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Background: The Integrated Palliative Care Outcome Scale (IPOS) validly and reliably measures symptoms and concerns of those receiving palliative care. Aim: To determine the equivalence of the paper version with an electronic version of the IPOS (eIPOS). Design: Multicentre randomised crossover trial (NCT03879668) with a within-subject comparison of the two modes (washout period 30 min). Setting/Participants: Convenience sample of specialist inpatient and palliative home care patients aged over 18 years with cancer and non-cancer conditions was recruited. Scores were compared using intraclass correlation coefficients (ICC), Bland-Altman plots and via a mixed-effects analysis of variance. Results: Fifty patients were randomised to complete paper-electronic (n = 24) and electronic-paper (n = 26) IPOS with median age 69 years (range 24–95), 56% male, 16% non-cancer. The ICCs showed very high concordance for the total score (ICC 0.99, 95% CI 0.98–1.00), lowest ICCs being observed for symptoms 'Appetite loss' and 'Drowsiness' (ICC 0.95, 95% CI 0.92–0.97). Nine of seventeen items had ICCs above 0.98, as did all subscales. No statistically significant mode, order, age, and interaction effects were observed for IPOS total score and subscales, except for 'Communication' (Fmode = 5.9, p = 0.019). Fifty-eight percent preferred the electronic version. In the group 75+ years, 53% preferred the paper version. Only three entries in the free-text main problems differed between the versions. Conclusion: The very high equivalence in scores and free text between the IPOS and the eIPOS demonstrates that eIPOS is feasible and reliable in an older palliative population. [ABSTRACT FROM AUTHOR]

BACKGROUND: Screening of hemoglobin (Hb) before blood donation is one among the vital tests. It is performed to select a blood donor to prevent the collection of blood from an anemic person. However, no accurate, cost-effective, reliable, and standardized method is available to estimate Hb. OBJECTIVE: The aim is to evaluate the efficacy of filter paper cyanmethemoglobin (FPCH) method with the automated hematology analyzer in the estimation of Hb concentration for screening of a suitable donor. METHODOLOGY: This was a cross-sectional study in which the blood samples of 2000 patients visiting KLE's Dr. Prabhakar Kore Charitable Hospital, Belagavi, were collected in vials and directly estimated for Hb using automated hematology analyzer. To evaluate the efficacy of FPCH, 20 μL of blood sample was transferred onto Whatman filter paper and dried at room temperature. After drying, it was placed in 5 mL of Drabkin's solution for 30 min. Optical density was estimated by measuring the absorbance. Data were analyzed using SPSS version 20. The correlation coefficient, paired t-test, and difference between the means of both the methods were calculated. RESULTS: The mean Hb estimated by FPCH was 11.25 g/dL and automated hematology analyzer gave 11.35 g/dL. The difference in the means of both the methods was 0.1 g/dL. Paired t-test was done to test the level of significance and the result was 8.151 (95% confidence interval: 0.08–0.13 g/dL, P < 0.001). The correlation coefficient was found to be 0.976 (P < 0.001). CONCLUSION: FPCH is an efficient method, which is comparable to the automated hematology analyzers for Hb estimation. It could be used as an alternative screening tool for detection of Hb in a blood donation camp. [ABSTRACT FROM AUTHOR]

Context: Racial identity may associate with clinical outcomes following sport-related concussion (SRC). This study compared clinical outcome scores before and after recovery from a SRC between Black or White college athletes. Design: Prospective cohort. Methods: Participants were self-reported White (n = 61, 18.5 [1.1] y of age) and Black (n = 24, 18.3 [1.1] y of age) NCAA Division 1 college athletes. The revised Head Injury Scale (HIS-r), the Immediate Postconcussion and Cognitive Test (ImPACT) battery, and the Sensory Organization Test (SOT) at baseline (T1), upon symptom resolution (T2) following a diagnosed SRC, and upon establishing a new baseline assessment (T3). Race was collected from paper and electronic medical records. The revised Head Injury Scale total symptom severity, ImPACT's Verbal Memory, Visual Memory, Visual Motor Speed (VMS), and Reaction Time, and the SOT Equilibrium Score, were compared between groups at each time point. Multivariate analyses of variance (2 [group] × 3 [time]) were used to compare revised Head Injury Scale, ImPACT, and SOT outcome scores. Post hoc analyses consisted of independent and paired sample t tests. Results: A significant main effect for time (λ = 0.66, F2,82 = 21.55, P <.001, η p 2 =.34) was observed for the SOT. White athletes significantly improved on the Equilibrium Score between all time points (all P <.006). Similarly, Black athletes significantly improved on the Equilibrium Score between T1–T2 and T1–T3 (all P <.001). A significant main effect of time was observed for ImPACT's Verbal Memory, Visual Memory, and VMS outcome scores (all P <.001). VMS improved for White athletes between T1–T2 (P =.02) and T3 (P =.006). Black athletes had improved VMS scores between T1–T3 (P =.015) and T2–T3 (P =.005). A between-group difference was observed for VMS at T2 (P =.004). Conclusions: There was 1 small and not clinically significant difference between groups for the VMS score at T2. Overall, groups performed consistently or improved upon their baseline balance, cognition, and symptom outcome scores at clinically relevant time points following a SRC. [ABSTRACT FROM AUTHOR]

Document forgeries that involve modification of the materials used, such as ink and paper, provide evidence of any malpractices being performed. Forensic specialists use different techniques to identify and classify these samples; however, the most preferred method is to use nondestructive techniques to avoid any potential damage to the original specimen under investigation. Hyperspectral imaging has already been explored in several application domains and used as a powerful method in forensic investigations to extract information about the materials under examination. To precisely classify the material information and utilize the hyperspectral imaging technique's potential, we probed the potential of some hybrid spectral similarity measures to classify different commonly used paper samples. A comparison of these methods is quantitatively presented in this article. Hybrid spectral similarity algorithms are tested on forensic analysis of paper data. We compared the classification capabilities of various hybrid spectral similarity algorithms on hyperspectral data of 40 different paper samples. The overall accuracy (OA), kappa K̂, Z‐score of kappa (ZK̂), and the 95% confidence interval of kappa (CI(K̂)) are used for comparison. The SID‐SAM and SID‐SCA produced an overall accuracy of 88% and 87%, respectively, which is highest among the hybrid spectral similarity measures tested. [ABSTRACT FROM AUTHOR]

Aims: The experiment tested the effects of a web‐push survey research protocol, compared with the standard mailed paper‐and‐pencil protocol, among young adults aged 19–30 years in the 'Monitoring the Future' (MTF) longitudinal study. Design, Setting and Participants: The US‐based MTF study has measured substance use trends among young adults in panel samples followed biennially, using consistent mailed survey procedures from 1977 to 2017. In 2018, young adult participants in the MTF longitudinal component scheduled to be surveyed at ages 19–30 in 2018 (from high school senior cohorts of 2006–17, n = 14 709) were randomly assigned to receive the standard mail/paper survey procedures or new web‐push procedures. Measurements Primary outcomes were responding to the survey and prevalence estimates for past 30‐day use of alcohol, cigarettes, marijuana and illicit drugs. Findings The web‐push response rate was 39.07% [95% confidence interval (CI) = 37.889, 40.258]; this was significantly better than the standard MTF response rate of 35.12% (95% CI = 33.964, 36.285). After adjusting for covariates, the web‐push condition was associated with a 19% increase in the odds of responding compared with standard MTF (adjusted odds ratio = 1.188; 95% CI = 1.096, 1.287). Substance use prevalence estimates were very similar and differences became negligible when using attrition weights and controlling for socio‐demographic characteristics. Conclusions: The web‐push protocol produced a higher response rate than the mailed pencil and paper protocol in the Monitoring the Future panel study, without substantially affecting estimates of substance use once attrition weights and socio‐demographic variables were factored in. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the effects that reading on screens (using digital devices with different screen sizes) and on paper have on reading time and comprehension. The study group was comprised of126 secondary students from a private school. To ensure balance, the participants were assigned into test groups, formed according to the size of the reading device, based on class levels, gender, and average school grade. In the data collection process, a narrative text was transferred to both print and electronic media. Access to the text was provided on paper and three digital devices. There were no time limitations. After reading, participants were given comprehension tests that consisted of twenty multiple-choice questions. Female participants' on-screen comprehension scores were found to be relatively higher compared to their paper comprehension scores. They also acquired better scores as the screen size increased. Conversely, male participants had higher comprehension scores on tablets and smart phones. Participants who read the text on smart phones and tablets completed the tasks in less time compared to other groups. However, the effects of reading modality on comprehension and reading time were not found to be statistically significant in either the male or female groups. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the relationship between sudden sensorineural hearing loss, vestibular neuritis, and infection with COVID-19. Materials and Methods: In this study, a total of 56 Iranians (32 females and 24 males) with a Mean±SD age of 45.12±14 years were studied in Tehran City, Iran. Individuals diagnosed with Sudden Sensorineural Hearing Loss (SSNHL) or vestibular neuritis based on definitive diagnostic criteria were included in the study. The methodology comprised four sections of underlying Sudden Hearing Loss,, auditory and vestibular inspection, SARS-CoV-2 Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test, and statistical analysis. Also, the videonystagmography test was used in participants with vertigo to diagnose vestibular neuritis. Pure tone audiometry confirmed SSNHL in some patients with a complaint of hearing loss. Furthermore, tuning fork, Rinne and Weber tests were also performed. Results: The results of SARS-CoV-2 RT-PCR in 56 subjects showed that eight subjects (22.2%) with vestibular neuritis and two with SSNHL (10%) had a positive RT-PCR test. The Chisquare and Fisher exact-tests with a 95% confidence interval revealed no statistically significant (P>0.05) relationship between COVID-19 infection and vestibular neuritis or SSNHL. Conclusion: The present study showed no statistically significant relationship between audiovestibular disorders and positive SARS-CoV-2 RT-PCR test. However, the possibility of this relationship cannot be ruled out, and there is a need for studies with larger sample sizes. [ABSTRACT FROM AUTHOR]

Background: There are multiple issues that arise when researchers focus on and only report "statistical significance" of study findings. An important element that is often not included in reports is a discussion of clinical relevance. Objectives: The authors address issues related to significance, the use of effect sizes, confidence or credible intervals, and the inclusion of clinical relevance in reports of research findings. Methods: Measures of magnitude, precision, and relevance such as effect sizes, confidence intervals (CIs), and clinically relevant effects are described in detail. In addition, recommendations for reporting and evaluating effect sizes and CIs are included. Example scenarios are presented to illustrate the interplay of statistical significance and clinical relevance. Results: There are several issues that may arise when significance is the focus of clinical research reporting. One issue is the lack of attention to nonsignificant findings in published works although findings show clinical relevance. Another issue is that significance is interpreted as clinical relevance. As well, clinically relevant results from small-sample studies are often not considered for publication, and thus, findings might not be available for meta-analysis. Discussion: Findings in research reports should address effect sizes and clinical relevance and significance. Failure to publish clinically relevant effects and CIs may preclude the inclusion of clinically relevant studies in systematic reviews and meta-analyses, thereby limiting the advancement of evidence-based practice. Several accessible resources for researchers to generate, report, and evaluate measures of magnitude, precision, and relevance are included in this article. [ABSTRACT FROM AUTHOR]

We propose a method for estimating the convective-heat-transfer coefficient (CHTC) distribution on building walls by using the water-evaporation method involving filter paper and three-dimensional laser scanning, and demonstrates consistency with the gravimetric evaporation method. The theory and method are established based on the convective heat- and mass-transfer analogy and a near-infrared laser-scanning system. The equations to remotely estimate the CHTC distribution are obtained empirically, and the proposed method is applied to the walls of a penthouse during winter. The spatial distribution of the surface reflection intensity that determines the evaporation rate is successfully retrieved with 0.2–0.3% accuracy from a measurement distance of 5 m. The comparison of evaporation rates with a gravimetric measurement does not show a statistically significant bias. The results show that the crucial factors for the precision of the CHTC estimation are errors in the laser-scanning system and their amplification when dividing the evaporation rate by the vapour pressure deficit to obtain the convective-mass-transfer coefficient. The estimated CHTC distributions on the target walls have approximately ≤ 2–3 W m−2 K−1 errors in the 95% confidence interval after applying spatial and/or temporal averaging. Although the error in the convective-heat-transfer coefficient is larger in winter during minimal vapour pressure deficits, it is generally well explained in the range of the random error in laser scanning. The correlation between the spatially-averaged convective-heat-transfer coefficient and near-wall wind speed is comparable to existing methods (R = 0.71–0.79), and the regression relation agrees with that obtained in previous studies performed in similar conditions. [ABSTRACT FROM AUTHOR]

Focused Clinical Question: For postpartum primiparous women, will a 16-week, supervised, targeted pelvic floor muscle training program result in a reduced prevalence of diastasis recti abdominis versus education only at discharge? Clinical Bottom Line: We can neither recommend nor caution against a targeted pelvic floor muscle training program to reduce the prevalence of postpartum diastasis recti abdominis. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Method Results Discussion Avoidant/restrictive food intake disorder (ARFID) is a feeding and eating disorder characterized by extensive avoidance and/or restriction of food. Existing research demonstrates that ARFID is over‐represented in Autistic populations and vice‐versa, with both groups exhibiting shared characteristics. This meta‐analysis investigated the co‐occurrence between ARFID and autism via determination of autism prevalence in ARFID populations, and ARFID prevalence in Autistic groups.This review systematically identified literature evaluating those with ARFID and Autistic individuals. Literature was searched for using SCOPUS, MEDLINE, and Web of Science. Selected publications included Autistic individuals and those with ARFID who either received a formal diagnosis of autism and/or ARFID or met clinical threshold cut‐off scores on validated autism and/or ARFID questionnaires. Prevalence was reported in proportion‐based values alongside 95% confidence intervals (CIs).This meta‐analysis identified 21 studies (kARFID = 18 papers; kAutism = 3 papers) comprising of n = 7442 participants (nARFID = 1708; nAutism = 5734). Prevalence of autism diagnoses was 16.27% in those with ARFID (95% CI = 8.64%–28.53%), and ARFID prevalence in Autistic groups was 11.41% (95% CI = 2.89%–35.76%). Gender and ethnicity served as significant sources of heterogeneity in ARFID papers. There was insufficient data to provide comparator values or prevalence across study population and distinct underpinning drivers of ARFID.Meta‐analytic findings highlight significant rates of co‐occurrence between autism and ARFID, suggesting that in clinical settings, it may be beneficial to consider screening Autistic individuals for ARFID and vice‐versa. Future research should further investigate co‐occurrence across ARFID profiles, gender, and ethnicity. [ABSTRACT FROM AUTHOR]

Background: A recent systematic review revealed issues in regard to performing and reporting agreement and reliability studies for ordinal scales, especially in the presence of more than two observers. This paper therefore aims to provide all necessary information in regard to the choice among the most meaningful and most used measures and the planning of agreement and reliability studies for ordinal outcomes. Methods: This paper considers the generalisation of the proportion of (dis)agreement, the mean absolute deviation, the mean squared deviation and weighted kappa coefficients to more than two observers in the presence of an ordinal outcome. Results: After highlighting the difference between the concepts of agreement and reliability, a clear and simple interpretation of the agreement and reliability coefficients is provided. The large sample variance of the various coefficients with the delta method is presented or derived if not available in the literature to construct Wald confidence intervals. Finally, a procedure to determine the minimum number of raters and patients needed to limit the uncertainty associated with the sampling process is provided. All the methods are available in an R package and a Shiny application to circumvent the limitations of current software. Conclusions: The present paper completes existing guidelines, such as the Guidelines for Reporting Reliability and Agreement Studies (GRRAS), to improve the quality of reliability and agreement studies of clinical tests. Furthermore, we provide open source software to researchers with minimum programming skills. [ABSTRACT FROM AUTHOR]

In order to solve the problem of strain modal identification under strain monitoring signals with poor vibration modal information, this paper proposes a strain mode identification method with statistical stability significance. This method removes noise, vehicle-induced effects, and temperature effects from the original dynamic strain signal, retaining only vibration-related components, and obtaining a statistically stable high quality bridge strain power spectrum, thereby identifying high quality strain mode parameters. Furthermore, in order to verify the confidence level of the strain modes obtained by this method, this paper adopts the interval estimation method to estimate the power spectrum, natural frequency, damping ratio, and modal shape after statistical processing. The credibility of strain modes has been estimated by interval estimation. The confidence interval of 95% confidence for each modal parameter is obtained, achieving the confidence-level evaluation of corresponding variable modal parameter identification. In response to practical engineering problems, this paper evaluates the actual bridge data of Tongji Road Bridge in Shanghai, and explains the abnormal phenomena that occurred in the data evaluation based on the measured diseases, verifying the practicality of this method. [ABSTRACT FROM AUTHOR]

The ability to reason about someone else's mental states, an ability known as theory of mind, is essential to help children navigate social life. However, not all children are socially skilled. Given socialisation is key for healthy development in children, finding what might exacerbate these difficulties is important. Emerging research suggests a potential link between anxiety and theory of mind abilities in children. This meta-analysis aims to characterise that link. Four electronic databases were systematically searched to identify relevant studies. Search terms included variations of terms for theory of mind, anxiety, and children. Studies were screened with inclusion and exclusion criteria for eligibility and identified papers were appraised on quality. The search returned 3674 papers of which 20 were included in the analysis. These included a total of 3110 participants, aged 4–19. Overall, it was found that anxiety had a negative relationship with theory of mind and this appeared to be more pronounced in theory of mind processes related to affective states. There were no differences in the negative relationship between subtypes of anxiety or between studies with autistic and neurotypical children. The findings suggest that anxious children may have difficulties using theory of mind abilities. Heterogeneity was substantial in the data, which limits the confidence in conclusions. Quality appraisal identified that the quality of theory of mind and anxiety measures varied between studies. • Anxiety disrupts both cognitive and affective Theory of Mind processes in children. • There was no significant difference of Theory of Mind performance between anxious neurotypical and anxious autistic children. • No differential effects between anxiety disorders on Theory of Mind performance were found. [ABSTRACT FROM AUTHOR]

This paper focused on the effectiveness of a parent empowerment intervention based on nursing education (PEINE). This study examined whether the intervention improved the quality of life of children with cystic fibrosis (CF) and improved their caregivers learn about the disease and develop problem-solving and coping skills. This randomized-controlled trial used a pretest-posttest parallel-group research design. The sample consisted of 48 parents (caregivers) of children with CF. Participants were randomly assigned to an intervention (n = 24) and a control group (n = 24). The intervention group received PEINE and standard care and treatment for ten weeks. The control group received standard care and treatment. Data were collected using a Disease Information Survey (DIS), the Ways of Coping Inventory (WCI), the Problem-Solving Inventory (PSI), and the Cystic Fibrosis Questionnaire (CFQ-R). After the intervention, the intervention group DIS scores (d: 1,627 [CI: 0.934,2.305], had more correct answers than the control group. Nursing interventions were effective (p <.001). There was no significant difference in the mean pretest-posttest PSI scores (d: 0.378 [CI: −0.221-0.972], posttest WCI scores (d: 0.239 [CI:-0.356-0.831]) between the intervention and control groups (p>.05). There was a significant difference in the mean posttest CFQ-R scores between the intervention and control groups (d: 1.363 [CI: l.698, 2.015]);(p <.001). PEINE increased the intervention group participants develop disease-management skills. However, the increase in their PSI and WCI scores was statistically insignificant. PEINE also increased the quality of life of children with CF. Parents of children followed in pediatric pulmonary diseases participated in the study. Parents were informed during outpatient clinic visits. After the first meeting, the children and parents who voluntarily agreed to participate in the research were contacted by phone. The outpatient nurse assisted in communicating with children and parents. What is already Known Planned nursing education positively affects disease management. Problem solving and coping skills of parents of children with chronic diseases are negatively affected. Health-related quality of life in children with CF varies depending on parent-related variables (disease knowledge, problem solving and coping with stress, etc.). What this paper adds PEINE helps caregivers. PEINE increase the quality of life of children with CF. PEINE results in positive clinical outcomes regarding the care and treatment of children with CF. PEINE did not increase parents' problem solving and stress coping skills. Nursing initiatives that deal with cultural and ethnic structure should be planned in parent-oriented interventions. Trial registration: ClinicalTrials.gov, NCT03800459. [ABSTRACT FROM AUTHOR]

Aims: This work aimed to analyse retrospective data on hypotension incidence and associated factors among patients requiring continuous renal replacement therapy. Background: The incidence and risk factors of continuous renal replacement therapy‐related hypotension have not been adequately explored. Design: The study was designed as a retrospective analysis. Methods: Patients who required continuous renal replacement therapy in the ICU between January 2017 and June 2021 were reviewed. The multivariate logistic regression model was used to determine the associated factors of hypotension. Results: Hypotension occurred in 242 out of 885 circuits (27.3%) among 140 patients. The logistic regression analysis identified seven factors associated with the occurrence of hypotension during CRRT: serum albumin (OR = 0.969, 95%CI: 0.934–0.999), serum calcium (OR = 0.514, 95%CI: 0.345–0.905), CO2CP (OR = 0.933, 95%CI: 0.897–0.971), use of vasopressors (OR = 5.731, 95%CI: 4.023–8.165), hypotension before CRRT initiation (OR = 2.779, 95%CI:1.238–6.242), age (OR = 1.016, 95%CI: 1.005–1.027), and fluid removal rate (OR = 1.002, 95%CI: 1.001–1.003). Conclusions: Hypotension frequently occurs in patients receiving continuous renal replacement therapy, especially in the early stages. Multiple factors can be associated with cardiac output or peripheral resistance changes, including excessive ultrafiltration, vasopressors, serum albumin and serum calcium levels, and carbon dioxide combining power. Summary statement: What is already known about this topic Continuous renal replacement therapy (CRRT) has been widely used in intensive care units for patients with acute kidney injury sepsis, acute pancreatitis, severe electrolyte and metabolic disturbances.Hypotension during CRRT has been reported as one of the most common adverse events.The incidence and risk factors of CRRT‐associated hypotension have not been adequately explored. What this paper adds? Despite its reputation as the dialysis modality with better haemodynamic tolerance, hypotension frequently occurs in patients receiving CRRT, and at any time during the treatment, especially in the early stage.Multiple factors leading to cardiac output or peripheral resistance changes can be linked with hypotension during CRRT include excessive ultrafiltration, vasopressor use, serum albumin and serum calcium level, and carbon dioxide combining power. The implications of this paper: It might not always be an appropriate response to lower the ultrafiltration rate for preventing hypotension during CRRT.There remains a lack of evidence in critically ill patients for CRRT‐related interventions to limit the occurrence of hypotension. [ABSTRACT FROM AUTHOR]

Aims: Cognitive frailty refers to the coexistence of physical frailty and cognitive impairment in older adults, without a concurrent diagnosis of Alzheimer's disease or other dementias. This review aims to evaluate the prevalence of CF subtypes and identify influencing factors among Chinese older adults. Methods: The following databases were searched: PubMed/Medline, Embase, Cochrane Library, WOS, PsycINFO and CNKI et al (1 January 2001 to 20 October 2022). The risk of bias was assessed using the Agency for Healthcare Research and Quality Evidence‐based Practice Center Methods Guide. Stata 17.0 software was used to pool the prevalence of cognitive frailty, and the pooled odds ratio and 95% CI of the influencing factors were calculated. Results: The meta‐analysis (56 studies and 80,320 participants) revealed the following prevalence rates: CF (18.9%), reversible CF (19.5%), potentially reversible CF (17.5%), CF in community‐dwelling older adults (14.3%), CF in nursing homes (22.7%) and CF in older inpatients (25.2%). Influential factors identified included age, gender, education, nutrition, depression, exercise, sleep and comorbidity. Conclusions: The prevalence of CF among Chinese older adults is notably high, and it probably underestimates the prevalence of reversible cognitive frailty. It is crucial to encourage adherence to healthy behaviours, as it can effectively reduce and delay the onset of cognitive frailty. Summary statement: What is already known about this topic? (Include key points and/or knowledge gaps) Older patients with cognitive frailty (CF) face higher risks of mortality, dementia and disability.CF has two subtypes: reversible cognitive frailty (RCF) and potential reversible cognitive frailty (PRCF). What this paper adds (research findings/key new information): The prevalence of CF is high in China, especially RCF.The incidence of CF in hospitalized older individuals is higher than that in community‐dwelling and nursing home older individuals. The implications of this paper (how findings influence or can be used to change policy/practice/research/education): Screening for CF should focus on RCF, and timely intervention and multidimensional management during the pre‐frailty and subjective cognitive decline stages are crucial.Routine screening for CF among hospitalized older adults is crucial.It is essential to focus on CF in non‐geriatric individuals with coexisting chronic diseases. [ABSTRACT FROM AUTHOR]

Aim: To examine the effect of the provision of care on health outcomes when provided based on Orem's Self‐Care Deficit Theory during perinatal period. Background: The perinatal period is a process with multidimensional care needs for the mother, baby and family. Care based on nursing theories can improve the quality of perinatal care. Design: A systematic review and meta‐analysis. Review methods: Studies on this topic from 2006 to 2020 have been accessed by nine database searches. The methodological quality of the studies was assessed using the Critical Appraisal Checklists for experimental and quasi‐experimental studies, developed by the Joanna Briggs Institute. This study was conducted by following the Preferred Reporting System for Systematic Reviews and Meta‐Analyses. Results: This systematic review included nine studies with a total sample size of 839 women. These studies showed that care based on Orem's theory significantly helped prolong the mean duration of pregnancy, reduced the incidence of preterm labor, improved hygiene behaviour and increased empowerment. Concerning the perinatal period, this intervention significantly improved self‐care and readiness for hospital discharge, adaptation and breastfeeding self‐efficacy and reduced nipple pain and pain due to abdominal distension. Conclusions: The implementation of this theory into care during the perinatal period can contribute to improved health outcomes. Summary statement: What is already known about this topic? The quality of pregnancy and postpartum care is important for the maternal health.The use of nursing theories—which nursing knowledge is produced—improves care quality and ensures that care is organized systematically. What this paper adds? There is insufficient research that supports Orem's theory of self‐care deficit in pregnancy and postpartum care and also no systematic review about this topic, but the current meta‐analysis showed that postnatal and prenatal treatments based on Orem's theory have a positive impact on the self‐care agency. The implications of this paper: The use of Orem's theory helps nurses understand women and their needs during pregnancy and postpartum periods.Integrating Orem's theory of self‐care deficit into pregnancy and postpartum nursing care services can help increase women's self‐care power. [ABSTRACT FROM AUTHOR]

Aim: This study has aimed to assess the effectiveness of the transitional care model (TCM) on functional status, perceived self‐efficacy and healthcare utilization in patients undergoing total knee arthroplasty (TKA). Method: This randomized controlled study was conducted between February and November 2021 in a public hospital. The study randomly assigned patients to either a 6‐week 'TCM' program or usual care. The sample size was n = 70, with each group comprising 35 individuals. Patient outcomes, including self‐efficacy, functional status and healthcare service readmission rates, were monitored for TKA patients. Results: Nursing care based on the 'TCM' was found to enhance functional status and increase the level of self‐efficacy among TKA patients, leading to a decrease in healthcare service readmissions. Conclusions: The study recommends preparing patients and their families for the preoperative and postoperative processes. It emphasizes the importance of providing necessary training and consultancy services under the leadership of orthopaedic nurses responsible for TKA patient care, guided by the principles of TCM. Summary statement: What is already known about this topic? Treatment for knee osteoarthritis aims to alleviate pain, maintain joint functions and improve the quality of life.The success of transitional care relies on effective hospital discharge planning, post‐discharge follow‐up and home support to reduce adverse events. What this paper adds? Patients receiving TCM demonstrated improved outcomes and reduced healthcare service readmission rates.Nursing care based on the transitional care model positively affected the functional status of TKA patients.TCM increased patients' self‐efficacy levels. The implications of this paper: Patient training and consultancy services should be led by nurses responsible for TKA patients, guided by the principles of TCM.TCM should serve as a valuable guide for nurses when planning care for TKA patients. [ABSTRACT FROM AUTHOR]

Aim: Coronary heart disease (CHD) is a prevalent cardiovascular disease with high mortality rates worldwide. Patients with CHD often experience adverse psychological stress related to the disease's diagnosis, treatment and recovery phases. This stress can hurt sleep quality and overall quality of life. Mindfulness‐based interventions (MBIs) have been studied as a psychotherapeutic approach to alleviating the psychological stress associated with CHD. This study aimed to determine the effectives of MBIs for health outcomes in patients with CHD. Methods: A total of eight English‐language databases were searched, and eight relevant studies were included in the analysis. The included studies were assessed for literature quality, and data were extracted and analysed using Review Manager 5.3. Results: A total of eight studies involving 802 participants were included in the analysis. Compared to control groups, MBIs significantly reduced anxiety, depression, perceived stress, and systolic blood pressure. However, there was no significant effect on diastolic blood pressure, quality of life or body mass index. One study reported that MBIs significantly improved sleep quality in patients with acute myocardial infarction after percutaneous coronary intervention but had no significant effect on body mass index. Conclusion: MBIs had significant effects on anxiety and depression in patients with CHD, reduced perceived stress and were associated with reductions in systolic blood pressure and improvements in sleep quality. However, they did not significantly affect diastolic blood pressure, quality of life or body mass index. Summary statement: What is already known about this topic? Coronary heart disease (CHD) is a leading cause of death globally. Patients with CHD experience psychological stress due to diagnosis, treatment and recovery.Mindfulness‐based interventions (MBIs) have shown promise in reducing stress in various populations. What this paper adds: This meta‐analysis investigated the effectiveness of MBIs for psychological outcomes in CHD patients. Our analysis of eight studies found MBIs significantly reduced anxiety, depression and perceived stress compared to controls.Additionally, MBIs were associated with lower systolic blood pressure and improved sleep quality in some studies.However, MBIs did not significantly impact diastolic blood pressure, quality of life or body mass index. The implications of this paper: Our findings suggest MBIs may be a valuable tool for managing psychological distress and improving some physiological outcomes in patients with CHD.Further research is needed to explore the long‐term effects of MBIs and their impact on other relevant outcomes in CHD patients. [ABSTRACT FROM AUTHOR]

Aim: The current study aimed to identify the association between social support, academic advising and mental health disorders among nursing students. Background: Stress and workload can trigger multiple mental health disorders, especially for nursing students. Thus, academic advising and counselling help support students with academic and mental health problems. Design: This cross‐sectional study utilized online questionnaires in Egypt and Saudi Arabia. Methods: Multidimensional Scale of Perceived Social Support (MSPSS), Patient Health Questionnaire (PHQ‐4) and the Student Academic Advising and Counseling Survey (SAACS) were utilized to measure social support, depression and anxiety and evaluation of academic advising and counselling services, respectively. Results: The study included 1134 nursing students (mean age of 20.3 years). Students with higher academic advising satisfaction were 37% less likely to experience depression (OR 0.63, 95% CI 0.46–0.85) and mental disorders (OR 0.68, 95% CI 0.50–0.94). Moderate family social support was associated with lower depression (OR 0.58, 95% CI 0.37–0.93) and mental disorders (OR 0.55, 95% CI 0.33–0.92). Conclusion: Academic advising and social support can mitigate mental health disorders among nursing students. These findings will help nurses and post‐secondary providers develop strategies to support nursing students during difficult times. Summary statement: What is already known about this topic? There is a lack of research on academic advising and its measurement among nursing students. What does this paper add? The current study findings add to the body of knowledge on how academic advising and levels of support affect students' experience of depression and other mental health disorders. The implication of this paper: The findings of the current study will help post‐secondary administrators and stakeholders improve academic advising and counselling and understand the effect of support levels on nursing students' mental health. [ABSTRACT FROM AUTHOR]

Researchers often use survey methods to elicit patient perspectives on their healthcare. Survey results are often subject to response bias and missing data. As part of an observational study of Veterans' healthcare preferences, we conducted a national survey of Veterans receiving care in the Veterans Affairs healthcare system. We describe two recruitment strategies offering concurrent online, paper, and phone survey options to different sets of participants and examine response and missingness patterns between recruitment methods and modalities. In Strategy 1 we sent recruitment letters presenting options to complete our survey online or on paper. If patients indicated that they wanted to complete a paper survey, we mailed them a paper survey. In Strategy 2 we sent recruitment letters with paper surveys and included the option to complete the survey online. We compared response rates, characteristics, and missingness for the strategies and survey modalities. We sent 4399 initial letters using Strategy 1 and 8148 initial letters using Strategy 2 with response rates 7.7% and 13.2%, respectively; 70.6% of respondents completed paper surveys. Across both strategies, paper survey respondents were older and had lower educational attainment. There were significantly more paper surveys missing greater than 2% of items than online surveys (OR 6.3, 95% CI [4.8, 8.1]). Our findings suggest tradeoffs associated with survey modality and recruitment strategies. Mixed-modality recruitment may increase response rates and decrease missing data and response bias. Researchers should consider their target population when choosing survey modalities given differing characteristics between paper and survey respondents. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Involuntary detention is a legislative power that allows people to be taken against their will for a mandatory mental health assessment and is known to be a restrictive and traumatizing process for patients.While there is some literature examining police/ambulance and mental health worker co‐response models, the conclusions are mixed as to whether they reduce rates of involuntary detentions in mentally ill people.The Police, Ambulance, Clinician Early Response (PACER) model is an example of a tri‐response mental health crisis response team whose role is to respond and assess people thought to be experiencing a mental health crisis.There is little literature to determine whether PACER tri‐response model reduces incidents of involuntary detention when compared with standard police and/or ambulance responses. What this paper adds to existing knowledge?: This paper describes the outcomes of patients assessed by a PACER team, compared with patients who were assessed by police or ambulance.It demonstrates that PACER may reduce unnecessary involuntary detentions through expert mental health assessment for patients coming to emergency services for assistance. It is one of only two published studies examining a tri‐response model. What are the implications for practice?: The results of this study may support health and policing policymakers to implement PACER models as a means of reducing involuntary detentions, reducing demand for emergency departments, reducing time spent by emergency services responding to people experiencing mental health crisis and improving outcomes for people with mental illness. Background: Involuntary detention is a common method of enforcing mental health assessment and treatment; however, it is associated with poor patient outcomes and high emergency service and hospital demand. Aim: To examine the association between (1) Police, Ambulance, Clinician, Early Response (PACER) model, (2) police or (3) ambulance response and rates of involuntary detention of mentally ill people. Methods: A retrospective observational study using routine administrative data in an Australian City, over a 12‐month period (2019–2020). Results: Over a 12‐month period, 8577 people received crisis mental health intervention in the study setting. We observed an 18% increase in the relative risk of being involuntarily detained by police, and a 640% increase in the relative risk of being detained by ambulance. The PACER team detained 10% of their total presentations, as compared with 12% by police and 74% by ambulance. Involuntary detentions enacted by PACER were more likely to convert to a post‐detention hospitalization (72%), when compared with police (27%) and ambulance (17%). Discussion: PACER was associated with lower rates of involuntary detention and higher rates of post‐detention hospitalization when compared to police and ambulance response. Implications for Practice: PACER cohort experience more positive outcomes than with police or ambulance cohorts. [ABSTRACT FROM AUTHOR]

Objective: Self-care-oriented positive approach are very important for the management of chronic neck pain. To evaluate the clinical efficacy of the Alexander Technique (AT) courses on pain and adverse events in chronic non-specific neck pain (CNSNP), compared to the conventional therapy. Methods: We evaluated the effects of the AT in the treatment of the CNSNP according to PICO (participant, intervention, comparison, outcome) elements. In this paper, we have utilized some English databases. Totally 140 records are included in the Cochrane Library (43), PubMed (18), Web of Science (27), EBSCO (21), EMBESE (31). The search dated from the day of the database's inception to June, 2024. Those parameters like Weighted mean differences (WMD), Standardized mean difference (SMD) and 95% confidence intervals (Cis) are calculated. A random-effects model is applied to minimize the heterogeneity, and I2 test is used to assess heterogeneity, the risk of bias of RCTs studies included are assessed by the PEDro tools. Results: A total of three studies (Two RCTs and a quasi-randomized trial) are included in this paper based on the predetermined eligibility criteria. Compared with the conventional therapy group, the included studies collectively show that the AT can provide a significant pain relief in CNSNP, whose effects can last for 2 months with a very low heterogeneity (immediate term pain score: SMD: -0.34, 95%CI: -0.87–0.19, P = 0.208, I2 = 0.0%; short term pain score: SMD: -0.33, 95%CI: -0.55–0.10, P = 0.005, I2 = 0%). In addition, compared with the conventional therapy group, the AT does not significantly increase the incidence of adverse events (AE: RR = 1.690, 95% CI: 0.67–4.27, P = 0.267, I2 = 44.3%). Conclusion: This meta-analysis preliminarily indicated that the Alexander Technique courses may not have a significant pain relief effective in patients with chronic Non-specific neck pain, which is related to the follow-up time of the post-intervention. However, it's necessary to interpret and apply the outcome of this research cautiously. Systematic review registration: PROSPERO, CRD420222361001. [ABSTRACT FROM AUTHOR]

Background: Autologous bone cranioplasty is associated with a high complication rate, particularly infections and bone resorption. Although there are studies on the incidence and risk factors for complications following autologous bone cranioplasty, the study design is typically limited to retrospective analysis with multiple statistical explorations in small cohorts from single centers. Thus, there is a need for systematic analysis of aggregated data to determine the rate and risk factors for cranioplasty complications. Objective: To determine the incidence and risk factors for complications after autologous bone cranioplasty. Methods: In this systemic review, we conducted a Medline, Embase, Cochrane, and Web of Science search: 11,172 papers were identified. Duplicates were removed and only articles on complications following autologous bone cranioplasty between the years 2000 and 2022 were included. After title, abstract, and article screening, 132 papers were included for further analysis. Results: In total, the 132 studies are based on 13,592 patients (14960 implants). One third of the studies include patients with less than 3 months of postoperative follow-up. Complication management (flap removal, revision without flap removal, and conservative treatment) of infection, bone resorption, and hematoma/seromas are not reported in 19–30% of the studies. In the studies with defined complications management, the overall complication rate is 7.6% (95% Confidence Interval (CI) [7.1–8.2]) for infection, 14.4% (95% CI [13.7–15.2]) for bone resorption with indication for reconstruction, and 5.8%, (95% CI 5.2–6.5) for hematoma/seromas. Factors such as younger age, an extended interval between craniectomy and cranioplasty, the use of a fragmented bone implant, a larger implant size, and shunt treatment are linked to an increased risk of postoperative bone resorption. Conclusion: The lack of consistent definitions of complications, variations in follow-up time, and small study cohorts limit the external validity of many studies. Overall, the rate of bone flap resorption that required reoperation is high, while the rate of infectious complications is comparable to synthetic implants. Thus, autologous bone should preferably be used in cases without strong risk factors for bone necrosis. [ABSTRACT FROM AUTHOR]

This paper addresses the challenge of multicollinearity in regression models, a condition that inflates the standard errors of coefficients, leading to unreliable estimates and wider confidence intervals. Multicollinearity, characterized by high intercorrelations among independent variables, undermines model accuracy by increasing the variance of the estimated coefficients, making them more sensitive to changes in the data and difficult to interpret. In this paper, we introduce three novel ridge estimators specifically designed to analyze data affected by multicollinearity. These are the Balanced Log Ridge Estimator (BLRE), the Inverse Influence Ridge Estimator (IIRE), and the Adaptive Shrinkage Ridge Estimator (ASRE), all designed to enhance estimation accuracy and stability in the presence of high multicollinearity and noise. Through Monte Carlo simulations and empirical analysis on a highly correlated real dataset, ASRE consistently demonstrates superior performance, achieving the lowest mean squared error compared to existing ridge estimators. The IIRE and BLRE also perform well; however, ASRE proves to be the most robust, especially in extreme scenarios. In contrast, the ordinary least squares estimator performs poorly under these conditions, underscoring the effectiveness of the new estimators. ASRE is recommended for most situations, with IIRE as a reliable alternative, offering significant improvements in handling multicollinearity. [ABSTRACT FROM AUTHOR]

Digital detoxification is a conscious disconnection from all smartphone activities for a certain period of time, which has been undertaken as effective by researchers to improve well-being, but studies found inconsistent results, with a primary focus on negative well-being, thus necessitating a need to focus on the positive aspect. As a result, the current study conducted a systematic review and meta-analysis to assess digital detoxification and its influence on users subjective and psychological well-being (PWB). A comprehensive search (up to November 19, 2023) across databases such as PubMed, Scopus, Web of Science, Pro-Quest, and Google Search yielded a total of 26 eligible studies (18 for meta-analysis) comprising 8,147 participants (Mage = 25.20 years). The Studies' quality was assessed using Cochrane's updated Risk of Bias Tool, and statistical analysis was performed in R Studio. Digital detoxification was found to be effective in improving subjective well-being (SWB) (Standardized mean difference [SMD] = 0.21, 95% CI: 0.06, 0.34; p < 0.01, I2 = 73.6%, n = 14 papers), as well as PWB (SMD = 0.27, 95% CI: 0.09, 0.46; p < 0.05; I2 = 0.0%, n = 4 papers). Notably, we detected no publication bias but addressed funnel plot asymmetry using Trim & Fill. Moderation analysis revealed the impact of internet coverage, developmental status, location, intervention effectiveness, and risk of bias on the estimated effect size for SWB. Meta-regression highlighted the significant influence of mean age, and although no potential outliers were identified, influential plots are provided for transparency. Our findings consolidate the efficacy of digital detoxification, emphasizing the need for nuanced consideration of study factors. This study contributes to the ongoing discourse on digital well-being, offering valuable insights for researchers, practitioners, and policymakers. [ABSTRACT FROM AUTHOR]

Background: Children and adolescents with language problems have poorer mental health compared with their non‐language impaired peers. Less is known about mental health in adults with a history of language problems. This paper presents a systematic review and meta‐analysis that addresses this gap in the literature. Specifically, it summarises the results from studies examining anxiety and depression in adults (aged 18 years and over) who were identified with language impairments or problems earlier in development. Methods & Procedures: Five electronic databases (PsycINFO, ERIC, CINAHL, EMBASE and PubMed) were searched for studies comparing anxiety and/or depression in a sample of adults with and without a history of language problems. Nine studies were found that met the inclusion criteria. From each, an odds ratio (OR) was computed measuring the relationship between childhood language problems and anxiety or depression in adulthood. The OR was computed so values > 1 which indicated anxiety/depression were associated with a history of language problems. ORs were averaged using multilevel random effects meta‐analysis. Outcomes & Results: Averaging the study's findings across both anxiety and depression outcomes, we found that a history of childhood language problems was associated with poorer mental health in adulthood (OR = 1.79, p = 0.004). The association for anxiety was also significant (OR = 1.80, p = 0.012) and close to statistical significance for depression (OR = 1.60, p = 0.054). Conclusions & Implications: This review reveals that adults with a history of language problems are more likely to experience poorer mental health outcomes compared with controls. These findings demonstrate childhood language problems affect not only communication but also mental health and well‐being in the long term. WHAT THIS PAPER ADDS: What is already known on the subject: Prior research examining mental health in children and adolescents with language problems reveals a twofold increased risk of internalising problems, including anxiety and depression. However, little is known about mental health outcomes in adults with a history of language problems. What this paper adds to the existing knowledge: The main finding was that childhood language problems are associated with increased risk of anxiety and depression in adulthood. What are the practical and clinical implications of this work?: First, the study demonstrates childhood language problems increase the risk of poor mental health in adulthood. Second, in adult mental health settings there is a need to screen for language problems and, where applicable, adjust interventions to accommodate communicative needs for patients/clients. Solving these issues requires integration and recognition of the importance of speech–language therapy in the adult mental health system. [ABSTRACT FROM AUTHOR]

Background: Phonological difficulties are prevalent in children with speech and/or language disorders and may hamper their later language outcomes and academic achievements. These children often form a significant proportion of speech and language therapists' caseloads. There is a shortage of information on evidence‐based interventions for improving phonological skills in children and adolescents with speech and language disorder. Aims: The aim of this systematic literature review and meta‐analysis was to systematically examine the effects of different intervention approaches on speech production accuracy and phonological representation skills in children with speech and language disorders. Methods: A preregistered systematic review (International Prospective Register of Systematic Reviews ID: CRD42017076075) adhering to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines was completed. Seven electronic databases (PubMed, Web of Science, ERIC, PsychINFO, Cochrane Library, SCOPUS and Linguistics & Language Behavior Abstracts) were searched for studies related to oral language interventions with children with developmental speech and/or language disorder (mean age ranging from 3–18 years) published between January 2006 and August 2022. The included articles reported intervention studies with a group design in which speech production accuracy was the outcome measure. Studies were appraised using the Cochrane risk of bias tool, and individual effect sizes were calculated using standardised means differences when enough data was available. A meta‐analysis was conducted obtaining the average standardised mean difference d. Heterogeneity, influence of possible moderator variables and publication bias were explored. Results: The 23 studies that met the inclusion criteria presented low‐medium risk of bias. Nine effect sizes were obtained from seven of these studies that presented a pre‐post‐test with a control group design. Medium‐high average effect sizes were found in phonological accuracy. Heterogeneity was found between individual effect sizes. Significant moderator variables and publication bias were not detected. Conclusions: The results of this meta‐analysis indicate positive effects on speech production accuracy. Based on this review, further improvements in the quality of reporting for intervention research are required in developing the evidence base for practice. What this paper adds: What is already known on the subject: An increasing number of interventions is available for children and adolescents with developmental speech and/or language disorders. Previous reviews suggest relatively low levels of evidence of interventions having phonology as an outcome measure. What this paper adds to the existing knowledge: This review and meta‐analysis summarise the intervention evidence from a substantial body of group design studies, indicating positive results from a range of interventions with phonological outcomes. It highlights the need to systematically implement and replicate different intervention procedures to understand factors that will maximise positive outcomes and to grow the evidence base for best practice. What are the potential or actual clinical implications of this study?: Tentative evidence is emerging for the effectiveness of various approaches in enhancing speech production accuracy skills of children and adolescents with developmental speech and/or language disorder. [ABSTRACT FROM AUTHOR]

Background: For over 30 years, parental reports have been used to study the vocabulary of children under 4 years of age. Research exploring parental checklists as a measure of vocabulary in older children is very limited. Typically, authors of parental checklists report the reliability of the developed tools but do not explore validity in terms of the agreement between parental assessments and the children's actual word knowledge. Aims: We aimed to explore the reliability and validity of a parental checklist for assessing vocabulary in children aged between 3 and 6 years. Furthermore, we aimed to evaluate the agreement between indirect (parental checklist) and direct (picture naming and picture recognition tasks) assessments of children's vocabulary. Methods and Procedures: A group of 94 typically developing monolingual Polish‐speaking children aged between 3 and 6 years were first directly tested onsite with picture naming and picture recognition tasks (Cross‐Linguistic Lexical Tasks). Subsequently, the participants' parents completed an online checklist containing the same set of 128 items and marked all the words that they had ever heard in their child's spontaneous speech. Outcomes and Results: The parental checklist demonstrated very high internal consistency. The scores of the parental checklist and vocabulary tasks were moderately correlated. We compared the total number of words marked by parents and the number of items correctly identified by children in the picture naming and picture recognition tasks. In picture naming, we found no difference between the children's scores and the number of words selected by parents. However, parents selected significantly fewer words than children correctly recognised in the picture recognition task. When data were analysed at the level of individual items (i.e., whether parents selected exactly the same items that children answered correctly), we found that the level of agreement was low. The level of agreement correlated negatively with the children's vocabulary; that is, the more words a child knew, the lower the agreement between the direct measure and the parental checklist. Conclusions and Implications: Parental checklists should be used with caution in children aged between 3 and 6 years, especially if the assessed children have a large vocabulary and if item analysis is planned. Such checklists may be of more use in younger children or in children with limited vocabulary. WHAT THIS PAPER ADDS: What is already known on the subject: Parental checklists are commonly used to assess the vocabulary of children younger than 4 years of age. Previous research has indicated that parental checklists are reliable in terms of internal consistency and valid in terms of predictive and convergent validity. What this paper adds to the existing knowledge: This study introduces a parental checklist designed for assessing the vocabulary of monolingual Polish‐speaking children aged between 3 and 6 years. Statistical analyses reveal that while the parental checklist exhibits high reliability, and the scores on the checklist correlate with direct measures of vocabulary, the agreement between parental reports and direct vocabulary measures (i.e., validity) is notably low, particularly when examining individual test items. What are the clinical implications of this work?: These findings underscore the importance of exercising caution when using parental vocabulary checklists with children aged between 3 and 6 years. These checklists can serve as a replacement for direct vocabulary tests only when the general/overall score is needed. However, when specific words are the subject of interest, parental reports may not be a valid measure. [ABSTRACT FROM AUTHOR]

Background: Speech and language therapists (SLTs) play an important role in assessing and rehabilitating communication disorders in people with dementia, but there is evidence to suggest that they do not receive appropriate training to provide management and support during their training. Aim: To investigate the level of awareness and knowledge that practising SLTs from Brazil have about dementia and their role in the care of dementia through an online survey. Methods & Procedures: An online survey tool was developed to collect information from practising Brazilian SLTs regarding their knowledge about dementia, awareness about their role in the care of people with dementia, and opinions on how SLTs may be better prepared to work in the dementia field. The survey was disseminated via social media, websites, and e‐mail lists of researchers and stakeholders. Outcomes & Results: A total of 227 SLTs completed the survey. Participants showed good knowledge of dementia in general, while their answers were less accurate on primary progressive aphasia. Regarding the awareness by SLTs of their role in the care of people with dementia, most agreed or strongly agreed that SLTs could help people in the diagnosis, treatment and prevention of dementia (> 80%). However, fewer participants agreed or strongly agreed that they felt confident in contributing to the treatment and diagnosis process of dementia (about 50%). To improve the training of SLTs in Brazil, most participants believed that it would be necessary to improve the teaching of dementia at the undergraduate speech and language therapy curriculum level and to develop recommendations or guidelines about speech and language therapy practice in dementia. Conclusions & Implications: The results of this survey point to a need for improvement in the knowledge and confidence of Brazilian SLTs about dementia. To reach this goal, targeted training courses and applied practice opportunities should be embedded within university curricula and training programmes. WHAT THIS PAPER ADDS: What is already known on the subject: Many studies confirm the importance of speech and language therapy in the non‐pharmacological treatment of people with dementia. However, other evidence suggests to a possible lack of training for Brazilian SLTs, especially in the curriculum of undergraduate courses. What this paper adds to existing knowledge: This study reveals that Brazilian SLTs have substantial knowledge of dementia and recognize the significance of their role in treating people with dementia. However, a minority expressed confidence in their ability to assess and treat people with dementia. What are the potential or actual clinical implications of this work?: The findings of this research demonstrate that Brazilian SLTs have good knowledge of dementia and endorse their professional role in dementia care; however, they lack confidence in their own skills and expertise in diagnostic assessment and treatment of dementia. Interventions aimed at boosting the SLT's confidence level could lead to improved patients outcomes and overall quality of care within clinical settings. [ABSTRACT FROM AUTHOR]

Background: Despite the ability of cochlear implants (CIs) to provide children with access to speech, there is considerable variability in spoken language outcomes. Research aimed at identifying factors influencing speech production accuracy is needed. Aims: To characterize the consonant production accuracy of children with cochlear implants (CWCI) and an age‐matched group of children with typical hearing (CWTH) and to explore several factors that potentially affect the ability of both groups to accurately produce consonants. Methods & Procedures: We administered the Bankson‐Bernthal Test of Phonology (BBTOP) to a group of 25 CWCI (mean age = 4;9, SD = 1;6, range = 3;2–8;5) implanted prior to 30 months of age with a mean duration of implant usage of 3;6 and an age‐matched group of 25 CWTH (mean age = 5;0, SD = 1;6, range = 3;1–8;6). The recorded results were transcribed, and the accuracy of the target consonants was determined. Expressive vocabulary size estimates were obtained from a language sample using the number of different words (NDW). A parent questionnaire provided information about maternal education, duration of CIs experience and other demographic characteristics of each child. Outcomes & Results: The CWCI group demonstrated some similarities to, and some differences from, their hearing peers. The CWCI demonstrated poorer consonant production accuracy overall and in various phonetic categories and word positions. However, both groups produced initial consonants more accurately than final consonants. Whilst CWCI had poorer production accuracy than CWTH for all phonetic categories (stops, nasals, fricatives, affricates, liquids and glides and consonant clusters), both groups exhibited similar error patterns across categories. For CWCI, the factors most related to consonant production accuracy when considered individually were expressive vocabulary size, followed by duration of CI experience, chronological age, maternal education and gender. The combination of maternal education and vocabulary size resulted in the best model of consonant production accuracy for this group. For the CWTH, chronological age followed by vocabulary size were most related to consonant production accuracy. No combination of factors yielded an improved model for the CWTH. Conclusions & Implications: Whilst group differences in production accuracy between the CWCI and CWTH were found, the pattern of errors was similar for the two groups of children, suggesting that the children are at earlier stages of overall consonant production development. Although duration of CI experience was a significant covariate in a single‐variable model of consonant production accuracy for CWCI, the best multivariate model of consonant production accuracy for these children was based on the combination of expressive vocabulary size and maternal education. WHAT THIS PAPER ADDS: What is already known on the subject: Research has shown that a range of factors is associated with consonant production accuracy by CWCIs, including factors such as the age at implant, duration of implant use, gender, other language skills and maternal education. Despite numerous studies that have examined speech sound production in these children, most have explored a limited number of factors that might explain the variability in scores obtained. Research that examines the potential role of a range of child‐related and environmental factors in the same children is needed to determine the predictive role of these factors in speech production outcomes. What this paper adds to the existing knowledge: Whilst the consonant production accuracy was lower for the CWCIs than for their typically hearing peers, there were some similarities suggesting that these children are experiencing similar, but delayed, acquisition of consonant production skills to that of their hearing peers. Whilst several factors are predictive of consonant production accuracy in children with implants, vocabulary diversity and maternal education, an indirect measure of socio‐economic status, were the best combined predictors of consonant production accuracy. What are the potential or actual clinical implications of this work?: Understanding the factors that shape individual differences in CWCI speech production is important for effective clinical decision‐making and intervention planning. The present findings point to two potentially important factors related to speech sound production beyond the duration of robust hearing in CWCI, namely, a lexical diversity and maternal education. This suggests that intervention is likely most efficient that addresses both vocabulary development and speech sound development together. The current findings further suggest the importance of parental involvement and commitment to spoken language development and the importance of receiving early and consistent intervention aimed both at skill development and parental efficacy. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluated a standardized paper triage process conducted by an advanced practice physiotherapist (APP) at a rheumatology center. The aims were to (1) determine the concordance between paper triage priority assignment and the rheumatologist's diagnosis; (2) determine the sensitivity and specificity of the paper triage process; and (3) assess reasons for incorrect priority ranking. Methods: Referrals were triaged by a formally trained APP into one of the three priorities, guided by a priority referral tool. A retrospective review of 192 charts was performed. Raw proportion of agreement between paper triage and rheumatologist's diagnosis was supplemented by a prevalence-adjusted bias-adjusted kappa (PABAK). Priority categories were collapsed to calculate sensitivity and specificity. For discordant cases, additional information was collected from the referral and chart to identify potential features leading to discrepancy. Results: Overall agreement was 76%. The PABAK was 0.80 [95% confidence interval 0.70–0.90]. Sensitivity ranged 0.64–0.92 and specificity ranged 0.81–0.94, depending on the priority category. Forty-six cases were discordant, with the APP choosing a higher priority in 37 cases. An incorrect diagnosis from the family physician with no supporting information for the paper triage led to discordance in 16 cases. Conclusion: A standardized paper triage process conducted by an APP showed substantial concordance, sensitivity, and specificity. [ABSTRACT FROM AUTHOR]

The Physical Activity Neighborhood Environment Scale (PANES) has been used internationally; however, PANES properties have not been assessed in all geographical contexts. Our objectives were to assess the reliability and validity of an online and paper version of the PANES in Canadian adults. Reliability was estimated using intraclass correlation coefficients (ICC), percent of overall agreement (p0) and Cohen's Kappa coefficient (κ). Lower 95% confidence interval (CI) ICC ranged from 0.10 to 0.70. Lower 95%CI for κ statistics ranged from −0.20 to 0.64 and p0 ranged from 80.1% to 95.7%. Cronbach's alpha coefficients (α) estimated internal consistency of the PANES (α = 0.58 for the paper version and α = 0.55 for the online version). Mean scores for the PANES Built Environment Index (BEI) significantly differed by neighborhood street pattern (p <.05). The PANES administrated via paper or online provides reliable overall agreement and valid estimates of the self-reported neighborhood built environment supportiveness of physical activity. [ABSTRACT FROM AUTHOR]

Background: Computerized methods to analyze pain drawings (PDs) have been developed and may aid to measure the pain area more precisely. Objective: The aim of this study was to verify whether examiners can reproduce the patient's PDs with acceptable reliability. Methods: This was an intra‐rater and inter‐rater reliability study. The protocol consisted of 4 steps: (1) scanning of paper PDs; (2) sharing the digitalized PD images between examiners; (3) reproducing the PD images in the sketching application; and (4) calculating the pain area in pixels and percentages. We calculated intraclass correlation coefficients (ICCs; 2,1), the standard error of the measurement (SEM), and the smallest detectable difference (SDD). Results: Reliability was tested using 31 PDs from 17 patients in our database (11 female [64.7%], mean age: 53.23 ± 11.57 years). Intra‐rater reliability varied from ICC (2,1) = 0.991 (95% confidence interval [CI] = 0.982 to 0.996; SEM = 3,432.45; SDD = 162.39 pixels; P < 0.001) to ICC (2,1) = 0.992 (95% CI = 0.978 to 0.997; SEM = 3,412.96; SDD = 161.93 pixels; P < 0.001). Inter‐rater reliability for the measurement between all examiners was considered excellent (ICC [2,1] = 0.976; 95% CI = 0.956 to 0.987; SEM =8,580.75; SDD = 256.76 pixels; P < 0.001), being higher between Examiners A and C (ICC [2,1] = 0.970; 95% CI = 0.936 to 0.986; SEM = 6,453.34; SDD = 222.67 pixels; P < 0.001). Conclusion: Our results show that intra‐ and inter‐rater reliabilities were excellent when an examiner reproduced the paper PDs into digitalized PDs. This process gives clinicians and researchers the opportunity to analyze pain extent more precisely using a computerized method. [ABSTRACT FROM AUTHOR]

Summary: The natural experiment proposed in this article extracts three stories from boxes of "100 paper clips". The activity requires students to apply three lessons from inferential statistics, starting with a hypothesis test and including confidence intervals as well as tolerance intervals. [ABSTRACT FROM AUTHOR]

Abstract—In my comment on the paper by A.A. Lyubushin, G.N. Kopylova, and Yu.K. Serafimova, I focus on the problem of legitimacy of seismological data pertaining to the unconventionally low frequency range from the standpoint of metrology and question the validity of the obtained results. The latter aspect is associated with the fact that in the discussed paper of Lyubushin et al. (2021), the estimates of confidence intervals in the calculated statistics are completely absent, which is at odds with the generally accepted approaches to the presentation of the results of measurement data processing. Without conducting such estimates, the authors made an unjustified conclusion about the correlation of the studied processes and, as a consequence, about a triggering effect of the irregularity of the Earth's rotation on the seismic process. [ABSTRACT FROM AUTHOR]

AbstractThis paper proposes a novel method for determining confidence intervals in non-probabilistic survey samples, addressing the challenge of statistically quantifying uncertainty in such samples. The method utilizes combinatorial calculations to assess the myriad combinations possible in the unsampled population, applying the symmetric property of binomial coefficients to optimize computational efficiency. The proposed approach offers a practical solution, making it feasible to calculate confidence intervals even with large sample sizes. This methodology represents a significant advancement in survey research, providing a tool to evaluate and generalize non-probabilistic data, particularly in contexts where probabilistic sampling is not viable. The paper also validates the method using extensive testing, demonstrating its applicability and effectiveness in real-world scenarios. [ABSTRACT FROM AUTHOR]

Background: Through advocacy initiatives such as roadshows during "National ACP Week", the Agency for Integrated Care (AIC) had increased advance care planning (ACP) engagement since 2011. Project Happy Apples (PHA), a community initiative project led by medical students from the National University of Singapore, also conducted a public exhibition to raise ACP awareness during this period. This study aimed to investigate and identify predictors of attitudes towards ACP documentation among 'ACP Week' respondents which may be used to formulate strategies to increase ACP documentation in Singapore. Methods: A cross-sectional study on ACP documentation attitudes of 262 respondents during local roadshows were conducted. Multiple logistic regression models were built to investigate the associations between demographic variables and attitudes toward ACP documentation. Results: The mean age was 43.5 years (SD = 17.4), 79 (30.15%) were males and 49 (18.7%) were healthcare professionals (HCP). 117 (44.66%) respondents had prior experience with serious illness and 116 (44.27%) had heard of ACP. Age was a significant predictor of readiness to sign official papers naming nominated healthcare spokesperson (NHS) (OR = 1.04, 95%CI: 1.02–1.07). Experience with serious illness was a significant predictor of readiness to discuss end-of-life (EOL) care with healthcare professionals (HCP) (OR = 3.65, 95%CI: 1.36–11.61). Being female was a significant predictor for readiness to speak to their nominated healthcare spokesperson about EOL care (OR = 7.33, 95%CI: 2.06–46.73). Subgroup analyses revealed that those aged 20–39 were less likely to speak to their healthcare professional about or sign official papers regarding EOL care. We also found that being a healthcare professional does not necessitate better or worse attitudes. Conclusion: Advocacy programs tailored to targeting respondents of different age groups and prior experience with serious illness may improve the efficacy of advocacy efforts. [ABSTRACT FROM AUTHOR]

Based on the stress coping theory, the present paper aims to investigate the influence of users' networking ability and profile control ability in mitigating the negativity of social media overload. This paper argues that in the social media context, instead of discontinuance, users tend to develop comprehensive strategies and practices to manage their social media usage. Via an exploratory factor analysis (EFA) study, five practices were identified, including continuous usage, reduced usage, setting adjustment, support seeking, and information avoidance. The results show that social media overload leads to both the perception of emotional exhaustion and disturbance handling while networking and profile control ability make users focus on disturbance handling. Besides, networking ability is found to weaken the relationship between social media overload and emotional exhaustion while profile control ability exaggerates that relationship. Finally, emotional exhaustion and disturbance handling both predict users' different social media management practices. [ABSTRACT FROM AUTHOR]

Objective To assess the association between use of an oxytocin decision support checklist with oxytocin usage and clinical outcomes. Study Design We conducted a retrospective cohort study of patients with singleton gestations at 37 0/7 weeks or greater who received oxytocin during labor from October 2012 to February 2017 at an integrated community health care system during three exposure periods: (1) prechecklist; (2) after paper checklist implementation; and (3) after checklist integration into the electronic medical record (EMR). The checklist was a clinical decision support tool to standardize the dosing and management of oxytocin. Thus, our primary outcomes included oxytocin infusion rates and cumulative dose. Secondary outcomes included maternal and neonatal outcomes. We controlled for maternal risk factors with multivariable regression analysis and stratified by mode of delivery. Results A total of 34,269 deliveries were included. Unadjusted analyses showed that compared with prechecklist, deliveries during the paper and EMR-integrated periods had a lower cumulative dose (4,670 ± 6,174 vs. 4,318 ± 5,719 and 4,286 ± 5,579 mU, p < 0.001 for both), lower maximal infusion rate (9.9 ± 6.8 vs. 8.7 ± 5.8 and 8.4 ± 5.6 mU/min, p < 0.001 for both), and longer duration of oxytocin use (576 ± 442 vs. 609 ± 476 and 627 ± 488 minutes, p < 0.001 and p = 0.01, respectively). The unadjusted rates of cesarean, 5-minute Apgar <7, mechanical ventilation, and neonatal hospital length of stay were similar between periods. The adjusted mean difference in time from admission to delivery was longer during the EMR-integrated period compared with prechecklist (3.0 [95% confidence interval: 2.7–3.3] hours, p < 0.001). Conclusion Oxytocin checklist use was associated with decreased oxytocin use patterns at the expense of longer labor times. Findings were more pronounced with EMR integration. Key Points An oxytocin decision support checklist is associated with reduced amounts of oxytocin used. However, checklists were associated with longer duration of oxytocin use and of labor. Results were more pronounced in the EMR-integrated checklist compared with paper checklist. [ABSTRACT FROM AUTHOR]

Aim: To determine the impact of home‐based management on hospital re‐admission rates in patients with chronic obstructive pulmonary disease (COPD). Design: Systematic review methodology was utilized, combining meta‐analysis, where appropriate, or a narrative analysis of the data from included studies. Data Sources: Electronic databases CINAHL, MEDLINE, PubMed, Embase and SAGE journals for primary papers, 2015 to 2021, were searched between December 2020 and March 2021, followed by hand‐searching key journals, and reference lists of retrieved papers. Methods: The review followed the guidance of PRISMA. Data were extracted using a predesigned data extraction tool. Quality appraisal was undertaken using RevMan 'risk of bias' tool. Meta‐analysis was undertaken using RevMan software. Results: This review integrates evidence from eight studies, five Random Control Trials, two observational studies and one retrospective study. The studies span three continents, Asia, Europe and North America, and include 3604 participants with COPD. Home‐based management in patients with COPD resulted in a statistically significant reduction in rates of hospital readmission. For the outcomes, length of stay and mortality, while slightly in favour of home‐based management, the results were not statistically significant. Conclusion: Given the burden of COPD on healthcare systems, and crucially on individuals, this review identified a reduction in hospital re‐admission rate, a clinically important outcome. Impact: This study focused on the impact on hospital re‐admission rates among the COPD patient cohort when home‐based management was involved. A statistically significant reduction in rates of re‐admission to the hospital was identified. This is positive for the patient, in terms of hospital avoidance, and reduces the burden on hospital systems. Further research is needed to determine the impact on cost‐effectiveness and to quantify the most ideal type of care package that would be recommended for home‐based management. [ABSTRACT FROM AUTHOR]

Background: Urinary Incontinence (UI) is a global health issue that mainly affects the female population worldwide. Different approaches have been sought for the management of UI including Pelvic floor muscle training (PFMT) using Virtual Reality (VR) gaming. We conducted this study to evaluate the effectiveness of VR gaming for rehabilitation of pelvic floor muscles (PFM) and improving urinary symptoms in patients with UI. Method: We've included studies that contain any type of VR in all geographic locations and settings with no restrictions on the date of publication, age, or gender. Our exclusion criteria include reviews, case series, case reports, unextractable data, unavailable full text, abstract only articles, and studies don't show the effects of VR as a treatment for UI. A pre‐specified search term was used and modified according to the requirements of each of the following databases: PubMed, Web of Science, Scopus, Cochrane, Google scholar, and ScienceDirect. For risk of bias assessment, two assessment tools have been used: ROB 2.0 for RCTs and NIH for single arm studies. Results: Of 915 papers identified from 6 databases, 341 papers were assigned for screening after removing duplicates, 11 papers were eligible for full text screening, and 4 papers were finally included. The qualitative analysis of the results identifies six outcomes grouped into three primary categories: PFM, urinary symptoms, and quality of life. Only urinary loss outcome was eligible for meta‐analysis. The net effect between Game therapy + PFMT and PFMT reached MD = −5.49, 95% CI [−12.36:1.38] (heterogeneity; I2 = 95%, p < 0.01). Conclusion: Our research underscores the potential of VR gaming as a valuable adjunctive therapy for pelvic floor muscle rehabilitation in patients with UI. However, further studies are needed to explore its long‐term effectiveness, optimal therapy parameters, and cost‐effectiveness. Registration: Our protocol has been registered in PROSPERO (CRD42022384500). [ABSTRACT FROM AUTHOR]

Background: The incidence of colorectal cancer (CRC) is rising in Iran, but reports vary across different regions due to diverse methods and data sources. This study aimed to conduct a systematic review and meta analysis to provide an overview of the incidence rate of CRC and its trend among Iranians in various provinces. Materials and Methods: A comprehensive literature search based on the Preferred Reporting Items for Systematic Reviews and Meta Analyses checklist was performed using national and international databases for papers published up to December 2023. CRC incidence rates were extracted from the numbers, crude rates, and age standardized rates (ASRs). A meta analysis was conducted to calculate the incidence rate and 95% confidence intervals (CIs) in subgroups of sex and province. Results: The initial database search retrieved 1287 papers, with 47 studies meeting the inclusion criteria after further screening. Overall, the trend of CRC incidence has been increasing, although a different pattern was observed in 2008. The pooled incidence rate of CRC was 8.46 (95% CI: 7.16-9.86) per 100,000 population before the publication of the annual continuous reports of the Iranian National Cancer Registry. The latest national data (2014-2017) indicated an ASR of approximately 15 per 100,000 population. Conclusion: The incidence of CRC in Iran is lower than the global average. However, inconsistent cancer registration policies and gaps in registration have hindered the ability to establish a reliable trend of CRC incidence over time. [ABSTRACT FROM AUTHOR]

Background: Multi-nozzle nebulisers for pressurised intraperitoneal aerosol chemotherapy (PIPAC) are implemented in clinical practice to improve the homogeneity of tissue drug delivery. Nonetheless, the advantages of such devices over one-nozzle nebulisers have not been demonstrated thus far. In this study, we compared the performance of multi- and one-nozzle nebulisers by conducting physical and ex vivo pharmacological experiments. Methods: The one-nozzle nebuliser Capnopen® and the multi-nozzle nebuliser were the subjects of this study. In physical experiments, the aerosol droplet size was measured by laser diffraction spectroscopy. Spatial spray patterns were depicted on blotting paper. Pharmacological experiments were performed on the enhanced inverted bovine urinary bladder model, demonstrating real-time tissue drug delivery, aerosol sedimentation and homogeneity of doxorubicin and cisplatin tissue distribution. Results: The multi-nozzle nebuliser had a sixfold greater aerosolisation flow and a threefold greater angle of aerosolisation than Capnopen®. The aerosol particle size and distribution range were higher than that of Capnopen®. Spray patterns on blotting paper were more extensive with the multi-nozzle nebuliser. Real-time tissue drug delivery with the multi-nozzle nebuliser was over 100 ml within 1 min, and the aerosol sedimentation was 48.9% ± 21.2%, which was not significantly different from that of Capnopen®. The doxorubicin and cisplatin tissue concentrations were greater with Capnopen®. Although there was no significant difference in the homogeneity of doxorubicin distribution between the two devices, the homogeneity of cisplatin distribution was significantly higher with Capnopen®. Conclusion: The multi-nozzle PIPAC nebuliser did not fulfil expectations. Even though the surface spray patterns were broader with the multi-nozzle nebuliser, the tissue drug homogeneity and concentration were greater with Capnopen®. [ABSTRACT FROM AUTHOR]

Objective: Clinical care ratios are used to quantify and benchmark the activity of allied health professionals. This study aims to review previous recommendations and identify what variables may influence them. Method: Data was collected from the core allied health professions (audiology, nutrition and dietetics, occupational therapy, physiotherapy, podiatry, prosthetics and orthotics, psychology, social work and speech pathology) across eight Australian hospitals. Data for 113 staff who were casual or from smaller professions (audiology, podiatry, prosthetics and orthotics and psychology) were excluded due to insufficient numbers for analysis. The remaining data were analysed according to profession, seniority (tiers 1, 2 and 3) and employment status (permanent versus casual staff). A two-way ANOVA was performed to assess the association of clinical care ratios with tier, profession, employment status and gender. Results: Data from 1246 staff from the five larger professions at participating hospitals were analysed. There were no interactions between profession and gender (P = 0.185) or employment status (P = 0.412). The relationship between clinical care ratio and profession was modified by tier (interaction term, P = 0.014), meaning that differences in clinical care ratios between professions depended on the tier. Conclusion: This research has confirmed that clinical care ratios are a useful tool in workload management and determining staffing levels for allied health professionals. The recommendations from this research provide a starting point that can be finessed with reference to profession, model of care, workforce structure, governance and training requirements. This will lead to increased staff wellbeing and improved patient outcomes. What is known about this topic? Clinical care ratios are a useful tool to quantify, monitor and compare workloads of allied health professionals. What does this paper add? This paper confirms that clinical care ratios are a useful workforce planning tool and that when developing roles and models of care, clinical care ratios need to be incorporated into staffing requests and considered as part of workload management tools. What are the implications for practitioners? Clinical care ratios enable the quantification and benchmarking of direct and clinical support activity components of a workload and can be used when planning new services and reviewing current services. [ABSTRACT FROM AUTHOR]

Aim: To assess the prevalence of non‐communicable disease risk factors among the nursing staff and educate them on prevention. Background: Nursing staff is integral to the Indian community healthcare systems. Recent studies report a high prevalence of non‐communicable diseases in Indian nursing staff. Therefore, data on the prevalence of non‐communicable disease risk factors among nursing staff are crucial for education on prevention. Design: A cross‐sectional digital survey‐based study. Method: We invited 4435 nursing staff to attend our online survey. We used a customized questionnaire for data collection, including a digitized version of the Community‐Based Assessment Checklist form. A score of >4 was considered high risk and warranted screening. Result: Among 682 nursing staff who attended, 70% had never undergone screening for non‐communicable diseases. The prevalence of non‐communicable disease risk factors was significantly higher in male nursing staff. In addition, logistic regression analysis showed that age, tobacco and alcohol use, increased waist circumference, physical inactivity and family history of non‐communicable diseases were significant risk factors among nursing staff. Conclusion: The study findings suggest that the nursing staff have suboptimal self‐health concerns on non‐communicable diseases. This situation warrants continued medical education, awareness campaigns on adopting a healthy lifestyle and health promotion. Summary statement: What is already known about this topic? The prevalence of non‐communicable diseases (NCDs) among Indian nursing staff is a growing concern, underscoring the need for comprehensive research and targeted interventions.Despite the significant health risks faced by this demographic, there is a notable lack of data on NCD risk factors specific to Indian nursing professionals. What this paper adds? This paper adds information on the prevalence of NCD risk factors chiefly among nursing staff in the Delhi National Capital Region.Male nursing staff have particularly high NCD risk factors. The implications of this paper: Findings may help develop routine screening programmes for nursing staff, continued nursing education and good, safe nursing practice. [ABSTRACT FROM AUTHOR]

Aims: This study describes the incidence of fatigue in kidney transplant recipients and analyses the relationship between physiological factors, psychological factors, situational factors and fatigue in kidney transplant recipients. Background: Fatigue, as a common symptom after kidney transplantation, is affected by many factors, but the influence of some factors on the fatigue of kidney transplant recipients is still controversial. Design: This cross‐sectional study was designed based on the theory of unpleasant symptoms. Methods: Our survey involved 307 participants attending the kidney transplant outpatient clinic of a tertiary Class A hospital (Changsha, Hunan, China). Data were collected between February and April 2021 using a structured questionnaire and electronic medical records. Data were analysed using IBM SPSS 25.0 (SPSS Inc.) Results: It was found that the incidence of fatigue in kidney transplant recipients was 53.1%. According to the binary logistic regression analysis, sleep quality, hypokalemia, anxiety, depression and education level were independent risk factors for fatigue in kidney transplant recipients. Conclusion: The incidence of fatigue in kidney transplant recipients was high and was influenced by physical, psychological and situational factors. Clinical nurses should assess fatigue levels in a timely and multidimensional manner in clinical practice and provide effective and scientific guidance about fatigue self‐coping and symptom management for kidney transplant recipients. Summary statement: What is already known about this topic? Fatigue is a common symptom of kidney transplant recipients and can impair postoperative recovery, reemployment, quality of life, social activities and physical and mental states, causing the body to be in a state of chronic energy consumption.Owing to the imperceptible physical injury upon kidney transplant recipients, fatigue is often underappreciated or even disregarded. What this paper adds? It was found that the rate of fatigue in kidney transplant recipients was high.The risk factors for fatigue in kidney transplant recipients based on the theory of unpleasant symptoms were analysed in three ways: physiological, psychological and situational. The results showed that sleep quality, duration after transplantation, serum potassium level, anxiety, depression, education level, financial burden and social support were associated with fatigue in kidney transplant recipients. The implications of this paper: Clinical nurses should conduct timely and multidimensional fatigue evaluations of kidney transplant recipients and pay more attention to those with a high level of fatigue.The findings can provide a scientific basis for kidney transplant specialist nurses to conduct targeted interventions and facilitate fatigue management for kidney transplant recipients. They can also help to develop fatigue intervention models based on the displeasure symptom theory to improve fatigue in kidney transplant recipients. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to investigate the effectiveness of the bladder stimulation technique (BST) to collect urine samples from newborns and its effects on physiological parameters and comfort of the newborn. Design: This was a randomized controlled trial conducted in a NICU. A total of 64 newborns were divided into 2 groups: 32 newborns in the experimental group and 32 newborns in the control group. Methods: Newborns in the experimental group (EG) were subjected to the BST, and in the control group (CG), urine collection was via sterile urine bags, which is routine practice. Procedural success was defined as the collection of urine samples within 3 min of beginning the stimulation technique in the experimental group and of placing the sterile urine bag in the control group. Results: The success rate of the procedure in 3 min was 62.5% in the EG and 28% in the CG (P = 0.006, absolute difference: 35%, 95% confidence interval 27% to 42%, NNT: 3). According to the comparison of the overall mean COMFORTneo scale and pain and distress subscale scores at the 1‐ and 3‐min marks, there was a significant difference between the EG and CG (p < 0.05). The mean scores in the EG were higher than those in the CG. The mean oxygen‐saturation was significantly lower in the EG than in the CG (p < 0.05), and the increase in heart rate was significantly higher in the EG (p = 0.018). Conclusions: BST is a more successful method within 3 min for collecting urine samples from newborns compared to sterile urine bags. However, the newborns' comfort levels minimally decreased at 3 min, and they had moderate pain and distress, while the BST was being implemented. This increase in physiologic parameters was statistically significant but not clinically significant. Summary statement: What is already known about this topic? Urinary tract infection is a commonly diagnosed bacterial infection in young infants with fever. However, the symptoms of this infection are non‐specific, so urine samples are needed to accurately diagnose and exclude it.There are multiple methods available for collecting urine samples, each with its own advantages and disadvantages.The bladder stimulation technique is a noninvasive and efficient method for collecting urine samples. However, few studies have examined the pain and distress effects of this technique, and these studies have reported varying results. What this paper adds? This study found that bladder stimulation techniques were more effective than sterile urine bags in collecting urine samples within 3 min from newborns.The bladder stimulation technique led to decreased saturation and comfort levels, increased heart rate, and increased pain and distress in the newborns during urine sampling; these increases in physiologic parameters were statistically significant but not clinically significant. The implications of this paper: The bladder stimulation technique is an effective noninvasive method for quickly collecting urine samples.Considering the pain and distress‐increasing properties of the technique, it may be recommended before invasive interventions (bladder catheterization and suprapubic aspiration) when urine sample collection with urine bags is not possible; it can be used in cases where urgent urine collection is required. [ABSTRACT FROM AUTHOR]