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

Domestic violence against women increased during COVID-19 lockdowns. This inaugural study examined the content of Australian government online portals, for women seeking support and help for domestic violence, during the 2021 COVID-19 pandemic. This mixed methods study incorporated four phases: a search; measurement of portal quality standard using DISCERN; enumeration of portal items; and a qualitative exploration of portal text. Australian governments must continue to work alongside domestic violence services as we found some portals were better than others. Continued review, revision, and funding are needed to meet the demands associated with this evolving public health emergency. [ABSTRACT FROM AUTHOR]

Ecological momentary assessment (EMA) can be used to examine the dynamics of suicidal ideation in daily life. While the general acceptability and feasibility of EMA in suicide research has been established, further examination of potential iatrogenic effects (i.e., negative reactivity) and identifying those more likely to react negatively is needed. Participants (N = 82) with current suicidal ideation completed 21 days of EMA (4×/day) and filled in M = 78% (Med = 84%) of the EMA. No positive or negative affect reactivity was observed in EMA ratings over the study period. Retrospectively, most participants rated their experience as positive (69%); 22% indicated mood worsening, and 18% suicidal ideation reactivity. Those with more borderline personality traits, posttraumatic stress disorder (PTSD), and higher depressive, anxiety, and suicidal ideation symptoms, were more likely to report iatrogenic effects. In conclusion, while high compliance rates and lack of affect reactivity during EMA indicate that EMA is well tolerated in suicide research, a minority of participants may report subjective mood effects in retrospect. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has posed unprecedented challenges with its impact on patient safety culture and staff well-being. This study was to identify potential changes in safety culture among health care workers from before to during the COVID-19 pandemic, and to determine the differences across occupational groups. The Safety Attitudes Questionnaire (SAQ) was administered electronically in both English and Malay languages using the Google Forms platform in 2018 and was repeated in 2021, during the COVID-19 pandemic. Comparisons were made between 2018 and 2021 to determine changes in patient safety culture for the overall staff population and by occupational groups. A total of 3175 health care workers completed the questionnaire in 2021. Overall, a comparable percentage agreement was found for all SAQ domains in 2018 and 2021 with visible improvements for doctors and support staff. Safety Attitudes Questionnaire domain scores differed in teamwork, safety climate, perception of hospital management, and working condition domains across occupational groups. Self-isolation and COVID-19 were associated with poorer SAQ domain scores, while redeployment was associated with improvements in SAQ domain scores. Interventions targeting areas of weakness as well as utilizing positive experiences such as redeployment should be explored to enhance patient safety in hospitals settings postpandemic. [ABSTRACT FROM AUTHOR]

Introduction: Increasing incidence of fragility fractures has spurred development of protocols, largely focused on peri-operative care, with numerous proven benefits. The purpose of this investigation was to evaluate outcomes of our hip fracture treatment program regarding successful protocol implementation, compliance, effect on subsequent fracture rates, and mortality during the first decade of adoption. Methods: A retrospective review identified patients >65 years old with fragility hip fractures between 2010 and 2022. The HiROC (+) cohort consisted of patients who received a "High-Risk Osteoporosis Clinic" (HiROC) referral for bone health evaluation and bisphosphonate initiation as indicated. Additional fracture rates and mortality at 3 years were calculated. Protocol implementation and compliance over the first 10 years was analyzed in the four identified cohorts. Results: A total of 1671 fragility hip fractures were identified, with 386 excluded due to insufficient follow-up, with an average age of 81.6 years and a median follow-up of 36.4 months. Of the 1280 included cases, 56% (n = 717) had a HiROC referral placed. HiROC(+) groups had lower subsequent fracture rates at two years, compared to those without referral (28% vs 13%, P < 0.0001) and those completing more steps of the protocol had lower subsequent fracture rates (28% vs 15% vs 13% vs 5%, P < 0.0001). No statistically significant difference was observed between the cohorts for anatomic site of subsequent fractures. Discussion: Greater than half of all eligible patients were successfully captured by the protocol. Patients completing more steps of the protocol had lower subsequent fracture rates. Captured patients demonstrated reduced mortality rates when compared to current literature. Conclusion: Successful implementation of this geriatric hip fracture protocol was associated with reduced additional fractures and mortality rates. Identifying steps of process failures in the protocol can provide opportunities for increased compliance and reduction in future fracture occurrences. [ABSTRACT FROM AUTHOR]

Following late-life spousal bereavement, sensory and quasi-sensory experiences of the deceased (SED) are commonly reported. This longitudinal study examined SED among 310 older widowed adults 6–10 (T1) and 18–20 (T2) months post loss. Reports of SED in the first 6–10 months after loss were associated with higher symptom levels of prolonged grief, post-traumatic stress, and loneliness at T1. Experiencers of SED were more likely to experience symptoms of prolonged grief and post-traumatic stress above cut-off scores at T1. Importantly, only a minority of the experiencers of SED displayed these elevated levels of bereavement-related distress. In addition, employing multi-level-modeling, a similar trajectory of decreasing bereavement-related distress over time was found for both experiencers and non-experiencers of SED. We argue that SED may be one of several potential reactions to bereavement, which should not be seen as an indicator of grief complications per se. [ABSTRACT FROM AUTHOR]

Students with mental health needs, behavioral support needs, and/or emotional disturbance can engage in internalizing behaviors, externalizing behaviors, or both. Preservice and induction phase elementary general education teachers are reported to have limited education in providing evidence-based behavior management strategies, especially for students who engage in internalizing and/or externalizing behaviors. There is little understanding as to the differences in elementary general education teachers' knowledge, application, and self-efficacy in applying evidence-based behavior management strategies between preservice teachers, first-year teachers, second-year teachers, and third-year teachers. The purpose of this preliminary secondary data analysis was to examine differences in U.S. elementary general education teacher knowledge, application, and self-efficacy in evidence-based behavior management strategies from preservice to induction phase teaching. Results indicated third-year teachers had significantly less behavior management knowledge than preservice teachers. All other results were nonsignificant; however, there were practical differences when comparing the four groups on the knowledge and application measures. Implications for findings indicate the need for induction programs to focus on evidence-based behavior management strategies to support the development of behavior management for induction phase elementary education teachers as they progress through their first 3 years of teaching. [ABSTRACT FROM AUTHOR]

Cyber dating abuse (CDA) concerns the use of digital technology to control, monitor, and hurt one's intimate partner. CDA can have profound detrimental outcomes, such as mental health problems. As such, it is important to identify intrapersonal factors that may explain these behaviors. Previous research suggests that one such factor is the personality cluster of Dark Triad traits (DTT), comprising Machiavellianism, narcissism, and psychopathy. Additionally, DTT and CDA perpetration have both been linked to poor self-control ability, but these relationships have not yet been tested together in one model. As such, the present study examines if individuals' poor self-control ability mediates the relationship between the DTT and CDA perpetration. To test these associations, we conducted a survey study among a representative sample of Belgian adults (n = 1,144; M age = 47.66 years; 51.3% female). Findings from correlation analyses revealed that all three DTT were individually associated with CDA perpetration, such that higher scores on these traits corresponded with more CDA perpetration. Additionally, pathway analyses from structural equation modeling revealed that individuals' poor self-control ability fully explained the relationship between Machiavellianism and narcissism and CDA perpetration, and partially explained the relationship between psychopathy and CDA perpetration. As our findings suggest that self-control plays an instrumental role in explaining why individuals control and monitor their partner via digital technology, prevention and intervention efforts should seek ways to improve individuals' self-control ability in situations that may trigger such harmful interpersonal behaviors, particularly among individuals who exhibit Dark Triad personality traits. [ABSTRACT FROM AUTHOR]

Background: A few studies have documented the long-term results of chondrocyte-based procedures for the treatment of patellofemoral cartilage lesions, but specific results are lacking after matrix-assisted autologous chondrocyte transplantation (MACT) for patellar and trochlear lesions. Purpose: To document the clinical results of MACT for the treatment of patellar and trochlear chondral defects at long-term follow-up. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 44 patients were prospectively evaluated after MACT for patellofemoral lesions. There were 24 patients affected by patellar lesions, 16 by trochlear lesions, and 4 with both patellar and trochlear defects. Clinical outcomes were analyzed using the International Knee Documentation Committee (IKDC) subjective form, EuroQol visual analog scale, and Tegner score for sport activity level before surgery and at follow-up time points of 5, 10, and a minimum of 15 years (mean final follow-up, 17.6 ± 1.6 years). A Kaplan-Meier survival analysis was performed to examine the survival to failure. Failure was defined as the need for a second surgery because of the persistence of symptoms related to the primary defect. Results: An overall significant improvement was documented from baseline to the last follow-up. The IKDC subjective score improved in the trochlear group from 41.0 ± 13.3 at baseline to 83.9 ± 21.6 at 5 years (P <.005), remaining stable up to the final follow-up (81.3 ± 20.5). In the patellar group, the IKDC subjective score improved from 36.1 ± 14.4 at baseline to 72.3 ± 17.5 at 5 years (P <.005), remaining stable up to the final follow-up (62.0 ± 20.3). Patients with trochlear lesions presented higher IKDC subjective scores compared with those with patellar lesions at 5 (P =.029), 10 (P =.023), and ≥15 years (P =.006) of follow-up. Similar trends were documented for the Tegner score, while no differences were documented for the EuroQol visual analog scale score between patellar and trochlear lesions. There were 4 failures (9.1%) during the follow-up period. The Kaplan-Meier survival analysis did not show statistically significant differences between trochlear and patellar lesions. Conclusion: This hyaluronic acid–based MACT technique offered positive and durable clinical outcomes with a low failure rate at long-term follow-up in patients affected by patellofemoral cartilage lesions. However, trochlear and patellar lesions demonstrated a notable difference in terms of clinical findings and sport activity level, with significantly higher results for patients with trochlear lesions but less satisfactory outcomes for patients with patellar lesions. [ABSTRACT FROM AUTHOR]

Background: High tibial osteotomy (HTO) aims to realign the varus knee to alleviate stress in the medial compartment. However, detailed information on the impact of HTO on stress distribution across the tibiofemoral joint surface still needs to be completely elucidated. Purpose/Hypothesis: The present study aimed to analyze the subchondral bone density distribution to validate the alignment threshold causing paradoxical changes. We hypothesized that there would be a paradoxical stress change in the medial compartment beyond a specific threshold for lower limb realignment after HTO. Study Design: Case series; Level of evidence, 4. Methods: A retrospective clinical study of 32 knees from 30 patients who underwent medial opening-wedge HTO between 2015 and 2019 was conducted at Hokkaido University Hospital. The subchondral bone density across the tibiofemoral joint was analyzed using computed tomography–osteoabsorptiometry before and after HTO. The high-density area (HDA) within the medial and lateral compartments and their subregions, which were quartered in the coronal plane, was specifically examined. Results: The hip-knee-ankle angle, medial proximal tibial angle (MPTA), joint line obliquity (JLO), and joint line convergence angle significantly changed after HTO (P <.01). The HDA of the medial compartment to the total HDA ratio decreased from 83% to 77%. Paradoxically, the HDA in the most central subregion of the medial compartment increased from 24% to 30%. There were significant differences between MPTA and JLO in patients with and without paradoxical changes in the HDA. MPTA and JLO cutoff values causing paradoxical changes in the HDA were 94° and 4°, respectively. Conclusion: There was a paradoxical stress increase in the M4 region at the medial compartment associated with the MPTA and JLO beyond specific thresholds. Therefore, surgical planning should be cautiously performed to prevent overcorrection, which can lead to adverse stress distribution changes. [ABSTRACT FROM AUTHOR]

Background: The clinical implications of structural integrity have been a subject of long debate. The oversimplified binary categorization of structural integrity into either healing or retear, along with faulty preoperative baselines for comparison, may contribute to the controversy. Purpose: To determine how the quality of structural integrity in a repaired cuff tendon affects both clinical and structural outcomes by dividing the patients into groups based on integrity and using the immediate postoperative baseline (time zero). Study design: Cohort study; Level of evidence, 3. Methods: A total of 504 patients with a full-thickness rotator cuff tear who underwent arthroscopic rotator cuff repair and were followed up for at least a year with magnetic resonance imaging (MRI) were included. The quality of structural integrity was graded using the Sugaya classification. To evaluate clinical outcomes, pain, range of motion, strength, functional scores, and overall satisfaction and function were used for within- and between-group analyses at the last follow-up. For the assessment of structural outcomes, the Goutallier classification for fatty infiltration (FI) and the tangent sign, occupation ratio, and normalized cross-sectional area for muscle atrophy (MA) were used. The baselines for these structural measurements were both the preoperative and the time-zero MRI scans. Results: The mean clinical follow-up period was 31.8 ± 27.5 months, and the MRI follow-up period was 10.9 ± 5.3 months. There were 178 (35.3%), 228 (45.2%), 58 (11.5%), 14 (2.8%), and 26 (5.2%) shoulders with Sugaya grades 1, 2, 3, 4, and 5, respectively. Regardless of structural integrity, all clinical outcomes at a mean follow-up of 31.8 months after repair significantly improved compared with those before repair. Only in shoulders with Sugaya grade 1 did the FI of the supraspinatus muscle improve significantly from baseline. FI of the infraspinatus muscle did not change significantly in those with grades 1 and 2 but worsened in those with grades 3 and 5. MA measured using the occupation ratio improved significantly in shoulders with Sugaya grades 1 and 2 but declined in those with grade 5. Conclusion: This study established a correlation between improved structural integrity of the repaired cuff tendon and enhanced structural outcomes in rotator cuff muscles. Furthermore, the findings revealed that both FI and MA could be reversed in patients exhibiting high-quality structural integrity. However, these structural improvements were not mirrored in the clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: Short- and midterm evaluations of arthroscopic meniscal surgery have shown little or no effect in favor of surgery, although long-term effects, including radiographic changes, are unknown. Purpose: To compare the 10-year outcomes in middle-aged patients with meniscal symptoms between a group that received an exercise program alone and a group that received knee arthroscopy in addition to the exercise program with respect to the prevalence of radiographic and symptomatic osteoarthritis (OA), patient-reported outcomes, and clinical status. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Of 179 eligible patients aged 45 to 64 years, 150 were randomized to undergo either 3 months of exercise therapy (nonsurgery group) or knee arthroscopy in addition to the exercise therapy (surgery group). Surgery usually consisted of partial meniscectomy (n = 56) or diagnostic arthroscopy (n = 8). Radiographs were assessed according to the Kellgren-Lawrence score at the baseline and 5- and 10-year follow-ups. Patient-reported outcome measures were reported at the baseline and 1-, 3-, 5-, and 10-year follow-ups. Clinical status was assessed at a 10-year follow-up. The primary outcomes were radiographic OA and changes in the Knee injury and Osteoarthritis Outcome Score Pain subscale (KOOSPAIN) from the baseline to the 10-year follow-up. The primary analysis was performed using the intention-to-treat approach. Results: At the time of the 10-year follow-up, eight patients had died, leaving 142 eligible patients. Radiographic OA was assessed for 95 patients (67%), questionnaires were answered by 110 (77%), and the clinical status was evaluated for 95 (67%). Radiographic OA was present in 67% of the patients in each group (P ≥.999); symptomatic OA was present in 47% of the nonsurgery group and 57% of the surgery group (P =.301). There were no differences between groups regarding changes from baseline to 10 years in any of the KOOS subscales. Conclusion: Knee arthroscopic surgery, in most cases consisting of partial meniscectomy or diagnostic arthroscopy, in addition to exercise therapy in middle-aged patients with meniscal symptoms, did not increase the rates of radiographic or symptomatic OA and resulted in similar patient-reported outcomes at the 10-year follow-up compared with exercise therapy alone. Considering the short-term benefit and no long-term harm from knee arthroscopic surgery, the treatment may be recommended when first-line treatment—including exercise therapy for ≥3 months—does not relieve patient's symptoms. Registration: Clinical Trials NCT01288768 (ClinicalTrials.gov identifier). [ABSTRACT FROM AUTHOR]

Background: Reusable elastomeric half-mask respirators (EHMR) are an alternative to address shortages of disposable respirators. While respirator discomfort has been noted as a barrier to adherence to wearing an N95 filtering facepiece respirator (FFR) among health care personnel (HCP), few have examined EHMR comfort while providing patient care, which was the purpose of this study. Method: Among a cohort of 183 HCP, we prospectively examined how HCP rated EHMR tolerability using the Respirator Comfort, Wearing Experience, and Function Instrument (R-COMFI) questionnaire at Study Week 2 and Week 10. At the completion of the study (Week-12), HCP compared EHMR comfort with their prior N95 FFR use. Overall R-COMFI scores and three subscales (comfort, wear experience, and function) were examined as well as individual item scores. Findings: The HCP reported an improved overall R-COMFI score (lower score more favorable, 30.0 vs. 28.7/47, respectively) from Week 2 to Week 10. Many individual item scores improved or remained low over this period, except difficulty communicating with patients and coworkers. The overall R-COMFI scores for the EHMR were more favorable than for the N95 FFR (33.7 vs. 37.4, respectively), with a large proportion of workers indicating their perception that EHMR fit better, provided better protection, and they preferred to wear it in pandemic conditions compared with the N95 FFR. Conclusion/Application to Practice: Findings suggest that the EHMR is a feasible respiratory protection device with respect to tolerance. EHMRs can be considered as a possible alternative to the N95 FFR in the health care setting. Future work is needed in the EHMR design to improve communication. [ABSTRACT FROM AUTHOR]

This study builds on existing literature on autism spectrum disorder (autism) and sexual and gender minority (SGM) identities and is the first to examine self-declared frequency rates, associated functional impairments, and treatment engagement levels for sexual minority (SM) and non-SM populations with and without autism cross-sectionally via a large nationwide college-student sample across 3 years. Using data from the American College Health Association-National College Health Assessment (ACHA-NCHA) III, we analyzed data from 81,286 college students (ages 18–25 years old) randomly selected from 75 U.S. colleges and universities. Included ACHA-NCHA-III measures consisted of self-reported demographics, SM and gender minority (GM) identities, autism diagnosis, stress, academic impairment, mental health symptoms, and treatment engagement. We found a 2.8% self-declared frequency of autism in the SM group, compared with 0.9% self-declared frequency among the non-SM sample. Autistic college students with both SM and GM identities had the greatest levels of reported adverse stress and the most negative academic and mental health outcomes (i.e., suicidality), followed by college students with two minority identities (i.e., Autism and SM, SM and GM), across all groups. These findings emphasize the need for mental healthcare providers to consider SM and GM identities in non-autistic and, especially, in autistic college students to assess suicide risk and inform treatment. Autistic individuals and those who identify with a sexual and/or gender minority are both at risk for various mental health concerns and related impairments. However, the connection between autism and sexual and/or gender minorities and mental health and functional outcomes is not clear. Here, we provide evidence of these connections by analyzing data from a large nationally representative dataset from the American College Health Association-National College Health Assessment III. We found that autistic college students who identify with both sexual and gender minorities reported the highest rates of stress, academic, and mental health concerns including suicidality when compared with autistic college students with or without a sexual and/or gender minority. In addition, college students with at least two identities, such as autism and a sexual minority identity or both a sexual and gender minority identity, reported the next highest rates of concern. These findings affirm the need for mental healthcare providers to consider the intersections of a sexual and gender minority identities in non-autistic and, especially, in autistic college students to develop and provide better support and resources. [ABSTRACT FROM AUTHOR]

Approximately one in five college women experience a sexual assault (SA), though a meaningful percentage of survivors do not acknowledge or label their experience as such. Research indicates that acknowledgment status is often influenced by how closely SA incidents align with the "real rape" script and degree of survivor rape myth acceptance (RMA). However, studies evaluating acknowledgment paired with other attitudes and health outcomes among survivors is sparse. The current study examined the relation between acknowledgment status, RMA, weight-related constructs, and psychological well-being among three groups of college women (N = 584): non-survivors, unacknowledged survivors, and acknowledged survivors. Findings indicate that, among survivors, acknowledged compared to unacknowledged SA is significantly associated with diminished body appreciation, self-esteem, and increased internalized weight bias, though no differences in psychological distress were found. [ABSTRACT FROM AUTHOR]

Background/Purpose: We aimed to investigate whether there is an interaction between life-space assessment (LSA) and movement control during one-leg standing on bone strength on the non-fractured side in patients with hip fracture. Methods: Two-way analysis of variance (ANOVA) was applied for osteoporosis parameter to examine the interaction and main effects of LSA and movement control during one-leg standing. Results: Two-way ANOVA revealed significant interaction and main effects of LSA and movement control during one-leg standing on bone mineral density (BMD) and Z -score. In parameters of hip structural analysis (HSA), the interaction and main effect of movement control during one-leg standing were detected only in cross-sectional area (CSA). Conclusion: The results of this study suggest that both high LSA and good movement control during one-leg standing are necessary to maintain or improve some parameters of bone strength, such as BMD (neck and total hip), Z-score (neck and total hip), and CSA. [ABSTRACT FROM AUTHOR]

Background: Breast cancer affects patients' quality of life, which is influenced by the body's functional abilities and the patients' spiritual well-being. Currently, there is no research on the spiritual determinants that affect quality of life in the Indonesian context. Purpose : This research analyzes the determinants of spiritual well-being in terms of breast cancer patients' quality of life using the Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being (FACIT-Sp). Methods: A cross-sectional study was conducted with 112 participants who were selected using purposive sampling. Women with breast cancer who had a Palliative Performance Scale version 2 score of 60 and who were able to read and write were included. The instruments used included the RAND SF-36 Quality of Life Questionnaire, which was modified to the Indonesian context and was used to survey breast cancer patients (Cronbach coefficient of >0.90), in addition to the FACIT-Sp (Cronbach coefficient of 0.768). The multivariate data were analyzed using logistic regression. Results: The determinants of spiritual well-being for the participants' quality of life included meaning (odds ratio of 0.436) and peace (odds ratio of 0.303). Conclusion: The meaning and peace domains of spiritual well-being significantly affect breast cancer patients' quality of life. [ABSTRACT FROM AUTHOR]

Approximately 85% of children with autism spectrum disorder from the SPARK study receiving standard interventions such as speech-language and occupational therapies. In contrast, only 32%–13% of children with autism spectrum disorder received movement therapies such as physical and recreational therapies, respectively. Little is known about how service receipt changes as a function of children's motor difficulties. Parents of children with autism spectrum disorder completed online surveys to provide a report of their child's motor difficulties using the Developmental Coordination Disorder–Questionnaire as well as the various therapies their child received (speech-language therapy, occupational therapy, physical therapy, applied behavioral analysis, social skill interventions, recreational therapy) by location (at school, privately/in community, or both). While movement therapies (occupational therapy, physical therapy, recreational therapy) increased with increasing motor risk and severity, there continued to be large disparities in physical therapy (37%–55%) and recreational therapy (15%–19%) compared to occupational therapy (85%–92%) across various settings indicating clear unmet needs for specific motor services given that 88.3% of this sample of children with autism spectrum disorder is at risk for motor difficulties/Developmental Coordination Disorder. Developmental Coordination Disorder–Questionnaire fine- and gross-motor subscale scores were fairly comparably affected yet physical therapy/recreational therapy were less received versus occupational therapy. These findings explain the paucity of physical therapy/recreational therapy and physical activity programs for individuals with autism spectrum disorder and the need for movement experts to receive appropriate access and training to work with individuals with autism spectrum disorder. There are clear disparities in motor services provided to children with autism spectrum disorder (physical and recreational therapies) compared to their standard therapies (speech-language and occupational therapies). Children with autism spectrum disorder need greater access to and funding for motor services (physical and recreational therapies) and physical activity programs. Movement experts including PTs, adapted physical educators, and community exercise/sports coaches/professionals need basic, specialized, and continuing education training to meet the needs of children and adults with autism spectrum disorder not only for providing early developmental and school-based services but also for ensuring appropriate built environments and providing general physical therapy/adapted physical education services as well as physical activity programs. [ABSTRACT FROM AUTHOR]

Background: Limited data are available on return to sports and patient psychometric ratings of success after patellofemoral arthroplasty (PFA) in younger patients with high expectations to return to an active lifestyle. Purpose/Hypothesis: The purpose of this article was to determine the role of PFA and its success in meeting patient expectations regarding the return to low-impact recreational sports and an active lifestyle in younger, active patients. It was hypothesized that PFA would allow younger patients to return to low-impact sports and an active lifestyle and achieve high patient psychometric ratings. Study Design: Case series; Level of evidence, 4. Methods: In this 10-year prospective study (2009-2018), robotic-assisted PFA was performed on 44 patients (32 women and 12 men; n = 51 consecutive knees), with a mean age of 37.2 years (range, 21-50 years). The follow-up rate was 98%, with a mean of 5.3 years (range, 2-9.3 years). Primary clinical outcomes were as follows: the validated Cincinnati Knee Rating System sports activity and symptom rating scales, patient psychometric ratings of the substantial clinical benefit (SCB), and the Patient Acceptable Symptom State (PASS). Secondary outcomes were the Cincinnati Knee Rating System occupational rating, visual analog pain scale, and the 12-Item Short Form Health Survey. Survivorship was defined by conversion to total knee replacement (TKR). Results: Before PFA, 78% of patients (35/45 knees) were symptomatic and unable to perform recreational sports, with only 20% of patients (9/45 knees) performing some low-impact sports. After PFA, 80% of patients (36/45 knees) were able to perform low-impact sports, and 7% (3/45 knees) performed jumping-pivoting sports (P <.001). The SCB scored by the patient showed 87% of knees as good, very good, or normal. On the PASS analysis, 89% of patients (95% CI, 76%-96%) were "pleased," and 93% (95% CI, 82%-99%) would undergo surgery again. There were clinically relevant improvements in symptoms of pain, swelling, and giving way (P =.0001). Preoperatively, 91% of knees had moderate to severe pain with activities of daily living, and only 11% of knees had pain at the follow-up. Five of the 50 knees (10%) underwent TKR conversion with one patient lost to follow-up. Conclusion: PFA resulted in a high return of patients to low-impact sports with high SCB and PASS psychometric ratings. The robotic-assisted 3-dimensional preoperative planning allowed precise intraoperative trochlear implant alignment in knees with severe trochlear dysplasia. PFA is recommended as an alternative treatment in younger patients with end-stage symptomatic patellofemoral arthritis. Registration: NCT02738476 (ClinicalTrials.gov identifier). [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]

Objective: To evaluate therapeutic footwear expectations and usability of individuals with diabetes and foot complications. Design: A prospective multicenter study was conducted on participants with a high risk of developing a diabetic foot ulcer. Setting: Participants were enrolled in 11 different specialized diabetic foot units in Spain between March 2022 and June 2023. Subjects: Patients with diabetes at moderate to high risk of foot ulceration receiving first therapeutic footwear prescription. Interventions: All the patients included in the research were prescribed with their first pair of therapeutic footwear. Main measures: Primary outcome measures were MOS-pre and MOS-post questionnaires evaluating use and usability of prescribed therapeutic footwear. Secondary outcome measures aimed to evaluate footwear clinical efficacy as ulceration rate and self-reported perceived walking distance per day. Results: The use of therapeutic footwear exceeded the patient's pre-provision prediction of their anticipated use in 94% of people (n = 126). Based on the visual analogic satisfaction scale, the median satisfaction of daily wearing their therapeutic footwear was 7 points, Interquartile Range (IQR) [5–8.25]. During the follow-up period, 39 participants (29.1%) experienced diabetic foot ulcer. Perceived walking distance participants reported an improvement in their perceived walking ability during various daily life activities. Conclusions: Diabetes patients at moderate to high risk of diabetic foot ulcer improved their perception of walking ability after therapeutic footwear prescription. Adherence to the therapeutic footwear prescription resulted in less ulcerations. [ABSTRACT FROM AUTHOR]

Supporting families experiencing critical illness through family interventions is essential to ease illness burden, enable family management, and reduce their risk for adverse health. Thus far, there is no validated German instrument to measure the perceived support families receive from nurses. We translated the 14-item Iceland–Family Perceived Support Questionnaire (ICE-FPSQ) and tested its psychometric properties with 77 family members of intensive care patients. Compared with the original instrument, the construct validity of the German ICE-FPSQ (FPSQ-G) showed unstable results with a partially divergent structure, most likely caused by the limited sample size. The first two principal components explained 61% of the overall variance and a good internal consistency with a Cronbach's alpha of.92. The FPSQ-G is a promising instrument to measure family members' perceptions of the support they received from nurses in the acute critical care setting but requires further validation. [ABSTRACT FROM AUTHOR]

Introduction: The Occupational Self-Assessment-Short Form (OSA-SF) is a client-centered instrument designed to assess goal setting and intervention planning for adults with a client-centered approach. This study aimed to assess the psychometric properties of the Bengali-translated Occupational Self-Assessment-Short Form (BOSA-SF), which could enable occupational therapists to evaluate the occupational competence and value of Bengali adults. Method: A total of 170 adult participants participated in the study after the translation phase. The data were analyzed using confirmatory factor analysis and Rasch analysis. Results: Among the 12 items, 11 on the competence scale and all 12 on the value scale were unidimensional and demonstrated local independence. The 11 competence items and 12 value items were fitted to the Rasch model, demonstrating good validity and reliability. Conclusion: The 11-item BOSA-SF demonstrates to be a valid and reliable tool for use in client-centered goal setting and intervention planning for Bengali adults. Nonetheless, further research is warranted to conduct more comprehensive analyses that thoroughly assess the functions of the BOSA-SF in various contexts. [ABSTRACT FROM AUTHOR]

Objective: To compare the evolution of depressive symptoms among depressive subtypes based on clinical and functional variables in a sample of primary care in Chile. Methods: A longitudinal study was conducted in the Maule Region of Chile, focusing on 8 primary care from February 2014 to September 2015. Clinical and functional variables, including Mini International Neuro-psychiatric Interview, Outcome Questionnaire interpersonal and social sub-scales, were applied in a latent class analysis. This analysis categorized 210 patients into 3 subtypes: complex depression (N = 100), recurrent depression (n = 96), and unique depression (n = 14). Complex depression, exhibited a higher probability of suicide attempts, interpersonal and social dysfunction, and association with adverse childhood experiences according the Brief Physical and Sexual Abuse Questionnaire. Patients were monitored over 1 year with the Hamilton scale. The Kruskal-Wallis, non-parametric test, followed by paired Mann-Whitney test evaluated difference in the severity of depressive symptoms between the groups. Additionally, data on mental health interventions were collected. Results: Out of the 210 patients, 89% were women, with a median age of 50 (range 37-58), and 40.1% with only primary education. Sociodemographic characteristics not differ between groups. Significant differences in depressive symptom severity between the groups were found (X 2 90.06, P <.001, Kruskal-Wallis test, η2 = 0.084). Post hoc analyses indicated higher depressive symptoms in complex depression compared to recurrent (Z = −9.501, P <.001) and unique (Z = −2.877, P =.004) depression, with no significant difference between recurrent and unique depression (Z = −1.58, P =.113). There were no differences in the number of medical and psychological controls between the groups. The patients with complex depression required greater modifications in the pharmacological prescriptions than those belonging to the other groups. Conclusion: These results provide additional evidence of a complex depression subtype in primary care in Chile associated with adverse childhood experiences, that had worse resolution of depressive symptoms. Contrary to expectations, patients belonging to this group did not receive further medical and psychological interventions, probably due to a lack of specific clinical recommendations. [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: The impact of the COVID-19 pandemic on the mental health of healthcare workers throughout the world has been reported, but most studies have been cross-sectional and excluded the Midwestern U.S. healthcare workforce. Objective: This study aimed to longitudinally assess the psychological wellbeing and wellness strategies used by a Midwestern academic health system's workforce at multiple points throughout waves of the COVID-19 pandemic to inform ongoing implementation of appropriate wellness activities. Methods: An anonymous REDCap survey linked within our team-developed wellness education was posted in the employee online newsletter in April (T1), July (T2), October 2020 (T3), and May 2021 (T4). Surveys were open to all employees (approx. 9000) for approximately 12 days at each time point. Anxiety, depressive symptoms, stress, self-efficacy, and self-care activities were assessed. Following each data collection, team members discussed findings and planned wellness education implementation. Results: Response ranged from n = 731 (T1) to n = 172 (T4). Moderate to severe stress was reported by 29.5% (n = 203) of respondents at T1 and 34.0% (n = 108) at T2. At T3, all psychological symptoms significantly increased (p <.001) as COVID-19 surged, with 48.5% (n = 141) of respondents reporting moderate to severe stress. At T4, stress significantly declined (p <.001). Exercise was the most frequently reported coping strategy. Conclusions: Mental health symptoms reported by a Midwestern healthcare workforce increased during surges of COVID-19 hospitalizations. Individuals in non-patient contact roles experienced symptom levels similar to and at times with greater severity than healthcare personnel with patient contact roles. [ABSTRACT FROM AUTHOR]

We investigated whether mood and lifestyle-related indicators of physical health are differentially expressed according to self-reported levels of depressive symptoms among young adults with a current episode of major depression. In a cross-sectional study, we recruited 94 young adults (females = 67, 71.3%; males = 27, 28.7%; aged 18–35 years) with a current episode of major depression. We assessed their mood with the Profile of Mood States (POMS), and Beck Anxiety Inventory-(BAI), sleep with the Pittsburgh Sleep Quality Index (PSQI), physical activity with the Simple Physical Activity Questionnaire (SIMPAQ), and their cardiorespiratory fitness. Participants' depression levels were classified as follows using established cut-points: (a) Mild Depressive Symptoms (MIDS, BDI-II 14-19 points, n = 17), (b) Moderate Depressive Symptoms (MODS, BDI-II 20–28 points, n = 37) or (c) Severe Depressive Symptoms (SEDS, BDI-II 29–63 points, n = 40). As expected, we found that young adults with SEDS, when compared to those with MODS and MIDS, showed higher depressive mood on the POMS, and they exhibited greater anxiety symptoms, lower reported 'vigor' on physical activity measures, worse sleep quality as expressed by their global score sleep; daytime dysfunction; and sleep disturbance, and they showed lower cardiorespiratory fitness. Those with moderate depressive symptoms only differed from those with mild symptoms with respect to hostility, fatigue and mood disturbance. Although there was a gradient whereby worse mental and physical health indicators were more closely related to the SEDS depression categorization, while healthier indicators were associated with the MIDS category, some parameters were not different between the MDD severity groups, particularly when comparing MIDS and MODS. Clinicians treating patients with MDD should consider these factors when designing lifestyle-based interventions. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the effect of lullabies and classical music on preterm neonates' cerebral oxygenation, vital signs, and comfort during orogastric (OG) tube feeding. Methods: This was a parallel-group pretest-posttest randomized controlled study. The research was conducted between December 2020 and May 2022. The sample consisted of 51 preterm neonates hospitalized in the neonatal intensive care unit (NICU) of Selçuk University Faculty of Medicine Hospital in Konya, Türkiye. Participants were randomized into three groups (17 preterm infants in each group). The first group listened to lullabies sung by their mothers and the second group listened to classical music during OG tube feeding. The control group received routine care with no music. Data were collected using a Neonatal Identification Information Form, Physiological Parameters and rSO2 Monitoring Form, and the Newborn Comfort Behavior Scale (Comfort-Neo). The study was registered on the ClinicalTrials database (NCT05333575). Results: The lullaby group had stable peak heart rates and oxygen saturation levels (p =.002). Both lullaby and classical music groups had significantly higher cerebral oxygenation levels than the control group. The classical music group had the highest cerebral oxygenation level (p =.001). Both lullaby and classical music groups had significantly higher mean Comfort-Neo scores than the control group. The classical music group had the highest mean Comfort-Neo score (p =.040). Conclusion: Preterm neonates who listen to lullabies and classical music are likely to have higher cerebral oxygen and comfort levels. Listening to lullabies helps stabilize vital signs. These results suggest that healthcare professionals should encourage parents to get their preterm neonates to listen to lullabies and classical music. [ABSTRACT FROM AUTHOR]

Background: Acupuncture is a potentially effective non-pharmacological treatment for insomnia. Objective: We observed the responses of patients with insomnia to acupuncture in routine clinical practice. In addition, we explored patient characteristics that might affect the treatment response to acupuncture for insomnia. Methods: Medical records of patients with insomnia in a Korean medicine clinic with baseline Insomnia Severity Index (ISI) scores ⩾8 and Pittsburgh Sleep Quality Index (PSQI) scores ⩾5 were reviewed. Acupuncture was applied at ST43, GB41, ST41, SI5, HT3, KI10, HT7 and ST3, for 1–2 months. The ISI and PSQI were measured monthly to assess insomnia severity. The effect of acupuncture over time was analyzed using a multilevel linear model for repeated measures. In addition, logistic regression was used to explore predictors of treatment response. Results: A total of 91 patients with insomnia aged 59.2 ± 12.5 years (mean ± standard deviation (SD)) (90.1% female) were included in the analysis. After the acupuncture treatment, ISI scores were significantly reduced by −3.75 (95% confidence interval (CI) = −4.99, −2.50) and −4.69 (95% CI = −6.22, −3.16) after the first and second month, respectively. The PSQI global scores also improved, and sleep duration showed a tendency to increase by 0.35 h (95% CI = −0.17, 0.86) after acupuncture treatment. Three cases of mild fatigue were reported. In addition, higher baseline pain/discomfort predicted a greater likelihood of response after acupuncture treatment (odds ratio (OR) = 1.66, 95% CI = 1.10, 2.60). Conclusion: In a real-world setting, the insomnia of outpatients in a clinic was slightly alleviated after acupuncture treatment. These findings require validation by randomized controlled trials. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: Companion animals (CAs) may benefit human health, but few studies have examined their impact on stroke survivors. This study examines participation, quality of life (QoL), attachment, cognition, and executive function differences between stroke survivors living with and without CAs. Methods: In this cross-sectional, community-setting study, 25 stroke survivors with a CA and a matched group of 27 without a CA completed standard tools. Results: Stroke survivors with a CA scored significantly higher in participation and 1 cognitive performance test. No significant differences were found in other cognitive measures or QoL, and attachment to a CA was not correlated with participation or QoL within the research group. However, lower attachment avoidance correlated with better participation in survivors living with dogs. Conclusion: Living with CAs, especially dogs, might be associated with some cognitive function and participation benefits among stroke survivors. The link between CAs and cognitive function is unclear: Survivors with higher cognitive functioning might be more capable of caring for a CA, or having and caring for a CA might promote better cognitive function. Attachment patterns also might explain stroke survivors' participation levels. Further study is warranted. [ABSTRACT FROM AUTHOR]

Background: There are multiple recommended protocols for Vitamin D (VitD) supplementation in elderly; however, only a few studies achieved to examine the role of VitD supplements before intertrochanteric fracture surgery on mortality and complications after surgery. Methods: This single-center block-randomized double-blinded trial was conducted on 80 patients with intertrochanteric fractures and a sufficient level of 25 (OH) VitD. The intervention group received an intramuscular 300,000 IU VitD ampule before surgery. The primary outcome was a 6-month mortality rate, and the secondary outcomes were 1- and 2-year mortality rates and Harris Hip Score (HHS) in 6, 12, and 24 months after surgery. Chi-square, t-test, repeated measure ANOVA, and Cox regression survival model was used for statistical analysis. Results: 40 patients were allocated to each group. Demographic, clinical characteristics, and preoperative evaluations were not significantly different between the groups. Mortality rate 6-month after the surgery was 7.5% and 10% for the intervention and placebo groups respectively (P value =.71), 15% and 12.5% at 1-year (P value =.83), and 25% and 27.5% at 2-year (P value =.98). Based on the Cox regression model, only age was significantly associated with mortality (HR = 1.229, P value <.001). Significant HHS changes from baseline through 24 months after surgery were observed within both groups; however, mean differences were not significantly different between groups. Conclusions: A single preoperative 300,000 IU VitD did not significantly impact 2-year survival and HHS in patients with intertrochanteric fractures and sufficient serum VitD level. [ABSTRACT FROM AUTHOR]

Background: Current classification systems for intra-articular pathology intraoperatively have been described for patients with femoroacetabular impingement rather than dysplasia. Purpose: To (1) describe intra-articular findings in dysplastic hips undergoing combined hip arthroscopy and periacetabular osteotomy (PAO); (2) propose a new chondrolabral classification system for dysplastic hips based on these findings; and (3) correlate patient-reported outcome measures (PROM) with the newly proposed classification. Study Design: Case series; Level of evidence, 4. Methods: A total of 46 hips underwent combined hip arthroscopy and PAO at our institution between September 2013 and December 2014, irrespective of symptoms or radiographic findings. PROMs were evaluated preoperatively and at 2 years postoperatively. At the time of hip arthroscopy, the chondrolabral junction was classified as normal without tear (1 hip, type 1); hypertrophic labrum without chondrolabral disruption (19 hips, type 2); chondrolabral disruption on the articular side, not extending into the capsular side (16 hips, type 3A); chondrolabral disruption extending through the capsular side (3 hips, type 3B); and exposed acetabular subchondral bone (7 hips, type 4). Results: There was a significant difference in postoperative modified Harris Hip Score (mHHS) (P =.020), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores (P =.037), and WOMAC total scores (P =.049) between chondrolabral junction types. Post hoc analyses demonstrated significant differences between type 2 (84.9 ± 12.9) and type 3A (67.8 ± 20.7; P =.198), and between type 2 and type 4 (59.3 ± 24.3; P =.011) in postoperative mHHS scores; and between type 2 (83.9 ± 12.9) and type 3A (68.9 ± 23.7; P =.045) in postoperative WOMAC total scores. In multivariate analysis, chondrolabral type 3 or type 4, age >35 years, and previous surgery were significantly correlated with worse mHHS scores at 2 years. Conclusion: This new chondrolabral classification is proposed to describe intra-articular pathology seen during combined hip arthroscopy and PAO, specifically in dysplastic hips. More advanced chondrolabral disease was associated with worse PROMs at 2 years. [ABSTRACT FROM AUTHOR]

Childhood traumas have been considered risk factors for many psychiatric disorders. Recent studies demonstrated that childhood traumas can also be considered risk factors for neurological diseases. In this context, the objective of this study is to investigate the effects of childhood traumas on treatment resistance in patients with epilepsy. The study sample consisted of 85 epilepsy patients, 40 male and 45 female, who were diagnosed and followed up by a neurologist. Of these patients, 45 were being followed up with the diagnosis of refractory epilepsy, and 40 were being followed up with the diagnosis of treatment-responsive epilepsy. Cranial magnetic resonance imaging and electroencephalography were performed on all patients. In addition, all patients were administered childhood trauma questionnaire (CTQ) and Hamilton depression rating scale (HAM-D). Epilepsy patients included in the study were divided into refractory epilepsy and treatment-responsive epilepsy groups. There was no significant difference between the groups in sociodemographic characteristics. On the other hand, total CTQ and all CTQ subscale scores and HAM-D scores were significantly higher in the refractory epilepsy group than in the treatment-responsive epilepsy group. This study demonstrates that childhood traumas may contribute to treatment resistance in epilepsy patients. Therefore, it is recommended that a history of childhood traumas be routinely queried in the treatment of epilepsy patients. [ABSTRACT FROM AUTHOR]

Background: Intensive and critical care nurses need to demonstrate ethical sensitivity especially in recognizing and dealing with ethical dilemmas particularly as they often care for patients living with life-threatening conditions. Theories suggest that there is a convergence between nurses' empathy and ethical sensitivity. Evidence in the literature indicates that nurses' emotional, demographic, and work characteristics are associated with their level of empathy and ethical sensitivity. Aim: To investigate the relationship between nurses' empathy and ethical sensitivity, considering their emotional states (depression, anxiety, and stress), demographic and work characteristics, and test an empirical model describing potential predictors of empathy (as a mediator) and ethical sensitivity using path analysis. Research design: Using a cross-sectional design, the philosophical theory of care ethics and empathy was extended and adopted as a conceptual framework for this study and tested by path analysis. Participants and research context: Data were collected from 347 intensive care nurses recruited by ten educational-medical hospitals in Iran using a questionnaire between February and March 2021. Ethical considerations: The study was reviewed by the Ethical Advisory Board in Iran and conducted according to the Declaration of Helsinki. Findings: Study participants demonstrated a mild level of stress, anxiety, and depression, alongside a relatively high level of empathy and ethical sensitivity. Nurses with good socioeconomic status had higher empathetic behavior with patients than those with weak status. Nurses aged over 40 who had received ethics training and had higher work experience were associated with higher ethical sensitivity compared to nurses under 20 years of age. Empathy directly affected ethical sensitivity; however, anxiety had an indirect effect on ethical sensitivity through empathy. Among demographic factors, age had a positive direct effect on ethical sensitivity. Conclusions: Less anxiety and a high level of empathy contribute to higher levels of ethical sensitivity among intensive and critical care nurses. [ABSTRACT FROM AUTHOR]

Aim and Objective: To study the prevalence and risk factors of prehypertension and hypertension among adolescents (18–19 years) at the entry level of professional course. Materials and Methods: After institutional ethics committee approval and informed consent from participants, the data were collected and entered into the Excel sheet. Appropriate statistical analysis was applied. The final result was statistically interpreted. Results: A total of 273 student participants were included in the study. There were 104 males and 169 females. One hundred and seven participants were 18 years old and 168 were 19 years old. Male: female ratio is 1:1.6. Prehypertension was seen in 91 (33.3%) and hypertension was observed in 34 (12.57%). Seven (20.6%) cases had a family history of hypertension. Twenty-two (8.1%) had addictive habits. Inadequate physical activity was seen in 32 (94.1%) of cases who had hypertension. Poor sleep quality was seen in hypertensives (17; 50%). In our study also, there was no statistically significant association between gender and systolic blood pressure and diastolic blood pressure (P > 0.05). There is a statistical significance association between the gender and body mass index (BMI) but not between BMI and hypertension status. There was statistically significant association was there between prehypertension and hypertension with habits. Conclusion: Change in habits and dietary modification will have impact on the development of prehypertension and or hypertension among adolescents. More emphasis must be given to screen adolescents at college entry. Adolescents are best target age group for primordial prevention. [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]

Confirmatory factor analyses (CFA) are often used in psychological research when developing measurement models for psychological constructs. Evaluating CFA model fit can be quite challenging, as tests for exact model fit may focus on negligible deviances, while fit indices cannot be interpreted absolutely without specifying thresholds or cutoffs. In this study, we review how model fit in CFA is evaluated in psychological research using fit indices and compare the reported values with established cutoff rules. For this, we collected data on all CFA models in Psychological Assessment from the years 2015 to 2020 (N Studies = 221). In addition, we reevaluate model fit with newly developed methods that derive fit index cutoffs that are tailored to the respective measurement model and the data characteristics at hand. The results of our review indicate that the model fit in many studies has to be seen critically, especially with regard to the usually imposed independent clusters constraints. In addition, many studies do not fully report all results that are necessary to re-evaluate model fit. We discuss these findings against new developments in model fit evaluation and methods for specification search. [ABSTRACT FROM AUTHOR]

Background: The role of arthroscopic Latarjet as a revision surgery after failed arthroscopic Bankart repair has yet to be established. Purpose: To compare clinical outcomes, recurrences, and complication rates of arthroscopic Latarjet as a revision procedure after failed arthroscopic Bankart repair versus arthroscopic Latarjet as a primary procedure. Design: Cohort study; Level of evidence, 3. Methods: This is a retrospective study of prospectively collected data of patients who were diagnosed with anterior shoulder instability and underwent arthroscopic Latarjet stabilization between 2009 and 2018. Patients were separated into 2 groups depending on whether Latarjet was performed after a previous instability surgery (revision) or as a primary surgery (primary). Rowe score, Western Ontario Shoulder Instability Index (WOSI), Constant-Murley Shoulder Outcome (CMSO) score, and Single Assessment Numeric Evaluation (SANE) were assessed pre- and postoperatively with a minimum 24 months of follow-up. In addition, pre- and postoperative levels of sports activity, dislocations, subluxations, and complications were assessed. Results: A total of 97 patients (n = 62 revision; n = 35 primary), with a mean age of 31.0 ± 8.8 and 29.4 ± 7.6 years old in the revision and primary Latajet group, respectively, met the inclusion criteria. The mean follow-up in the revision group was 32 months (24-53) and 35.5 months (27.7-42.2) in the primary Latarjet group. No significant differences between groups were observed in Rowe score (revision = 91.4, primary = 94.1; P =.223), CMSO score (revision = 90.7, primary = 94; P =.105), and SANE (revision = 85.8, primary = 87.3; P =.683) postoperatively. However, the postoperative difference in the WOSI score between the revision and primary Latarjet groups was nearly significant (510 ± 334 vs 403 ± 343, respectively; P =.05). Four (6.4%) postoperative dislocations were reported in the revision and 1 (2.8%) in the primary Latarjet group (P =.14). Patients in the revision group had a lower return to the previous level of sports participation (P =.008) and decreased external rotation with the arm by the side compared with the primary Latarjet group (P =.000). Conclusion: Arthroscopic Latarjet as a revision surgery is a reasonable surgical option in failed Bankart repair cases. The decision to perform arthroscopic Latarjet stabilization as a revision surgery should not be influenced by the potential risk of future complications as it provides comparable clinical outcomes to the primary Latarjet procedure with a low postoperative recurrence rate. However, a decreased level of postoperative sports participation and external rotation with the arm by the side can be expected. [ABSTRACT FROM AUTHOR]

Child maltreatment (CM) is a major global public health issue, and a strong association exists between CM and aggression. However, the underlying mechanism of this association has not been understood to date. The objective of this study was to explore the mediating role of irritability in the association between CM and aggression in Chinese early adolescents. A cross-sectional study was conducted using a self-report questionnaire to evaluate the levels of CM, aggression, and irritability in 5,724 middle school students from the Anhui Province, China. Structural equation modeling was used to test the hypothesis of the mediating effect of irritability on the relationship between CM and aggression. We further investigated gender differences in this association using multiple group analyses. CM was positively related to both irritability and aggression, and irritability was positively associated with aggression (p <.01). The mediating effects of irritability between CM and aggression were significant (β =.107, 95% confidence intervals [CI]: 0.077–0.133, p <.05). Males had a higher indirect effect size of the pathway from CM to aggression via irritability compared with females. Overall, irritability was a crucial mediator in the relationship between CM and aggression in Chinese adolescents, and males were more prone to engage in aggression compared with females through the pathway of irritability. Therefore, early irritability characteristics should be carefully monitored in adolescents, and they should be provided adequate support to acquire critical emotion regulation skills. [ABSTRACT FROM AUTHOR]