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The study aimed to analyze the Journal of Hospital Librarianship (JHL) publications between 2001 and 2020 as indexed in Elsevier's Scopus database. The dataset was extracted on February 25, 2021 and 807 records were identified for data analysis. Various bibliometric indicators of the papers were assessed. There was an average of 1.32 citations per document. Sixty percent of the papers were single-authored, but the multi-author papers had a higher number of citations. The USA was identified as the country with the most contributions; Louisiana State University was the highest contributing institution, while Helen-Ann Brown Epstein was the most prolific author. [ABSTRACT FROM AUTHOR]

College students have been recognized as a risk group for substance use. Nevertheless, coherent risk factors for stimulant use remain to be elucidated. The objective of this paper is to identify risk factors associated with the recreational use of MDMA, cocaine, amphetamine and methamphetamine. An online questionnaire was distributed among colleges in Berlin. A sample of 12,914 college students participated, of which 9,382 met the inclusion criteria. Past-month prevalence was 7.0% for MDMA, 6.7% for amphetamine, 5.8% for cocaine and 0.1% for methamphetamine. Associated factors included male gender, "other" gender, homosexual and bisexual orientation, open relationship status or being single, engaging in sexual risk-taking behavior, having a psychiatric diagnosis, tobacco use, drinking alcohol and an increased number of (illicit) substances consumed in the past month and in life. Berlin college students showed a substantially higher prevalence of stimulant use compared to both the general population and college students in other cities. Certain parameters, e.g., polydrug use, were particularly high in this group. The results can be used in further development of prevention efforts. However, conclusions about causality are limited by the cross-sectional nature of this study, highlighting the necessity for longitudinal studies in this field. [ABSTRACT FROM AUTHOR]

Determination of smoking habits of medical students in Belgrade and the factors influencing cigarette use. A cross-sectional study was conducted among undergraduate medical students from all study years at the Faculty of Medicine, University of Belgrade, during the 2015–2016 academic session. A questionnaire, composed of four parts, was administered to all participants: 1. socio-demographic characteristics; 2. habits and lifestyle; 3. Fagerstrom Test for Nicotine Dependence; 4. the Rosenberg self-esteem scale. Logistic regression analysis was conducted to identify the factors significantly associated with cigarette smoking. A total of 2551 subjects, which constituted 81.8% of all undergraduate medical students, participated in the survey. The prevalence of current regular smokers among medical students was 21.7%. The results obtained using the Fagerstrom tolerance scale showed that 41.8% of the students had high nicotine dependence. According to the results of a multivariate analysis, the following were the independent determinants of being a smoker: being male, grade point average of <8/10, daily coffee consumption, self-reported excessive leisure time, self-reported pressure from parents, alcohol consumption, and smokers among parents. Understanding the factors influencing tobacco use is the first step in implementing prevention strategies and can be helpful in the cessation of smoking. What is already known about this topic Previous studies showed a strong association between smoking and alcohol consumption among undergraduate medical students. There is an association between tobacco use and academic performance. Higher-income families and the parents without higher education are significantly associated with students' smoking, but these associations were not independent. What this paper adds Independent predictive factors for smoking among undergraduate medical students are being male, having smokers among parents, daily coffee consumption, self-reported excessive leisure time, self-reported pressure from parents and consumption of alcohol. Family income does not influence smoking status of students directly, but students participated in this study from the higher-income families were more likely to have smokers among parents, which were found to be an independent predictive factor. Early psychologists' cessation smoking interventions can have implications for motivating students to quit smoking. [ABSTRACT FROM AUTHOR]

Chronic pain is a common feature of hypermobile Ehlers–Danlos Syndrome (hEDS), yet how patients assess and communicate their pain remains poorly understood. The objective of the present study was to explore the use of numeric pain assessment in individuals with hEDS, from a patient-centered perspective. Our analysis is based on in-depth qualitative interviews. The interviews were conducted over the phone. Our participants were patients living with hEDS (N = 35). Interviews were recorded, transcribed, and analyzed to identify factors related to their use of these pain assessment instruments. Three primary themes emerged from these data, namely, (1) confusion around the quantification of multidimensional pain, (2) the subjectivity of pain experience, and (3) a strategic use of assessments for practical purposes beyond the accurate representation of pain. These results demonstrate the need for caution in relying exclusively on numeric pain assessment instruments. We conclude with a brief proposal for a clinical communication strategy that may help to address the limitations of numeric pain assessment that were identified in our interviews. Chronic pain is a common feature of hypermobile Ehlers–Danlos Syndrome (hEDS), yet how patients assess and communicate their pain remains poorly understood. Clinicians should be aware that patients have difficulties with the Numeric Rating Scale (NRS) for at least three reasons: (1) confusion around the quantification of multidimensional pain, (2) the subjectivity of pain experience, and (3) a strategic use of assessments for practical purposes beyond the accurate representation of pain. Clinicians should use caution in relying exclusively on NRS instruments. Clinicians may benefit from using clinical communication strategies outlined in our paper, which may help to address the limitations of the NRS that were identified in our interviews. [ABSTRACT FROM AUTHOR]

This paper reports findings from a qualitative study on the triggers of hospital social workers' moral distress at a large southern U.S. health system. Moral distress occurs when ethical conflict cannot be resolved in a way that aligns with an individual's personal and professional values and ethics. Participants indicated that moral distress derives from both individual interactions and the culture and climate of health systems. For example, participants expressed how sources of moral distress derived from client-centered decisions, such as end-of-life care and patient autonomy; interpersonal dynamics, including team or supervisory conflict; structural issues, such as insurance barriers or internal hospital policies; and organizational values, such as perceptions of institutional support and validation. Implications of this research suggest that health systems need to foster positive ethical environments that nurture clinicians' health and mental health through programs that aim to increase moral resilience, promote empowerment, and foster wellness. [ABSTRACT FROM AUTHOR]

Falling is one of the most common adverse events leading to patient injury. The purpose of this study (as part of a Ph.D. paper) was to investigate the effects of educational interventions on patients' self-efficacy and falls prevention knowledge. A sample of 176 participants were recruited at a university hospital in Iran. Each patient received an educational pamphlet on falls prevention. The questionnaire measured patient knowledge (scores ranged from 0 to 20) and falls prevention self-efficacy (scores ranged from 20 to 60) before and after the third day of the intervention. Overall, the mean knowledge score improved from 47.8% (9.57 ± 2.51) to 68.3 (13.68 ± 1.85), which was statistically significant (p < 0.001). For falls prevention self-efficacy, the pre-test mean was 41.0 ± 7.42 (range: 20–56; total: 60), but the post-test mean improved to 47.26 ± 9.12. 0.05. Our study suggests that the hospitalized patients have little knowledge of falls prevention and that educational interventions have improved their knowledge of falls prevention. Study participants were confident in implementing useful falls prophylaxis during hospitalization. [ABSTRACT FROM AUTHOR]

Purpose:The construct validity, test–retest reliability, and measurement error of the Arm Function in Multiple Sclerosis Questionnaire (AMSQ) were examined. Additionally, the influence of administration-method on reliability and measurement error was investigated. Method:112 Dutch adult MS-patients from an academic- and a residential care-facility participated. Questionnaires were administered on paper, online or as interview, and patients performed several performance tests. Construct validity was assessed by testing pre-defined hypotheses. Reliability was assessed using Intraclass Correlation Coefficients (ICCs), Standard Error of Measurements (SEMs) and Smallest Detectable Changes (SDCs). Results:For construct validity (N = 105) 9 of 13 hypotheses were confirmed (69%). As expected, the AMSQ showed moderate to strong relationships with the instruments measuring similar constructs. The test–retest reliability coefficient was 0.96 (95% Confidence Interval 0.94–0.97); SEM was 6.3 (6.3% of scale range); SDC was 17.5 (on a sale from 0 to 100). Different administration-methods showed good reliability (ICC 0.88–0.94) and small standard errors (SEM 5.6–7.2). Conclusion:The AMSQ shows satisfying results for validity and excellent reliability; allowing for proper use in research. Due to a large SDC value, caution is needed when using the AMSQ in individual patient care. Further research should determine whether the SDC is smaller than the minimal important change.Implications for RehabilitationThe Arm Function in Multiple Sclerosis Questionnaire (AMSQ) measures activity limitations due to hand and arm functioning in patients with Multiple Sclerosis (MS).Results of this study confirm adequate validity and reliability of the AMSQ in patient with MS.The equivalence of scores from online, paper or interview administration is supported.A change score of ≥18 points on the scale of the AMSQ (on a scale 0–100) needs to occur to be certain a change beyond measurement error has occurred in an individual patient. [ABSTRACT FROM AUTHOR]

This paper presents findings of a study that explored the challenges and coping strategies of parents of children with mental disorders. In-depth interviews were conducted with 35 parents of children with mental disorders at the Psychiatric Unit of the Komfo Anokye Teaching Hospital in Kumasi. Data were analyzed using thematic content analysis. Findings indicated that financial constraints, inability to secure permanent employment, and stigma were the challenges of the parents. Having faith in God and accepting their children's condition were the coping strategies adopted by the parents. However, lack of effective support system makes coping difficult for the parents. [ABSTRACT FROM AUTHOR]

While Electronic Medical Records (EMRs) are an important mechanism used to document patient information and service provision, most interfaces prioritize collection of information required for medical billing purposes, rather than complexities of behavioral and social service needs. An emphasis on encounter data renders it challenging for social workers (SWs) to communicate statistically compelling explanations of contributions to team-based care and overall value to the health system. This paper reports outcomes of feasibility, acceptability, and appropriateness of integrating a validated psychosocial acuity metric into standardized social work (SW) documentation at a large, pediatric quaternary hospital in the northeastern United States. Approximately 20% (N = 42) of departmental SWs participated in an open pilot trial wherein participants were first trained in scale administration, utilized it for a circumscribed period following training, and evaluated implementation outcomes. Across five unique practice settings, results showed that the metric was feasible, acceptable and appropriate for use; 78% of participants were in favor of integrating it into the EMR interface as a required component of SW documentation. Assessing psychosocial acuity in every documented patient encounter facilitates intermittent review of psychosocial acuity at individual, setting, and programmatic levels and opportunities to evaluate how SW interventions address psychosocial acuity. [ABSTRACT FROM AUTHOR]

In this paper, we analyse how Italian-speaking children with cochlear implants produce subject and object questions introduced by who and which+NP. The aim of the study is to analyse whether a correlation exists between the accuracy of the responses of an elicitation task of wh-questions and clinical variables (i.e. age of hearing aid fitting; age of cochlear implantation; duration of hearing experience) in a group of children with cochlear implants, in order to provide new evidences in support of the efficacy of early intervention in Italian-speaking children with hearing loss. The experimental group was composed of 10 children fitted with a cochlear implant, who were diagnosed and promptly fitted with hearing aids within the first year of life. All these participants received a cochlear implant when hearing aids did not provide enough auditory input anymore. Indeed, while the hearing aids only amplify sounds, cochlear implants directly stimulate the auditory nerve providing better auditory perception. Results were compared with those of two control groups. The first group was composed of 10 children with normal hearing and comparable chronological age, while the second group was composed of 10 children with normal hearing matched on comparable hearing experience. Children were assessed with a test for the elicitation of subject and object who and which+NP questions. Results show that the two control groups performed better than the experimental group. Moreover, some correlations were found between the accuracy of the production of complex structures and the age of fitting of the hearing aids and the hearing experience. [ABSTRACT FROM AUTHOR]

Global demand for capacity building has increased interest for eLearning. As eLearning resources become more common, effective implementation is required to scale up utilization in Low- and Middle-Income Countries (LMICs). This paper describes the process of implementing a malnutrition eLearning course, effectiveness of course delivery models devised, factors affecting course completion, and cost comparison between the models and face-to-face training at healthcare and academic institutions in Ghana. Four delivery models: Mobile Training Centre (MTC), Online Delivery (OD), Institutional Computer Workstation (ICW) and Mixed Delivery (MD) – a combination of OD and ICW – were determined. Participants were enabled to access the course using one of the four models where contextually appropriate. Pre and post-assessments and questionnaires were administered to compare participants' course completion status and knowledge gain between delivery models. The effect of access to computer and Internet at home and relevance of course to job and academic progression on course completion were further investigated. Comparison of delivery model costs against face-to-face training was also undertaken. Of 7 academic and 9 healthcare institutions involving 915 people, 9 used MTC (34.8%), 3 OD (18.8%), 3 ICW (34.2%) and 1 MD (12.2%). Course completion was higher among institutions where the course was relevant to job or implemented as part of required curriculum activities. Knowledge gain was significant among most participants, but higher among those who found the course relevant to job or academic progression. The implementation costs per participant for training with MTC were £51.0, OD £2.2, ICW £1.2 and MD £1.1, compared with a face-to-face training estimate of £105.0 (1 GHS = 0.14 GBP). The malnutrition eLearning course makes global capacity building in malnutrition management achievable. Adopting contextually appropriate delivery models and ensuring training is relevant to job/academic progression can enhance eLearning effectiveness in LMICs. [ABSTRACT FROM AUTHOR]

Objectives. This study aims to compare the work stress and obsessive-compulsive symptoms of nurses and office workers and to determine the relationship between work stress and obsessive-compulsive symptoms. Methods. A total of 127 nurses and 127 office workers participated in the cross-sectional study and comparative study. Data were collected using the perceived work stress scale and the Maudsley obsessive-compulsive inventory. Results. Nurses had higher work stress scores (p = 0.003) in general than office workers. In particular, nurses with a low (p < 0.039) and average (p < 0.007) economic status, nurses who had been employed for 1–10 years (p < 0.001) and nurses working 40 h per week (p < 0.042) had higher work stress scores than office workers. There was no difference (p > 0.05) between obsessive-compulsive symptom scores. There was a positive significant relationship (p < 0.001) between work stress and obsessive-compulsive symptom scores of nurses and office workers. Work stress explains 6.1% of the obsessive-compulsive symptoms in nurses and 12.4% in office workers. Conclusion. The results of this study concluded that work stress of nurses is higher than that of office workers and work stress affects the obsessive-compulsive symptoms in both groups. [ABSTRACT FROM AUTHOR]

Non-communicable diseases (NCDs) are a global health burden that affects a broad scope of individuals worldwide. Pharmacists, as members of the multidisciplinary team, play a significant role in promoting public awareness towards potential risk factors for NCDs. This study aims to gauge the knowledge of NCDs risk factors among pharmacy students of a Malaysian public university. This paper also outlines perspectives of pharmacy students on the strategies to raise the awareness of NCDs risk factors. A descriptive cross-sectional study was conducted in the Faculty of Pharmacy, International Islamic University Malaysia. Self-administered questionnaires were pretested and validated before being distributed to pharmacy students across different years of study. The data indicated an average level of knowledge towards risk factors of NCDs among study participants with no significant differences in knowledge between male and female genders (p = 0.583). However, there is a significant difference in knowledge concerning the year of study (p < 0.001); as positive correlation can be seen between the level of education and the knowledge of NCDs risk factor. Most of the students (75%) were unaware of the planning by the Ministry of Health (MOH) to control NCDs. Reinforcement of NCDs-related education activities is imperative in order to increase the overall awareness concerning the risk factors of NCDs among future pharmacy practitioners. Further collaborations between educational institutions and the MOH were proposed to help raise awareness of NCDs risk factors among the younger population. [ABSTRACT FROM AUTHOR]

This article describes data on the gender distribution of mental health disorders among adolescents of Togo, West Africa. The sample size of this study included 242 patients. Gender and mental health disorders according to the definition of International Classification of Disease, tenth revision (ICD-10) were considered. Females were significantly more likely to develop a mental health disorder than males (61.16% vs 38.84% of the sample), and females were significantly 3 times more likely to develop Somatoform Disorders- Other Neurotic Disorders compared to males. Males were significantly 2 times more likely to develop Acute and Transient Psychotic Disorders. [ABSTRACT FROM AUTHOR]

Health care costs incurred prior to the appropriate patient–provider transaction (i.e., transaction costs of access to health care) are potential barriers to accessing health care in low- and middle-income countries. This paper explores these transaction costs and their implications for health system governance through a cross-sectional survey of adult patients who received their first diagnosis of pulmonary tuberculosis (TB) at the three designated secondary health centres for TB care in Ebonyi State, Nigeria. The patients provided information on their care-seeking pathways and the associated costs prior to reaching the appropriate provider. Of the 452 patients, 84% first consulted an inappropriate provider. Only 33% of inappropriate consultations were with qualified providers (QP); the rest were with informal providers such as pharmacy providers (PPs; 57%) and traditional providers (TP; 10%). Notably, 62% of total transaction costs were incurred during the first visit to an inappropriate provider and the mean transaction costs incurred was highest with QPs (US$30.20) compared with PPs (US$14.40) and TPs (US$15.70). These suggest that interventions for reducing transaction costs should include effective decentralisation to integrate TB care with services at the primary health care level, community engagement to address information asymmetry, enforcing regulations to keep informal providers within legal limits and facilitating referral linkages among formal and informal providers to increase early contact with appropriate providers. [ABSTRACT FROM PUBLISHER]

Purpose: This paper reports on research aimed at advancing understanding haptic capability and needs of users with low vision. The objective is to apply this understanding to the design of haptic-incorporated user interfaces. Method: Study 1 investigated the haptic perception between sighted participants and those with low vision through the magnitude estimation technique, and Study 2 explored the degree to which similar user interface needs were observed among the two vision groups. Results: Overall, our findings indicate there was no significant difference between the two vision groups in terms of haptic perception and user interface needs. A few differences in user interface preference did exist, however, and designers should take these into account. Conclusions: Participants with low vision were a group who relied on their vision in everyday life instead of touch. Thus, their haptic capability was less likely to be enhanced via brain plasticity, which probably contributed to no significant difference in haptic-incorporated user interface needs. [ABSTRACT FROM AUTHOR]

This paper explores the lived experiences of older surgical patients' (aged 74 years and older) experienced challenges during a brief admission to hospital. Age, gender, polypharmacy, and the severity of illness are also factors known to affect the hospitalization process. For an ethnographic study using participant observation and interviews, surgical cancer patients (n=9, aged 74 years and older) were recruited during admission to a Danish teaching hospital. Using ethnographic strategies of participant observation and interviews, each patient was followed through the course of 1 day during their stay at the hospital. Interviews were carried out with all patients during this time. Three areas of concern were identified as prominent in the patients' experiences and challenges during their short hospital stay: teeth and oral cavity, eating in a hospital setting, and medication during hospitalization. Short-term hospitalization requires focused collaboration between staff and patient concerning individual challenges from their teeth and oral cavity as support of nutritional needs during surgical treatment for cancer. [ABSTRACT FROM AUTHOR]

Objective. The main objective of this paper is to investigate whether incorporating an electronic optional guideline tool (EOGT) in the standardized referral template used by general practitioners (GPs) when referring patients to specialized care can improve outpatient referral appropriateness. Design. Intervention study with an intervention and a control group. Setting. 210 GPs in the municipality of Bergen and the Department of Thoracic Medicine at Haukeland University Hospital. Subjects. 2400 patients referred to the Department of Thoracic Medicine at Haukeland University Hospital. Results. An electronic optional guideline tool (EOGT) was implemented on 93 of 210 GPs' computer systems. The referral quality and the time spent reviewing each referral were evaluated by the hospital specialists. The GPs did not know that their referrals were being evaluated. The specialists were blinded with regard to information concerning the intervention and the control group. The specialists reported significantly higher referral quality and considerably less time spent on evaluating referrals when using the EOGT, with an overall time reduction of 34%. Likewise, GPs also reported that the EOGT was easy to use, time-saving and led to an improved quality of their referrals. Conclusion. This study documents an improvement in the quality of the referrals. Since the GPs save time by using the EOGT, there is no reason to believe that they will discontinue using it. In fact, the tool may be even more beneficial for the GP. The authors believe that it is possible to implement the EOGT as a standard referral tool within various fields of medicine and are currently in the process of developing these tools. [ABSTRACT FROM AUTHOR]

Conclusions: Our data highlight that uvulopalatopharyngoplasty (UPPP) with harmonic scalpel (HS) is a reliable treatment in selected patients affected by obstructive sleep apnea (OSA) and users of continuous positive airway pressure (CPAP). Objectives: The aim of this paper was to verify the efficacy and applicability of UPPP with HS in the treatment of patients affected by OSA and users of CPAP. Methods: A total of 21 patients with a retropalatal obstruction and users of CPAP underwent UPPP with HS and were evaluated (before and 6 months after surgery) using the apnea/hypopnea index (AHI); oxygen desaturation index ≥4% (ODI4); Epworth Sleepiness Scale (ESS); snoring level (SL); subjective assessment of the postoperative pain on postoperative days 1, 3, and 10; and number of days until return to solid food. Results: Six months after surgery: AHI decreased significantly ( p < 0.05) from 31.8 ± 2.83 to 9.0 ± 0.68; ODI4 was 2.1 ± 0.4 vs a preoperative value of 24.0 ± 1.9; ESS scores were also significantly decreased ( p < 0.05) from 14.0 ± 3.7 to 4.7 ± 2.2; SL was significantly lower ( p < 0.05) 1.6 ± 0.3 vs 7.9 ± 0.8. Postoperatively, patients experienced lower levels of pain and the median of time to return to normal diet was 3 days. [ABSTRACT FROM AUTHOR]

We assessed fidelity of delivery and participant engagement in the implementation of a community paramedic coach-led Care Transitions Intervention (CTI) program adapted for use following emergency department (ED) visits. The adapted CTI for ED-to-home transitions was implemented at three university-affiliated hospitals in two cities from 2016 to 2019. Participants were aged ≥60 years old and discharged from the ED within 24 hours of arrival. In the current analysis, participants had to have received the CTI. Community paramedic coaches collected data on program delivery and participant characteristics at each transition contact via inventories and assessments. Participants provided commentary on the acceptability of the adapted CTI. Using a multimethod approach, the CTI implementation was assessed quantitatively for site- and coach-level differences. Qualitatively, barriers to implementation and participant satisfaction with the CTI were thematically analyzed. Of the 863 patient participants, 726 (84.1%) completed their home visits. Cancellations were usually patient-generated (94.9%). Most planned follow-up visits were successfully completed (94.6%). Content on the planning for red flags and post-discharge goal setting was discussed with high rates of fidelity overall (95% and greater), while content on outpatient follow-up was lower overall (75%). Differences in service delivery between the two sites existed for the in-person visit and the first phone follow-up, but the differences narrowed as the study progressed. Participants showed a 24.6% increase in patient activation (i.e., behavioral adoption) over the 30-day study period (p < 0.001). Overall, participants reported that the program was beneficial for managing their health, the quality of coaching was high, and that the program should continue. Not all participants felt that they needed the program. Community paramedic coaches reported barriers to CTI delivery due to patient medical problems and difficulties with phone visit coordination. Coaches also noted refusal to communicate or engage with the intervention as an implementation barrier. Community paramedic coaches delivered the adapted CTI with high fidelity across geographically distant sites and successfully facilitated participant engagement, highlighting community paramedics as an effective resource for implementing such patient-centered interventions. [ABSTRACT FROM AUTHOR]

Stuttering is a fluency disorder that is multidimensional because it involves more than speech difficulties. People who stutter can use the Internet to find out more about their condition and connect with other people in the same position, yet in Croatia, there are not nearly as many online sources on stuttering or as many possibilities to connect with other people who stutter as in the USA or Great Britain. If one does not speak English well, a lot of information about stuttering will simply be denied to them, especially to those who have never received speech therapy. The present study, the first of its kind in Croatia, was conducted in order to understand how often and for what reasons people who stutter search for Internet resources related to their condition. The study also assessed whether Internet use depended on age, experience with speech-language therapy, self-reported satisfaction with such therapy, and self-assessed severity of stuttering. An online questionnaire integrating the 9-Point Stuttering Severity Scale was developed for this study and administered to 51 individuals aged 18 years and older in Croatia. All collected data and findings on the internet searches come from the questionnaire. Age did not significantly affect the frequency or purpose of Internet searches. Individuals who were not attending speech therapy were more likely to search online sources about stuttering than those who received it before. People who rated their stuttering as severe were more likely to search online sources for stuttering than those who rated their condition as mild. These results suggest that there is a need for more useful, high-quality online content and materials in Croatian for people who stutter. Such resources would offer people who stutter a new world of support, mutual understanding, shared experiences and knowledge, and ways for them to help themselves. [ABSTRACT FROM AUTHOR]

The purpose of this literature review was to identify interventions designed to improve healthcare team communication in the United States. We conducted a review of peer-reviewed, English-language articles describing interventions aimed at improving healthcare team communication. We analyzed articles that met pre-specified inclusion and exclusion criteria and characterized who is testing communication interventions, the rationale for testing, and ways of measuring effectiveness. We descriptively categorized the strength and types of study findings. Thirty articles were retained in our analysis. Most assessments were conducted by academic medical centers, the Veterans Health Administration, and teaching hospitals. Interventions sought to improve teamwork, patient safety, clinical outcomes, costs of care, and enhance provider job satisfaction and well-being. Intervention strategies included didactic lectures, simulation, Crew Resource Management, quality improvement, or a combination of these approaches. The vast majority employed a pre-post survey design and measured outcomes using participant feedback. Many assessments failed to utilize a social science theory or communication-specific measures. Interventions with the best training content were conducted at academic medical centers, used a pre-post design, and utilized statistical analysis to analyze results. While interventions for improving healthcare team communication are diverse and have uneven effectiveness, early markers of success merit continued development and assessment. [ABSTRACT FROM AUTHOR]

Injection drug use carries significant risks for injury and infection, particularly when injection supplies are reused or shared. Syringe service programs and pharmacy nonprescription sale of syringes minimize this risk by promoting access to supplies. This study aimed to characterize how individuals accessing medical care obtain supplies and the impact of perceived barriers to accessing safer injection supplies. One hundred and twenty participants reporting past seven-day injection drug use were recruited from a large urban academic medical center. Participants completed a survey about their injection drug use practices, access to injection supplies, as well as barriers to accessing supplies. Most participants (68%) reported obtaining syringes from multiple sources over the past 3 months, most commonly syringe service programs (78%) or a pharmacy (68%). Few (3%) reported obtaining supplies from medical settings. Participants who found syringes easy to obtain were less likely to report reusing a syringe >10 times (25% vs. 81%, p <.001). More participants were comfortable obtaining syringes through syringe service programs (89%) than nonprescription sale of syringes (60%, p =.001). Perceiving syringe service programs as not convenient or not comfortable reduced the odds of obtaining syringes there by 90% (p <.001) and 88% (p <.003), respectively. Perceiving pharmacies as not comfortable or not affordable reduced the odds of obtaining syringes there by 82% (p <.001) and 75% (p <.002), respectively. Even in regions with legalized syringe service programs and nonprescription sale of syringes, barriers to accessing safer injection supplies remain, and may be partially addressed by expanding syringe service program hours and locations, addressing cost of nonprescription sale of syringes, pharmacy staff training, and expansion of injection supply distribution in medical settings. [ABSTRACT FROM AUTHOR]

Multicomponent mind-body interventions are increasingly studied in oncology to improve patients' quality of life (QOL). However, the respective usefulness of each of their components or their long-term use by the participants are rarely assessed. In this study, 95 women with different cancer diagnoses participated in a self-hypnosis and self-care group. Different questionnaires were administrated before (T1), right after (T2), 3 to 4 months after (T3), and 1 year after (T4) the intervention. After the intervention, 97.5% of the participants regularly practiced any kind of relaxation (vs. 50% at baseline), especially hypnosis. The different components of the intervention (i.e., being in a group, hypnosis exercises during the sessions and at home, self-care tasks, and discussions during the group sessions) were all considered to be very useful (M = 6.91–7.75/10). One year after the intervention, the 10 most used techniques were mainly concrete activities to take care of oneself. This intervention seems very relevant for women who had cancer. Our results allow a first reflection about the mechanisms of action of our intervention. Registration: ClinicalTrials.gov (NCT03144154). Registered on the 1st of May 2017. [ABSTRACT FROM AUTHOR]

There is often very little training during medical school focused on how to provide care to individuals with intellectual disabilities. This curriculum gap results in students reporting low levels of confidence in their ability to care for this population. Medical students attended an interactive, narrative-based session on caring for individuals with intellectual disabilities. Student confidence was assessed through pre- and post-session surveys. Students reported low levels of confidence in their overall ability to provide care to people with intellectual disabilities, but this level significantly increased following the course session. Student confidence also increased significantly across all learning objectives. The success of this session provides additional support for the importance of including individuals with intellectual disabilities within the medical school curriculum; however, we must continue to advocate for more longitudinal educational opportunities in this field to ensure current and future physicians can provide care to this population. [ABSTRACT FROM AUTHOR]

We aimed to examine the impact of maternal hypothyroidism on placental pathology and perinatal outcomes in singleton live births resulting from IVF, using medical records of IVF births between 2009 and 2017 at a tertiary hospital. The primary outcomes included anatomical, inflammation, vascular malperfusion, and villous maturation placental features. Secondary outcomes included foetal, maternal, perinatal, and delivery complications. There were 1,057 live births, of which 103 (9.7%) and 954 (90.3%) were in the study and control groups, respectively. Patients in the study group were more likely to have diabetes mellitus, polycystic ovarian syndrome, gestational diabetes mellitus, and non-reassuring foetal heart rate (NRFHR) tracing during delivery. After adjustment for potential confounding factors, hypothyroidism was significantly associated with the bilobed placenta (aOR 4.1; 95% CI 1.2–14.3), retroplacental haematoma (aOR 2.4; 95% CI 1.2–4.9), decidual arteriopathy (aOR 2.0; 95% CI 1.2–4.1) and subchorionic thrombi (aOR 2.4; 95% CI 1.3–5.0). Additionally, there was a statistically significant relationship with NRFHR tracing. The incidence of acute chorioamnionitis and severe foetal inflammatory response was higher in the study group. In conclusion, the placental histopathology patterns of singleton IVF live births show that maternal hypothyroidism has a significant impact on adverse perinatal outcomes. [ABSTRACT FROM AUTHOR]

One of the most essential steps in improving the quality of service delivery in the health service is the improvement of patients' medical record completeness. The aim of this study is to assess patient medical record completeness in the Saint Paul hospital department of surgery and assess the pattern of improvement in record completeness after intervention. surgical Patient charts were randomly reviewed with a standard patient chart completeness evaluation checklist prepared by the Federal Ministry of Health. Baseline data was collected in June 2019 and post intervention data was collected in November 2019. The schedule for intervention was carried out between July and October 2019. Interventions include modification of formats, continuous monitoring, and inclusion of chart completeness in the monthly morbidity and mortality conference, and establishment of a recognition system for best performing wards. A total of 253 and 273 medical charts were evaluated during baseline and post intervention. The Post intervention assessment showed 206 (75.5%) of records had admission notes completed, 205 (75%), the order sheet was completed in 218 (79.7%) and the discharge summary was completed in 217 (79.5%) of medical records. From nursing parameters, the medication sheet was completed in 177 (64.8%) and the nursing care plan was completed in 155 (56.8%) of medical records. When all six indicators were seen in aggregate, total medical record completeness showed a statistically significant improvement from 41% during base line to 72% post intervention (p < 0.05). Study has shown that small and persistent quality improvement interventions that focus on continuous evaluation, leadership engagement, and innovative strategies bring significant improvement in record completeness. [ABSTRACT FROM AUTHOR]

Participation in recreation activities is an important contributor to quality of life and well-being. However, recreation participation and satisfaction are reduced among individuals with autism spectrum disorder (ASD) due to barriers at the individual and environmental level. Community-based recreation events offer inclusive solutions but remain understudied. This study sought to examine families' goals for participation, explore their perspectives and evaluate their satisfaction following participation in a series of community-based recreation events. Anonymous data was collected for 53 attendees. Following quantitative and qualitative analysis, three primary goals for participation were identified: desire for an inclusive space, socialisation and spending time as a family in the community. Three similar themes emerged as the most valuable aspects of the events: non-judgemental environment, networking and social interaction, and fun activities. Lastly, aspects that participants disliked were categorised into five themes: environmental characteristics, opportunities for structured interaction, food options, geographical distance and incompatibility with age and/or interest. Overall, families were satisfied with the events, likely to attend again, and likely to recommend to others. The implications of the study's findings are discussed, including considerations for improving community-based recreation events for individuals with ASD and directions for future study. [ABSTRACT FROM AUTHOR]

Nutritional support is a fundamental component of holistic patient care in the intensive care unit (ICU). There is a paucity of local data pertaining to nutritional support practices at ICUs in South Africa. The aim of this study was to determine nutritional support practices at an academic hospital ICU in Johannesburg, South Africa. In this cross-sectional, descriptive and retrospective study, a simple random sampling method was utilised to select 50 data collection days from a three-month period (1 August–31 October 2018). Data relevant to the study were extracted from the ICU charts of patients who received formulae-based enteral and/or parenteral nutrition on the selected days. Charts were categorised into acute phase days (≤ 72 hours from ICU admission) and recovery phase days (> 72 hours from ICU admission). A total of 387 ICU charts were included in the final sample, comprising 114 acute phase and 273 recovery phase days. Overall, enteral nutrition was prescribed on 296 (76.5%) chart days while parenteral nutrition was prescribed on 111 (28.7%) chart days. The median daily fluid balance was approximately 600 ml positive. Target protein and calorie intake was achieved on 67 (17.3%) and 110 (28.4%) chart days respectively. Although protein and calorie intake was suboptimal in comparison with the recommended targets, it is in keeping with general international trends. Regular audits, training of staff, attention to minimising feeding interruptions and encouraging the timely initiation of enteral nutrition are recommended interventions that may be useful in achieving nutritional targets. [ABSTRACT FROM AUTHOR]

Assistive technology is the products and services used by individuals with functional limitations to enable participation in society and realisation of rights afforded by the United Nations Convention on the Rights of Persons with Disabilities. The Assistive Product List is a comprehensive list of products identified as essential for access through universal health coverage. Key stakeholders, including organisations of persons with disabilities, civil service organisations, academic organisations and government ministries are collaborating to integrate assistive technology into policy and develop a priority assistive products list for Malawi. To understand the organisational characteristics of, and assistive products provided by, key stakeholders working in AT in Malawi. Online survey of representatives from key stakeholder organisations. We surveyed representatives of key stakeholder organisations to gather information regarding assistive technology product and service provision in Malawi. Responses were analysed using counts for closed-ended questions, and conventional content analysis for open-ended questions. A total of 36 of the 50 APL products were provided by eight organisations. Related services were provided for 36 of the 50 APL products by twelve organisations. Five organisations reported providing both products and services. Products and services are largely funded by donation and provided free to those who require them. A range of organisations in Malawi play a role in assistive product delivery and related services. Coordinated AP delivery and service provision is required at a national level which is sustainable and inclusive, and is based on identified needs of the Malawian population. Policies supporting assistive product and service provision must acknowledge the contextual needs of the communities where they are implemented. Coordination is required for assistive product and service provision at the national and subnational level. Existing and potential gaps in service provision must be addressed when implementing a national assistive products list. [ABSTRACT FROM AUTHOR]

Environmental and ecological degradation has raised concerns worldwide. Negative attitudes toward the environment plus disinterest have led to improper behavior, influencing climate change and global warming. Awareness could have a positive environmental impact by influencing attitudes and behaviors. One way to generate awareness and ensure positive behavior is through education. Using the Theory of Reasoned Action (TRA), a 33-questions survey was implemented to college students from Texas, Louisiana, and Honduras to (1) compare students' environmental attitudes, behaviors, and subjective norms at the three universities; and (2) predict how much of the undergraduate students' environmental behavior variance could be explained by their environmental attitude, subjective norms, and perceived environmental knowledge. Multivariate analysis of variance and hierarchical regressions were performed to address the objectives, respectively. Results showed that Honduras and Louisiana students' environmental attitudes, behavior, and subjective norms are significantly different than Texas students, and TRA variables increased the prediction of behavior variance by 15%. Understanding interactions between behavior, attitude, knowledge, and subjective norms among college students from different universities may help assess environmental interventions and design successful programs based on group needs. [ABSTRACT FROM AUTHOR]

A national movement has been developed in the last decade to use simulation training to train child welfare workers. This article reports on a practical measurement method, Daily Experience of Simulation Training (DEST), that the authors have used since 2018 to evaluate every cohort in a week-long statewide simulation training program for new child protection investigators. The DEST measures daily changes in trainees' self-report confidence, solicits feedback on the training team, and offers trainees the opportunity to reflect on their experience. Trainees report substantially increased confidence in 13 child protection skills, provided positive feedback to the training team, and offered a number of suggestions for improvement. We discuss methods for implementing a measurement system like the DEST, even for programs with limited resources. DEST results demonstrated considerable consistency across 27 training cohorts. [ABSTRACT FROM AUTHOR]

Autobiographical memory is severely impaired in schizophrenia, but previous work has largely treated both as unitary concepts. Here, we examined how various dimensions of autobiographical memory relate to different aspects of psychosis. Participants were recruited from the general population (Study 1, N = 264) and a university subject pool (Study 2, N = 305). We examined different measures of autobiographical memory and self (i.e., involuntary memory, autobiographical recollection, self-knowledge and self-awareness), at the trait level in Study 1 and both trait and state levels in Study 2, as a function of positive-and negative-like symptoms of psychosis. Across both studies, positive and negative dimensions of psychosis were found to be related to an increase in involuntary memories (i.e., the spontaneous recall of personal memories), and to lower self-concept clarity and insight. Positive and negative dimensions of psychosis correlated differently with autobiographical recollection characteristics, measured at both trait (Studies 1 and 2) and state levels (Study 2). Positive-like symptoms (in particular hallucination-proneness) showed a stronger and more consistent pattern of correlations than negative-like symptoms. These findings call for a dimensional approach to the relationship between autobiographical memory and psychosis symptoms in clinical and non-clinical individuals, to better understand the breakdown of autobiographical memory in the psychopathology of psychosis. [ABSTRACT FROM AUTHOR]

To investigate whether neuropsychological test performance or presence of some specific injury symptoms at 1–3 months following pediatric mild traumatic brain injury (mTBI) can help to identify the children at risk for developing post-traumatic psychiatric symptoms. Data from 120 children and adolescents aged 7–15 years, treated at Turku University Hospital between 2010 and 2016 due to mTBI, and who had undergone neuropsychological evaluation at 1–3 months following injury, were enrolled from the hospital records. Neuropsychological test performancesand injury symptom reports were retrospectively retrieved from the patient files. Slow information processing speed (p = 0.044), emotion regulation deficit (p = 0.014), impulsivity (p = 0.013), verbal processing difficulties (p = 0.042) and headache (p = 0.026) were independent predictors for having later contact in psychiatric care. Neuropsychological examination containing measure of information processing speed, injury symptom interview, and parental questionnaires on behavioural issues of the child at 1–3 months following mTBI seems to be useful in detecting children with risk for post traumatic psychiatric symptoms. Targeted support and guidance for this group of children and adolescents and their families are recommended to prevent the development of an unfavorable psychosocial outcome. [ABSTRACT FROM AUTHOR]

University faculty are considered trusted sources of information to disseminate accurate information to the public that abortion is a common, safe and necessary medical health care service. However, misinformation persists about abortion's alleged dangers, commonality, and medical necessity. Systematic review of popular media articles related to abortion, gun control (an equally controversial topic), and cigarette use (a more neutral topic) published in top U.S. newspapers between January 2015 and July 2020 using bivariate analysis and logistic regression to compare disclosure of university affiliation among experts in each topic area. We included 41 abortion, 102 gun control, and 130 smoking articles, which consisted of 304 distinct media mentions of university-affiliated faculty. Articles with smoking and gun control faculty experts had statistically more affiliations mentioned (90%, n = 195 and 88%, n = 159, respectively) than abortion faculty experts (77%, n = 54) (p = 0.02). The probability of faculty disclosing university affiliation was similar between smoking and gun control (p = 0.73), but between smoking and abortion was significantly less (Ave Marginal Effects – 0.13, p = 0.02). Fewer faculty members disclose their university affiliation in top U.S. newspapers when discussing abortion. Lack of academic disclosure may paradoxically make these faculty appear less 'legitimate.' This leads to misinformation, branding abortion as a 'choice,' suggesting it is an unessential medical service. With the recent U.S. Supreme Court landmark decision, Dobbs v. Jackson Women's Health Organization, and subsequent banning of abortion in many U.S. states, faculty will probably be even less likely to disclose their university affiliation in the media than in the past. [ABSTRACT FROM AUTHOR]

Efforts to conceptualize risk factors for postoperative delirium in older adults have focused on the time proximate to the episode, but how early-life exposures influence delirium risk is poorly understood. An observational cohort of 547 patients aged 70+undergoing major non-cardiac surgery at two academic medical centers in Boston. Demographic characteristics, cognition, parental education, health, and participation in cognitively stimulating activities were assessed prior to surgery. Delirium incidence and severity were measured daily during hospitalization. Higher paternal education was associated with significantly lower incidence of delirium (X2(1, N =547)=8.35, p <.001; odds ratio OR=.93, 95% CI,.87 to.98) and inversely associated with delirium severity (r(545)=−.13, p <.001). Higher maternal education was associated with lower delirium incidence but did not reach statistical significance. The effect of paternal education on delirium incidence was independent of the patient's education, estimated premorbid intelligence, medical comorbidities, neighborhood disadvantage, and participation in cognitively stimulating activities (X2(2, N =547)=31.22, p <.001). Examining early-life exposures may yield unique insights into the risks and pathogenesis of delirium. Evaluating long-term factors that increase vulnerability to delirium may improve our ability to calculate risk. It may guide clinical decision-making and inform pre- and post-operative recommendations. [ABSTRACT FROM AUTHOR]

Health-related quality of life allows the health care professionals to envisage new axes of improvement in antenatal care and is a core aspect of contemporary maternity care provision. This study aims to estimate the prevalence of anxiety symptoms and explore the relationship between anxiety symptoms and health-related quality of life among Chinese pregnant women. A cross-sectional study was conducted in a local teaching hospital in Guangzhou, China between April and June, 2018. Seven hundred and seventy Chinese pregnant women completed the 36-Item Short-Form Health Survey (SF-36), the Self-rating Anxiety Scale (SAS) and socio-demographic questionnaires. 18.2% women were classified as having elevated anxiety symptoms as evidenced by a SAS score ≥50. Compared with women without anxiety symptoms, the pregnant women with anxiety symptoms had worse physical (SF36-PCS) and mental (SF36-MCS) health-related quality of life and a lower level of seven domains of SF-36 (GH, RP, BP, VT, SF, RE and MH). Elevated anxiety symptoms predicted worse physical (SF36-PCS) and mental (SF36-MCS) health-related quality of life. The third trimester predicted a lower level of physical (SF36-PCS) health-related quality of life, while an unsatisfied relationship with mother-in-law predicted a lower level of mental (SF36-MCS) health-related quality of life. The pregnant women with anxiety symptoms had impaired health-related quality of life. Health care professionals should identify pregnant women with anxiety symptoms and facilitate their treatment, which could improve their health-related quality of life. [ABSTRACT FROM AUTHOR]

Objective: First, to examine general health care attitudes and health care utilization of a University Health Service (UHS) at a large university. Second, to identify differences between LGBT and non-LBGT students. Participants: 2,943 university students were surveyed in Spring 2013; 7.8% LGBT, 67% undergraduate and 65% female. Methods: A cross-sectional mixed-methods online survey to assess health care utilization and attitudes. Results: A majority had utilized UHS and held positive attitudes in general. LGBT students were more likely to: use UHS for ongoing care, mental health, and preventive care; report concerns about utilization (e.g. confidentiality, sensitivity, and discrimination issues); report provider discomfort discussing sexuality; and hold positive attitudes toward the health care needs of LGBT students. Conclusions: University health centers have an important role in student health. Barriers to care should be removed, including perceived discrimination. Student health center staff should be trained on LGBT health issues. [ABSTRACT FROM AUTHOR]

We examined socioeconomic, academic, and health-related factors associated with respondent reports that childcare interfered with academics. 176 undergraduate student parents We administered a cross-sectional survey to a representative sample of students at a public university in New York City. Using a sub-set of those who reported being parents/guardians (n = 176), we conducted bivariate analyses to assess factors associated with childcare problems interfering with school. About 30% of the sample reported that childcare interfered with school somewhat/moderately/a lot in the last year. Compared to those with no/little perceived interference, they were significantly more likely to need mental health treatment (30% vs. 13%; p < 0.01), worry that they would run out of food sometimes/often (32% vs. 16%; p < 0.01), and experience housing problems (26% vs. 9%; p < 0.01). Offering mental healthcare and services addressing food and housing insecurity can help college students to navigate challenges inherent to being a student parent. [ABSTRACT FROM AUTHOR]

Scholars of global health have embraced universal education as a structural intervention to prevent HIV. Yet the costs of school, including fees and other ancillary costs, create an economic burden for students and their families, indicating both the challenge of realising the potential of education for preventing HIV and the ways in which the desire for education may produce vulnerabilities to HIV for those struggling to afford it. To explore this paradox, this article draws from collaborative, team-based ethnographic research conducted from June to August 2019 in the Rakai district of Uganda. Respondents reported that education is the most significant cost burden faced by Ugandan families, sometimes amounting to as much as 66% of yearly household budgets per student. Respondents further understood paying for children's schooling as both a legal requirement and a valued social goal, and they pointed to men's labour migrations to high HIV-prevalence communities and women's participation in sex work as strategies to achieve that. Building from regional evidence showing young East African women participate in transactional, intergenerational sex to secure school fees for themselves, our findings point to the negative health spillover effects of Uganda's universal schooling policies for the whole family. [ABSTRACT FROM AUTHOR]

Medical students have reported high prevalence of mental health difficulties and burnout. However, there are limited investigations examining the association between resilience and these difficulties. We investigated: (1) depression, anxiety, personal and professional burnout, and comorbidity; (2) demographic and education characteristics associated with these outcomes; (3) the association between resilience and these outcomes; and (4) whether these results were attributable to sampling bias. Participants were n = 521 medical students from RCSI University of Medicine and Health Sciences. Outcomes were measured using validated scales. We report descriptive statistics, and risk factors for the difficulties were investigated using generalized linear modelling. One-in-three students reported incidence of depression or anxiety (24.5% co-morbidity). 8.9% of students reported all four difficulties. Difficulties were more common in female students and those in middle years of the programme. Resilience was negatively correlated with all outcomes and stable across demographic and educational variables. Weighting the data for sampling bias did not affect these results. Our results emphasise the high incidence of depression, anxiety, burnout, and comorbidity in students. We advocate for further investigation into the role of resilience as a modifiable factor that may ameliorate the incidence of depression, anxiety, and burnout in medical students. [ABSTRACT FROM AUTHOR]

This prospective one-year cohort study aimed to assess the feasibility and outcomes of a routine psychosocial screening at patients' admittance to specialist inpatient palliative care. Patients admitted to an academic palliative care ward were routinely screened for self-reported distress and psychological morbidity, psychosocial stress factors, and subjective need for help from psychosocial professions. Cognitive impairments were the most common patient barrier to screening. Screenings were completed in 138 of 428 patients (32%). Based on established cutoffs, distress was indicated in 89%, depression in 51%, and anxiety in 50% of these patients. The burden on next-of-kin emerged as the most prevalent stress factor (73%). One-half of the patients disclosed a subjective need for help (53%). Possible depression (p =.023), anxiety (p <.001), and subjective need for help (p <.001) correlated positively with a higher amount of time spent by psychologists and creative arts-based therapists with small to moderate effects. Patients who completed the screening were attributed with a higher amount of time by social workers than patients who did not (p =.004), but there were no relationships between screening results and social work. Results suggest the potential of screenings for the allocation of specialist psychosocial care during specialist palliative care; however, barriers to screening do exist. [ABSTRACT FROM AUTHOR]

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Relatives of terminally ill patients most often experience distress. Advance Care Planning (ACP) has been developed to plan end-of-life care and support patients and relatives. ACP has been shown to have a positive impact on relatives of terminally ill patients and may affect their healthcare-seeking behaviour. The aim of the study was to investigate associations between ACP and relatives' contacts with general practitioners (GPs) and hospital admissions. Based on a prior randomized controlled trial we conducted a prospective longitudinal study. Relatives of patients formerly randomized into one ACP conversation or control group were included. Information regarding relatives' GP and hospital contacts was achieved through healthcare registries using personal Civil Registration numbers. The content, distribution, and median number of GP and hospital contacts were analyzed in two time windows: the caregiving period (from randomization until loss) and the bereavement period (from loss until six months after). No significant difference in the median number of GP or hospital contacts between the two groups was found. However, in the caregiving period, we found a significant difference in the distribution of GP contacts (p = 0.022); More relatives in the control group had no contact with their GP. The prior ACP conversation did not affect the median number of GP or hospital contacts among relatives, but statistically significantly more relatives in the ACP group had a least one GP contact in the caregiving period. The study emphasizes the importance of performing ACP trials with outcomes in relation to relatives and patients. [ABSTRACT FROM AUTHOR]

The Functional Status Score for the Intensive Care Unit (FSS-ICU) evaluates the physical function of ICU patients. The objective of the study was to translate and cross-culturally adapt the FSS-ICU into Korean and assess its reliability and validity. An expert committee supervised the forward and backward translation process and the final translated version. Experienced physiotherapists assessed patients (n= 31) from a medical ICU using the Korean version of FSS-ICU. Intra-class correlation coefficients (ICCs) and Bland–Altman's plots were used to evaluate reliability, and Cronbach's alpha for internal consistency. Construct validity was evaluated using Spearman's correlation coefficients. Two physiotherapists in each of the two university hospitals independently assessed 31 medical ICU patients, with a mean FSS-ICU total score of 23 (range: 4–35). The FSS-ICU Korean version demonstrated excellent internal consistency, with Cronbach's alpha of 0.897 for the total FSS-ICU score, and a range of 0.844–0.892 with deletion of each individual activity within the FSS-ICU. Intra-rater and inter-rater reliability were excellent for all of five FSS-ICU activities and the total score, with an ICC range of 0.930–0.993. Bland–Altman's plots revealed a mean difference in FSS-ICU total score of 0.2 (95% limits of agreement: −1.9 to 2.3) between two physiotherapists. The Korean version of FSS-ICU had good convergent and divergent validity with moderate to strong correlation with mobility and muscle strength measures, and poor correlation with unrelated measures. The Korean version of the FSS-ICU showed excellent intra-rater and inter-rater reliability, internal consistency, and construct validity for medical ICU patients. The results of this study, along with prior publications, support that the FSS-ICU Korean version is a valid and reliable assessment tool for the ICU environment. Intensive care unit patients usually experience decreased muscle strength and physical function. The Korean version of the Functional Status Score for the Intensive Care Unit (FSS-ICU) is suitable for use with Korean speakers and has a valid, reliable measurement tool for physical function of intensive care unit patients. A well-standardized training with videos and written materials is important to ensure correct implementation of the Korean version of the FSS-ICU. [ABSTRACT FROM AUTHOR]

Teamwork quality has been shown to influence patient safety, and simulation-based team-training (SBTT) is an effective means to increase this quality. However, long-term effects are rarely studied. This study aims to investigate the long-term effects of interprofessional SBTT in emergency medicine in terms of global confidence, self-efficacy in interprofessional communication and in emergency medicine situations. Newly graduated doctors, nurses, auxiliary nurses, and medical and nursing students participated. Four emergency medicine scenarios focused on teamwork according to the A-B-C-D-E-strategy. All participants increased their global confidence from 5.3 (CI 4.9–5.8) before to 6.8 (CI 6.4–7.2; p <.0001) after SBTT. Confidence in interprofessional communication increased from 5.3 (CI 4.9–5.8) to 7.0 (CI 6.6–7.4; p <.0001). Students had the greatest gain. The self-efficacy following the A-B-C-D-E strategy increased from 4.9 (CI 4.4–5.3) to 6.6 (CI 6.2–7.0). Again, students had the steepest increase. Newly graduated doctors achieved a superior increase in global confidence as compared to nurses and auxiliary nurses (p <.0001). Their propensity to recommend SBTT to colleagues was 9.9 (CI 9.8–10.0). The positive effects were sustained over a six-month period, indicating that interprofessional SBTT had a positive impact on competence development, and a potential to contribute to increased team quality in emergency medicine care. [ABSTRACT FROM AUTHOR]

The purpose of our study was to investigate factors which predicted first appointment attendance within a traumatic brain injury (TBI) neuropsychology outpatient department. A newly introduced telephone triaging system was implemented in a clinical neuropsychology service for individuals with a TBI. The effects of receiving a triage telephone call, amongst other variables, were analysed as predictors of attendance at the first face-to-face clinic appointment. The data from 161 individuals were analysed using routine patient information collected by the clinical neuropsychology service. Logistic regression analyses were performed to investigate predictors of first appointment clinic attendance. Logistic regression analyses identified higher age, shorter waiting times, and answering the triage call as potential predictors of attendance, highlighting where the service might focus efforts to facilitate attendance. Both patient and service factors were found to be significant predictors of patient attendance. Further service evaluation could explore patients' experiences of triage telephone calls, and investigate relationships between waiting times and neuropsychological outcomes. Identifying predictors of appointment attendance can allow the service to focus on the needs of particular patient groups. Implementing a telephone triage initiative had positive effects, both on waiting times and efficient use of face-to-face clinic time. The analysis highlighted the need to think about better ways of reaching out to younger individuals and those who have waited longer to attend appointments, who are less likely to attend once invited. [ABSTRACT FROM AUTHOR]

Objective: This study examined whether program climate factors, stressors, demographic, and institutional variables were associated with doctoral students' clinically significant generalized anxiety disorder and major depressive disorder symptoms. Participants: This study examined doctoral students' responses from the gradSERU survey, which was administered at five U.S. public research universities in 2017–2018 (n = 2,582). Methods: This study utilized confirmatory factor analysis and binary logistic regression. Results: Sense of belonging reduced doctoral students' odds of clinically significant anxiety and depression symptoms, while academic stressors, relationships stressors, and financial stressors increased such odds. There were no differences in the odds of clinically significant symptoms based on students' academic program. Students identifying as heterosexual or straight had significantly reduced odds of clinically significant symptoms for both disorders than lesbian, gay, bisexual, or questioning students. Conclusions: The results can aid institutional stakeholders in developing interventions that may be associated with the wellness of their students. [ABSTRACT FROM AUTHOR]

The study investigates if physical libraries are popular for research by students in the internet age post COVID-19. The study used a descriptive survey research design. The population consisted of 3457 Adeleke University undergraduates. Descriptive statistic was used to analyze data. The findings suggested that physical libraries are increasingly less popular among students for research purposes, owing mostly to the development of the internet era. Other reasons cited include physical library congestion and excessive surveillance, a preference to read with friends outside of the physical library, and a lack of motivation to visit the physical library. It was also discovered that students have a culture of completing their own research rather than paying professionals to do it for them. The study concluded that physical libraries are less popular for research among students, majorly due to the popularity of the internet. As a result, the study recommends that library management make physical libraries the strongest internet hub on campus, where all students would want to come for research. More efforts should be made to expand physical libraries and provide a variety of quiet reading options for those who detest crowds. [ABSTRACT FROM AUTHOR]

Uncertainty is ubiquitous in medicine. Studies link intolerance of uncertainty to burnout, ineffective communication, cognitive bias, and inappropriate resource use. Little is known about how uncertainty manifests in the clinical learning environment. We aimed to explore the perceptions and experiences of uncertainty among residents and attendings. We conducted a mixed-methods study including a survey, semi-structured interviews, and ethnographic observations during rounds with residents and attendings at an academic medical center. The survey included three validated instruments: Physicians' Reaction to Uncertainty Scale; Maslach Burnout Inventory 2-item; and Educational Climate Inventory. 35/60 (58%) of eligible residents and 14/21 (67%) attendings completed the survey. Residents reported higher anxiety due to uncertainty than attendings, higher concern about bad outcomes, and greater reluctance to disclose uncertainty to patients. Residents reported increased symptoms of burnout (p <.05). Perceiving the learning environment as more competitive correlated with reluctance to disclose uncertainty (r = −0.44; p <.01). Qualitative themes included: recognizing and facing uncertainty, and consequences for the learning environment. Observations revealed senior clinicians have greater comfort acknowledging uncertainty. Medical curricula should be developed to promote recognition and acknowledgement of uncertainty. Greater acknowledgement of uncertainty, specifically by attendings and senior residents, may positively impact the clinical learning environment. [ABSTRACT FROM AUTHOR]