranged from 20-400 mcg/min for respondents using non-WBD (median [interquartile range] 30 [30-50]) and ranged from.2-10 mcg/kg/min for respondents using WBD (1 [.5-3]). The dose cap was 50 (40-123) mcg/min with non-WBD and 2 (1-3) mcg/kg/min with WBD. Conclusions: An international, multi-professional survey of critical care and emergency medicine clinicians revealed wide variability in norepinephrine dosing practices including maximum doses allowed. [ABSTRACT FROM AUTHOR]