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Low health literacy (LHL) significantly impacts patients' ability to participate actively in their healthcare. Registered nurses (RNs) play a crucial role in identifying LHL and addressing patient knowledge gaps and skill deficits. This correlational study examined the relationship between RNs' predictions of patients' health literacy levels (HLL) and the actual HLL of a predominately Hispanic patient population. In addition, personal factors (i.e., demographics) were analyzed to determine their influence on the nurse's predictions and patients' HLL. Data were collected from 84 participant patient–nurse couplets admitted to a medical-surgical unit in a rural setting located on the United States–Mexico border. In addition to demographic information collected via survey, RNs were asked to predict their patient's health literacy abilities while the Newest Vital Sign, a health literacy assessment tool, was deployed to determine the actual HLL of patients participating in the study. Data were analyzed using descriptive statistics, t -tests, and chi-square tests while a Spearman correlational model was used to examine the relationship between predicted HLL and actual HLL. Finally, a logistic regression model was used to analyze the relationship between personal factors and HL data for RNs and patients. Analysis of the data revealed that RNs consistently overestimated patients' abilities, as evidenced by the disparity between patients' actual HLL (mean 1.71) and predicted HLL (mean 4.26) by RNs, with a moderately strong positive relationship (rs =.418). Notably, higher academic preparation and years of experience did not enhance the RNs' ability to identify LHL while the highest level of education completed was the only statistically significant predictor of adequate health literacy in the patient population sampled. These findings emphasize the need to prioritize effective health literacy education in RN academic preparation and clinical practice to support the detection of LHL when a standardized health literacy assessment tool is not utilized in the clinical setting. By recognizing the presence of LHL, healthcare professionals can better support patients' needs and bridge the knowledge gap, ultimately improving patient outcomes. [ABSTRACT FROM AUTHOR]

Objectives: To examine the effects of acupuncture and therapeutic exercise alone and in combination on temporomandibular joint symptoms in tension-type headache and to evaluate the potential interaction of existing temporomandibular dysfunction on the success of headache treatment. Design: Pre-planned secondary analysis of a randomized controlled, non-blinded trial. Setting: Outpatient clinic of a German university hospital. Subjects: Ninety-six Participants with frequent episodic or chronic tension-type headache were randomized to one of four treatment groups. Interventions: Six weeks of acupuncture or therapeutic exercise either as monotherapies or in combination, or usual care. Follow-up at 3 and 6 months. Main measures: Subjective temporomandibular dysfunction symptoms were measured using the Functional Questionnaire Masticatory Organ, and the influence of this sum score and objective initial dental examination on the efficacy of headache treatment interventions was analyzed. Results: Temporomandibular dysfunction score improved in all intervention groups at 3-month follow-up (usual care: 0.05 [SD 1.435]; acupuncture: −5 [SD 1.436]; therapeutic exercise: −4 [SD 1.798]; combination: −3 [SD 1.504]; P = 0.03). After 6 months, only acupuncture (−6 [SD 1.736]) showed a significant improvement compared to the usual care group (P < 0.01). Subjective temporomandibular dysfunction symptoms had no overall influence on headache treatment. Conclusions: Only acupuncture had long-lasting positive effects on the symptoms of temporomandibular dysfunction. Significant dental findings seem to inhibit the efficacy of acupuncture for tension-type headache. [ABSTRACT FROM AUTHOR]

Students with emotional and behavioral disorders (EBD) characteristically experience academic difficulties. There is growing evidence that the continuum from academic competence to underachievement is partially explained by executive function (EF; neurocognitive attention-regulation processes) and stress. Yet, there is scarce research investigating these relationships among students with or at risk for EBD, especially during the elevated stress and risk period of middle school, and particularly among racially/ethnically under-represented groups. Therefore, with 118 U.S. middle schoolers with or at risk for EBD and typical peers (70% Hispanic/Latinx; 25% Black), we examined group differences and relationships among perceived family, peer, and school stress, EF, and academic outcomes. When compared with their typical peers, students with or at risk for EBD scored lower on EF and academic tasks. For all students, higher EF predicted better academic functioning. Perceived stress was directly and negatively related with EF and indirectly associated with academic outcomes via EF. [ABSTRACT FROM AUTHOR]

Background: Recent studies have investigated the effect of psychological factors on return to sport (RTS), but none has tested the existence of psychological profiles linked to reinjury anxiety and its links with RTS and reinjury. Purpose: To assess the effect of different psychological profiles on RTS and reinjury. Study Design: Cohort study; Level of evidence, 2. Methods: The study screened patients who were involved in all types of sports for anterior cruciate ligament (ACL) reconstruction (hamstring and patellar tendon autografts). All participants were included during the RTS phase (90-180 days after ACL reconstruction). Reinjury anxiety, fear of reinjury, kinesiophobia, perceived stress, anxiety, depression, knee confidence, self-esteem, optimism, coping, and pain were measured. Hierarchical cluster analysis (Ward method) and analysis of variance were performed. In the second year after surgery, patients were recontacted by telephone to follow-up. RTS and reinjury were compared by profile type. Results: A total of 162 athletes were initially included, of whom 123 responded regarding RTS and reinjury. Cluster analysis showed a 4-cluster solution (χ2[21] = 428.59; λ =.064; P <.001). Profile 1 (27.8%) was characterized by moderate reinjury anxiety and no depression. Profile 2 (22.8%) was characterized by moderate reinjury anxiety and minor anxious-depressive reaction. Profile 3 (30.9%) was characterized by no reinjury anxiety, no depression, and high confidence. Profile 4 (18.5%) was characterized by high anxiety, high depression, and low confidence. Profile 4 had the lowest self-esteem and optimism scores compared with profile 3 (P <.001). In addition, a higher percentage of men was found in profile 3 as opposed to profile 4 (χ2[3] = 11.35; P <.01). Profile 4 had the highest rate of non-RTS with 54.2% (profile 1: 14.3%, P =.001; profile 2: 25.0%, P =.031; profile 3: 22.2%, P =.011). Finally, patients with profile 3 had a higher risk of reinjury (13.9%) than those with profile 4 (0%) (P =.047), who had an extremely conservative RTS. Conclusion: The different profiles will affect RTS, but also the risk of reinjury exclusively for profiles 3 and 4. Rehabilitation management will probably require all stakeholders to understand psychological profiles of athletes to develop an on-demand rehabilitation plan. [ABSTRACT FROM AUTHOR]

Objective: This study investigates the influence of aerobic exercise training on inhibitory control of executive functions in children with hemiplegic cerebral palsy. Design: Single-blind randomized controlled trial. Setting: Outpatient Physical Therapy Clinic. Participants: Children aged 7–11 with left-sided hemiplegic cerebral palsy with emotional and behavioral dysregulation evidenced by scores >28 on Paediatric Symptom Checklist and GMFCS I or II (n = 60). Intervention: Participants were randomly allocated into two equal groups. The control group received standard-of-care physical therapy for 1 h, and the aerobic exercise group received standard-of-care physical therapy for 30 min and moderate-intensity continuous exercise on a bicycle ergometer for 30 min. All groups received treatment three times a week for 12 weeks. Main Measures: The Eriksen Flanker test and Stroop Color–Word test were used to assess inhibitory control of executive function at the baseline and after 12 weeks. Results: Differences between pre- and post-treatment values in the exercise group showed significant improvement in Flanker response accuracy and Stroop response accuracy (p = 0.001) and significant decreases in Flanker congruent reaction time and Stroop congruent reaction time (p < 0.05). However, there were no significant differences between both groups in Flanker incongruent reaction time and Stroop incongruent reaction time (p > 0.05). Conclusions: Aerobic exercise has a promising effect on inhibitory control of executive function in children with left-sided hemiplegic cerebral palsy. [ABSTRACT FROM AUTHOR]

Background: Quantitative analysis of the glenoid face knotless-type anchor placement for arthroscopic Bankart repair has not been reported. Purpose: To evaluate the clinical and radiologic outcomes after arthroscopic Bankart repair using knotless bioabsorbable anchors depending on the anchor location. Study design: Case series, Level of evidence, 4. Methods: A total of 124 patients (113 men and 11 women; age, 25.6 ± 7.5 years; follow-up time, 46.5 ± 18.2 months [range, 6.2-75.5 months]) who underwent arthroscopic Bankart repair with the bioabsorbable knotless anchor between 2017 and 2021 were included in this study. Among them, 118 patients were observed for >2 years (mean, 48.2 ± 16.8 months [range, 24-75.5 months]) and were analyzed for final clinical and radiologic outcomes. Using postoperative 6-month magnetic resonance imaging, remnant glenoid (%) and labral height were measured. Shoulder range of motion (ROM), radiographic osteoarthritic change, dislocation, apprehension test, and return to sports were recorded. Three groups were established based on the remnant glenoid, which represented the percentage of the exposed glenoid anteroposterior diameter to the original diameter using the best-fit circle method—group A: lower quartile; group B: interquartile; and group C: upper quartile—and variables were analyzed. Results: Overall, the remnant glenoid was 57% ± 6.4% (range, 41.5%-75%) after the surgery. Osteoarthritic change, dislocations, and positive apprehension tests were observed in 5 (4.2%), 4 (3.4%), and 12 (10.2%) patients, respectively. A total of 34 (28.8%) and 64 (54.2%) patients could return to sports without and with restrictions, respectively. Comparing groups A, B, and C, postoperative labral height (7 ± 1, 7 ± 2, and 7 ± 1 mm; P =.623), final osteoarthritic change (1, 4, and 0; P =.440), positive apprehension tests (5, 5, and 2; P =.387), and return to sports (complete/restricted/unable, 6/18/5, 19/29/11, 9/17/4; P =.769) were not different. All ROM were similar across the groups (all P >.054), except for external rotation (ER) at postoperative 6 months (41.3°± 12.8°; 50.2°± 18.5°; and 49.8°± 15.2°; P =.050). However, ER after 1 year was similar across the groups (all P >.544). In further analysis, patients with positive apprehension tests had lower labral height compared with others (5 [4-6] mm and 7 [6-8] mm; P <.001). Conclusion: In arthroscopic Bankart repair, the placement of knotless bioabsorbable anchors on the glenoid face, combined with the remplissage procedure or rotator interval closure, resulted in a low recurrence rate and moderate return to sports. However, most patients had some restrictions in returning to sports. Moreover, this technique was not associated with postoperative arthritis and shoulder stiffness, including ER deficit, which was not affected by the position of the anchor on the glenoid face for a minimum 2-year follow-up. [ABSTRACT FROM AUTHOR]

Background: Chronic ankle instability (CAI) is a clinical sequela that causes the recurrence of ankle sprain by inducing ankle sensorimotor dysfunction. Animal models of CAI have recently shown that ankle ligament injuries mimicking an ankle sprain result in chronic loss of ankle sensorimotor function. However, the underlying mechanisms determining the pathogenesis of CAI remain unclear. Hypothesis: Ankle instability after an ankle sprain leads to the degeneration of the mechanoreceptors, resulting in ankle sensorimotor dysfunction and the development of CAI. Study Design: Controlled laboratory study. Methods: Four-week-old male Wistar rats (N = 30) were divided into 2 groups: (1) the ankle joint instability (AJI) group with ankle instability induced by transecting the calcaneofibular ligament (n = 15) and (2) the sham group (n = 15). Ankle instability was assessed using the anterior drawer test and the talar tilt test at 4, 6, and 8 weeks after the operation (n = 5, for each group at each time point), and ankle sensorimotor function was assessed using behavioral tests, including ladder walking and balance beam tests, every 2 weeks during the postoperative period. Morphology and number of mechanoreceptors in the intact anterior talofibular ligament (ATFL) were histologically analyzed by immunofluorescence staining targeting the neurofilament medium chain and S100 proteins at 4, 6, and 8 weeks postoperatively (n = 5 per group). Sensory neurons that form mechanoreceptors were histologically analyzed using immunofluorescence staining targeting the mechanosensitive ion channel PIEZO2 at 8 weeks postoperatively (n = 5). Results: Ankle sensorimotor function decreased over time in the AJI group, exhibiting decreased ankle instability compared with the sham group (P =.045). The number of mechanoreceptors in the ATFL was reduced (P <.001) and PIEZO2 expression in the sensory neurons decreased (P =.008) at 8 weeks postoperatively. The number of mechanoreceptors was negatively correlated with ankle sensorimotor dysfunction (P <.001). Conclusion: The AJI model demonstrated degeneration of the mechanoreceptors in the ATFL and decreased mechanosensitivity of the sensory neurons, which may contribute to CAI. Clinical Relevance: Ankle instability causes degeneration of mechanoreceptors and decreases the mechanosensitivity of sensory neurons involved in the development of CAI. This finding emphasizes the importance of controlling ankle instability after ankle sprains to prevent recurrence and the onset of CAI. [ABSTRACT FROM AUTHOR]

Adverse events lead to the emergence of several groups of victims, among which the second victims are medical staff involved in them. The suffering of second victims can lead to new adverse events and new victims. This study describes the cycle of an adverse event and its victims. Using the example of the largest Croatian hospital centre, authors try to understand how deep medical staff experience adverse events, and how different groups of medical staff (by profession, gender, qualification, and position) perceive adverse events. With the help of a special survey using the Bonferroni method from ANOVA, it was established that males feel more mental stress after adverse events than females. The results indicate that medical staff of different professions perceive adverse events differently, e.g. they are the least painful for psychiatrists and microbiologists and the most stressing for emergency and intensive care workers. In addition, nurses are more vulnerable to adverse events and experience various types of mental disorders more deeply than doctors. However, qualifications do not seem to affect the extent to which medical staff perceive adverse events. The results of this study differ from previous data for other countries and suggest new implications. [ABSTRACT FROM AUTHOR]

Background: Aortic aneurysms represent a chronic degenerative disease with life-threatening implications. In order for patients to comprehend health related information, it must be written at a level that can be readily understood. Study Design: In January 2023, we searched "aneurisma aorta" and "endoprótesis aorta" terms on Google, Yahoo and Microsoft/Bing. The 31th websites provided by each search engine were analyzed. Four readability measures were used to evaluate websites regarding aortic aneurysm and their endovascular treatment in Spanish language: Flesch Index, Flesch-Szigriszt Index, Fernández-Huerta Index and grading Inflesz scale. The quality on information was evaluated by the HONcode seal, the DISCERN instrument and the JAMA benchmark criteria. Results: 180 websites containing the terms "aneurisma aorta" and "endoprótesis aorta" were analyzed. Among the websites retrieved, the mean Flesh index score (53.12 ± 6.09 and 47.48 ± 7.12, respectively; P =.019), the Flesch-Szigriszt index (56.39 ± 5.72 and 48.10 ± 8.33; P =.000), and the Fernández Huerta index (61.30 ± 5.59 and 53.19 ± 8.21; P =.000), corresponding to a "somewhat difficult" readability level. In addition, the Inflesz scale (2.62 ±.59 and 2.07 ±.61; P =.000) reported a "somewhat difficult" readability, higher for the websites regarding aortic aneurysm. The HONcode seal was only presented in websites regarding aortic aneurysm (16.7%), whereas none of the websites relating to aortic endoprostheses presented it (0%) (P =.000). Websites that presented the HONcode seal obtained higher DISCERN score (P =.000, 95% CI = 6.42-16.84) and JAMA score (P =.000, 95% CI = 3.44-11.32). Conclusion: Internet information on aortic aneurysms and aortic endoprostheses is too difficult to read for the general Spanish-speaking population and is lacking in quality. [ABSTRACT FROM AUTHOR]