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Women veterans (WV) are the fastest growing veteran subpopulation and recognized to be at increased risk for suicide compared with civilians. Improving engagement (e.g., response rates) of WV in survey research is critical to ensuring valid and generalizable findings, which can inform suicide prevention programs tailored for this population. Many factors are known to influence response rates, yet little is known about ways to optimize survey response rates among WV. Three recruitment cohorts (Waves 1 [W1], 2a [W2a], and 2b [W2b]) of WV were invited to participate in an online survey for a national, mixed‐methods study examining suicide risk among WV using reproductive health care services paid for or provided by the Veterans Health Administration. To examine the effects of enhanced recruitment efforts, standard recruitment materials were mailed to all three cohorts, with the additions of: a study flyer aiming to build trust between participants and researchers (W2a, W2b) and a paper survey (W2b). Characteristics of responders and non‐responders were compared by wave and across survey modalities. Response rates were significantly higher for groups receiving enhanced (W2a = 17.1%; W2b = 24.6%) versus standard (W1 = 12.2%) recruitment materials. WV residing in rural areas were significantly more likely to respond by paper (37.1%) than online (19.8%). Non‐respondents were disproportionately racial and ethnic minorities. Disclosure of sensitive information (e.g., military sexual trauma) did not differ by survey modality. Findings suggest that enhanced recruitment materials improve survey response rates among WV, an important consideration for future research with this population. [ABSTRACT FROM AUTHOR]

Background: Preoperative education can improve postoperative quality of life in patients undergoing stoma surgery. However, the prevalence and when, where, and how preoperative education is implemented are unclear. Therefore, this study aimed to assess the current status of outpatient preoperative education for patients undergoing stoma surgery for rectal cancer as perceived by nurses. Additionally, it sought to identify the information provided by Japanese healthcare providers as a part of preoperative education. Methods: This cross-sectional study included 1,716 wound, ostomy, and continence nurses (WOCNs) in charge of stoma clinics at Japanese hospitals. Unsigned self-administered survey forms were mailed to the participants, and paper- or web-based responses were obtained. The main questions included: overview of the participants and their facilities, provision of outpatient preoperative education, status of implementation, and preoperative education components. To examine the factors associated with preoperative education, the independent variable was the presence or absence of preoperative education in the clinic, and the explanatory variables were the years of experience as a nurse, years of experience as a WOCN, type of hospital, number of beds, and number of intestinal stoma surgeries per year. Regression analysis was performed. Results: We received 773 valid responses (valid response rate: 45%). Duration of experience as a nurse and as a WOCN were 24.6 and 10.9 years, respectively. Outpatient preoperative education was provided by 24% of the participants. Most preoperative education sessions were conducted for patients or caregivers. Preoperative education took 31–60 min per patient, and one to five patients received preoperative education each month. Booklets, ostomy appliances, and stoma models/dolls were used as supplementary materials for preoperative education. The most frequently mentioned components of preoperative education were stoma care, daily life, social security, stoma clinic, traveling and going out, quality of life after stoma surgery, and precautions for medical treatment. In addition, education on the use of restrooms on the go, disaster preparedness, defecation disorders after restorative proctectomy, and complications after stoma closure were considered necessary. Conclusions: The implementation rate of outpatient preoperative education was low (24%). Future challenges include the development of specific educational content and procedures suitable for the Japanese medical environment and the establishment of preoperative medical care teams for stoma surgery to promote the provision of outpatient preoperative education. [ABSTRACT FROM AUTHOR]

Aim: To investigate the mental well‐being of early career nurses working in the United Kingdom during the COVID‐19 pandemic, with a particular emphasis on symptoms related to post‐traumatic stress disorder. Design: A longitudinal survey study. Methods: Data were acquired at three timepoints during the COVID‐19 pandemic (between May 2020 and March 2021) to determine whether symptoms of post‐traumatic stress disorder persisted over time. Quantitative measures of well‐being were supplemented with survey data on the nurses' experiences of working during the pandemic. Results: Twenty‐seven per cent of participants suffered from persistent symptoms of post‐traumatic stress while working as nurses during the pandemic. The nurses' baseline resilience, as well as their perception of the quality of their work environment, were significant negative predictors of symptoms of post‐traumatic stress. Participants identified a range of strategies that would have helped them during the crisis, including visible, consistent and empathetic leadership, adequate training and a supportive work environment. Conclusion: The context of the pandemic has highlighted the vulnerability of the psychological well‐being of early career nurses in the workforce. Immediate implementation of some of the more simple interventions suggested in this paper would provide early career nurses with rapid support. More complex support mechanisms should be given immediate consideration, with a view to implementation in the longer term. Implications for the Profession: This study contributes new knowledge about the psychological well‐being of early career nurses working during the pandemic and suggests support mechanisms that will be crucial for the retention of these nurses in the profession. A measurement of resilience may be useful for determining the appropriate level of support to provide to early career nurses. Impact: Early career nurses are vulnerable to attrition from the profession. This could be exacerbated if the psychological well‐being of these nurses is not being supported.Around 25% of early career nurses suffered from persistent symptoms of post‐traumatic stress disorder while working as nurses during the height of the pandemic, which is a novel finding compared to other longitudinal studies.Understanding the psychological well‐being of early career nurses working during a crisis period (such as a pandemic) equips nurse managers with appropriate strategies to improve nurses' emotional health and to enhance their retention within the workforce.The current findings may be of interest to clinical practitioners who have responsibility for the retention of nursing staff. No patient or public contribution. One of the authors is a statistician. [ABSTRACT FROM AUTHOR]

This paper examines how experiences with a previous pandemic, particularly HIV/AIDS, may have informed approaches to COVID-19, with a focus on sexual orientation. Method: The sample was drawn from an online survey of Canadians 55+ conducted in 2020, comprising 1143 persons (mean age = 67; 88 gay or bisexual (GB) men, 65 lesbian or bisexual (LB) women, 818 heterosexual women, and 172 heterosexual men). Respondents reported if they, or someone close to them, "had been affected by" one or more pandemics and whether COVID-19 led them to "think more about their prior epidemic/pandemic experiences" and/or feel they "couldn't handle it again". Correlated items reflecting feeling "they have been here before"; "prepared for what is happening"; and "like they needed to act or do something" formed a scale named "agentic familiarity". Results: About half of respondents reported thinking about their previous pandemic experience; about 5% reporting feeling like "they couldn't handle it again" with no gender or sexual orientation differences. Higher agentic familiarity scores were found for GB men and for those with experience with HIV/AIDS vs. other pandemics. Discussion: These outcomes speak to resilience and growth experienced by LGBT (and especially GB) persons through shared stigma and trauma—with implications for current pandemic experiences and future actions, like advance care planning. [ABSTRACT FROM AUTHOR]

Objective: To examine implicit bias in employees at a cancer centre using an Australian race (Aboriginal–white) Implicit Association Test (IAT), in an attempt to understand a potential factor for inequitable outcomes of First Nations Australians cancer patients. Methods: All employees at an Australian cancer centre were invited to take part in a web-based, cross-sectional study using an Australian race IAT. The results were analysed using Welch t-tests, linear regression and ANOVA. Results: Overall, 538/2871 participants (19%) completed the IAT between January and June 2020. The mean IAT was 0.147 (s.d. 0.43, P < 0.001, 95% CI 0.11–0.18), and 60% had a preference for white over First Nations Australians. There was no significant mean difference in IAT scores between sub-groups of gender, age or clinical/non-clinical employees. 21% of employees (95% CI 17.65–24.53) had moderate to strong preference for white over First Nations Australians, compared to 7.1% with moderate to strong preference for First Nations over white Australians (95% CI 5.01–9.09). Conclusions: Inequitable cancer survival for First Nations patients has been well established and cancer is now the leading cause of mortality. This paper documents the presence of racial bias in employees at one cancer centre. We argue that this cannot be understood outside the history of colonialism and its effects on First Nations Australians, healthcare workers and our society. Further research is required to evaluate measures of racism, its effect on health care, and how to eliminate it. What is known about this topic? Australian cancer care providers deliver inequitable access and outcomes for First Nations Australians. Systemic and personal racism experienced by First Nations patients are thought to contribute to these inequities. What does this paper add? This paper documents the presence of cancer centre employee racial bias and reiterates the need for further research to document the effect of racism on cancer care outcomes for First Nations patients. What are the implications for practitioners? Healthcare practitioners, similar to other Australians, have implicit bias against First Nations Australians. Previous studies suggest that the presence of bias affects treatment options and outcomes for people of colour. In order to eliminate racism and associated inequities in cancer care services, multi-faceted anti-racism approaches are required. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) continues to be a global problem. The increasing international research, focussing on children who witness IPV between their parents, indicates that these circumstances might influence children in different ways. Despite these efforts, little evidence stems from Germany. Using data from a German school student survey from 2017 and 2019 (N = 21,382), this paper aims to examine the consequences of witnessing IPV. The present paper takes a closer look at children's violent behaviour, attitudes and quality of life while controlling for other potential influences (e.g. physical and psychological child abuse). Results indicate that IPV has a significant negative effect on children's quality of life, in particular on children's sense of security at home and children's life satisfaction. No other effects were significant. In discussing these complex dynamics, the results of the present study highlight the importance of considering children who witness IPV as direct victims. A home with personal threats cannot provide emotional and physical security. Coping with this absence of a secure base at home may lead to the neglect of important developmental tasks during that time, which can have possible far-reaching implications on different areas of children's lives (e.g. social competence). Further research examining the severity and duration of witnessing IPV within the context of a longitudinal design is recommended. [ABSTRACT FROM AUTHOR]

Aim: To explore the significance of culture, professional support in the community, social interactions and intrapersonal determinants of adults' preferences for life‐sustaining treatments and palliative care. Methods: A cross‐sectional design with a Social Ecological Model was used. Between 1 October 2012 and 31 December 2012, 474 adults aged ≥20 years living in a city of Southern Taiwan completed the survey. Data were analysed using hierarchical multiple regression. Results: The life‐sustaining measures model was significant with 15.3% (p < 0.0001) of the variance in the Modified Emmanuel Medical Directives being explained by variables of death of self and healthcare services' support. The palliative care model was significant with 18% (p < 0.0001) of the variance in the Modified Hospice Attitude Scale being explained by variables of palliative care knowledge, death of self and social interactions. However, cultural value adherence did not predict adults' preferences for life‐sustaining measures and community resources support did not predict palliative care preference. Conclusions: Findings enhance our understanding of the significance of different societal levels on adults' preferences for end‐of‐life care. Palliative care knowledge, fear of death, healthcare services' support and social interactions are essential factors that need to be taken into consideration when it comes to discussion about life‐sustaining treatments and palliative care. Summary statement: What is already known about this topic? End‐of‐life (EOL) preferences can be shaped not just by knowledge, values and individuals' attitudes but rather a host of social influences.Few studies with theoretical frameworks or models in the literature are available to provide a comprehensive understanding of factors contributing to responses at the EOL. What this paper adds? The findings advance the knowledge of the influence of social interactions, healthcare services' support, palliative care understanding and fear of death on adults' preferences for life‐sustaining treatments and palliative care.The identified relationships in the context of life‐sustaining treatments and palliative care provide practical guidelines, which can help to inform appropriate supportive interventions for EOL care planning. The implications of this paper: Healthcare services that provide a mediating structure where a person belongs should focus on enhancing community resources regarding EOL healthcare planning, knowledge about palliative care and reinforcing life and death education.The social support network and emotional ties with a person's significant others should also be taken into consideration to facilitate EOL healthcare planning and to promote good quality of life at EOL. [ABSTRACT FROM AUTHOR]

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This paper explores public sentiment towards strike action among healthcare workers, as a result of their perceived inadequate pay. By analysing survey data collected in England between 2022 and 2023, the study focuses on NHS nurses and junior doctors, due to their critical role in delivering essential public services. Results indicate higher public support for strikes by nurses and junior doctors compared to other professions such as postal workers, teachers, rail workers, airport workers, civil servants and university lecturers. However, variation in support for strikes by healthcare workers is observed across societal segments. Significant disparities in support are linked to individual political affiliations, left–right ideological positions and trust in the NHS. In short, nonconservative voters, individuals leaning towards left‐wing politics and those with greater trust in the NHS demonstrate higher likelihoods of supporting strikes by health workers. These findings carry implications for future strike decisions and highlight specific target groups for enhanced communication efforts to garner increased public support. [ABSTRACT FROM AUTHOR]

This paper examines the associations between social participation and individual life satisfaction among older adults. It specifically considers the diversity of the practices and social inequalities among this population. For analyses, we used a large survey of individuals of 65 years and older conducted in 2011 in Switzerland (N = 2,727). The first set of linear regression analyses examines Diener's Satisfaction with Life Scale and its association with various indicators of social participation. While the second set of logistic regression addresses the issue of social inequalities by evaluating the impacts of gender, age group, region and education on social participation indicators that are significantly associated with the satisfaction with life score. Our results stressed the importance of combining multiple forms of participation for life satisfaction and shows that some forms are particularly meaningful: in particular, the involvement in associations, visitation of family or visitation of friends/acquaintances and church attendance. When inequalities among older adults are considered, having rich and varied social participation, being involved in associations and maintaining private sociability with non-kin appear more elitist. While institutionalised and/or private sociability types of participation appear particularly significant for older adults' life satisfaction, the most traditional integration forms – i.e. family and religions – are crucial for the more vulnerable. Implications for active ageing was equally discussed as well. [ABSTRACT FROM AUTHOR]

The formation of information security behavioural intention (ISBI) can be complex and dynamic in different contexts. This paper aims to examine and compare different users' ISBI formalisation mechanisms when dealing with their personal affairs (non-work users) and organisational affairs (work users). Drawing on two principles of Conservation of Resources (COR) theory (i.e. resource loss principle, and resource gain principle), we developed two models to examine how situational support affects ISBI formation. The results of a study of 432 non-worker users and 261 work users indicate a curvilinear relationship between situational support and ISBI through subjective norms and risk perception for non-worker users, whilst a linear relationship via subjective norms is found for worker users. This is the first time that COR has been applied to explain the formation of ISBI. The findings broaden the research scope of individuals' ISBI by revealing how situational support affects the formalisation mechanism for different users in cross-contexts. The theoretical and practical implications of the findings and the future study are discussed. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and the steps governments took to combat it tormented societies across the globe. Accordingly, existential positive psychologists have emphasized the importance of self-transcendence in mitigating the distress and agony caused by prolonged and rigorous health measures. In this cross-cultural study, the correlation between self-transcendence, people's confidence in government, and democracy was examined. Based on the findings of an online survey (n = 36,304) conducted in 16 societies in Europe, Latin America, Asia, and the Commonwealth of Independent States (CIS), the multi-level analysis established that self-transcendence had a negative relationship with people's confidence in their own government, especially in less democratic societies. Besides expanding the Schwartz theory of basic values and inspiring theoretical developments for new research, this paper recommends that related institutions obtain community consent before pushing out strict health measures. [ABSTRACT FROM AUTHOR]

INTRODUCTION Exposure to advertising is a determinant of electronic cigarette (e-cigarette) use among young adults. Few studies have explored the underlying mechanisms of advertising exposure on e-cigarette use among young Chinese adults. METHODS An online survey was administered to a sample of 2956 young adults (aged 20-34 years) who were never smokers, from April to May 2022, in China. Mediation analyses were used to test the mediating effects of curiosity and harm perception, and moderated mediation models were conducted to examine whether the relationships in mediation modeling vary across different levels of socioeconomic status (household income, education level, and residence). RESULTS Greater advertising exposure was associated with a higher likelihood of e-cigarette use (AOR=1.39; 95% CI: 1.26-1.54) and curiosity about e-cigarettes (AOR=1.33; 95% CI: 1.25-1.42), and the latter mediated the association between advertising exposure and e-cigarette use (proportion mediated=26.9%; 95% CI: 15.8%-40.7%) while harm perception did not. Additionally, the effect of advertising exposure on curiosity was moderated by household income (p=0.03) and residential area (p=0.001), and was stronger among participants with lower socioeconomic status. CONCLUSIONS E-cigarette advertising may promote young adults' experimentation by increasing their curiosity towards the products. Socially disadvantaged groups may be more susceptible to e-cigarette advertising. The study suggests that the government should explore options for better regulation of e-cigarettes to prevent initiation by never smokers and protect vulnerable populations. [ABSTRACT FROM AUTHOR]

Background: Recruitment of sufficient participants for clinical trials remains challenging. Primary care is an important avenue for patient recruitment but is underutilized. We developed and pilot tested a questionnaire to measure relevant barriers and facilitators to primary care providers' involvement in recruiting patients for clinical trials. Methods: Prior research informed the development of the questionnaire. The initial instrument was revised using feedback obtained from cognitive interviews. We invited all primary care providers practicing within the University of Utah Health system to complete the revised questionnaire. We used a mixed-mode design to collect paper responses via in-person recruitment and email contacts to collect responses online. Descriptive statistics, exploratory factor analysis, Cronbach's alpha, and multivariable regression analyses were conducted. Results: Sixty-seven primary care providers participated in the survey. Exploratory factor analysis suggested retaining five factors, representing the importance of clinical trial recruitment in providers' professional identity, clinic-level interventions to facilitate referral, patient-related barriers, concerns about patient health management, and knowledge gaps. The five factors exhibited good or high internal consistency reliability. Professional identity and clinic-level intervention factors were significant predictors of providers' intention to participate in clinical trial recruitment activities. Conclusions: Results of this exploratory analysis provide preliminary evidence of the internal structure, internal consistency reliability, and predictive validity of the questionnaire to measure factors relevant to primary care providers' involvement in clinical trial recruitment. [ABSTRACT FROM AUTHOR]

Access to safe drinking water is critical in improving health and well-being. It is estimated that >40% of urban households in Ghana do not have access to safe drinking water. Although the willingness and ability of community members to collectively take local initiatives are essential to curtailing inequities in water access in Ghana, the determinant of collective action is less explored. This paper explores determinants of collective action in water-insecure neighbourhoods and examines how perceived inequities in access to water and trust mediate the relationship between lack of access to water and collective action in urban Ghana. The results show that the urban poor OR = 12.047 (p = 0.000) were more likely to participate in water-related collective action compared to wealthy individuals. Primary decision-makers were 1.696 times more likely to participate in collective (p = 0.02). We also found that perceived inequities OR = 0.381 (p = 0.00) significantly predict participation in collective action to address water insecurity. Water service providers should be subjected to a rigid state-level framework that ensures inclusivity, fairness and justice in their distribution systems. [ABSTRACT FROM AUTHOR]

FFQ are commonly used to examine the association between diet and disease. They are the most practical method for usual dietary data collection as they are relatively inexpensive and easy to administer. In Australia, the Cancer Council of Victoria FFQ (CCVFFQ) version 2 and the online Commonwealth Scientific and Industrial Research Organisation FFQ (CSIROFFQ) are used. The aim of our study was to establish the level of agreement between nutrient intakes captured using the online CSIROFFQ and the paper-based CCVFFQ. The CCVFFQ and the online CSIROFFQ were completed by 136 healthy participants. FFQ responses were analysed to give g per d intake of a range of nutrients. Agreement between twenty-six nutrient intakes common to both FFQ was measured by a variety of methods. Nutrient intake levels that were significantly correlated between the two FFQ were carbohydrates, total fat, Na and MUFA. When assessing ranking of nutrients into quintiles, on average, 56 % of the participants (for all nutrients) were classified into the same or adjacent quintiles in both FFQ, with the highest percentage agreement for sugar. On average, 21 % of participants were grossly misclassified by three or four quintiles, with the highest percentage misclassification for fibre and Fe. Quintile agreement was similar to that reported by other studies, and we concluded that both FFQ are suitable tools for dividing participants’ nutrient intake levels into high- and low-consumption groups. Use of either FFQ was not appropriate for obtaining accurate estimates of absolute nutrient intakes. [ABSTRACT FROM PUBLISHER]

Aims: To explore the relationship between nurse practitioner work environment and nurse practitioner outcomes (job satisfaction and intent to leave) in the United States. Design The study used a cross‐sectional survey design to collect survey data from primary care nurse practitioners in six states in the United States. Methods: We sent mail surveys to 5689 eligible nurse practitioners in Arizona, New Jersey, Washington, Pennsylvania, California and Texas. The mail also contained an online link. Participants could complete either the paper or online questionnaire. In total, 1244 participants completed the survey in 2018–2019. The work environment was measured using the Nurse Practitioner‐Primary Care Organizational Climate Questionnaire comprised of four subscales: Nurse Practitioner‐Administration Relations, Nurse Practitioner‐Physician Relations, Independent Practice and Support and Professional Visibility. Global items measured job satisfaction and intent to leave. We used mixed‐effect proportional‐odds cumulative logit models to assess the association between work environment and job satisfaction and intent to leave. Results: Overall, 90% of participants were either very satisfied or somewhat satisfied with their job and 22% reported intent to leave their job in 1 year. With a one‐unit increase in the organizational‐level Nurse Practitioner‐Administration Relations score, the odds of having a higher job satisfaction level increased by about four times and the odds of intent to leave job decreased by about 60%. A higher organizational‐level Nurse Practitioner‐Physician Relations score was significantly associated with higher job satisfaction and lower odds of intent to leave. Conclusion: Improvements in work environments may improve nurse practitioner job satisfaction and retention. Impact This study examined the relationship between work environment, job satisfaction and turnover intention of nurse practitioners. Better work environment is associated with higher job satisfaction and lower turnover intention. Findings have implications for clinical leadership who can take actions to create better work environments to increase the nurse practitioner workforce capacity. [ABSTRACT FROM AUTHOR]

The objective of this paper was to estimate the influence of being affiliated with an NH chain on perceived consumer quality, and whether this relationship is affected by maintaining a collaboration agreement with public administrations. We used a combination of theoretical foundations: (1) From the consumer perspective, we focussed on online reviews of the quality of nursing homes (NHs); (2) from the industrial organisation literature, we proposed arguments regarding the advantages and disadvantages of belonging to a chain; (3) the theory of transaction costs was used to explain public–private collaboration. The study was carried out on a sample of 642 chain-affiliated Spanish NHs, with data from quality scores downloaded from the website topMayores.es. We distinguished between the six largest chains and the rest. We applied linear regression models. The results show that NHs affiliated with one of the largest NH chains obtained worse quality scores in the assessment made by users, although quality scores improved for the largest chains of NHs involved in an agreement with the public administration. [ABSTRACT FROM AUTHOR]

Although people with a migration background (MB) have more unmet mental health needs than the general population, patients with a MB are still underrepresented in mental health care services. Provider bias towards these patients has been evidenced repeatedly but its driving factors remain elusive. We assessed the moderating effect of the individual (e.g. age and ethnicity), interpersonal (e.g. healthcare provider trust), and organisational (e.g. perceived workload) factors on general practitioners (GPs) differential decision-making regarding diagnosis, treatment, and referral for a depressed patient with or without a MB. An experimental study was carried out in which GPs were shown one of two video vignettes featuring adult male depressed patients, one with a MB and the other without. Belgian GPs (n = 797, response rate was 13%) had to decide on their diagnosis, treatment, and referral. Analysis of variance and logistic regression were used to analyse the effect of a MB, adding interaction terms for the explanatory variables. Overall, we found that there were ethnic differences in GPs' decisions regarding diagnosis and treatment recommendations. GPs perceived the symptoms of the patient with a MB as less severe (F = 7.68, p < 0.01) and demonstrated a reduced likelihood to prescribe a combination of medical and non-medical treatments (F = 11.55, p < 0.001). Those differences increased in accordance with the GP's age and perceived workload; at an interpersonal level, we found that differences increased when the GP thought the patient was exaggerating his distress. This paper showed that lower levels of trust among GPs' towards their migrant patients and high GP workloads contribute to an increased ethnic bias in medical decision-making. This may perpetuate ethnic inequalities in mental health care. Future researchers should develop an intervention to decrease the ethnic inequities in mental health care by addressing GPs' trust in their migrant and ethnic minority patients. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to examine the relationship between education and health amongst Australian women. Design/methodology/approach: This study uses the Household, Income and Labour Dynamics in Australia data set. Spouse's education is employed as an instrument to solve the potential endogeneity of educational attainment. Findings: The results indicate that an additional year of schooling can lead to an increase in self-reported health, physical health, mental health and a reduced likelihood of having long-term health conditions. Women who are not in the labour force are likely to enjoy higher benefits of education compared to their employed counterparts. The findings also suggest that the relationship between education and health can be explained by the extent of positive health behaviours and social capital as mediators. Research limitations/implications: The conclusion from the results might be different in the case of men, reducing the generalisability of the results. Several objective health variables should be used to provide further aspects of health on which education has an impact. Practical implications: As the positive effect of education on women's health is empirically found, investment in women's education should be seriously considered and reevaluated. Originality/value: This paper focuses on Australian women which not only reduces the heterogeneity between genders but also adds to the rare number of studies on this topic in Australia. This paper also employs a formal mediation analysis to examine what are the mechanisms explaining the relationship between education and health. [ABSTRACT FROM AUTHOR]

Aim: To assess the attitudes of newly graduated nurses in China toward their work environment and identify the factors affecting their perception. Background: Newly graduated nurses are the primary supply to cover the nursing shortage, but their stressful transition into clinical work has contributed to high turnover for decades. Although serving as a source of stress, the work environment can also be a source of support for new nurses. Methods: A total of 2361 new nurses at 31 tertiary hospitals in 20 provinces were surveyed from June to November 2018, using the Chinese version of the Practice Environment Scale‐Nursing Work Index. Basic information and their perception about work environment were collected. Results: New nurses rated their work environment with an overall score of 84.67 (12.85). Multiple linear regression identified that education level, monthly income, hospital type and location, participation (or not) in standardized training programmes and having (or not) a mentor/preceptor were factors significantly associated with their perception of the work environment. Conclusion: The perception of newly graduated nurses in China was mainly positive overall. Nursing managers may take full advantage of factors affecting the perception of work environment to support newly graduated nurses better, to help their retention and transition. Summary statement: What is already known about the topic? Newly graduated nurses experience transition shock at the beginning of their work.Supportive work environments can help successful transition. What this paper adds? Newly graduated nurses are not fully supported in their work environment.Staffing and resource inadequacy were the poorest environmental factors.Residency programmes had the most impact on the perceptions of newly graduated nurses about their work environment. Implications for nursing practice: These results can guide nursing managers to support the newly graduated nurses better in their transition process, thus helping retention of nursing human resource. [ABSTRACT FROM AUTHOR]

Objectives: Despite the obstacles of limited education and employment opportunities—and the stress associated with immigration and pregnancy—Mexican immigrant women have low rates of preterm birth (PTB) compared to the US national average for all races and ethnicities. Stressors during pregnancy, and stressors associated with acculturation, may accelerate cellular aging manifested by shortened telomere length (TL) in pregnant women. Our objectives were to: (1) determine whether women with PTBs had shorter telomere lengths compared to women who had full term births; (2) assess the association of acculturation with TL and PTB. Methods: This prospective pilot study collected data from 100 self-identified Mexican-origin pregnant women. Survey data included self-administered sociodemographic and acculturation measures and was collected from participants via paper and pen, while biologic data was collected via a single blood draw during a regularly scheduled prenatal visit between 26 and 36 weeks gestation. PTB data was collected from the participant's medical record after delivery. Results: TL was significantly associated with PTB; the median TL of the women with PTB was less than the median TL for the full sample (p = 0.02). Based on regression analysis for PTB vs acculturation, we found no significant associations between acculturation and PTB or TL. Conclusions for Practice: This study provides important evidence of the association between shortened maternal TL and adverse birth outcomes. By linking social, clinical and biologic data, we can enhance our understanding of social determinants that may affect racial and ethnic disparities in preterm birth. [ABSTRACT FROM AUTHOR]

Prior studies have focused on general technology use and technology use in domain‐general applications and quantity of technology use. Recent evidence suggests that investigations should consider how technology is used in more contextually specific ways, including how technology is used for various cognitive tasks in specific classrooms. The purpose of this study was to examine the ways in which classroom content area and student goal orientation have a coordinated influence for how students used technology to support learning. The sample included high school students in a Midwestern state who were surveyed on their motivation and how they used technology to support learning. The study employed hierarchical linear modelling to examine how goal orientation and classroom content area predicted various levels of Bloom's Digital Taxonomy. Students who adopted mastery‐oriented goals were more likely to use technology for various cognitive tasks, especially those at higher levels of complexity. Lastly, the association between mastery goal orientation and some aspects of technology use was conditioned on content area, although effect sizes were small. This study showed that, overall, technology is used differentially across four core content areas. Students in mathematics classrooms used technology less, however much of technology use was evident at lower cognitive levels. Second, students' goal orientation, and in particular their mastery goals influence how technology is used across content areas, and this is marginally conditioned on content area. Technology use should match the instructional context to maximize technology use and students' goal orientation. Lay Description: What is already known about this topic: Computer technology tools support cognitive engagementTechnology tool availability differs by content areaStudent motivation is often positively related to increased technology use What this paper adds: Student technology use for various cognitive tasks differed by content areaStudents with mastery goals were more likely to use technology differentlyMotivational patterns' effect on technology use did not differ by content areaStudents in math used technology qualitatively less than other content areas Implications for practice and/or policy: Greater emphasis should be placed on choosing technology to match content areasTechnology should be appropriately chosen to maximize cognitive learning tasksTo support technology use, teachers should help student mastery learning goals [ABSTRACT FROM AUTHOR]

Objective: Ethnic newspapers have the potential to reach and influence various cultural and ethnic subpopulations traditionally underserved in the United States. The current study sought to explore how ethnic news consumption interacts with health motivation to predict cancer prevention behaviors in a sample of Spanish-speaking adults.Design: Participants (N = 100) completed a survey in Spanish, with items measuring demographics, acculturation, health literacy, health motivation, ethnic newspaper consumption (for two papers: La Viva and La Raza), and cancer prevention behaviors.Results: Results indicated consumption of ethnic newspapers correlated positively to acculturation, and cancer screening utilization. In hierarchical regression analyses, the interaction of consumption of an ethnic newspaper (La Raza) and health motivation predicted two of the six prevention behaviors assessed: avoidance of fatty foods and screening behavior.Conclusion: The study provides evidence that consumption of Spanish-language newspapers enhances the likelihood that individuals with high levels of health motivation will engage in healthy behaviors. This finding highlights the utility of utilizing Spanish-language newspapers to reach underserved populations. [ABSTRACT FROM AUTHOR]

INTRODUCTION Using more than one tobacco product increases the risk of tobacco-related diseases. We investigated trends in the prevalence and dual use of factory-made (FM) cigarettes, other tobacco products, and electronic cigarettes (e-cigarettes) in South Africa over a 12-year period. METHODS Data from five waves (2007, 2010, 2011, 2017, and 2018) of the South African Social Attitudes Survey (n=14582) were analyzed. The use of FM, roll-your-own (RYO) cigarettes, cigars, waterpipe, smokeless tobacco (SLT), any combustible tobacco products (CTP), any tobacco product (ATP) use, and e-cigarettes was investigated. The dual use of FM cigarettes with either SLT, waterpipe or e-cigarettes was also explored. Chi-squared analyses and regression models were used to explore trends in prevalence over the 12-year period. RESULTS About 51% of the participants were female, and 51.9% were aged 16-34 years. CTP smoking significantly increased from 18.1% (2010) to 23.6% (2018) (p=0.015), while ATPU increased from 20.2% (2010) to 25.9% (2018) (p=0.005). Though dual use of FM cigarettes and SLT, waterpipe, or e-cigarettes was generally low, the prevalence of dual use significantly increased for all product combinations investigated: FM cigarettes and SLT (0.5% in 2007 to 1.3% in 2018, p=0.017), FM cigarettes and waterpipe (0.9% in 2010 to 2.5% in 2018, p=0.014), FM cigarettes and e-cigarettes (0.4% in 2010 to 1.8% in 2018, p<0.001). Compared to 2010, the odds of the prevalence of CTP and ATP use significantly increased by 37% in 2018 (adjusted odds ratio, AOR=1.37; 95% CI: 1.06-1.77; p=0.018 and AOR=1.37; 95% CI: 1.08-1.73; p=0.009, respectively) during the 12-year period after adjusting for demographic characteristics. CONCLUSIONS The use and dual use of tobacco and electronic cigarette products have been increasing in recent years in South Africa. Interventions to help users quit and prevent young people from initiating use are urgently needed to curb these increases. [ABSTRACT FROM AUTHOR]

Best practice in mass reach physical activity campaigns includes a role for communities to support the initiative with sustained programs and shorter-term events. The purpose of this paper was to report on an outcome evaluation of ParticipACTION's 150 Play List, a population-level, year-long, national mass reach campaign that included community events. Participants (N = 1,185) were recruited in the last month of the program to complete a questionnaire measuring demographic information, leisure-time physical activity, campaign awareness, attitudes, intentions, and behavioral trialing. Data were also collected, measured using cell phone proximity, on the number of people who attended 150 Play List events, which ranged from large-scale (e.g. national sports events) to smaller community events. Approximately 43% of respondents were aware of the 150 Play List and 19.5% reported participating in some way (e.g. visiting the website). Almost half of the participants who were aware of the campaign reported increased sport or physical activity-related intentions. Among those who participated, 90.6% reported trying at least one physical activity or sport related behavior as a result of the 150 Play List, whereas only 27.5% (n = 75) of those who were aware but did not participate in the 150 Play List tried a behavior. Event attendance goals were mostly met or exceeded. The 150 Play List was valued by those aware of it and the campaign was related to interest in sport and physical activity in Canada. The community events had potential to augment campaign effects but adequate evaluation requires sufficient resources. [ABSTRACT FROM AUTHOR]

Purpose The prevalence of intimate partner domestic violence (DV) increased in frequency during the global COVID-19 pandemic. The purpose of this pilot study was to assess dental hygienists' knowledge, attitudes, and readiness to manage patients experiencing DV in the state of Minnesota. Methods A cross-sectional study design was used on a convenience sample of dental hygienists. The validated Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) was used to collect the data. Survey items included demographic variables and measured attitudes and knowledge regarding intimate partner DV. Paper surveys were distributed to attendees at the Minnesota Dental Hygienist Association Annual Meeting. ANOVA and linear regression models were used to assess associations between domestic violence knowledge scores and respondent demographics and attitudes. Results Eighty-eight surveys were distributed; 31 surveys were completed and met the inclusion criteria for data analysis. The overall mean knowledge score was 11.6 from a possible score of 17. No significant differences were found by age, degree type, or years in practice and domestic violence knowledge or attitudes. Most respondents (64.5%) indicated a lack of preparedness to ask appropriate questions regarding DV and only a little more than half knew how to respond to disclosures of DV (51.6%) or were aware of the state's legal requirements for reporting DV (58.0%). Conclusion Participants demonstrated moderate knowledge of DV and recognized the importance of identifying and providing support for DV victims. However, participants were unsure of current state-mandated guidelines for reporting DV. Future exploration of reporting mandates will better support dental hygienists in their professional obligations identifying victims of DV. [ABSTRACT FROM AUTHOR]

INTRODUCTION Alzheimer's disease (AD) is a disease caused by many factors including occupational and environmental factors. Secondhand smoke (SHS) can affect cognitive function. However, there is limited recent epidemiological research on how SHS and occupational factors affect AD in Zhejiang province. METHODS We established a cohort of an AD high-risk population. In 2018, a cohort of 1742 elderly aged ≥60 years was established. In 2020, the cohort was followed up, and a total of 1545 people participated in the two surveys. Data collection included demographic and economic information such as age, gender, occupation, education level etc., and relative health behavior information such as smoking, drinking and tea drinking, etc. Basic physical examination data included height, weight, blood pressure, etc. At the same time, related cognitive status was assessed. Cox proportional hazards regression models, both unadjusted and adjusted models, were used to determine associations between cohort characteristics and AD. RESULTS The results showed that SHS exposure and occupational characteristics were associated with an increased risk of cognitive impairments in seniors. Subgroups who used to work as blue-collar workers, who never worked, who kept standing for most of the time at work, and who were engaged in hard physical labor prior to retirement, had high incidence rates of AD. CONCLUSIONS It was revealed that SHS, standing for most of the time and hard physical labor were associated risk factors of AD among seniors, compared with white-collar work. We recommend that the government establish a community supervisory mechanism to persuade smokers to quit or control smoking. [ABSTRACT FROM AUTHOR]

OBJECTIVES: This paper examines (1) the rate of plan switching among beneficiaries enrolled in a Medicaid managed long-term services and supports (MLTSS) program in Virginia, (2) barriers that prevent beneficiaries from changing plans, and (3) the extent to which a change in plans is associated with greater satisfaction with the current health plan. STUDY DESIGN: Survey data from a representative sample of 1048 members enrolled in Commonwealth Coordinated Care Plus, a Virginia Medicaid MLTSS program. METHODS: The survey ascertained whether beneficiaries changed plans at the previous open enrollment period, whether they wanted to change plans but did not, and reasons for not following through with a plan change. Logistic regression analysis examined the association between the intention to change plans and satisfaction with the current health plan. RESULTS: Seven percent of respondents changed plans during the previous open enrollment. However, twice as many respondents (15%) wanted to change plans but did not. The main reason for not changing plans was uncertainty about whether the new plan would meet their needs better than their current plan. Logistic regression analysis shows that an intention to change plans (realized or not) was associated with higher odds (3.5 times higher) of being dissatisfied with the current health plan compared with beneficiaries who had no intention to change plans. CONCLUSIONS: Greater dissatisfaction after a recent plan change may indicate that these members have specific needs beyond the scope of services offered by managed care organizations. [ABSTRACT FROM AUTHOR]

There is growing interest in factors which can contribute to the wellbeing of older adults. Participation in learning could have beneficial effects, but to date research on the benefits of learning has tended to focus on young people or those in mid-life and there is currently little evidence on the impact of learning on the wellbeing of older adults. In this paper we provide new, quantitative evidence on the relationship between participation in learning and the wellbeing of older adults. Our study used data from the English Longitudinal Study of Ageing (ELSA), a continuing, longitudinal survey of older adults. To measure wellbeing we used the CASP-19 instrument, a subjective wellbeing measure which is available at all waves of the ELSA survey. Respondents were asked about four types of learning activity: obtaining qualifications; attendance at formal education/training courses; membership of education, music or arts groups or evening classes; membership of sports clubs, gym and exercise classes. To take account of unobservable factors which might influence wellbeing, we applied fixed effects panel regressions to four waves of ELSA data. Learning was associated with higher wellbeing after controlling for a range of other factors. We found evidence that more informal types of learning were associated with higher wellbeing. There was no evidence that formal education/training courses were associated with higher wellbeing. [ABSTRACT FROM AUTHOR]

The role of the social environment can facilitate positive health outcomes through active community engagement, normalization of healthy behaviors, and stress buffering. We aim to examine the associations of neighborhood social cohesion with changes in BMI over time. A total of 7641 participants from The Maastricht Study between the ages of 40 and 75 years were analyzed. Weight and height were measured at baseline, and weight was self-reported annually up to 10 years of follow-up (median = 4.7 years). Perceived social cohesion was obtained by questionnaire. Home addresses for each participant were linked to geographic information system data from the Geoscience and Health Cohort Consortium to create neighborhood exposure variables including area level social cohesion, neighborhood walkability, and food environment within a 1000 m Euclidian buffer. Linear regression analyses were performed with BMI adjusted for socioeconomic variables. A mixed model analysis was carried out to examine changes in BMI. Living in the highest quartile area of individually perceived social cohesion was associated with lower BMI (Q4 B: −.53; 95% CI = −.79, −.28) compared to the lowest quartile. Similar findings were discovered using the area level measure (Q4 B: −.97; 95% CI = −1.29, −.65). There was no longitudinal association between social cohesion and BMI. Neighborhood social cohesion was associated with lower BMI classifying it as an obesogenic area characteristic that influences weight, independent of conventional built environment features. [ABSTRACT FROM AUTHOR]

Introduction and Objectives: Canadians rely on their primary care providers to address their mental health needs, but there are longstanding system gaps that must be addressed to enhance their ability to deliver mental health care. The present study addressed the gap in pediatric mental health care through the development, delivery, and evaluation of a mental health literacy training among non-physician primary care providers. Methods: We delivered the training among 97 participants, with all completed the pre-test survey, and 74 completed the post-test survey on knowledge, attitudes toward mental health, and help-seeking intentions. Additionally, participants explained why they attended the training and shared how they would apply the knowledge learned into their practice (behaviors). Results: Participants improved their knowledge significantly from pre-test to post-test, P <.001, d = 2.51. We didn't find any statistical significance between pre-test and post-test on attitudes, P =.067, nor on help-seeking intentions, P =.274. However, participants' scores were exceedingly high on both outcomes, indicating positive attitudes and intentions at 2 time points and implying a ceiling effect of both outcomes. We did not find outcome differences by demographics, practice year, practice zone, or professional role. While knowledge, years of practice and prior mental health training predicted participants attitudes at pre-test, they didn't at post-test. Attitudes toward mental health predicted help-seeking intentions. Participants indicated this training will change their practice behaviors. Conclusion: This mental health literacy training for primary care providers demonstrated strong evidence of the need to integrate mental health and addiction support into primary care practice. [ABSTRACT FROM AUTHOR]

Background: Poly-victimization (PV) not only threatens physical and mental health but also causes a range of social problems. Left-behind children in rural areas are more likely to experience PV problems. However, there have been fewer studies on PV among rural children, and even fewer intervention studies. Objective: The difference-in-differences method was employed to analyze the impact of intervention measures, based on the theory of planned behavior, on PV among left-behind children in rural areas. Methods: The study subjects were left-behind children from six middle schools in two cities in southern China, who completed the baseline survey from 2020 to 2021. They were divided into a control group and an intervention group, each consisting of 228 cases, based on their schools. Before and after the intervention, the Self-made victimization-related knowledge, attitude, and practice questionnaire, Poly-victimization scale, and Middle school students' coping style scale were used to evaluate the victimization-related KAP(knowledge, attitude, and practice), victimization occurrence, and coping styles of left-behind children, respectively. Stata 15.0 was used to establish a difference-in-differences regression model to analyze the impact of the intervention measures on poly-victimization and coping styles. Results: Mixed Anova revealed that after the intervention, the KAP scores of the intervention group were significantly higher than those of the control group (p < 0.05). After the intervention, the incidence of child victimization in the intervention group dropped to 9.60% (n = 22), lower than in the baseline survey, with a statistically significant difference (p < 0.01). The incidence of PV among children in the intervention group was lower than that in the control group, with the difference being statistically significant (p < 0.01). The net reduction in the incidence of PV among children was 21.20%. After the intervention, the protection rate for preventing PV among children was 73.33%, and the effect index was 3.75. The intervention improved children's coping styles, problem-solving, and help-seeking, while reducing negative coping styles such as avoidance and venting, with the differences being statistically significant (p < 0.05). Conclusion: Intervention measures based on the theory of planned behavior reduce the occurrence of PV among left-behind children, and the intervention effects on different types of victimization are also different. [ABSTRACT FROM AUTHOR]

Aim: To explore the effects of demographic characteristics, mental workload, and Adversity quotient (AQ) on the job engagement of nurses in East China. Design: A quantitative and cross‐sectional study. Method: The survey collected questionnaire data on mental workload, adversity quotient, and job engagement from 473 nurses selected working in 12 Grade‐A tertiary hospitals based on informed consent in East China between July 2020 and March 2021. Results: The total score of mental workload was 78.24 ± 11.65, the adversity quotient score was 128.26 ± 15.84, job engagement score was 42.32 ± 7.79. Job engagement has a remarkable positive correlation with adversity quotient (r = 0.613, p<0.001), and a negative correlation with mental workload (r = −0.499, p<0.001). Mental workload has an apparent negative correlation with adversity quotient (r = −0.291, p<0.001). Labor‐management relationship with current organization, department, study to get a degree or diploma in spare time, attitude towards a career in Nursing, attitude towards the current career position, satisfaction with marriage, social support, load feelings, self‐assessment, control, and endurance could predict 70.9% of job engagement of nurses. Conclusions: The mental workload of nurses was higher, the AQ was at a medium level, and the job engagement of nurses was also slightly higher. Labor‐management relationship with current organization, department, study to get a degree or diploma in spare time, attitude towards a career in Nursing, attitude towards the current career position, satisfaction with marriage, social support, load feelings, self‐assessment, control, and endurance had predictive effects on nurses' job engagement. It is necessary to take a variety of measures according to the social‐demographic characteristics, improve the adversity quotient, and evaluate the mental workload correctly, to improve the job engagement of nurses. Impact: The epidemic situation and other emergencies make the work pressure of nurses in Grade‐A tertiary hospitals increase suddenly. It should pay attention to the influence of different demographic factors, and pay attention to the correct guidance of work demand‐mental workload, as well as the cultivation, and improvement of job resource‐AQ, which can improve the job engagement of nurses to some extent. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Feeding challenges are a significant concern for autistic children. Literature has yet to comprehensively characterize feeding challenges for autistic children. Further research is needed to understand predictors of feeding severity and identify opportunities for screening and intervention. The purpose of this study was to characterize the presentation of feeding challenges in autistic children and identify predictors of feeding challenge classification and severity. Data from a national cross-sectional survey of caregivers (n = 427) of autistic children with feeding challenges was used. Feeding challenges were characterized using descriptive statistics. Autism diagnosis age and age of onset of feeding challenges was compared using non-parametric testing. Bi-directional stepwise multivariate linear regression was used to identify significant predictors of feeding challenge scores. Sensory-based feeding challenges were the most common. Age of onset of feeding challenges was significantly lower than the age of autism diagnosis. Early feeding challenges differentially predicted feeding challenge severity and classification scores. The results of this study identify the relationships among early feeding challenges and the severity and classification of feeding challenges in later childhood. Results demonstrate the importance of early monitoring of feeding challenges. These findings can be used to inform the identification of critical timepoints for intervention. Feeding challenges are common for autistic children. Currently, research and intervention for feeding challenges focuses on single factors (e.g. behavior or sensory). Research is needed to understand the complexity of feeding challenges. This study provides a comprehensive description of feeding challenges. Furthermore, this study identifies what factors predict the severity and type of feeding challenges experienced by autistic children. Using the Survey for Characterization of Feeding Challenges in Autistic Children—United States, 427 caregivers of autistic children provided information about their child's feeding challenges. Children were between the ages of 2 and 12 with an average age of 8.42 years. Children in the study had a wide variety of feeding difficulties including challenges in early childhood, sensory challenges, difficulty with family mealtime, and variable self-help skills. On average children's feeding challenges were present prior to their autism diagnosis. We found that children who had early feeding challenges had more severe feeding challenges in later childhood. Also, specific early feeding challenges predicted the types of feeding challenges children would have later in childhood. For example, children who had difficulty transitioning to table foods and who continued to restrict their diet over time were more likely to have sensory-based feeding challenges. Results from this study show how feeding challenges present in a wide variety of ways for autistic children. The findings also highlight the importance of screening for feeding challenges in early childhood and collaborating with families to understand individualized feeding challenge experiences. These results could be used to inform evaluation and intervention for feeding. [ABSTRACT FROM AUTHOR]

Simple Summary: Survivors of childhood cancer are predisposed to a range of late effects of treatment, including high symptom burden. Symptom burden may vary over time. The aim of this prospective pilot study was to assess the feasibility of collecting daily symptoms from adult survivors of childhood cancer using mobile health (mHealth) technology to evaluate symptom fluctuation and associations with future health-related quality of life (HRQOL). The 41 survivors included in this study had high adherence to symptom reporting (83%) and HRQOL reporting (95%). Variability of daily symptom burden differed from person-to-person (74%), day-to-day (18%), and month-to-month (8%). Additionally, a higher symptom burden was associated with poorer HRQOL in the future. Daily assessment of symptoms using mHealth technology revealed fluctuations in symptomology and the association between symptom burden and HRQOL. This method of symptom assessment is valuable for improving our understanding of symptom dynamics and sources of variability. Background: Cancer therapies predispose survivors to a high symptom burden. This study utilized mobile health (mHealth) technology to assess the feasibility of collecting daily symptoms from adult survivors of childhood cancer to evaluate symptom fluctuation and associations with future health-related quality-of-life (HRQOL). Methods: This prospective study used an mHealth platform to distribute a 20-item cancer-related symptom survey (5 consecutive days each month) and an HRQOL survey (the day after the symptom survey) over 3 consecutive months to participants from the Childhood Cancer Survivor Study. These surveys comprised a PROMIS-29 Profile and Neuro-QOL assessed HRQOL. Daily symptom burden was calculated by summing the severity (mild, moderate, or severe) of 20 symptoms. Univariate linear mixed-effects models were used to analyze total, person-to-person, day-to-day, and month-to-month variability for the burden of 20 individual symptoms. Multivariable linear regression was used to analyze the association between daily symptom burden in the first month and HRQOL in the third month, adjusted for covariates. Results: Out of the 60 survivors invited, 41 participated in this study (68% enrollment rate); 83% reported their symptoms ≥3 times and 95% reported HRQOL in each study week across 3 months. Variability of daily symptom burden differed from person-to-person (74%), day-to-day (18%), and month-to-month (8%). Higher first-month symptom burden was associated with poorer HRQOL related to anxiety (regression coefficient: 6.56; 95% CI: 4.10–9.02), depression (6.32; 95% CI: 3.18–9.47), fatigue (7.93; 95% CI: 5.11–10.80), sleep (6.07; 95% CI: 3.43–8.70), pain (5.16; 95% CI: 2.11–8.22), and cognitive function (–6.89; 95% CI: –10.00 to –3.79) in the third month. Conclusions: Daily assessment revealed fluctuations in symptomology, and higher symptom burden was associated with poorer HRQOL in the future. Utilizing mHealth technology for daily symptom assessment improves our understanding of symptom dynamics and sources of variability. [ABSTRACT FROM AUTHOR]

Background: Nursing educators play a critical role in training future nurses, and high turnover can disrupt the training quality and process. This study identified the institutional and personal factors influencing Canadian nursing educators' job satisfaction and turnover intention. Methods: This cross-sectional study used an online survey to obtain the levels of job satisfaction, turnover intention, role description, and institutional and personal/demographic characteristics of nursing faculty across Canadian institutions. Data were analysed using descriptive statistics, chi-square, bivariate linear regression, and hierarchical linear regression. Results: A total of 645 participants, with a mean ± SD age of 48.82 ± 10.11 years, returned a completed questionnaire. The average/maximum job satisfaction and turnover intention scores were 12.59/20 ± 3.96 and 6.50/15 ± 3.05, respectively. Higher job satisfaction was significantly associated with lower turnover intention (β=-0.559, p < 0.001). The multivariate analysis showed that having a partner or being married (β = 0.086, p = 0.031), working ≤ 40 h weekly (β=-0.235, p < 0.001), teaching ≤ 4 courses annually (β=-0.115, p = 0.007), and having higher than bachelor's degree qualification (β=-0.091, p = 0.042) predicted high job satisfaction, while high turnover intention was associated with faculty in the Prairie region (β = 0.135, p = 0.006) and working ≥ 41 h weekly (β = 0.151, p = 0.001). Conclusion: Having a partner, manageable workload, and advanced qualifications positively influenced job satisfaction, while high turnover intention was associated with high workloads. Institutions may benefit from ensuring proportionate faculty workloads, fostering career advancement, and providing robust support systems that can stabilise the workforce and preserve the quality of nursing education. [ABSTRACT FROM AUTHOR]

Background: Due to the significant increase in the prevalence of food-related diseases, the value that physicians place on nutritional advice may have implications for patient treatment. The objective of this study was to evaluate the perception of the importance of nutritional intervention among physicians in the Universidad San Francisco de Quito's (USFQ) healthcare system. Methods: This cross-sectional study employed a telephone survey administered to a subset of all medical doctors (MDs) working in the healthcare system clinics of USFQ between 2021 and 2022. Study participants were recruited through voluntary response sample from a complete list of 253 MD. The single time questionnaire consisted of a 22-item validated survey in which attitudes, self-perceived capacity, and knowledge about nutrition ofmedical doctors were evaluated. Data was analyzed using descriptive statistics, two-sided t test, bivariate associations and linear and logistic regressions. Results: 136 MDs completed the survey yielding a response rate of 54%. Our analysis grouped participants into clinical (CE) and non-clinical specialties, hereafter referred to as surgical MDs. While a higher percentage of physicians in CE are confident in their ability to provide examples of recommended food portions based on national or international guidelines, 1 in 10 do not know how to use and interpret BMI or waist circumference, and around 1 in 3 do not know how many calories there are in one gram of fat, protein, or carbohydrates, and their basic metabolic functions. Almost all survey participants believe MDs can have an impact on the eating behavior of a patient if time is used to discuss the problem, however, almost half of survey participants believe nutrition counseling is not an effective use of time. Conclusion: It is important to explore the perceptions and self-confidence of physicians around nutrition related issues. Our results demonstrated that nearly 1 in 4 surgical MDs do not feel capable of recognizing nutritional risk in patients, which highlights the essentiality of physicians having an updated understanding of basic nutrition principles. Future research should examine how commonly MDs refer patients to nutritionists/dietitians, as well as strategies for improving physician knowledge on basic nutrition concepts. [ABSTRACT FROM AUTHOR]

This study used longitudinal survey data of Filipino American and Korean American youth in the Chicago Metropolitan area (N = 786, MAGE = 15.00, SD = 1.91 at Wave 1 in 2014) to examine whether and how a set of organized predictors (i.e., universal predictors of youth outcomes and cultural orientations) independently and collectively explains internalizing and externalizing problems and academic performance. The results were that universal predictors such as youth antisocial beliefs, peer antisocial behaviors, and the quality of parent–child relations, were extensively predictive of youth outcomes in the expected directions. The magnitudes of universal predictors were largely unchanged when bilinear and multidimensional cultural orientation variables were accounted for together. The magnitudes of cultural orientation variables were slightly attenuated in full models but showed independent associations with youth outcomes. Specifically, English and heritage language proficiencies were protective of externalizing and internalizing problems. Behavioral practices in respective cultures increased youth problems. In addition, ethnic identity, although beneficial to mental health, can increase externalizing problems. The findings of this study provide insights into understanding the mixed outcomes among Asian Americans and important empirical evidence that can inform intervention programs to prevent youth problems, ultimately toward a pathway to positive youth development among Asian American youth. [ABSTRACT FROM AUTHOR]

Peer victimization (PV) is a common and serious problem in school contexts, which hinders adolescents' emotional development and social adaptation. The present study aimed to test the longitudinal relationship between PV and the increase of depressive symptoms (DSs) among Chinese mid-late adolescents using a two-wave longitudinal design and examine the buffering effects of self-compassion (SC) and parental autonomy support (PAS) on this relationship. A relatively large sample of Chinese high school students (N = 722, 52.1% boys; age at Time 2 = 16.23 years old, SD = 0.79) were surveyed annually at two time points. The results showed that PV at Time 1 positively predicted DSs at Time 2 after controlling for the DSs at Time 1. In addition, SC and PAS moderated the longitudinal relationship between PV and the development of DSs, while such moderating effects only existed in girls but not in boys. Specifically, the positive relationship between PV and DSs was non-significant among girls with higher levels of SC or PAS. Our findings highlighted that SC and PAS might be important protective factors buffering against DSs for victimized girls. [ABSTRACT FROM AUTHOR]

Understanding how informal care impacts formal care utilisation for home‐based end‐of‐life patients is an important policy‐ and practice‐relevant question. This paper aims to assess the relationship between informal and formal home care among home‐based end‐of‐life patients and how this relationship has changed over the last decade and over the end‐of‐life trajectory. We focus on informal care provided by family members or friends, and three types of home‐based formal care services: care by personal support workers, physician visits, and nurse visits. Using survey data collected in a home‐based end‐of‐life care programme in Ontario, Canada from 2005 to 2016, we build a two‐part utilisation model analysing both the propensity to use each type of formal care and the amount of formal care received by patients. The results suggest that informal care is a substitute for care by personal support workers, but a complement to physician visits and nurse visits. In the case of nurse visits, an increased complementary effect is observed in more recent years. For home‐based physician and nurse visits, the complementary effect grows with patient's proximity to death. These results highlight the complexity of the relationship between informal and formal care among home‐based end‐of‐life patients. Decision‐makers need to take into account the relationship between informal care and different types of formal services when introducing future policies. [ABSTRACT FROM AUTHOR]

Purpose Poor health-related quality of life (HRQoL) is one of the important issues in the health sector. The purpose of this paper is to investigate the prevalence and socio-economic inequality in poor HRQoL in Tehran city, Iran.Design/methodology/approach In total, 562 adults were included in this cross-sectional study. The cluster sampling method was used for data collection from May to June, 2016 in Tehran city, Iran. Data on HRQoL, using EuroQol 5-dimensions questionnaire, and data on socio-economic and demographic variables were gathered. Convenience regression method was performed to measure the concentration index (CI). Decomposition analysis was performed to determine the contribution of variables on socio-economic inequality in poor HRQoL. All analyses were performed by Stata v.14.Findings The prevalence of poor HRQoL was 28.3 percent. The value of CI for "poor HRQoL" was −0.299 (95% confidence interval: −0.402 to −0.195). Socio-economic status (SES) was the largest contributor to socio-economic inequality in poor HRQoL (69.44 percent of inequality was explained by SES). Age, obesity and race had a positive contribution to socio-economic inequality in poor HRQoL among the participants. Nonetheless, sex and smoking intensity had a negative contribution to inequality in poor HRQoL.Originality/value There is little evidence about the prevalence of poor HRQoL in insured people. This study provided new evidence in this area through the investigation of socio-economic inequality in poor HRQoL and its determinants among people with health insurance in Iran using decomposition analysis. [ABSTRACT FROM AUTHOR]

Objectives: To ascertain Australian multistate prevalence and incidence of five commonly collected clinical indicators of aged-care home quality and to measure associations between these clinical indicators and levels of care needs and consumer and staff satisfaction. Methods: A retrospective analysis of national audit data collected from 426 facilities between 2015 and 2016 was performed. Regression models were used to examine associations between five clinical indicators (falls, pressure injury, physical restraint, unplanned weight loss and polypharmacy) and level of care needs measured by the Aged Care Funding Instrument (ACFI) and consumer and care staff survey responses. Results: With the exception of polypharmacy, commonly collected negative clinical outcomes were rare events. Compared with care homes with <25% of residents having high-level care needs (high ACFI), homes with 25<75% high-ACFI residents had more occurrences of all negative clinical outcomes except pressure injury. Homes with ≥75% high-ACFI residents reported the highest rates of polypharmacy (odds ratio 1.48, 95% confidence interval 1.39 – 1.57). Falls, unplanned weight loss and pressure injury were inversely associated with satisfaction scores adjusted for residents' level of care needs. Conclusions: This first Australian study of multistate clinical indicator data suggests interpretation of clinical indicators of aged-care home quality requires consideration of the level of residents' care needs. What is known about the topic?: Many Australian aged-care providers use quality indicators (QI) through benchmarking companies or in-house programs. The five most widely used aged-care clinical QIs in Australia are falls, pressure injury, physical restraint, unplanned weight loss and polypharmacy. Prevalence and incidence of these QIs are highly variable among Australian studies. A consistent message in the international literature is that residents' clinical characteristics influence QI outcomes at baseline and may continue to influence outcomes over time. Study of associations between Australian aged-care home characteristics and QI outcomes has been limited. What does this paper add?: This is the first Australian study of multistate clinical QI data. It is also the first to consider the level of resident care needs in the interpretation of clinical QI outcomes and exploration of the association between level of consumer and staff satisfaction and QI outcomes. What are the implications for practitioners?: Understanding the connections between aged-care home characteristics, consumer and staff perceptions and clinical QIs is crucial in the meaningful interpretation of QI outcomes in context. With the recent introduction of the National Aged Care Quality Indicator Program, it is timely to review national policy, to gauge current quality of care and the measure of care quality in the sector, and to develop directions for possible research to inform and resolve debates regarding the potential influence and unplanned effects that such a program may have. [ABSTRACT FROM AUTHOR]

This paper addresses the question of the relative importance of work-integrated learning placement quality, structure (whether part-time or full-time), and duration (in weeks), for producing employability outcomes. Additionally, we explore whether the quality of those placements is more, less, or equally important than the structure and duration. Drawing on responses to questions in a survey from 2,313 participants, 1,316 of whom had no placement experience and 997 of whom had had a placement experience, as part of their university studies, we tested a series of related hypotheses. After controlling for prior work-experience, results show that the quality of the placement experience is a greater predictor of a variety of employability outcomes than either structure of the placement experience or its duration. Findings will inform curriculum designers, practicum supervisors, and those interested in the outcomes of higher education. [ABSTRACT FROM AUTHOR]

Introduction: Quality of life is included in the economic evaluation of health services by measuring the preference for health states, i.e. health state utilities. However, most intervention studies include a disease-specific, not a utility, instrument. Consequently, there has been increasing use of statistical mapping algorithms which permit utilities to be estimated from a disease-specific instrument. The present paper provides such algorithms between the MacNew Heart Disease Quality of Life Questionnaire (MacNew) instrument and six multi-attribute utility (MAU) instruments, the Euroqol (EQ-5D), the Short Form 6D (SF-6D), the Health Utilities Index (HUI) 3, the Quality of Wellbeing (QWB), the 15D (15 Dimension) and the Assessment of Quality of Life (AQoL-8D). Methods: Heart disease patients and members of the healthy public were recruited from six countries. Non-parametric rank tests were used to compare subgroup utilities and MacNew scores. Mapping algorithms were estimated using three separate statistical techniques. Results: Mapping algorithms achieved a high degree of precision. Based on the mean absolute error and the intra class correlation the preferred mapping is MacNew into SF-6D or 15D. Using the R squared statistic the preferred mapping is MacNew into AQoL-8D. Implications for research: The algorithms reported in this paper enable MacNew data to be mapped into utilities predicted from any of six instruments. This permits studies which have included the MacNew to be used in cost utility analyses which, in turn, allows the comparison of services with interventions across the health system. [ABSTRACT FROM AUTHOR]

Background:Narrative communication is gaining attention in the health education literature. In this article, we evaluate the acceptability and psychosocial impact of a book of role model stories presenting low-income women's success stories in changing diet and physical activity.Methods:Free copies of theBe Wellbook were distributed through organizations, and recipients were asked to fill out a paper or online questionnaire on completion of the book. Of the 317 recipients who returned valid questionnaires, 62.5% indicated that they had read at least one story in the book. Regression models were run to examine the strength of change in psychosocial and cognitive measures by degree of exposure; that is, number of stories read.Results:Overall, exposed respondents reported significantly greater self-efficacy and slightly greater knowledge and intent to change than unexposed respondents. Among exposed respondents, reported knowledge and intent to change behaviors varied directly with number of stories read.Discussion:The role model stories presented in theBe Wellbook were acceptable to the participants and successful in increasing readiness for behavior change.Translation to Health Education Practice:A narrative communication approach presented as a book of role model stories can bring about positive change in lifestyle behaviors and associated cognitions. [ABSTRACT FROM PUBLISHER]

Objectives: Whereas data collection on subjective anthropometric measures is inexpensive and sometimes may be the only feasible option for large-scale population-based surveys, self-reported height and weight can be susceptible to measurement error and social desirability bias. In this study, we aimed to assess the level of discrepancy between self-reported and devicemeasured height, weight, and obesity indicators, and to construct regression models to predict corrected anthropometric measures using self-reported data. Methods: Paper-and-pencilbased health surveys were administered to all freshmen enrolled in Tsinghua University in Beijing, China. Freshmen's height and weight were measured by trained staff using stadiometer and digital scale within one week following survey completion. Robust regressions were performed to predict corrected height, weight, body mass index (BMI), and overweight and obesity prevalence using self-reported data (N = 16,675). Results: Male freshmen over-reported both height and weight, whereas female freshmen over-reported height but under-reported weight. Both resulted in underestimation of BMI and overweight prevalence. The predicted values based on robust regressions substantially reduced the discrepancy between self-reported and objectively-measured height, weight, BMI, and overweight prevalence. Conclusions: Parsimonious regression models could be useful in obesity surveillance by predicting corrected anthropometric measures using self-reported data. [ABSTRACT FROM AUTHOR]

Malaysia is a multi-ethnic country with Malay, Chinese and Indian being the dominant ethnic groups. This paper investigates the three ethnic cultures in Malaysia by examining the individual-level values of managers and professionals. Based on 528 responses to a Schwartz Value Survey ( SVS) questionnaire, the paper identifies partial convergence of the value systems of Malay, Chinese and Indian people. It was found that the three ethnic groups do not differ significantly in the individualistic value dimensions of Self-enhancement and Openness-to-change. However, Malays are found to be more conservative and less self-transcendent than Chinese or Indians, while Chinese and Indians attribute the same importance to these two sets of values. [ABSTRACT FROM AUTHOR]

Aims and objectives: The many negative effects of burnout have prompted researchers to better understand the factors contributing to it. The purpose of this paper is to add to this body of knowledge through the study of burnout among direct‐care workers in nursing homes. Background: Perhaps the factor most often associated with employee burnout is the level of staffing—insufficient staffing results in work overload and eventually employee burnout. A closer look at research findings suggests that there are many other factors also contributing to burnout. These range from those at the organisational level, such as availability of training and resources to individual characteristics such as self‐esteem and length of employment. Methods: A self‐administered survey instrument was completed by 410 direct‐care workers working within 11 nursing homes in the north Texas region. Regression analyses were performed, adjusting for clustering by nursing home. Beta coefficients and structure coefficients are reported. Burnout was measured through three dimensions: emotional exhaustion, depersonalisation and personal accomplishment. Results: Organisational, work design, interpersonal and individual characteristics were found to be associated with one or more dimensions of burnout. Conclusions: The analyses largely support previous research. Organisational variables of significance included the availability of resources to do the work, available training and fair pay. Work design variables of significance included adequate staffing. The individual characteristic, self‐esteem, appeared to have the strongest impact on burnout. Commitment to the organisation also had a large impact. Relevance to clinical practice: While the data do not allow for the testing of causal relationships, the data do suggest that providing adequate staffing, perceived fair pay, sufficient work resources (e.g., towels, gowns), management support and adequate training may result in less direct‐care worker burnout on the job. [ABSTRACT FROM AUTHOR]

Aim. This study aims to investigate the level of organizational learning within urban Chinese Community Health Centres and reveal its potential association with primary care nurses' work performance and well‐being. Background. Globally, there is a push to establish learning healthcare systems for complex health reform challenges. Existing studies on organizational learning mainly focus on North American and European hospital settings, offering limited insights into primary care environments, particularly in developing countries. Design. Cross‐sectional study. Methods. We recruited 175 nurses from 38 community health centres in four Chinese cities (Shanghai, Shenzhen, Tianjin, and Jinan) using convenience sampling. Trained research assistants conducted face‐to‐face surveys, measuring organizational learning with the Learning Orientation Scale. Nurse‐level outcomes included self‐directed learning, quality of care, organizational commitment, and work stress. Data analysis employed multilevel linear modelling. Results. The 38 community health centres displayed a relatively high level of organizational learning, and there was a positive and significant association between organizational learning within community health centres and nurses' self‐directed learning as well as the quality of care. However, there was no significant association between organizational learning and nurses' organizational commitment or work stress. Conclusion. This study demonstrates a high‐level organizational learning capacity in urban community health centres in China. It provides a new perspective on the potential relationship between CHCs' organizational learning and primary care nurses' well‐being and work performance. Further research is needed to clarify unexpected findings and identify factors promoting organizational learning in primary care settings. Implications for Nursing Management. In China's evolving primary care system, nurses play a vital role amidst physician shortages. Policy should prioritize internal management reform alongside structural changes. This study highlights the importance of fostering organizational learning in primary care settings. Strategic interventions should promote a learning culture in CHCs, which may enhance nurses' self‐directed learning and improve the quality of care. [ABSTRACT FROM AUTHOR]