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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]

In this article, we explore ethical issues of Deaf people's engagement in research. To focus on the perspectives of Deaf people, we investigated existing qualitative and mixed methods research within a qualitative evidence synthesis. Our synthesis is based on a systematic database search (Scopus, PubMed) and reference check of included papers which resulted in 27 eligible papers. We analyzed the data using thematic synthesis and developed 5 analytical themes. The results present research as a struggle for Deaf people and emphasize the need for changes regarding recognition of Deaf research in a cross-cultural context, maintaining equal and partner relations, and provision of accessible communication. Our research contributes to understanding what the ethical inclusion of Deaf people in research implies. It may also support the development of evidence-based normative recommendations and scientific cooperation between Deaf and hearing people. [ABSTRACT FROM AUTHOR]

The European Commission Horizon 2020 project—PreventIT—evaluated two approaches to delivering Lifestyle-Integrated Functional Exercise (LiFE) programs for maintaining older adults' physical function: the paper-based adapted LiFE and mobile health device delivered enhanced LiFE. A self-reported method was used to measure users' monthly adherence over 12 months. This analysis aimed to explore young seniors' adherence patterns between enhanced LiFE and adapted LiFE groups. Results showed that adherence level decreased with time in both groups. The enhanced LiFE group had slightly higher adherence than the adapted LiFE group during most of the 12 months. However, the overall adherence levels were not significantly different during either intervention or follow-up periods. Monthly self-reported adherence measurement can help to understand users' adherence comprehensively. The comparable adherence levels between both groups indicate mobile health could be an alternative to delivering home-based physical activity for young seniors. However, this feasibility study was not powered to detect differences between groups. [ABSTRACT FROM AUTHOR]

The goal of this study is a comparative analysis of the relation between funding (a main driver for scientific research) and citations in papers of Nobel Laureates in physics, chemistry and medicine over 2019-2020 and the same relation in these research fields as a whole. This study utilizes a power law model to explore the relationship between research funding and citations of related papers. The study here analyzes 3,539 recorded documents by Nobel Laureates in physics, chemistry and medicine and a broader dataset of 183,016 documents related to the fields of physics, medicine, and chemistry recorded in the Web of Science database. Results reveal that in chemistry and medicine, funded researches published in papers of Nobel Laureates have higher citations than unfunded studies published in articles; vice versa high citations of Nobel Laureates in physics are for unfunded studies published in papers. Instead, when overall data of publications and citations in physics, chemistry and medicine are analyzed, all papers based on funded researches show higher citations than unfunded ones. Results clarify the driving role of research funding for science diffusion that are systematized in general properties: a) articles concerning funded researches receive more citations than (un)funded studies published in papers of physics, chemistry and medicine sciences, generating a high Matthew effect (a higher growth of citations with the increase in the number of papers); b) research funding increases the citations of articles in fields oriented to applied research (e.g., chemistry and medicine) more than fields oriented towards basic research (e.g., physics). The results here explain some characteristics of scientific development and diffusion, highlighting the critical role of research funding in fostering citations and the expansion of scientific knowledge. This finding can support decisionmaking of policymakers and R&D managers to improve the effectiveness in allocating financial resources in science policies to generate a higher positive scientific and societal impact. [ABSTRACT FROM AUTHOR]

The First 1000 Days (the period from conception to a child's second birthday) is an important developmental period. However, little is known about experiences of parents with refugee and migrant backgrounds during this period. A systematic review was conducted according to PRISMA guidelines. Publications were identified through searches of the Embase, PsycINFO, PubMed, and Scopus databases, critically appraised, and synthesised using thematic analysis. A total of 35 papers met inclusion criteria. Depressive symptomatology was consistently higher than global averages, however maternal depression conceptualisations differed across studies. Several papers reported changes in relationship dynamics as a result of having a baby post-migration. Consistent relationships were found between social and health support and wellbeing. Conceptualisations of wellbeing may differ among migrant families. Limited understanding of health services and relationships with health providers may impede help-seeking. Several research gaps were identified, particularly in relation to the wellbeing of fathers, and of parents of children over 12 months old. [ABSTRACT FROM AUTHOR]

Physical activity program interventions often lack sensitivity to the needs of older immigrant adults. The objective of this systematic realist review is to explain how, why, for whom, and under which circumstances community group-based physical activity programs work for immigrant older adults. The initial program theory was developed using prior research, team expertise, social cognitive theory, and knowledge user consultations. The program theory was tested and refined via a systematic review of the literature. Database searches were conducted in MEDLINE, EMBASE, CINAHL, Scopus, Cochrane Library, Sports Medicine and Education Index, and SPORTDiscus. A total of 22 sources of evidence met inclusion criteria and included intervention studies, systematic reviews, and a discussion paper. Intervention studies were appraised using the Mixed Methods Appraisal Tool. The final program theory constituted eight context–mechanism–outcome configurations that highlight the importance of facilitator characteristics, access to safe spaces, group dynamics, and social support. A limitation was the small number and variable quality of included evidence. Physical activity programs that target immigrant older adults must strengthen physical and psychological safety and maximize opportunities for role modeling and socialization. This research was supported by the Alberta Health Services Seniors Health Strategic Clinical Network and is registered in PROSPERO (ID#258179). [ABSTRACT FROM AUTHOR]

Purpose: The popularity of fencing and intense sports competition has burdened adolescents with excessive training, harming their immature bodies. Traditional training methods fail to provide timely movement corrections and personalized plans, leading to ineffective exercises. This paper aims to use artificial intelligence technology to reduce ineffective exercises and alleviate the training burden. Methods: We propose an action recognition algorithm based on the characteristics of adolescent athletes. This algorithm uses multimodal input data to comprehensively extract action information. Each modality is processed by the same network structure, utilizing attention mechanisms and adaptive graph structures. A multibranch feature fusion method is used to determine the final action category. Results: We gathered the fencing footwork data set 2.0. Our model achieved 93.3% accuracy, with the highest precision at 95.8% and the highest F1-Score at 94.5% across all categories. It effectively recognized actions of adolescents with different heights and speeds, outperforming traditional methods. Conclusion: Our artificial intelligence-based training solution improves training efficiency and reduces the training burden on adolescents. [ABSTRACT FROM AUTHOR]

The goal of this study is to analyze the relationship between funded and unfunded papers and their citations in both basic and applied sciences. A power law model analyzes the relationship between research funding and citations of papers using 831,337 documents recorded in the Web of Science database. The original results reveal general characteristics of the diffusion of science in research fields: a) Funded articles receive higher citations compared to unfunded papers in journals; b) Funded articles exhibit a super-linear growth in citations, surpassing the increase seen in unfunded articles. This finding reveals a higher diffusion of scientific knowledge in funded articles. Moreover, c) funded articles in both basic and applied sciences demonstrate a similar expected change in citations, equivalent to about 1.23%, when the number of funded papers increases by 1% in journals. This result suggests, for the first time, that funding effect of scientific research is an invariant driver, irrespective of the nature of the basic or applied sciences. This evidence suggests empirical laws of funding for scientific citations that explain the importance of robust funding mechanisms for achieving impactful research outcomes in science and society. These findings here also highlight that funding for scientific research is a critical driving force in supporting citations and the dissemination of scientific knowledge in recorded documents in both basic and applied sciences. This comprehensive result provides a holistic view of the relationship between funding and citation performance in science to guide policymakers and R&D managers with science policies by directing funding to research in promoting the scientific development and higher diffusion of results for the progress of human society. [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: The Japanese Society for Respiratory Care and Rehabilitation, Japanese Association on Sarcopenia and Frailty, Japanese Society of Respiratory Physical Therapy, and Japanese Association of Rehabilitation Nutrition proposed the definition and diagnosis of respiratory sarcopenia using low respiratory muscle strength and appendicular skeletal muscle mass (ASM; ASM/height2) instead of respiratory muscle mass; however, these parameters have not been validated. This study aimed to confirm the validity of the respiratory sarcopenia definition proposed by these four professional organizations. Methods: Participants of our cohort study in 2015 of 468 community‐dwelling older people who were evaluated for sarcopenia and underwent spirometry were included in this analysis. We determined two respiratory sarcopenia models based on low skeletal muscle mass and respiratory muscle strength. Low skeletal muscle mass was defined by low ASM/height2, and low respiratory muscle strength was defined by peak expiratory flow rate (PEFR) or percentage of predicted PEFR (%PEFR). Survival status was assessed 5 years after baseline assessment (in 2020). To evaluate the validity of the cut‐off values for PEFR and %PEFR, we determined different respiratory sarcopenia models by sequentially varying the cut‐off values for each parameter, including ASM/height2, from high to low. We subsequently calculated the hazard ratio (HR) for mortality for each respiratory sarcopenia model using the Cox proportional hazards model. Additionally, we plotted the HR for each combination of cut‐off values for ASM/height2 and PEFR or %PEFR on a three‐dimensional chart to observe the relationship between the different cut‐off values and HR. Results: A total of 31 people died during the 5‐year observation period. With ASM/height2 cut‐off values of approximately 7.0 kg/m2 for men and 5.7 kg/m2 for women and %PEFR cut‐off values of 66–75%, respiratory sarcopenia was associated with mortality risk (HR, 2.36–3.27, point estimation range). Conclusions: The definition of respiratory sarcopenia by the four professional organizations is related to future health outcomes, and this definition is valid. Geriatr Gerontol Int 2024; 24: 948–953. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to elucidate the connection between osteoclastic forkhead transcription factor O1 (FoxO1) and periodontitis and explore the underlying mechanism by which FoxO1 knockdown regulates osteoclast formation. Materials and Methods: A conventional ligature‐induced periodontitis model was constructed to reveal the alterations in the proportion of osteoclastic FoxO1 in periodontitis via immunofluorescence staining. Additionally, RNA sequencing (RNA‐seq) was performed to explore the underlying mechanisms of FoxO1 knockdown‐mediated osteoclastogenesis, followed by western blotting, quantitative polymerase chain reaction, and enzyme‐linked immunosorbent assay. Results: FoxO1+ osteoclasts were enriched in the alveolar bone in experimental periodontitis. Moreover, FoxO1 knockdown led to impaired osteoclastogenesis with low expression of osteoclast differentiation‐related genes, accompanied by an insufficient osteoclast maturation phenotype. Mechanistically, RNA‐seq revealed that the nuclear factor kappa B (NF‐κB) and nucleotide‐binding oligomerization domain‐like receptor family pyrin domain containing 3 (NLRP3) inflammasome signaling pathways were inhibited in FoxO1‐knockdown osteoclasts. Consistent with this, MCC950, an effective inhibitor of the NLRP3 inflammasome, substantially attenuated osteoclast formation. Conclusions: FoxO1 knockdown contributed to the inhibition of osteoclastogenesis by effectively suppressing NF‐κB signaling and NLRP3 inflammasome activation. This prospective study reveals the role of FoxO1 in mediating osteoclastogenesis and provides a viable therapeutic target for periodontitis treatment. [ABSTRACT FROM AUTHOR]

The apps for drawing are present in our children's life. Nevertheless, little is known about the impact of mobile technology on the freehand drawing educational activity. There are few works which are contextualised within short periods of time, with teachers who are not theirs and, in some cases, outside the children's classroom. In this paper, we are focussed on the use of technology on freehand drawing activity. Thus, we have compared the graphics produced by 4- and 5-year-old children with paper&crayon in comparison with those with tablet-finger. Children made the drawings during a planned free-drawing activity, in their ordinary classrooms, with their teachers and during five sessions. Assessment of drawings has evidenced tablet feasibility for making graphics. Nevertheless, with the passing of time, quality of graphics (tablet-finger vs paper&crayons), are nearly matched, demonstrating the low impact level technology has on this activity. In addition, if drawings are analysed specifically according to ages, results have shown that both groups have to develop adaptation strategies of visual perceptual skills and fine motor skills for the touch screen in order to obtain the same quality in the drawings made on both support types. [ABSTRACT FROM AUTHOR]

Green financing is able to reduce carbon dioxide emissions and support long-term economic growth. The paper presents a systematic literature review, evaluating the research on green finance and sustainability from 2005 to 2023. To perform this review, PRISMA technique was followed. A total of 51 papers selected from Web of Science (WOS) and Scopus were reviewed, and the results show that China is a global pioneer in this area, and research on this concept has been gaining momentum. The findings indicate that publications on the direct effect of green finance on sustainability are available in large number, as compared to those on indirect effect. [ABSTRACT FROM AUTHOR]

Background: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has long recognized and championed increasing diversity within the surgical workplace. SAGES initiated the Fundamentals of Leadership Development (FLD) Curriculum to address these needs and to provide surgeon leaders with the necessary tools and skills to promote diversity, equity, and inclusion (DEI) in surgical practice. In 2019, the American College of Surgeons issued a request for anti-racism initiatives which lead to the partnering of the two societies. The primary goal of FLD was to create the first surgeon-focused leadership curriculum dedicated to DEI. The rationale/development of this curriculum and its evaluation/feedback methods are detailed in this White Paper. Methods: The FLD curriculum was developed by a multidisciplinary task force that included surgeons, education experts, and diversity consultants. The curriculum development followed the Analysis, Design, Development, Implementation and Evaluation (ADDIE) instructional design model and utilized a problem-based learning approach. Competencies were identified, and specific learning objectives and assessments were developed. The implementation of the curriculum was designed to be completed in short intervals (virtual and in-person). Post-course surveys used the Kirkpatrick's model to evaluate the curriculum and provide valuable feedback. Results: The curriculum consisted of interactive online modules, an online discussion forum, and small group interactive sessions focused in three key areas: (1) increasing pipeline of underrepresented individuals in surgical leadership, (2) healthcare equity, and (3) conflict negotiation. By focusing on positive action items and utilizing a problem-solving approach, the curriculum aimed to provide a framework for surgical leaders to make meaningful changes in their institutions and organizations. Conclusion: The FLD curriculum is a novel leadership curriculum that provided surgeon leaders with the knowledge and tools to improve diversity in three areas: pipeline improvement, healthcare equity, and conflict negotiation. Future directions include using pilot course feedback to enhance curricular effectiveness and delivery. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic has affected lives and dental treatment. Aerosols and droplets generated during dental treatment present a risk of infection for dental care workers. However, detailed elucidation of the conditions under which those are generated has yet to be presented, and no clear countermeasures for protection have been established. The present study aimed to clarify the process of generation of aerosol and droplets in dental treatment, as well as their dynamics for establishment of effective countermeasures and protection strategies. Methods: Images were obtained using a high-speed camera of aerosol and droplets generated during dental treatments performed on a mannequin. The effects of intraoral vacuum and extraoral vacuum to reduce those, as well as splash range with different body position were examined. Quantitative evaluations of aerosol and droplets were also performed using water-sensitive paper. Results: Aerosol and droplets quantities were significantly reduced by use of both intraoral and extraoral vacuums as compared to no vacuum in both image analysis and findings obtained with water-sensitive paper (p < 0.05). Additionally, the intensity of aerosol and droplets when using the intraoral and extraoral vacuum devices with a body position of 45 degrees was a significantly less as compared to the other settings (p < 0.001). Conclusions: The present study demonstrated the effectiveness of visualization of the aerosol and droplets generated by dental tools using a high-speed camera. Use of an extraoral vacuum resulted in a reduction of those generated during simulated dental treatment, and also contributed to diffusion prevention to protect the operator and assistant. Nevertheless, it is necessary to be careful because the use of extraoral vacuums may reverse the spread of aerosol and droplets depending on the position of patient. [ABSTRACT FROM AUTHOR]

Co-occurring regulatory problems in infancy, RPs, including excessive crying, feeding–eating and sleeping, have been found associated with mental health problems in school ages. Still, an overview is needed on trajectories of co-occurring or combined RPs, and mental health problems in early childhood. The aim of this review is to systematically review the literature on longitudinal community-based studies of combined RPs measuring mental health outcomes in early childhood. Following the PRISMA guideline, we systematically reviewed the literature published 2000–2020, in which combined RPs are assessed in infancy, and mental health is examined using standardised measures at ages 1–7 years. The search was performed in four databases MEDLINE, EMBASE, PsycINFO and Scopus. A protocol is published on PROSPERO. Based on 1978 screened articles, 42 papers were screened for eligibility, of which six were included, comprising data on two or more RPs investigated among a total of 20,675 children. Assessment of risk of bias in the studies showed overall good quality in five of the six papers. The literature reviewed suggests that combined RPs in infancy are early markers of mental health problems during early childhood, and highlights that community studies exploring the longitudinal associations of combined RP and mental health problems in preschool and early school age are still scarce. Overall, the review points to the need of research into preventive intervention targeting early manifestations of childhood dysregulation, such as RPs. [ABSTRACT FROM AUTHOR]

Background: Many individuals with advanced dementia die in hospital, despite preferring home death. Existing evidence of factors affecting their place of death is inconsistent. To inform policies/practices for meeting needs/preferences, systematically establishing the evidence is pertinent, particularly given the exponential rise in advanced dementia prevalence. Aim: To identify factors influencing where people with advanced dementia die. Design and data sources: This systematic review with meta-analysis was registered on PROSPERO (CRD42022366722). Medline, CINAHL, PsycINFO, SocINDEX and a grey literature database, Overton, were searched on 21/12/2022, supplemented by hand-searching/citation tracking. Papers reporting quantitative data on factors associated with place of death in advanced dementia were included and appraised using QualSyst. Data were analysed using random effects with the certainty of evidence determined using the GRADE criteria. Results: Thirty-three papers involving >5 million individuals (mean age = 89.2 years) were included. Long-term care setting deaths were relatively common but hospice deaths were rarer. Marriage's association with home death underscores social networks' importance, while younger age's and male gender's associations with hospital death demonstrate patients' and families' interdependency. Pneumonia/COPD's opposing effects on hospital deaths with cancer/functional impairment highlight the challenges of advanced dementia care. Unlike hospital/nursing home bed availability's lack of effect, capitated funding (fixed-amount-per-patient-per-period) decreased hospital death likelihood. Conclusion: This comprehensive review of place of death determinants highlight the profound challenges of advanced dementia end-of-life care. Given that bed capacity did not affect place of death, a capitation-based, integrated palliative care model would appear more likely to meet patients' needs in a resource-constrained environment. [ABSTRACT FROM AUTHOR]

Introduction. Social prescribing (SP) is an integrated care program aimed to improve individuals' health and wellbeing. Understanding the influence of SP and determining best practices and processes are challenging due to variability in its delivery, implementation, and intervention characteristics between different studies and countries. This study aimed to identify the intervention characteristics, mechanisms, and outcomes associated with SP research and explore how these factors relate to the influence of SP on health and wellbeing, healthcare utilization, and care experiences. Method. A comprehensive search was conducted in twelve databases, Google Scholar, and reference lists of relevant studies published from January 2010 up to April 2023. Searches were limited to literature written in English or Dutch. We utilized ASReview, an open‐source machine learning tool, to conduct title and abstract screening. The methodological quality of the included studies was assessed using the Mixed Methods Appraisal Tool, and the risk of bias was evaluated using the Cochrane RoB2 and the ROBINS‐I. We coded all intervention characteristics, mechanisms, and relevant outcomes. Quantitative data were visually presented using Harvest Plots, and qualitative data were narratively summarized. Results and Discussion. In total, 49 papers were included, of which seven qualitative, seventeen quantitative, and 25 mixed method studies. The findings highlight the importance of social‐related mechanisms, including loneliness and social connectedness, in contributing to the observed positive influence of SP on mental health and wellbeing. The observed outcomes seem to be influenced by various characteristics, including gender, age, the presence of a link worker, and the use of behavior change techniques. However, we should be cautious when interpreting these results due to limitations in study designs, such as the lack of controlled trials and statistical considerations. Further rigorous research is needed to comprehensively understand the impact and potential benefits of SP. [ABSTRACT FROM AUTHOR]

Autistic children and young people (CYP) experience mental health difficulties but face many barriers to accessing and benefiting from mental health care. There is a need to explore strategies in mental health care for autistic CYP to guide clinical practice and future research and support their mental health needs. Our aim was to identify strategies used to improve mental health care for autistic CYP and examine evidence on their acceptability, feasibility, and effectiveness. A systematic review and meta-analysis were carried out. All study designs reporting acceptability/feasibility outcomes and empirical quantitative studies reporting effectiveness outcomes for strategies tested within mental health care were eligible. We conducted a narrative synthesis and separate meta-analyses by informant (self, parent, and clinician). Fifty-seven papers were included, with most investigating cognitive behavioral therapy (CBT)-based interventions for anxiety and several exploring service-level strategies, such as autism screening tools, clinician training, and adaptations regarding organization of services. Most papers described caregiver involvement in therapy and reported adaptations to communication and intervention content; a few reported environmental adjustments. In the meta-analyses, parent- and clinician-reported outcomes, but not self-reported outcomes, showed with moderate certainty that CBT for anxiety was an effective treatment compared to any comparison condition in reducing anxiety symptoms in autistic individuals. The certainty of evidence for effectiveness, synthesized narratively, ranged from low to moderate. Evidence for feasibility and acceptability tended to be positive. Many identified strategies are simple, reasonable adjustments that can be implemented in services to enhance mental health care for autistic individuals. Notable research gaps persist, however. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine the validity and reliability of the electronic Compassion Competence Scale (e-CCS). Methods: A cross-sectional, randomized, two-period crossover design was used. Nursing students from four South Korean universities were surveyed between June 2017 and April 2018. The participants were randomly assigned to one of three groups-paper/paper, electronic/electronic, and paper/electronic or electronic/paper-and a test-retest procedure was implemented. The reliability and validity of the e-CCS were evaluated using linear weighted kappa coefficients and intraclass correlation coefficients (ICCs). Internal consistency reliability was verified using linear weighted kappa coefficients and ICCs. Pearson's correlation coefficients between the initial test and retest scores were all statistically significant. Results: The newly developed e-CCS was found to have good reliability and validity. We suggest that future research should increase sample heterogeneity by recruiting diverse age groups, nurses working in different nursing fields, and students from multiple colleges. Conclusion: This electronic instrument will help determine the differences in the level of compassion competence and devise interventions to improve compassion competence in nurses and nursing students. Further studies on enhancing compassion competence among nurses and nursing students may rely on the use of this electronic format. [ABSTRACT FROM AUTHOR]

Rapid automatized naming (RAN) is a powerful predictor of reading fluency, and many digitized dyslexia screeners include RAN as an essential component. However, the validity of digitized RAN has not been established. Using a sample of 174 second-graders, this study tested (1) the comparability between paper and digitized versions of RAN and (2) the validity of the digitized version. We found that paper and digital versions were highly correlated, and such correlation was consistent across students' reading levels. Further, the digital RAN predicted children's word reading proficiency as well as the paper version. Moreover, the constructs measured by paper and digital versions of RAN were comparable. We conclude that the digitized RAN is a valid alternative to the traditional paper version for this age group. [ABSTRACT FROM AUTHOR]

Donor human milk (DHM) from a milk bank is the recommended feeding method for preterm infants when the mother's own milk (MOM) is not available. Despite this recommendation, information on the possible contamination of donor human milk and its impact on infant health outcomes is poorly characterised. The aim of this systematic review is to assess contaminants present in DHM samples that preterm and critically ill infants consume. The data sources used include PubMed, EMBASE, CINAHL and Web of Science. A search of the data sources targeting DHM and its potential contaminants yielded 426 publications. Two reviewers (S. T. and D. L.) conducted title/abstract screening through Covidence software, and predetermined inclusion/exclusion criteria yielded 26 manuscripts. Contaminant types (bacterial, chemical, fungal, viral) and study details (e.g., type of bacteria identified, study setting) were extracted from each included study during full‐text review. Primary contaminants in donor human milk included bacterial species and environmental pollutants. We found that bacterial contaminants were identified in 100% of the papers in which bacterial contamination was sought (16 papers) and 61.5% of the full data set (26 papers), with the most frequently identified genera being Staphylococcus (e.g., Staphylococcus aureus and coagulase‐negative Staphylococcus) and Bacillus (e.g., Bacillus cereus). Chemical pollutants were discovered in 100% of the papers in which chemical contamination was sought (eight papers) and 30.8% of the full data set (26 papers). The most frequently identified chemical pollutants included perfluoroalkyl substances (six papers), toxic metal (one paper) and caffeine (one paper). Viral and fungal contamination were identified in one paper each. Our results highlight the importance of establishing standardisation in assessing DHM contamination and future studies are needed to clarify the impact of DHM contaminants on health outcomes. Key messages: Research regarding chemical contamination in donor human milk (DHM) is limited and needs to be studied further to draw appropriate conclusions on reducing potential risks for infants.Parents/guardians should be educated on the availability of DHM as a supplemental feeding option and made aware of the current research in the field.DHM use requires further standardisation both within the United States and abroad. This standardisation should ensure that risks are not overemphasised and DHM is a cost‐effective, accessible resource as a short‐term intervention when used appropriately as part of optimal lactation and breastfeeding support. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to identify how aged care organizations can foster a culture that supports the implementation of innovation. Introduction: The aged care sector must innovate to meet clients' evolving needs and increased regulatory requirements. Given the need to account for the values, beliefs, expectations, and assumptions held by a diverse range of stakeholders, implementing innovations within aged care can be exceptionally complex. Fostering a supportive organizational culture can facilitate the implementation of these critical innovations. Methods: Papers from a large scoping review that identified organizational culture as a barrier and/or enabler to implementing innovations in aged care were imported into NVivo. Data relating to how organizations fostered (or could foster) a culture that supported the implementation of innovations were then extracted, inductively coded, interpreted, and grouped into approaches. Results: Of the 193 papers from the original scoping review, 109 were included in this secondary analysis. From these 109 papers, we identified six key approaches: cultivating collaboration; valuing contributions; ensuring alignment between the organizational vision, culture, and innovation; demonstrating organizational commitment; developing and communicating the implementation plan; and accounting for stability. Conclusions: Our study outlines effective approaches that can be used by aged care organizations to cultivate a culture that supports the implementation of innovations. However, these approaches should not be viewed in isolation; rather, they are interconnected and mutually reinforcing. Together, these insights offer practical guidance for aged care entities seeking to adapt and evolve through innovation implementation. [ABSTRACT FROM AUTHOR]

In clinical nutrition research, the medical industry chain generates a wealth of multidimensional spatial data across various formats, including text, images, and semi-structured tables. This data's inherent heterogeneity and diversity present significant challenges for processing and mining, which are further compounded by the data's diverse features, which are difficult to extract. To address these challenges, we propose an innovative integration of artificial intelligence (AI) with the medical industry chain data, focusing on constructing semantic knowledge graphs and extracting core features. These knowledge graphs are pivotal for efficiently acquiring insights from the vast and granular big data within the medical industry chain. Our study introduces the Clinical Feature Extraction Knowledge Mapping (CFEKM) model, designed to augment the attributes of medical industry chain knowledge graphs through an entity extraction method grounded in syntactic dependency rules. The CFEKM model is applied to real and large-scale datasets within the medical industry chain, demonstrating robust performance in relation extraction, data complementation, and feature extraction. It achieves superior results to several competitive baseline methods, highlighting its effectiveness in handling medical industry chain data complexities. By representing compact semantic knowledge in a structured knowledge graph, our model identifies knowledge gaps and enhances the decision-making process in clinical nutrition research. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to identify and visualize from different perspectives the topic on occupational exposure in operating room (OEOR). Methods: In the Web of Science Core Collection (WoSCC), all the half-century data were retrieved from January 1st, 1973 to December 31st, 2022. CiteSpace, VOSviewer and Excel 2019 were employed to analyze and visualize data, based on publications, countries, institutions, journals, authors, keywords. Result: A total of 336 journal papers were found. The increase of publications virtually started in 1991, peaked in 2020 and has been slowing down ever since. USA played most significant part among all the 49 countries/regions, while Universidade Estadual Paulista out of 499 institutions published the most papers. International Archives of Occupational and Environmental Health bears the most documents and citations in all the 219 retrieved journals. There are 1847 authors found, among whom Hoerauf K is the most influential one. "Occupational exposure", "nitrous oxide" and "operating room personnel" are the top 3 co-occurrences keywords. Conclusion: The trend in the field lies in "anaesthetic gas", "blood borne pathogen", "radiation" and "aerosol", while "surgical smoke" and "occupational safety" are the recently researching hot spots in this study. Accurate recognize and effective protection are always essential subjects for researchers. [ABSTRACT FROM AUTHOR]

Background: Isokinetic normative data in females' soccer players is scarce in comparison to males. Furthermore, evaluation protocols employed to obtain those data in female's studies, strongly differ from each other, using different ranges of speeds and movement patterns, thus producing different output data. Thus, it is difficult for the researcher and the clinician to choose a correct protocol for knee isokinetic test in female soccer players. Aim of this paper is to review the literature to provide updated information on how to interpret a knee isokinetic testing in healthy females. Methods: Google Scholar, PubMed, Sport Discus, and Psych info databases were queried, and 17 papers were selected. Following PRISMA methodology and PEDro scale, we classified the retrieved papers and assessed the quality. Results: In this review some common features of isokinetic testing in female soccer players of various levels of qualification are highlighted. The isokinetic performance indexes widely accepted are the hamstring/quadriceps (H/Q) ratio and dominant/non-dominant (D/ND) ratio. It also emerges that, 3 reps at the speed of 60°/sec in knee flexion/extension are preferable due to the higher reliability and that the optimal H/Q ratio in healthy female soccer players of different level of qualification and age is 50%, while the interlimb differences (D/ND) should be below 10%. Conclusions: Normative data and methodologies reviewed can be useful for the isokinetic test of female soccer players. It emerges that simplifying test procedures limiting at few testing speed and considering selected H/Q and D/ND gives all the necessary relevant informations. [ABSTRACT FROM AUTHOR]

Background: Isokinetic normative data in females' soccer players is scarce in comparison to males. Furthermore, evaluation protocols employed to obtain those data in female's studies, strongly differ from each other, using different ranges of speeds and movement patterns, thus producing different output data. Thus, it is difficult for the researcher and the clinician to choose a correct protocol for knee isokinetic test in female soccer players. Aim of this paper is to review the literature to provide updated information on how to interpret a knee isokinetic testing in healthy females. Methods: Google Scholar, PubMed, Sport Discus, and Psych info databases were queried, and 17 papers were selected. Following PRISMA methodology and PEDro scale, we classified the retrieved papers and assessed the quality. Results: In this review some common features of isokinetic testing in female soccer players of various levels of qualification are highlighted. The isokinetic performance indexes widely accepted are the hamstring/quadriceps (H/Q) ratio and dominant/non-dominant (D/ND) ratio. It also emerges that, 3 reps at the speed of 60°/sec in knee flexion/extension are preferable due to the higher reliability and that the optimal H/Q ratio in healthy female soccer players of different level of qualification and age is 50%, while the interlimb differences (D/ND) should be below 10%. Conclusions: Normative data and methodologies reviewed can be useful for the isokinetic test of female soccer players. It emerges that simplifying test procedures limiting at few testing speed and considering selected H/Q and D/ND gives all the necessary relevant informations. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study reported in this paper was to explore the role of animals in buffering against cisgenderist violence experienced by trans young people. Method: Interviews were conducted with 17 Australian trans young people and one of their parents who spoke with us about their relationships with their animals living in the home, including in terms of animals providing a protective function against the negative effects of cisgenderism. The transcribed interviews were analyzed thematically. Results: Thematic analysis resulted in the development of three themes. First, at the psychological level, animals helped young people to combat feelings of dysphoria, wrought by the violent effects of social norms about gender. Second, at the interpersonal level, animals helped to soothe young people when they were faced with less than supportive or indeed hostile responses from family members and other people in their lives. Third, at the community level, the companionship provided by animals offered a buffer against feelings of marginalization premised on cisgenderist social norms. Conclusions: All three themes speak to the importance of conceptualizing violence in family contexts as more than just the obvious: as encompassing more subtle forms of marginalization that in their net effect may constitute forms of violence or microaggressions. As a counter to these subtle forms of violence, animals are thus perceived as playing an important role as confidantes, as offering a place of non-judgemental safety, and as a touchstone to the more-than-human. [ABSTRACT FROM AUTHOR]

Open data as an integral part of the open science movement enhances the openness and sharing of scientific datasets. Nevertheless, the normative utilization of data journals, data papers, scientific datasets, and data citations necessitates further research. This study aims to investigate the citation practices associated with data papers and to explore the role of data papers in disseminating scientific datasets. Dataset accession numbers from NCBI databases were employed to analyze the prevalence of data citations for data papers from PubMed Central. A dataset citation practice identification rule was subsequently established. The findings indicate a consistent growth in the number of biomedical data journals published in recent years, with data papers gaining attention and recognition as both publications and data sources. Although the use of data papers as citation sources for data remains relatively rare, there has been a steady increase in data paper citations for data utilization through formal data citations. Furthermore, the increasing proportion of datasets reported in data papers that are employed for analytical purposes highlights the distinct value of data papers in facilitating the dissemination and reuse of datasets to support novel research. [ABSTRACT FROM AUTHOR]

This paper investigates retracted articles indexed in the Scientific Electronic Library Online (SciELO) Brazil, using bibliometric techniques to identify the characteristics of these retractions and relevant citation trends. All records of retracted articles from the first record in October 2004 to April 2022 were included. Sixty-seven retractions and 870 citations pre- and post-retraction were analyzed. Results indicate a change of scenario that began in 2015, with recurrences of retracted articles allegedly produced by paper mills. The prevalence of retractions derived from professional misconduct in health research and the frequency of post-retraction citations in health sciences raise concerns in the chain of stakeholders, public health, and scientific development. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate associations between digital urine color and paper urine color with other urine indices to assess hydration status. Methods: Twelve male subjects (mean ± standard deviation; age, 26 ± 8 years; body mass, 57.8 ± 5.3 kg; height, 177.5 ± 8.9 cm; VO2max, 57.8 ± 5.8 ml·kg−1·min−1) performed four exercise trials in the heat. Before and following exercise trials, subjects provide urine samples. Urine samples were measured using a digital urine color chart on a portable device screen. Urine samples were also assessed with urine specific gravity (USG), urine osmolality (UOsmo), and a validated paper urine color chart. Results: There were extremely large associations found between digital urine color and paper urine color (r = 0.926, p < 0.001). Correlation coefficients showing associations with USG and UOsmo were similar between digital urine color (USG, r = 0.695, p < 0.001; UOsmo, r = 0.555, p < 0.001) and paper urine color (USG, r = 0.713, p < 0.001; UOsmo, r = 0.570, p < 0.001). Bland–Altman analysis indicated that no proportional bias was observed between digital and paper urine colors (bias, − 0.148; SD of bias, 0.492; 95% LOA, − 1.11, 0.817; p = 0.094). Conclusions: Strong associations were found between digital and paper urine colors with no proportional bias. Furthermore, the degree of associations with USG and UOsmo was similar between digital and paper urine color. These results indicate that digital urine color is a useful tool to assess hydration status and this method could be used as an alternative method to using paper urine color. [ABSTRACT FROM AUTHOR]

Introduction: In the big data era, where corporations commodify health data, non-fungible tokens (NFTs) present a transformative avenue for patient empowerment and control. NFTs are unique digital assets on the blockchain, representing ownership of digital objects, including health data. By minting their data as NFTs, patients can track access, monetize its use, and build secure, private health information systems. However, research on NFTs in healthcare is in its infancy, warranting a comprehensive review. Methods: This study conducted a systematic literature review and thematic analysis of NFTs in healthcare to identify use cases, design models, and key challenges. Five multidisciplinary research databases (Scopus, Web of Science, Google Scholar, IEEE Explore, Elsevier Science Direct) were searched. The approach involved four stages: paper collection, inclusion/exclusion criteria application, screening, full-text reading, and quality assessment. A classification and coding framework was employed. Thematic analysis followed six steps: data familiarization, initial code generation, theme searching, theme review, theme definition/naming, and report production. Results: Analysis of 19 selected papers revealed three primary use cases: patientcentric data management, supply chain management for data provenance, and digital twin development. Notably, most solutions were prototypes or frameworks without real-world implementations. Four overarching themes emerged: data governance (ownership, tracking, privacy), data monetization (commercialization, incentivization, sharing), data protection, and data storage. The focus lies on user-controlled, private, and secure health data solutions. Additionally, data commodification is explored, with mechanisms proposed to incentivize data maintenance and sharing. NFTs are also suggested for tracking medical products in supply chains, ensuring data integrity and provenance. Ethereum and similar platforms dominate NFT minting, while compact NFT storage options are being explored for faster data access. Conclusion: NFTs offer significant potential for secure, traceable, decentralized healthcare data exchange systems. However, challenges exist, including dependence on blockchain, interoperability issues, and associated costs. The review identified research gaps, such as developing dual ownership models and data pricing strategies. Building an open standard for interoperability and adoption is crucial. The scalability, security, and privacy of NFT-backed healthcare applications require further investigation. Thus, this study proposes a research agenda for adopting NFTs in healthcare, focusing on governance, storage models, and perceptions. [ABSTRACT FROM AUTHOR]

Aim: To map existing evidence and identify gaps in the literature concerning psychosocial impacts of being nil by mouth (NBM) as an adult. Design: A scoping review of the literature was undertaken using JBI guidance. A protocol was registered on the Open Science Framework (osf.io/43g9y). Reporting was guided by Preferred Reporting Items for Systematic Reviews and Meta‐Analysis extension for Scoping Reviews (PRISMA‐ScR). Methods: A comprehensive search of six databases (CINAHL, Embase, MEDLINE, PsycINFO, SCOPUS and Web of Science) was performed for studies published up to February 2023, with no restriction to study type. A scope of the grey literature was also undertaken. Two authors independently assessed eligibility and extracted data. Descriptive statistical analysis and narrative synthesis were used, and patient and public involvement included in funding discussions. Results: A total of 23 papers were included in the review, consisting of 14 primary studies (7 qualitative and 7 quantitative) and 9 grey literature. Both global psychological distress and distress specific to being NBM (thirst, missing food and drink) were reported. Caregivers also experience distress from their family member being NBM. Furthermore, social impacts were reported for both patient and caregiver, primarily social isolation and subsequent low mood. Conclusion: Furthermore, research is needed to understand the prevalence of this population, how best to measure psychosocial impacts and to explore whether (and how) psychosocial impacts change over time. Advancement in this area would enable better service development to optimize care for this patient group. What is known about this topic?: Eating and drinking provides more than nutrition and hydration.A wide range of conditions can lead to recommendations for no longer eating and drinking (nil by mouth).Being nil by mouth (NBM) for short periods such as pre‐operative fasting causes distress; however, little is understood about impact on longer‐term abstinence from eating and drinking. What this paper adds?: Psychosocial consequences of being nil by mouth (NBM)have been investigated by both quantitative and qualitative studies.Being NBM impacts both patients and caregivers in various psychosocial aspects, including distress and social isolation.Several gaps remain, however, regarding ways to measure psychosocial impact of being NBM. [ABSTRACT FROM AUTHOR]

Background: Working together and co‐production with public advisors have become popular among health researchers. This practice extends to doctoral researchers who involve public advisors at different stages of their research or throughout their doctoral journey. Objective: A doctoral researcher and two public advisors jointly evaluated public involvement in doctoral research. Methods: Using the established public involvement evaluation framework by Gibson and colleagues, public advisors and a doctoral researcher mapped and evaluated their experiences of public involvement in doctoral research. The four‐dimensional framework allowed the authors to reflect on (1) the strength of the public voice, (2) the number of ways in which public advisors had an opportunity to get involved, (3) whether the discussion was about the public or organisation's (doctoral researcher, university or funder) concerns and (4) if the organisation changed or resisted feedback. Results are presented in a diagrammatic and narrative way. Results: Public advisors saw themselves as having a stronger voice in doctoral research than the doctoral researcher perceived. All agreed that there existed multiple ways for public advisors to be involved. Public advisors' feedback was taken on board, but it was also limited due to restrictions of what the doctoral programme allowed. Conclusion: Public advisors ensured that the doctoral research was more relevant to the public. The ongoing involvement also shaped the doctoral researcher's thinking and views. Patient and Public Involvement: Two public advisors were involved throughout the 3 years of this doctoral research. They co‐evaluated this involvement and are co‐authors of this paper. [ABSTRACT FROM AUTHOR]

Higher education professional recognition programs, which lead to the awarding of such accolades as teaching and learning fellowships, offer participants opportunities to reflect carefully on their practice. However, few resources exist to help participants engage in reflection after the award-receiving stage. This reflection is important in helping participants not rest on their laurels and, instead, build on the practices for which they received recognition. Through a process of collaborative reflection, a group of fellowship-recipients, from different disciplines and higher education institutions, addressed this gap as stakeholder-participant-researchers by developing a transdisciplinary approach to undertaking post-award reflective practice. From this collaboration, a novel two-stage tool was developed using an iterative design methodology. The tool presented in this paper as the result of this research can be understood as a means of supporting self-paced, continued post-award reflective practice; the tool's first stage guides users through retrospective reflection, looking back on previous achievements, while the second stage leads users through anticipatory planning, looking towards the future, to achieve fresh goals. The tool thus deepens the reflective practice of recognition program awardees and supports their ongoing professional development. This paper reports on the development of this bespoke tool, which may be enacted in varied settings. [ABSTRACT FROM AUTHOR]

Introduction: Noncommunicable diseases (NCDs) are associated with high and rising burden of morbidity and mortality in sub-Saharan Africa, including Nigeria. Diabetes mellitus (DM) is among the leading causes of NCD-related deaths worldwide and is a foremost public health problem in Nigeria. As part of National policy, Nigeria has committed to implement the World Health Organization (WHO) Package of Essential Non-communicable Disease interventions for primary care. Implementing the intervention requires the availability of essential elements, including guidelines, trained staff, health management information systems (HMIS), equipment, and medications, in primary healthcare centers (PHCs). This study assessed the availability of the DM component of the WHO package, and the readiness of the health workers in these PHCs to implement a DM screening, evaluation, and management program to inform future adoption and implementation. Methods: This cross-sectional formative assessment adapted the WHO Service Availability and Readiness Assessment (SARA) tool to survey 30 PHCs selected by multistage sampling for readiness to deliver DM diagnosis and care in Abuja, Nigeria, between August and October 2021. The SARA tool was adapted to focus on DM services and the availability and readiness indicator scores were calculated based on the proportion of PHCs with available DM care services, minimum staff requirement, diagnostic tests, equipment, medications, and national guidelines/protocols for DM care within the defined SARA domain. Results: All 30 PHCs reported the availability of at least two full-time staff (median [interquartile range] = 5 [4–9]), which were mostly community health extension workers (median [interquartile range]) = 3 [1–4]. At least one staff member was recently trained in DM care in 11 PHCs (36%). The study also reported high availability of paper-based HMIS (100%), and DM screening services using a glucometer (87%), but low availability of DM job aids (27%), treatment (23%), and national guidelines/protocols (0%). Conclusion: This formative assessment of PHCs' readiness to implement a DM screening, evaluation, and management program in Abuja demonstrated readiness to integrate DM care into PHCs regarding equipment, paper-based HMIS, and nonphysician health workers' availability. However, strategies are needed to promote DM health workforce training, provide DM management guidelines, and supply essential DM medications. [ABSTRACT FROM AUTHOR]

Introduction Clinical debriefing (CD) improves teamwork and patient care. It is implemented across a range of clinical contexts, but delivery and structure are variable. Furthermore, terminology to describe CD is also inconsistent and often ambiguous. This variability and the lack of clear terminology obstructs understanding and normalisation in practice. This review seeks to examine the contextual factors relating to different CD approaches with the aim to differentiate them to align with the needs of different clinical contexts. Methods Articles describing CD were extracted from Medline, CINAHL, ERIC, PubMed, PsychINFO and Academic Search Complete. Empirical studies describing CD that involved two or more professions were eligible for inclusion. Included papers were charted and analysed using the Who-What-When-Where-Why-How model to examine contextual factors which were then used to develop categories of CD. Factors relating to what prompted debriefing and when debriefing occurred were used to differentiate CD approaches. Results Forty- six papers were identified. CD was identified as either prompted or routine, and within these overarching categories debriefing was further differentiated by the timing of the debrief. Prompted CD was either immediate or delayed and routine CD was postoperative or end of shift. Some contextual factors were unique to each category while others were relatively heterogeneous. These categories help clarify the alignment between the context and the intention of CD. Conclusions The proposed categories offer a practical way to examine and discuss CD which may inform decisions about implementation. By differentiating CD according to relevant contextual factors, these categories may reduce confusion which currently hinders discourse and implementation. The findings from this review promote context-specific language and a shift away from conceptions of CD that embody a one-size-fits-all approach. [ABSTRACT FROM AUTHOR]

Aims: To describe intensive care unit nurses' experiences of moral distress during the COVID‐19 pandemic, and their recommendations for mitigative interventions. Design: Interpretive description. Methods: Data were collected with a purposeful sample of 40 Canadian intensive care unit nurses between May and September 2021. Nurses completed a demographic questionnaire, the Measure of Moral Distress—Healthcare Professionals survey and in‐depth interviews. Quantitative data were analysed using descriptive statistics. Qualitative data were categorized and synthesized using reflexive thematic analysis and rapid qualitative analysis. Results: Half of the nurses in this sample reported moderate levels of moral distress. In response to moral distress, nurses experienced immediate and long‐term effects across multiple health domains. To cope, nurses discussed varied reactions, including action, avoidance and acquiescence. Nurses provided recommendations for interventions across multiple organizations to mitigate moral distress and negative health outcomes. Conclusion: Nurses reported that moral distress drove negative health outcomes and attrition in response to moral events in practice. To change these conditions of moral distress, nurses require organizational investments in interventions and cultures that prioritize the inclusion of nursing perspectives and voices. Implications for the Profession: Nurses engage in a variety of responses to cope with moral distress. They possess valuable insights into the practice issues central to moral distress that have significant implications for all members of the healthcare teams, patients and systems. It is essential that nurses' voices be included in the development of future interventions central to the responses to moral distress. Reporting Method: This study adheres to COREQ guidelines. Impact: What Problem did the Study Address?: Given the known structural, systemic and environmental factors that contribute to intensive care unit nurses' experiences of moral distress, and ultimately burnout and attrition, it was important to learn about their experiences of moral distress and their recommendations for organizational mitigative interventions. Documentation of these experiences and recommendations took on a greater urgency during the context of a global health emergency, the COVID‐19 pandemic, where such contextual influences on moral distress were less understood. What Were the Main Findings?: Over half of the nurses reported a moderate level of moral distress. Nurses who were considering leaving nursing practice reported higher moral distress scores than those who were not considering leaving. In response to moral distress, nurses experienced a variety of outcomes across several health domains. To cope with moral distress, nurses engaged in patterns of action, avoidance and acquiescence. To change the conditions of moral distress, nurses desire organizational interventions, practices and culture changes situated in the amplification of their voices. Where and on Whom Will the Research Have an Impact on?: These findings will be of interest to: (1) researchers developing and evaluating interventions that address the complex phenomenon of moral distress, (2) leaders and administrators in hospitals, and relevant healthcare and nursing organizations, and (3) nurses interested in leveraging evidence‐informed recommendations to advocate for interventions to address moral distress. What Does this Paper Contribute to the Wider Global Community?: This paper advances the body of scientific work on nurses' experiences of moral distress, capturing this phenomenon within the unique context of a global health emergency.Nurses' levels of moral distress using Measure of Moral Distress—Healthcare Professional survey were reported, serving as a comparator for future studies seeking to measure and evaluate intensive care unit nurses' levels of moral distress.Nurses' recommendations for mitigative interventions for moral distress have been reported, which can help inform future interventional studies. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Cleft lip and palate (CLP) is one of the most common birth defects worldwide. It typically results in significant maxillary dysplasia, causing severe oral function problems and substantially affecting the patient's facial aesthetics. Maxillary anterior segmental distraction osteogenesis (MASDO) has gained popularity in recent years as an effective treatment for correcting maxillary dysplasia. However, the evaluation of its effectiveness in patients with CLP varies across different studies. Our research was aimed at providing evidence of the effects of MASDO among CLP patients. Methods: A meta-analysis covered Medline, Web of Science, Embase, Scopus, and Cochrane Library. Controlled clinical trial studies published before February 2024 and analyzed changes in maxillary cephalometric landmarks before and after MASDO among patients with maxillary hypoplasia and CLP were included. Results: Our meta-analysis included 10 papers in total. One study was at low risk of bias, seven were at medium risk, and two were at serious risk. MASDO significantly increased the maxillary length. The mean SNA angle increased by 6.43° (95% CI, 4.11° to 8.74°) and A-McNamara rose by 7.29 mm (95% CI, 6.21 mm to 8.37 mm). The maxilla also showed a slight counterclockwise rotation; however, this reached no statistical significance. The mandibular position did not vary remarkably. Moreover, a significant increase in upper anterior tooth tipping and overjet, a decrease in overbite, and an improvement in nasolabial soft tissue were observed. Conclusions: MASDO might be a valid therapy option for CLP patients. It causes a significant increase in the maxillary length, anterior tooth crossbite, and nasolabial soft tissue were also greatly improved. [ABSTRACT FROM AUTHOR]

Recent methodological developments have contributed to a significant advance in computerised neuropsychological instruments and procedures, including those accessible from remote. In this paper we present Auto-GEMS, a newly developed, web-based, self-administered screening test allowing to quickly estimate an individual's cognitive state also considering their cognitive reserve. Auto-GEMS measures cognitive functioning on eleven items similarly to the in-person paper-and-pencil version (GEMS) and to the remote (phone or video call) version (Tele-GEMS) of the same screening. We collected normative data on a sample of 1308 Italian-speaking participants (age range 18–93) to verify its psychometric properties and computed regression models on demographic variables to establish clinical cut-offs. The psychometric properties of Auto-GEMS have shown good internal consistency, test-retest reliability and convergent validity. This short and user-friendly tool has a number of potential applications. For instance, it can be useful in clinical practice to monitor the cognitive profile of patients or vulnerable individuals, or even administered in a face-to-face, standard clinical setting. It can also be used in research studies to screen participants. The testing materials and the collected data are freely available in a digital archive along with a web App to visualise the test outcome with reference to its normative data. [ABSTRACT FROM AUTHOR]

Fertility punishment is a powerful interpretation of the low birth rate in contemporary China, but it is not consistent with the fact that the proportion of second children has been increasing year by year for some time. From the perspective of Bandura's "Self-efficacy", based on the post-80 s and post-90 s youth samples in the Psychology and Behavior Investigation of Chinese Residents 2021, this paper explores the quantitative relationship between the number of children and individual self-efficacy. The data indicates that: (1) Fertility is closely linked to self-efficacy, with young people who have two children exhibiting higher self-efficacy; (2) The quantitative relationship between the number of children and self-efficacy varies based on parental roles—men/fathers show almost no change in self-efficacy when moving from having no children to one child, but demonstrate a significant increase in self-efficacy when they have two children. In contrast, women/mothers experience the lowest self-efficacy when having one child, which only shows a significant improvement when they have two children. These findings provide a new perspective for theoretically explaining the current fertility situation and expand the application of self-efficacy. In terms of policy efforts, it is necessary to provide support for women's one-child fertility, and to increase the publicity of the view of more children and more efficacy to resist the potential energy of low fertility that arises from the view of more children and more burdens. [ABSTRACT FROM AUTHOR]

Objective: This study provides a comprehensive overview of the knowledge structure and research hotspots regarding barriers and strategies for the implementation of clinical practice guidelines. Methods: Publications on barriers and strategies for guideline implementation were searched for on Web of Science Core Collection from database inception to October 24, 2022. R package bibliometrix, VOSviewer, and CiteSpace were used to conduct the analysis. Results: The search yielded 21,768 records from 3,975 journals by 99,998 authors from 3,964 institutions in 186 countries between 1983 and 2022. The number of published papers had a roughly increasing trend annually. The United States, the United Kingdom, and Canada contributed the majority of records. The University of Toronto, the University of Washington, and the University of Sydney were the biggest node in their cluster on the collaboration network map. The three journals that published the greatest number of relevant studies were Implementation Science, BMJ Open, and BMC Health Services Research. Grimshaw JM was the author with the most published articles, and was the second most co-cited author. Research hotspots in this field focused on public health and education, evidence-based medicine and quality promotion, diagnosis and treatment, and knowledge translation and barriers. Challenges and barriers, as well as societal impacts and inequalities, are likely to be key directions for future research. Conclusions: This is the first bibliometric study to comprehensively summarize the research trends of research on barriers and strategies for clinical practice guideline implementation. A better understanding of collaboration patterns and research hotspots may be useful for researchers. [ABSTRACT FROM AUTHOR]

The transportation industry involves various ergonomic injuries caused by activities exceeding workers' capabilities. Although the construction industry has been thoroughly studied regarding work--related injuries, hazardous activities, and effective ergonomic solutions, there is a lack of such research in the transportation sector. However, injuries, risky activities, and effectiveness of solutions may be different in transportation activities due to different work duration, intensity, and frequency. Thus, this research intends to explore the common work-related injuries, hazardous transportation activities, and the effectiveness of ergonomic solutions for transportation maintenance workers. This thorough examination incorporated historical injury records, online surveys, in-person site observations, and field experiments. Specifically, a preliminary list was first created based on transportation workers' historical injury data, including common injured worker positions, injury types, activities causing most injures, and potential risk factors. An online survey was then designed to identify work-related injuries and activities. Following observations, field experiments involved 29 transportation maintenance workers. Back injuries emerged as the most prevalent when engaging in lifting and pushing/pulling tasks. Using a back exoskeleton can eliminate physical fatigue risks when lifting weights of 50 pounds or more. In addition, lifting lighter loads (31.5 pounds) can significantly reduce the risk of injuries. RELEVANCE TO HUMAN FACTORS/ERGONOMICS THEORY: Prevalent work-related injuries, hazardous activities, and effective ergonomic solutions have been thoroughly researched in the construction domain. However, with the injury and fatality statistics of the transportation industry, there is a lack of studies investigating what injuries are prevalent, what activities are risky, and what solutions could be effective in the transportation industry. To the best of author's knowledge, this paper is the first research presenting a new framework exploring prevalent work-related injuries, hazardous activities, and ergonomic solutions' effectiveness in the domain of transportation maintenance work through the analysis of historical data, online survey data, onsite observations, and field experiment. Theoretically, this paper fills the lack of research about identification of ergonomic injuries and risky activities in the transportation industry, and contributes to the development of ergonomically effective process, practice, and technique for improved health and safety in the transportation maintenance work. Practically, the research team worked with a state Department of Transportation to help the transportation-related workers, managers, and organizations better realize the risky activities and understand how to prevent the risks. [ABSTRACT FROM AUTHOR]

Aim: To explore general nurses' experiences of modifying and implementing contextually suitable Safewards interventions into medical and surgical hospital wards. Design: Qualitative action research was used working with nurses as co‐researchers. Methods: Pre‐implementation focus groups were conducted in April 2022 to understand and explore the current strategies nurses utilized to avert, respond to or decrease violence. Following this, two Safewards interventions were modified by the nurses on the wards. Post‐implementation focus groups were conducted in October 2022, to explore the nurses' experience of implementing Safewards interventions and the effect on their nursing practice. Data were analysed using Braun and Clarke's framework for thematic analysis. Results: Three themes emerged from the analysis of the pre‐implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred: 'the space is hectic'; 'it can feel like a battlefield'; and 'the aftermath'. These themes encompass the nurses' experience of violence from patients and their visitors. Following the implementation of two modified Safewards interventions, the analysis of the focus groups reflected a change in nursing skills to avert or respond to violence: 'Safewards in action'; 'empathy and self‐reflection'; and 'moving forward'. Conclusion: Safewards interventions can be successfully modified and used in general hospital wards and influence nursing practice to manage patient and visitor violence. Implications for the Profession: In the interests of safety, successful interventions to reduce violence towards general hospital nurses should be a priority for managers and healthcare organizations. Averting, mitigating and managing violence can decrease the negative professional and personal effect on nurses and ultimately improve well‐being, job satisfaction and retention rates. Furthermore, decreasing violence or aggressive incidents leads to a safer patient experience and decreased number of nursing errors ultimately improving patient experiences and outcomes. Understanding nurses' experiences of violence and working with them to explore and develop contextually relevant solutions increases their capacity to respond to and avert violent incidents. Contextually modified Safewards interventions offer one such solution and potentially has wider implications for healthcare settings beyond the specific wards studied. Impact: This study addressed the implementation of modified Safewards strategies in medical and surgical wards to prevent violence.Three themes emerged from the analysis of the pre‐implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred.Following the implementation of two modified Safewards interventions, the post‐implementation focus groups reported positive changes to their practices using the modified resources to prevent violence from patients and their visitors.Mental health interventions, such as those used in the Safewards model can be modified and provide a tool kit of interventions that can be used by medical and surgical nurses. Reporting Method: This paper has adhered to the COREQ guidelines. Patient or Public Contribution: No patient or public contribution. What Does this Paper Contribute to the wider Global Clinical Community?: This paper outlines and discusses the action research approach undertaken to work with general hospital nurses to modify mental health nurses' Safewards interventions into their clinical practice.This paper provides evidence of the 'real world' application of Safewards interventions by medical and surgical nurses in general hospital wards.This paper presents qualitative findings based on focus group methods to highlight the narratives of general nurses and their experiences of violence. [ABSTRACT FROM AUTHOR]

With the aging population, the financial burdens associated with chronic diseases continue to escalate. Among various management strategies, family physician contracting stands out as a significant initiative aimed at addressing this challenge, officially introduced in China in 2016. However, current research has given relatively little attention to the economic benefits of family physician contracting in developing countries. This paper evaluates the economic effect of family physician contracting by employing microdata of patients with chronic diseases at the Yuyuantan Community Health Service Center, Haidian District, Beijing, from January 2019 to May 2021. This research contributes to the theoretical discourse in healthcare services by introducing a modified Anderson model. The empirical findings demonstrated that family physician contracting effectively reduced healthcare costs for patients with chronic diseases. Notably, the effect of family physician contracting on healthcare costs was more pronounced among patients with chronic diseases aged less than 65 years. At the same time, it is inferred that expediting the reform of the health insurance payment system, coupled with the promotion of family physician contracting services, would enhance the wellbeing of patients with chronic diseases. This research offers valuable insights into the ongoing and future development of family physician contracting in developing countries. [ABSTRACT FROM AUTHOR]

Background: The use of mobile applications helps improving self-management in adolescents with asthma. However, no evidence is available for children with preschool wheezing. In addition, we have no data on the reliability of medical history collected at visits. The first aim was to assess the feasibility of a smartphone app in the management of preschool wheezing; secondly we aimed to evaluate the reliability of anamnestic data collected during face-to-face medical interviews. Methods: Children with recurrent wheezing, age between 25 and 72 months, were randomly assigned to the intervention group, provided with a smartphone app for symptoms monitoring and asthma attack treatment, or to the control group, with a written action plan. At follow-up medical history was collected and the asthma control test and a clinical questionnaire were completed. App acceptability was also explored. Respiratory symptoms, medication and utilization of healthcare resources were collected. Plus, medical information obtained from the paper questionnaires was compared with data daily recorded by the app. Results: We enrolled 85 preschool children with recurrent wheezing: 43 assigned to the intervention and 42 to the control group. The average (SD) adherence to e-Diary compilation was 60 (15)%. The acceptance and usability of the intervention was favorable as 70% and 93% of participants in the intervention arm described the app as ''simple and intuitive" at Visit1 (after 3 months from enrollement) and Visit2 (3 months later than Visit1), respectively and 95% and 98% found it useful in symptoms management. There were no significant differences between the two groups in clinical outcomes. At Visit1, the cACT median score (IQR) was 23,5 (21–25) for the control group (42 patients) and 23 (21–24) for the intervention group (43 patients). At Visit2 (41 controls and 42 in the intervention group) it was 25 (24–25) and 24 (24–25), respectively. Secondary analysis of data from the intervention group showed higher incidence of daily symptoms recorded by the app in comparison with the paper questionnaire, suggesting that collection of retrospective medical history may not be completely reliable. Conclusions: The smartphone app is usable and acceptable by families of preschool wheezers. Future controlled trial are needed to prove an impact on clinical outcomes or its efficacy in a telemedicine program. Finally a daily questionnaire could provide physicians with a more reliable clinical picture as reflected better daily asthma symptoms than the written retrospective questionnaire filled at clinical visit. [ABSTRACT FROM AUTHOR]

Background: Delivery of consistent patient-centred care at end-of-life care continues to challenge healthcare providers and research continues to suggest that peoples' needs are not being reliably met. Consequently, healthcare services are looking to innovate how support is provided, such as commissioning doulas to support dying people and those close to them. Objective: Within the United Kingdom, there is little existing research about peoples' experience of receiving end-of-life doula support. This paper outlines the design of a survey for the family or friends of a person who received end-of-life doula support. Design: To evaluate the role of an end-of-life doula in supporting the dying person and those who care for them, we designed a post-bereavement survey as part of a wider evaluation strategy of doula services. Following multiple literature reviews and an iterative process of consulting with the professional organisation and previous service users, a questionnaire was developed to collect this data. This survey is hosted online, with paper copies available to widen accessibility. Conclusion: End-of-life doula support is a relatively new area of provision for dying people and those important to them, such as family and friends. It is even more innovative to have doula support commissioned as part of a locality's healthcare service. There is a dire need for empirical research to understand the impact of this further. The process of researching the area and designing the evaluation survey for this service revealed the complexity of the role and the difficulty of capturing what was found to be helpful for the dying person and those around them. [ABSTRACT FROM AUTHOR]

Background: This paper evaluates the introduction of ten Community Health and Well-being Workers (CHWW) in four pilot sites across Cornwall. The period evaluated was from the initial start in June 2022 until June 2023, covering the project setup and implementation across a range of Primary Care Networks (PCNs) and Voluntary sector partners (VSCO). Methods: All ten CHWWs and their managers at each site were interviewed (n = 16) to understand the barriers and enablers to implementation and wider learning that could be captured around the project setup. Qualitative methods were used for data collection, including semi-structured interviews and focus groups. Transcripts were thematically analysed for cross-cutting themes, as well as site-specific effects. Results: In terms of learning, we cover the following key areas, which were of most importance to the successful implementation of the pilot: The CHWWs were introduced into an already established, successful social prescribing (SP) system by the time the CHWW project began. CHWWs can access some of the same training and office space as SPs, with overlapping meeting schedules allowing them joint input on some topics. It seemed that all the pre-work in terms of relationships and learning about a similar role helped a rapid implementation. Each site's CHWW management structure uses the same line management as the SPs. Roles were clustered together to remove duplication, maximise coverage and triaging of residents. The largest barrier to overcome was integrating VSCO staff into NHS systems. Conversely, hosting CHWWs within an NHS organisation has pros and cons, namely better access to NHS data and staff, but longer lead-in time for registration on systems, and more bureaucracy for procurement/spend. Conclusions: Looking to the future, the pilot's success has spread the programme to other integrated care areas in the country, with ongoing plans for further rollout and evaluation in the coming years. [ABSTRACT FROM AUTHOR]

Introduction: Empirical evidence shows that many family carers, especially immigrants, experience considerable health disadvantages and poorer quality of life. Australia has a rapidly increasing multicultural population, officially referred to as Culturally and Linguistically Diverse (CALD) people. This paper explores similarities and differences in the carer profile and physical and mental health of CALD and non-CALD family carers. Methods: A cross-sectional anonymous survey was conducted of self-reported family carers aged 18 years and older. Identical paper and online survey modes were provided to enable choice. Key variables included demographic and carer profile, diagnosed chronic physical health conditions, and validated scales such as CESD-12 and MOS-SF12, including derivative composite Physical and Mental Component Summary (PCS and MCS, respectively) scores. The sample comprised 649 participants (CALD = 347, non-CALD = 302). The analyses included univariate, bivariate, and multivariable linear regression analyses for three outcome variables: PCS, MCS, and CESD-12. Results: CALD carers were comparatively younger and married, and 54% had university-level education (29% in the gfvnon-CALD group). Women were primary carers in both groups (67.4% versus 72.2%). The weekly care hours were higher for non-CALD carers. Both groups had below population-referenced scores for mean PCS and MCS values. For CESD-12, non-CALD respondents had higher scores (17.5 vs. 11.2, p < 0.022). Regression analyses showed significant differences for demographic, carer, and physical health variables across the three outcome variables. Discussion and Conclusion: Women have a higher domestic workload, which, when combined with high care hours, adversely impacts physical and mental health. The need for improved and culturally aligned care support systems is required. [ABSTRACT FROM AUTHOR]