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Research suggests parental ability to recognise when their child has overweight is limited. It is hypothesised that recognition of child overweight/obesity is fundamental to its prevention, acting as a potential barrier to parental action to improve their child's health-related behaviours and/or help seeking. The purpose of this study was to investigate the efficacy of an intervention (MapMe) to improve parental ability to correctly categorise their child as having overweight one-month post-intervention, and reduce child body mass index (BMI) z-score 12 months post-intervention. MapMe consists of body image scales of known child BMI and information on the consequences of childhood overweight, associated health-related behaviours and sources of support. We conducted a three-arm (paper-based MapMe, web-based MapMe and control) randomised control trial in fifteen English local authority areas with parents/guardians of 4–5- and 10–11-year-old children. Parental categorisation of child weight status was assessed using the question 'How would you describe your child's weight at the moment?' Response options were: underweight, healthy weight, overweight, and very overweight. Child weight status and BMI z-scores were calculated using objectively measured height and weight data and UK90 clinical thresholds. There was no difference in the percentage of parents correctly categorising their child as having overweight/very overweight (n = 264: 41% control, 48% web-based, and 43% paper-based, p = 0.646). BMI z-scores were significantly reduced for the intervention group at 12 months post-intervention compared to controls (n = 338, mean difference in BMI z-score change −0.11 (95% CI −0.202 to −0.020, p = 0.017). MapMe was associated with a decrease in BMI z-score 12 months post-intervention, although there was no direct evidence of improved parental ability to correctly categorise child overweight status. Further work is needed to replicate these findings in a larger sample of children, investigate mechanisms of action, and determine the use of MapMe as a public health initiative. [ABSTRACT FROM AUTHOR]

As the economic sector transitions to digitalization, Indians now have access to the best goods and services from the best companies, even in the most remote regions of their nation. E-marketing is booming in India, a nation that is both highly populated and home to millions of people who utilise social media and mobile devices. Internet-based marketing is essential for everyone who wants to grow their company and advertise their goods and services globally because it has no territorial restrictions. To scatter the needs paper aims at analysing the connections between e-Marketing tools and marketing performance among SMEs in India, in addition to the dearth of studies examining the adoption of e-Marketing by small enterprises. A structured questionnaire with both openended and closed-ended questions in Vijayawada & Guntur Areas of the Andhra Pradesh State was chosen from a list of 1,200 SMEs that employ fewer than 50 people using a simple random sampling method. Findings revealed that the internet tools were showing positive effect on the market performance in the companies. The rest of the paper consists of implications, and scope for the future research. [ABSTRACT FROM AUTHOR]

The mining sector in most developing countries including Tanzania has become an important sector for the economy. However, the sector still faces many challenges to realize its full potential. This paper assesses whether mining companies complied with the regulatory framework of the mining sector based on community perspectives in Kahama District. A total of 215 households were sampled for the study based on Bailey’s method using a sampling per cent of 9.3%. Within villages, respondents were selected using simple random sampling technique. Data were collected using questionnaire, focus group discussions, observations and document reviews. While content analysis was used to analyse primary qualitative data, factor analysis was employed to reduce variables which were then analyzed to find extent of compliance of large-scale mining companies with regulatory framework for sustainable mining, and documentary review was used to analyse secondary data. The findings show that consultation for views on issues, publication of anticipated effects and benefits in communities were positively attained by the mining companies. However, mining companies’ operations to a large extent have negatively affected the qualities of water, soil, air and use of the available resources within operation areas. The paper concludes that although large mining companies are required in Tanzania, addressing the existing challenges would lead to achieving sustainable mining practices. [ABSTRACT FROM AUTHOR]

Night-time vehicle detection plays a vital role due to the high incidence of abnormal events in our daily security field. However, existing studies mainly focus on vehicle detection in autonomous driving and traffic intersection scenes, but ignore urban scenes. There are vast differences between these scenes, such as viewpoint, position, illumination, etc. In this paper, the authors present a night-time vehicle detection dataset collected from urban scenes, named Vehicle Detection in Night-Time Urban Scene (VD-NUS). The VD-NUS dataset consists of more than 100 K challenging images, comprising a total of about 500 K labelled vehicles. This paper introduces a vehicle detection framework via an active auxiliary mechanism (AAM) to reduce the annotation workload. The proposed AAM framework can actively select the informative sample for annotation by estimating its uncertainty and locational instability. Furthermore, this paper proposes a computer-assisted detection module embedded in the AAM framework to help human annotators to rapidly and accurately label the selected data. AAM outperformed the baseline method (random sampling) by up to 0.91 AP and 3.0 MR−2 on the VD-NUS dataset. [ABSTRACT FROM AUTHOR]

Northern European international retirement migrants are often viewed as affluent and use migration as a route to a better quality of life. However, as these migrants transition into the 'fourth age', the onset of age-related illnesses, frailty and care needs can lead to increased levels of risk and insecurity. Through 34 qualitative interviews with older British migrants in Spain, the paper explores how these migrants access and experience care as they age. It draws on a lens of precarity that allows an understanding not only of individual care needs, but of the political, economic and social context in which they are situated, including social protections and public safety nets. The findings suggest that distant family relationships and limited access to formal social protection can both create and exacerbate precarity. These older migrants therefore develop different strategies to access care that include drawing on informal relationships and voluntary organisations within the British community in Spain. The paper contributes to understanding how international retirement migrants manage their care needs, and theoretically extends our understanding of how the intersection of old age, migration and care can create new forms of precarity. [ABSTRACT FROM AUTHOR]

Molecular dynamics (MD) is the method of choice for understanding the structure, function, and interactions of molecules. However, MD simulations are limited by the strong metastability of many molecules, which traps them in a single conformation basin for an extended amount of time. Enhanced sampling techniques, such as metadynamics and replica exchange, have been developed to overcome this limitation and accelerate the exploration of complex free energy landscapes. In this paper, we propose Vendi Sampling, a replica-based algorithm for increasing the efficiency and efficacy of the exploration of molecular conformation spaces. In Vendi sampling, replicas are simulated in parallel and coupled via a global statistical measure, the Vendi Score, to enhance diversity. Vendi sampling allows for the recovery of unbiased sampling statistics and dramatically improves sampling efficiency. We demonstrate the effectiveness of Vendi sampling in improving molecular dynamics simulations by showing significant improvements in coverage and mixing between metastable states and convergence of free energy estimates for four common benchmarks, including Alanine Dipeptide and Chignolin. [ABSTRACT FROM AUTHOR]

Background: Errors in medication administration by qualified nursing staff in hospitals are a significant risk factor for patient safety. In recent decades, electronic medical records (EMR) systems have been implemented in hospitals, and it has been claimed that they contribute to reducing such errors. However, systematic research on the subject in Israel is scarce. This study examines the position of the qualified nursing staff regarding the impact of electronic medical records systems on factors related to patient safety, including errors in medication administration, workload, and availability of medical information. Methods: This cross-sectional study examines three main variables: Medication errors, workload, and medical information availability, comparing two periods– before and after EMR implementation based on self-reports. A final sample of 591 Israeli nurses was recruited using online private social media groups to complete an online structured questionnaire. The questionnaires included items assessing workload (using the Expanding Nursing Stress Scale), medical information availability (the Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire), and medical errors (the Medical Error Checklists). Items were assessed twice, once for the period before the introduction of electronic records and once after. In addition, participants answered open-ended questions that were qualitatively analyzed. Results: Nurses perceive the EMR as reducing the extent of errors in drug administration (mean difference = -0.92 ± 0.90SD, p < 0.001), as well as the workload (mean difference = -0.83 ± 1.03SD, p < 0.001) by ∼ 30% on average, each. Concurrently, the systems are perceived to require a longer documentation time at the expense of patients' treatment time, and they may impair the availability of medical information by about 10% on average. Conclusion: The results point to nurses' perceived importance of EMR systems in reducing medication errors and relieving the workload. Despite the overall positive attitudes toward EMR systems, nurses also report that they reduce information availability compared to the previous pen-and-paper approach. A need arises to improve the systems in terms of planning and adaptation to the field and provide appropriate technical and educational support to nurses using them. [ABSTRACT FROM AUTHOR]

The aim of this study is to explore Effects of Classroom Environment on Student Learning at Elementary Level. The present paper seeks to identify the effects of Classroom Environment on students' learning and to evaluate the effects of classroom management at elementary level students. Descriptive research method was used by the researcher. Narowal division selected as a population, and district Narowal selected for sample of the study. This study restricted the sample to elementary school students who responded that the Effects of Classroom Environment on Student Learning at Elementary Level. In the 1st phase through convenience sampling teaching for select district Narowal from division Gujranwala. In 2nd phase researcher used simple random technique to select schools, teachers. Simple random sampling technique was used to collection data. Questionnaire was used as data collection tool. In the current study, out of the total 1,043 school, 72 schools (urban, rural) selected through simple random sample technique for the purpose of data collection. In present study 530 female teacher's responses received. Frequency, percentage, mean score and standard Deviation tests were used to analyses the data collected through SPSS version 25.0. The responses paint a favorable view of the circumstances. Frequency, Percentage, mean score, religion, origins or gender is more prevalent. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the effect of motivational interviewing based on the trans‐theoretical model promoting physical activity in older adults. Methods: A randomized controlled trial study was conducted with 117 older adults (intervention group: 58, and control group: 59) between April and November 2019. The data were collected via a questionnaire, trans‐theoretical model scales, the Physical Activity Scale for the Elderly, the Katz Activities of Daily Living scale and a pedometer. The 24‐week intervention consisted of regular motivational interviewing. The control group received usual care at the family health centre. Results: Following the intervention, the Intervention Group showed significant improvements Exercise Processes of Change Scale, Exercise Self‐Efficacy Scale and Perceived Benefits of the Decisional Balance Scale for Exercise. There was a significant difference between the groups in terms of stages of change. In the Intervention Group, 81.5% were in the contemplation stage in the pre‐test, while in the post‐test, 70.4% had transitioned to the action stage. In contrast, in the control group, 62.5% were in the contemplation stage initially, but in the post‐test, only 9.3% had reached the action stage. The mean number of step counts increased significantly in favour of the Intervention Group, as did the Physical Activity Scale for the Elderly total score. Conclusion: The trial indicated that after the trans‐theoretical model‐based motivational interviewing, the stages of change among the older adults improved, as did their exercise behaviours. It is recommended that the trans‐theoretical model and motivational interviewing be used by nurses to improve healthy lifestyle stage behaviours in older adults. Summary statement: What is already known about this topic? Physical immobility ranks fourth among the leading risk factors for mortality globally.Older adults constitute the age group which leads the most sedentary life in society and is most affected by physical inactivity.In Turkey, one out of every two people undertakes insufficient physical activity, and this rate increases with advancing age. What this paper adds? Nurse‐led motivational interviewing based on the trans‐theoretical model was effective in increasing the physical activity levels of the older adults. The implications of this paper: It is recommended that the trans‐theoretical model and motivational interviewing should be used by nurses to improve healthy lifestyle behaviours in older adults.It is recommended that studies be conducted to assess the effectiveness of interventions aimed at promoting physical activity in older adults via both qualitative and quantitative methods. [ABSTRACT FROM AUTHOR]

Aim: This study examined the preliminary effects of a nurse‐led self‐management education and support programme on the self‐management behaviours and quality of life among people with type 2 diabetes in Western Ethiopia. Methods: A pilot randomized controlled trial was conducted between January and August 2021. Participants were recruited in the hospital and randomly assigned to the control arm to continue usual care (n = 38) or the intervention arm to receive usual care and the diabetes self‐management education and support programme (n = 38) in the community. Self‐management behaviours and quality of life were assessed using a 10‐item summary of diabetes self‐care activity (expanded) scale and a 34‐item diabetes quality of life measure, respectively, at baseline and 2 months after follow‐up. Generalized estimating equation models were used to examine the preliminary effects of the programme on the outcomes. Results: Preliminary results indicated that the programme outperformed usual care in self‐management practise, with large effect sizes immediately postintervention and at 2 months after the intervention, and quality of life at 2 months after the intervention. Conclusion: A nurse‐led diabetes self‐management education and support intervention, including the families of people with diabetes, may be an option to boost the self‐management practise and quality of life of patients with diabetes. Summary statement: What is already known about this topic? Family‐supported diabetes self‐management education intervention produced inconclusive effects on self‐management behaviour and quality of life. What this paper adds? A social‐cognitive theory‐guided, culture‐tailored, and community‐based diabetes self‐management education and support programme resulted in a preliminary effect on improving self‐management behaviour and quality of life.A nurse‐led diabetes self‐management education and support programme intervention, including the families of patients, may be an option to boost the self‐management practise and quality of life of people with diabetes. The implications of this paper: Culturally tailored diabetes self‐management education and support programme could be an option to improve self‐management behaviour and enhance quality of life.Community‐based nurse‐delivered diabetes self‐management education and support can improve self‐management behaviours and enhance quality of life in 2 months duration. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to assess the validity and reliability of the Salutogenic Health Indicator Scale (SHIS) among a sample of Turkish university students. Methods: This study was conducted with 291 university students. The SHIS was evaluated in terms of language equivalence, validity and the reliability. Content validity was assessed with the content validity index (CVI). Construct validity was determined by confirmatory factor analysis (CFA). A Cronbach's alpha reliability coefficient was used for the analysis of internal consistency, a Pearson's correlation coefficient was used for parallel form reliability, and the intraclass correlation coefficient (ICC) was used for the test–retest technique. Results: The CVI of the SHIS was between 0.80 and 1.00. When the results of the CFA were examined, the factor loadings of all items were above 0.50. A statistically significant moderate positive correlation was found between the SHIS and the Sense of Coherence (SOC) scores for parallel form reliability (r = 0.489). Within the scope of the test–retest analysis, an ICC = 0.762 was determined (p < 0.001). Conclusion: The findings obtained from this validity and reliability study carried out on a sample of Turkish university students showed that the SHIS was both valid and reliable. Summary statement: What is already known about this topic? In recent years, as awareness of the impact of stress on human life has grown, the significance of the salutogenesis concept has increased, resulting in an upsurge in related studies.Several studies have shown the robust psychometric properties and validity of the Salutogenic Health Indicator Scale (SHIS).SHIS, being a semantic type of scale, sets it apart from other measurement scales in the literature that assess positive health and salutogenic health due to its structure. What this paper adds? The results of this adaptation study, which was carried out on a sample of Turkish university students, showed that the SHIS is a valid and reliable tool for measuring health in Turkish culture. The implications of this paper: A culturally and developmentally appropriate, valid and reliable tool can enable individuals to recognize health indicators, resources and coping skills.SHIS can be utilized by healthcare professionals, particularly nurses responsible for patient care, researchers, educators and university students. It proves valuable in conducting comprehensive evaluations of health, positive health and well‐being care, as well as in the planning, development and evaluation of suitable intervention programmes. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to (i) evaluate the effectiveness of mindfulness‐based interventions in improving self‐efficacy, reducing stress and anxiety among peritoneal dialysis patients, and (ii) compare the most effective method of mindfulness based interventions. Methods: This randomized three‐arm controlled trial recruited first‐time peritoneal dialysis patients from the peritoneal dialysis outpatient clinic in Singapore. Patients were randomly allocated to either video‐assisted mindfulness training, therapist‐assisted mindfulness training or treatment‐as‐usual. All groups received 4.5 days of structured peritoneal dialysis training at the peritoneal dialysis centre, while video‐assisted mindfulness training and therapist‐assisted mindfulness training groups were taught additional mindfulness‐based techniques. The perceived stress scale, self‐efficacy, and anxiety (State and Trait Anxiety Inventory) were measured at baseline, 4‐ and 12 weeks post‐randomization, using reliable and valid instruments. Results: Thirty‐nine patients were recruited (13 in each group). All the therapies showed a significant time trend in anxiety. Only therapist‐ and video‐assisted mindfulness training showed a significant trend in perceived stress scale scores but not treatment‐as‐usual. All Intervention X Time interactions were not significant. Patients in therapist‐ and video‐assisted mindfulness training groups had reduced perceived stress scale scores compared to treatment‐as‐usual at week 12. Conclusion: This study demonstrated the potential of mindfulness‐based interventions in reducing stress among first‐time PD patients. Summary Statement: What is already known about this topic? Mindfulness‐based interventions have been recommended to mediate stressful events.Mindfulness‐based interventions as complementary therapy can be taught to patients who are starting peritoneal dialysis for the first time; however, the best method to guide mindfulness‐based interventions is unknown. What this paper adds? The findings showed that mindfulness‐based interventions can potentially reduce stress and anxiety but have no statistically significant effect on self‐efficacy for patients undergoing peritoneal dialysis for the first time.Video‐ or therapist‐guided mindfulness training is just as effective in teaching mindfulness‐based interventions. The implications of this paper: Nurses hold an essential role in improving the experience of patients undergoing peritoneal dialysis by advocating and facilitating the use of MBI during dialysis, especially those who display high levels of stress and anxiety, as well as signs of coping issues. [ABSTRACT FROM AUTHOR]

Aims: To test the psychometric properties of the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory on a sample of patients with chronic obstructive pulmonary disease in China. Background: Measuring the self‐care of patients with chronic obstructive pulmonary disease is vital to promote the performance of effective self‐care behaviours. However, few instruments have been developed to measure self‐care in chronic obstructive pulmonary disease, and the existing instruments lack theoretical support and satisfactory psychometrics properties. The Self‐Care in Chronic Obstructive Pulmonary Disease Inventory based on Middle‐Range Theory of Self‐Care of Chronic Illness has been developed and tested previously in Italian and US population. Design: A cross‐sectional instrument development study. Methods: Construct validity was tested by confirmatory factor analysis and hypothesis testing, and reliability internal consistency using factor score determinacy coefficients. Results: A convenience sample of 185 patients with chronic obstructive pulmonary disease was recruited from September 2020 to January 2022. The instrument consists of three scales: self‐care maintenance, self‐care monitoring and self‐care management. Confirmatory factor analysis performed on the three scales produced good fit indices. The internal consistency was adequate with factor score determinacy coefficients ranging from 0.891 to 0.953 in Self‐Care Maintenance Scale, 0.990 to 0.993 in Self‐Care Monitoring Scale and 0.750 to 0.976 in Self‐Care Management Scale. Conclusions: The Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory has acceptable reliability and validity. Some differences from the original instrument were identified. Further validation studies should be conducted to confirm the psychometric properties of the instrument in Chinese population. Summary statement: What is already known about this topic? The Middle‐Range Theory of Self‐care of Chronic Illness has been used to direct clinical nursing practice for coronary heart disease, heart failure, hypertension, chronic obstructive pulmonary disease and other chronic illnesses and has been shown to have good guiding significance for clinical nursing practice for the self‐care of clinical chronic illness.In patients with chronic obstructive pulmonary disease, self‐care has a significant positive effect on preserving disease stability and enhancing health‐related quality of life.There is a shortage of moderate length evaluation instruments for chronic obstructive pulmonary disease self‐care with comprehensive theoretical assessment content, but the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory, based on the Middle‐Range Theory of Self‐care of Chronic Illness, has been demonstrated to have positive application effects in Italy and the United States. However, its applicability in China is unclear. What this paper adds? This paper indicates that the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory has good reliability and validity and can reflect the self‐care ability of patients with chronic obstructive pulmonary disease in China. The implications of this paper: The results show that the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory is simple and accessible, and nurses can use it to assess patients' capacity for self‐care regularly.The Chinese version of the Self‐Care Scale has different dimensions from the original scale, indicating that different medical backgrounds and varying understanding of concept of self‐care in various nations may result in various self‐care behaviours.To ensure its wider application, the development of this scale necessitates cross‐cultural adaptation of populations in more countries. [ABSTRACT FROM AUTHOR]

Aims: Psychological insulin resistance is a common barrier to initiation and persistence with insulin therapy that affects approximately 42.7% of people living with type II diabetes mellitus, which may negatively impact self‐management. This study aimed to assess patients' levels of psychological insulin resistance and to identify factors associated with self‐management in patients with type II diabetes mellitus treated with insulin therapy. Methods: We adopted a cross‐sectional design. Subjects from the metabolism and endocrinology outpatient departments of a regional teaching hospital in central Taiwan were recruited by consecutive sampling. Patients were assessed for psychological insulin resistance and self‐management using the barriers to insulin treatment questionnaire and the partners in health scale. Results: A total of 222 patients with type II diabetes mellitus were recruited. Patients had an average psychological insulin resistance score of 3.14 (maximum of 8). Positive self‐management was associated with insulin therapy injection by patient, fewer expectations regarding positive insulin‐related outcomes, no diabetes‐related complications, less fear of injection and self‐testing, no hypoglycaemia within the previous year, and younger age. Conclusion: Insulin therapy injection by patient and no diabetes‐related complications were the most common factors associated with overall self‐management and with each domain of self‐management in patients with type II diabetes mellitus treated with insulin therapy. Insulin therapy education should be offered to improve patients' beliefs about insulin therapy and enhance patients' ability to perform self‐management. Summary statement: What is already known about this topic? Psychological insulin resistance is a common psychological barrier to initiation and persistence with insulin therapy.Psychological insulin resistance causes poor glycaemic control and diabetes‐related complications.Psychological insulin resistance may negatively impact self‐management in patients with type II diabetes mellitus. What is the contribution of this paper? Positive self‐management was associated with insulin therapy injection by patient, fewer expectations regarding positive insulin‐related outcomes, no diabetes‐related complications, less fear of injection and self‐testing, no hypoglycaemia within the previous year, and younger age.Insulin therapy injection by patient and no diabetes‐related complications were the most common factors associated with overall self‐management and with each domain of self‐management in patients with type II diabetes mellitus treated with insulin therapy.Patients with poor self‐management had statistically significantly higher levels of overall psychological insulin resistance, fear of injections and self‐testing, expectations regarding positive insulin‐related outcomes, and stigmatization by insulin injections, compared to those with appropriate self‐management. What are the implications of this paper? Knowing in advance the factors associated with diabetes self‐management will allow healthcare professionals prevent psychological insulin resistance in patients with type II diabetes mellitus treated with insulin therapy.Healthcare professionals can design and provide patient‐centred diabetes education based on education level to enhance self‐management. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to examine the relationship between heart failure knowledge, self‐efficacy, social support, grit and self‐care behaviour in patients with heart failure and to identify factors associated with patients' self‐care behaviour. Background: Most patients with heart failure are not as active in implementing self‐care behavioural practices as recommended by the guidelines. Design: This descriptive cross‐sectional study was designed based on Bandura's Social Cognitive Theory. Methods: This study included 138 patients who were diagnosed with heart failure in an outpatient department of cardiology at a tertiary hospital in Korea. Data were collected between July and October 2020 using a structured questionnaire and electronic medical records. Data were analysed using the SPSS/WIN 27.0 program. Results: Grit had the strongest association with self‐care behaviour among patients with heart failure, followed by social support, self‐efficacy and heart failure knowledge. These variables accounted for approximately 52% of the variance in self‐care behaviour. Conclusions: Health‐care professionals should assess patients' grit and develop patient‐tailored grit enhancement programmes. Based on the social cognitive theory, nursing intervention programmes that can simultaneously manage cognitive (knowledge and self‐efficacy), social and environmental (social support) and behavioural support (grit) factors should be developed and applied to nursing practices to promote self‐care. Summary statement: What is already known about this topic? Most patients with heart failure are not as active in implementing self‐care behavioural practices as recommended by the guidelines.Social cognitive theory is conceptualized as cognitive, social, environmental and behavioural in nature.Self‐care behaviour can be influenced by multi‐dimensional factors, including cognitive factors, such as knowledge and self‐efficacy, and social and environmental factors, such as social support. What this paper adds? Grit—a behavioural supporting element—was confirmed as a factor influencing the self‐care behaviour of patients with heart failure. The implications of this paper: Interventions for enhancing patients' grit should be developed; self‐efficacy, social support and heart failure knowledge for patients with heart failure should be considered in clinical nursing settings.Health‐care professionals should assess patients' grit and develop patient‐tailored grit enhancement programmes. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the association between medication literacy and blood pressure control among hypertensive patients. Background: Blood pressure control is a challenge for global health systems. Medication literacy is essential for medication self‐management in hypertensive patients and a basis for managers to develop comprehensive intervention strategies for hypertension medication use. Design: A cross‐sectional observational study was conducted. Methods: A total of 378 hypertensive patients was selected by convenience sampling from two tertiary hospitals and four community health service centres from December 2021 to January 2022 in Changsha, China. Associations between medication literacy and blood pressure control were identified with chi‐square, independent samples t‐tests and logistic regression analyses. Results: The average medication literacy score of the hypertensive patients investigated was low. Over a third of patients had uncontrolled blood pressure. Logistic regression analysis showed that medication literacy was an influencing factor for blood pressure control rate in hypertensive patients. Conclusions: Medication literacy and blood pressure control among hypertensive patients was poor. Medication literacy was a facilitator of blood pressure control so improving medication literacy may be of value to improve blood pressure control in hypertensive patients. Summary statement: What is already known about this topic? Medication literacy is essential for medication self‐management in hypertensive patientsThe association between medication literacy and blood pressure control in hypertensive patients is unclear. What this paper adds? Medication literacy and blood pressure control rates among hypertensive patients were poor and in need of urgent improvement.Medication literacy was a facilitator of blood pressure control in hypertensive patients. The implications of this paper: Clinical nurses may enhance hypertension management by improving medication literacy.Findings provide a base for implementing medication literacy intervention strategies and promoting blood pressure management. [ABSTRACT FROM AUTHOR]

Background: Anxiety and depressive disorders typically emerge in adolescence and can be chronic and disabling if not identified and treated early. School-based universal mental health screening may identify young people in need of mental health support and facilitate access to treatment. However, few studies have assessed the potential harms of this approach. This paper examines some of the potential mental health-related harms associated with the universal screening of anxiety and depression administered in Australian secondary schools. Methods: A total of 1802 adolescent students from 22 secondary schools in New South Wales, Australia, were cluster randomised (at the school level) to receive either an intensive screening procedure (intervention) or a light touch screening procedure (control). Participants in the intensive screening condition received supervised self-report web-based screening questionnaires for anxiety, depression and suicidality with the follow-up care matched to their symptom severity. Participants in the light touch condition received unsupervised web-based screening for anxiety and depression only, followed by generalised advice on help-seeking. No other care was provided in this condition. Study outcomes included the increased risk of anxiety, depression, psychological distress, decreased risk of help-seeking, increased risk of mental health stigma, determined from measures assessed at baseline, 6 weeks post-baseline, and 12 weeks post-baseline. Differences between groups were analysed using mixed effect models. Results: Participants in the intensive screening group were not adversely affected when compared to the light touch screening condition across a range of potential harms. Rather, participants in the intensive screening group were found to have a decreased risk of inhibited help-seeking behaviour compared to the light touch screening condition. Conclusions: The intensive screening procedure did not appear to adversely impact adolescents' mental health relative to the light touch procedure. Future studies should examine other school-based approaches that may be more effective and efficient than universal screening for reducing mental health burden among students. Trial registration Australian and New Zealand Clinical Trials Registry (ACTRN12618001539224) https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375821. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to critically examine the effects of COVID-19 social discourses and policy decisions specifically on older adult volunteers in the UK, comparing the responses and their effects in England, Scotland, Wales and Northern Ireland, providing perspectives on effects of policy changes designed to reduce risk of infection as a result of COVID-19, specifically on volunteer involvement of and for older adults, and understand, from the perspectives of volunteer managers, how COVID-19 restrictions had impacted older people's volunteering and situating this within statutory public health policies. Design/methodology/approach: The study uses a critical discourse approach to explore, compare and contrast accounts of volunteering of and for older people in policy, and then compare the discourses within policy documents with the discourses in personal accounts of volunteering in health and social care settings in the four nations of the UK. This paper is co-produced in collaboration with co-authors who have direct experience with volunteer involvement responses and their impact on older people. Findings: The prevailing overall policy approach during the pandemic was that risk of morbidity and mortality to older people was too high to permit them to participate in volunteering activities. Disenfranchising of older people, as exemplified in volunteer involvement, was remarkably uniform across the four nations of the UK. However, the authors find that despite, rather than because of policy changes, older volunteers, as part of, or with the help of, volunteer involving organisations, are taking time to think and to reconsider their involvement and are renewing their volunteer involvement with associated health benefits. Research limitations/implications: Working with participants as co-authors helps to ensure the credibility of results in that there was agreement in the themes identified and the conclusions. A limitation of this study lies in the sampling method, as a convenience sample was used and there is only representation from one organisation in each of the four nations. Originality/value: The paper combines existing knowledge about volunteer involvement of and for older adults. [ABSTRACT FROM AUTHOR]

This article compares two optimization methods considering random variations in design parameters. One is reliability-based design optimization, which depends on the availability of the joint probability density function. A more practical alternative is robust optimization, which does not require the estimation of failure probability. It accounts for the random response of the structure through definitions of objective functions and constraints, incorporating mean values and response variances. An important element of the algorithm involves approximating unknown responses of the structures and employing efficient statistical moment estimation methods. The kriging method was used in this paper. Additionally, the article evaluates two experimental plan techniques: the classical random sampling plan and the OLH plan. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to describe the development and implementation of a co-designed value-based healthcare (VBHC) framework within the public dental sector in Victoria. Methods: A mixed-method study was employed. Explorative qualitative design was used to examine patient, workforce and stakeholder perspectives of implementing VBHC. Participatory action research was used to bring together qualitative narrative-based research and service design methods. An experience-based co-design approach was used to enable staff and patients to co-design services. Quantitative data was sourced from Titanium (online patient management system). Results: Building a case for VBHC implementation required intensive work. It included co-designing, collaborating, planning and designing services based on patient needs. Evidence reviews, value-stream mapping and development of patient reported outcomes (PROMs) and patient reported experience measures (PREMs) were fundamental to VBHC implementation. Following VBHC implementation, a 44% lower failure to attend rate and 60% increase in preventive interventions was reported. A higher proportion of clinicians worked across their top scope of practice within a multi-disciplinary team. Approximately 80% of services previously provided by dentists were shifted to oral health therapists and dental assistants, thereby releasing the capacity of dentists to undertake complex treatments. Patients completed baseline International Consortium for Health Outcomes Measurement PROMs (n = 44,408), which have been used for social/clinical triaging, determining urgency of care based on risk, segmentation and tracking health outcomes. Following their care, patients completed a PREMs questionnaire (n = 15,402). Patients agreed or strongly agreed that: the care they received met their needs (87%); they received clear answers to their questions (93%); they left their visit knowing what is next (91%); they felt taken care of during their visit (94%); and they felt involved in their treatment and care (94%). Conclusion: The potential for health system transformation through implementation of VBHC is significant, however, its implementation needs to extend beyond organisational approaches and focus on sustaining the principles of VBHC across healthcare systems, policy and practice. What is known about the topic? Value-based healthcare (VBHC) has gained significant momentum within the healthcare sector and is seen as a driver for improving patient outcomes and equitable use of resources. What does this paper add? The paper describes firsthand experience and lessons learnt from implementing VBHC within a Victorian public healthcare system; the learnings are applicable to other organisations wanting to implement VBHC. What are the implications for practitioners? In implementing a co-designed VBHC framework, we ensured that its principles are applicable at both patient and population levels, centres on equity of access to care, achieves the best possible health outcomes and sustainable use of resources. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Photoacoustic microscopy (PAM) is a medical-imaging technique with the merits of high contrast and resolution. Nevertheless, conventional PAM scans specimens in a diameter-by-diameter fashion, resulting in a time-consuming process. Furthermore, deep-learning-based PAM image enhancement necessitates acquiring ground-truth data for training purposes. In this paper, we built an optical-resolution photoacoustic microscopy system and introduced an innovative unsupervised-learning algorithm. First, we enhanced the rotational-scanning method, transitioning from a diameter-by-diameter approach to a sector-by-sector one, significantly reducing imaging time (from 280 s to 109 s). Second, by establishing a metric for unsupervised learning, we eliminated the need for collecting reliable and high-quality ground truth, which is a challenging task in photoacoustic microscopy. A total of 324 pairs of datasets (mouse ears) were collected for unsupervised learning, with 274 for training and 50 for testing. Additionally, carbon-fiber data were sampled for lateral resolution and contrast evaluation, as well as the effective rate evaluation of the algorithm. The enhanced images demonstrated superior performance compared with that of maximum projection, both subjectively and objectively. A 76% improvement in the lateral resolution was observed. The effective rate of the algorithm was measured to be 100%, which was tested on 50 random samples. The technique presented in this paper holds substantial potential for image postprocessing and opens new avenues for unsupervised learning in photoacoustic microscopy. [ABSTRACT FROM AUTHOR]

Persistent pain (PP) is a complex mechanism affecting 35% to 51.3% of adults in the United Kingdom and is associated with significant reductions in quality of life. Understanding of PP and how best to treat it has developed over the past 50 years, but there is still a vacuum of research to inform novel applications for self-management. Mindfulness techniques and nature exposure have separately been found to have beneficial effects on general well-being and health. The integration of the two could produce much needed self-management strategies, improving quality of life in this patient group. To determine if nature-based mindfulness (NBM) interventions improve pain and quality of life in adults with PP. Systematic literature review. Seven electronic databases were searched to identify quantitative papers investigating nature-based mindfulness and persistent pain. Included articles were appraised using the PEDro tool. A total of 362 studies were identified. Of these, three were included in the final review. All studies reported statistically significant improvements in self-reported scores for pain (p ≤ 0.001–0.006) and depression (p ≤ 0.001–0.000). Other outcomes, such as stress and fatigue produced mixed results. Despite showing statistical significance in multiple outcomes, the minimal clinically important difference was not reached across all measures. Heterogeneity of interventions and outcomes, as well as methodological issues of internal and external validity, preclude definitive conclusions. Further research is required, employing explicit mindfulness interventions and outcome measures with greater relevance and specificity, as well as further investigation of theoretical mechanisms. [ABSTRACT FROM AUTHOR]

Purpose: Although batterers' intervention programs (BIPs) constitute an important part of the coordinated response to intimate partner violence (IPV) and contribute to increasing the perpetrators' accountability and keeping victims safe, the effectiveness of these programs is still debated. Only recently has the focus of these debates shifted away from researching outcomes by measuring overall program effectiveness toward specific qualities of interventions across program models that may be effective for the distinct client (Babcock et al., Clinical Psychology Review,23(8), 1023–1053, 2004; Zarling et al., Psychology of Violence,9(3), 257–266, 2019). The discussion on the practical implementation of BIPs was supplemented by various significant concepts emerging from new empirical findings, such as differential treatment, motivational interviewing, and effective facilitator–client alliances (Hamel et al., Partner Abuse,11(4), 387–414, 2020; Holtrop et al., Journal of Interpersonal Violence,32(8), 1267–1290, 2017). This paper aimed to address some of the abovementioned concepts by identifying challenges that arise during the implementation of BIPs in Lithuania. Methods: Using qualitative data from semi-structured interviews and focus group discussions with BIPs facilitators, BIPs attendees, and various stakeholders, the paper discusses how to contribute to more effective BIPs outcomes. Results: According to this study, the process of implementing BIPs in Lithuania should be systematized by incorporating existing instruments, such as motivational interviewing, risk-based assessment, and differential treatment, evidence-based programs focused on different theoretical approaches, and forms of implementation. Conclusion: The study found that the consistency and integrity of the entire BIP implementation process should be prioritized, and institutional cooperation in Lithuania needs to be improved to achieve a successful coordinated response to intimate partner violence. [ABSTRACT FROM AUTHOR]

Background: Vaccination is the most important public health practice for preventing infectious diseases and maintaining health. However, some parents are hesitant to vaccinate their children. Design: This study was designed as an instrument development study. Methods: This study aimed to develop a scale to measure the attitudes of parents with children aged 0–5 years towards vaccination and to evaluate the validity and reliability of this scale. The data were collected from 691 participants between November 2020 and January 2021. During the development of the scale, experts provided feedback on its technical, content and language dimensions. The data were analysed using exploratory and confirmatory factor analyses for conceptual validity and Cronbach's α and item‐level test–retest analyses for reliability. Results: The developed scale is a reliable and valid tool for measuring attitudes towards vaccination among parents (Cronbach's α = 0.97, variance explained by these 28‐item two factors = 62.47%). Conclusion: This scale can be used as a guide in measuring the attitudes of parents towards vaccination and determining the direction of primary health‐care services based on the results of the measurement. Summary statement: What is already known about this topic? Vaccination plays an important role in health practice.Parents' attitudes towards vaccination affect their children's vaccination status.Increasing vaccination rates in children will contribute to the reduction of infectious diseases and mortality. What this paper adds? A new valid and reliable measurement tool for determining vaccine hesitancy has been developed.The validity and reliability of the scale of attitudes towards vaccination among parents of children aged 0–5 years were tested.The tool could be used to determine the attitudes of parents of children aged 0–5 years towards vaccination. The implications of this paper The scale may help in determining factors affecting parents' attitudes on vaccination.The scale can generate data to guide nursing practices to increase vaccination rates.The scale can be used to influence nursing practices to increase vaccination rates and promote vaccine awareness, trust and acceptance. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to identify the effects of a web‐based birth preparation programme based on the Health Belief Model and supported by motivational interviews on fear of childbirth, self‐efficacy and the labour process in primigravida women. Methods: The study was conducted in a single‐blind, randomized controlled design with 73 pregnant women. The Birth Health Belief Scale, the Wijma Delivery Expectation/Experience Questionnaire A‐B, the Childbirth Self‐efficacy Scale and the Labour Process Assessment forms were used to collect data. Five sessions of motivational interviews were held with the pregnant women in the experimental group, while those in the control group were administered placebo education. Results: Fear of birth was lower, and the birth self‐efficacy total score was higher in the experimental group. None of the groups indicated significant differences in terms of their mode of delivery. Conclusion: Health Belief Model‐based web‐based birth preparation programme and motivational interviews were found to reduce the fear of birth, increase self‐efficacy and positively affect the birth process in primigravida women. Summary statement: What is already known about this topic? Caesarean delivery is an important health problem that is common all over the world.Fear of childbirth and low self‐efficacy are two important reasons for the increase in the frequency of caesarean section rates.Nurses can make important contributions to the prevention of optional caesarean birth by providing women with health education.What this paper adds? The web‐based birth preparation programme based on the Health Belief Model and motivational interview decreased fear of birth and improved attitudes and behaviours towards vaginal delivery by increasing health beliefs and birth self‐efficacy.The implications of this paper: This study brings a new perspective, indicating that a birth preparation programme based on the Health Belief Model and supported by motivational interviews with primigravida women is an effective method of preventing elective caesarean delivery.It is recommended that nurses use web‐based training tools and conduct cognitive behavioural strategies in antenatal classes. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the incidence, predictors, and outcomes of delirium in intensive care units. Background: Delirium is a common complication in intensive care units. In developing countries, it can be misdiagnosed or unrecognised. Design: Prospective cohort study reported according to the strengthening the reporting of observational studies in epidemiology criteria. Methods: We included patients who were conscious, >18 years old, and admitted to the intensive care units for at least 8 h between December 2019 and February 2020. Patients with a Richmond score of −4 or −5, mental disability, receptive aphasia and/or visual or auditory impairment were excluded from the study. Delirium was assessed using the Confusion Assessment Method for the ICU (CAM‐ICU), whereas the functional outcome was assessed by the Katz Activity of Daily Living Index. Results: This study included 111 patients with a delirium incidence of 31.5%. The severity of illness was the only significant predictor of delirium. Patients with delirium had longer intensive care unit and in‐hospital stays in contrast to those without delirium. Delirium was associated with in‐hospital and 4‐month mortality but not the activities of daily living. Conclusions: Delirium is associated with increased length of stay and mortality. Further investigation to determine whether delirium management can improve outcomes is warranted. Summary statement: What is already known about this topic? Delirium is a common complication in the intensive care unit and can affect patients' outcomes.The incidence and the effect of delirium on patients' outcomes in low‐resource countries remain largely unexplored. Delirium is potentially underdiagnosed and commonly undetected in these countries. What this paper adds? Delirium is associated with a longer duration of stay in the hospital and the intensive care unit as well as mortality in the hospital and 4 months after discharge.Delirium may not affect long‐term functional outcomes after discharge.The severity of illness is an independent predictor of delirium. The implications of this paper In low‐resource countries, the increased length of stay can add a significant burden on healthcare systems.Proper management of delirium will potentially maximise resource utilisation.Delirium affects mortality and length of stay, thus investigating the effect of the current management protocols on these outcomes is warranted. [ABSTRACT FROM AUTHOR]

The purpose of this study is to provide an overview of patients' experiences using a precision medicine (PM) clinic that conducts pharmacogenomics-based (PGx) testing for adverse drug reactions. The study aimed to identify the features of the clinic valued most by patients and areas for improvement. A paper survey was used to collect data. Survey questions focused on patients' perceptions of the PM testing and the overall clinic experience. Sixty-seven patients completed the survey. Quantitative data were analyzed using SPSS and frequencies were reported. Open-ended responses were coded and organized thematically. Patients reported that the clinic services increased confidence in their medication usage. Feeling respected by staff, receiving education, and quick appointments were highly valued by patients. Suggested areas for improvement included better communication from the clinic to patients, expansion of clinic services, and education for other healthcare providers. The findings demonstrate that patient experience goes beyond the clinical care provided. Current and potential future providers of PM should invest the time and energy to configure their care delivery system to enhance the patient experience. [ABSTRACT FROM AUTHOR]

Aim: To explore undergraduate nursing and midwifery student perspectives of using digital patient systems on clinical placements. Design: This was an interpretative qualitative design study. Methods: Undergraduate nursing and midwifery students in a large Australian metropolitan university were invited to participate in two focus groups from April to June 2019. Twenty (20) students participated and data on their perspective of using digital systems on placement were collected. Thematic analysis using NVivo 12 software was undertaken. Findings: Students identified benefits and challenges when moving between paper records and digital systems. Whilst paper reporting was more efficient for some processes, the students recognised the advantages of digital technology, such as enabling greater confidentiality and consolidation of patient data in one place. However, they also reported difficulty with student access and the size of the portal digital workstation at the bedside. Generally, the lack of preparation and access was considered frustrating and mitigated some of the benefits described when using digital systems. Conclusions: Nursing and midwifery students prefer to be prepared for both paper and digital record keeping. Whilst students identify the benefits of digital platforms, not having direct access mitigates the benefits of these systems. Students identified the use of simulation and interactive modules prior to commencement of clinical practice to enable them to feel more confident with using the systems in patient care. Impact: Health care students require direct access to digital health platforms whilst on clinical placement to facilitate their learning. Higher Education Institutions (HEIs) are in a unique position to work with health care providers to better prepare health care professionals, including nurses and midwives, to work with digital health care systems. Further research is needed to develop the educational preparation for nurses, midwives, and other health care professionals to work with digital systems in practice. [ABSTRACT FROM AUTHOR]

Segmentation helps an organization or institution better understand the people it serves and adjust products or services to their needs. This article presents the results of the segmentation of Polish readers and library users. The study was based on 1,010 computer-assisted telephone interviews with a representative random sample of adult Polish residents. The two-step cluster analysis method was used for segmentation. Based on the average number of books read in the 3 months before the interviews, the frequency of reading the press, reading electronic texts, and the use of libraries, five segments were distinguished: almost absolute nonreaders, (news)paper enthusiasts, library lovers, occasional users, and short-form surfers. The distinguished segments were described in terms of 5 behavioral and 12 descriptive variables. Segmentation of library readers and users enables us to understand the population of actual and potential users better than traditional measures (i.e., statistics). The article also discusses the possibilities and advantages of the application of the two-step cluster analysis. [ABSTRACT FROM AUTHOR]

The paper attempts to contextualize the significance of the work of unpaid female family helpers' (UPFFH) for women empowerment. Additionally, it brings into light the subjective feelings and perceptions of unpaid family helpers. The current research is based on primary data collected through a self-structured questionnaire from 200 females aged 15+ years who were helping in the household income generation without getting paid. A cross-sectional survey was conducted among UPFFHs residing in district Lahore, Pakistan. The participants were selected using a simple random sampling technique. The analysis of UPFFHs empowerment was performed by employing a percentage distribution approach based on four levels of participation in decision making. The research puts emphasis on the impact of excessive, unequal, and unpaid work on women and further argues for social rational of recognizing the work through empowering women in decision-making process at their personal, household, and community level. The findings of the study indicates that the young UPFFHs are less empowered as they face the greatest familial and community pressure when it comes to making their life decisions. However, the paper further documents their aspiration to attain economic independence which would then bring change in gender perceptions and their overall social standing. The paper concludes by highlighting the problems associated with "unpaid work" and why it must be addressed, especially if the country has to fully realize the valued goal of women empowerment and gender equality. [ABSTRACT FROM AUTHOR]

Deep neural networks are increasingly used in medical imaging for tasks such as pathological classification, but they face challenges due to the scarcity of high-quality, expert-labeled training data. Recent efforts have utilized pre-trained contrastive image-text models like CLIP, adapting them for medical use by fine-tuning the model with chest X-ray images and corresponding reports for zero-shot pathology classification, thus eliminating the need for pathology-specific annotations. However, most studies continue to use the same contrastive learning objectives as in the general domain, overlooking the multi-labeled nature of medical image-report pairs. In this paper, we propose a new fine-tuning strategy that includes positive-pair loss relaxation and random sentence sampling. We aim to improve the performance of zero-shot pathology classification without relying on external knowledge. Our method can be applied to any pre-trained contrastive image-text encoder and easily transferred to out-of-domain datasets without further training, as it does not use external data. Our approach consistently improves overall zero-shot pathology classification across four chest X-ray datasets and three pre-trained models, with an average macro AUROC increase of 4.3%. Additionally, our method outperforms the state-of-the-art and marginally surpasses board-certified radiologists in zero-shot classification for the five competition pathologies in the CheXpert dataset. [ABSTRACT FROM AUTHOR]

Background: Few studies have evaluated the effectiveness of family functional care interventions among stroke caregiver dyads. This study aimed to examine the effect of a nurse‐led therapeutic conversation intervention on resilience, family function, self‐efficacy in managing the disease, and quality of life (QoL) in stroke family caregiver dyads. Aims: This study aimed to examine the effect of a nurse‐led therapeutic conversation intervention on resilience, family function, self‐efficacy in managing the disease, and QoL in stroke–family caregiver dyads. Design: This study was a single‐blind (evaluator) randomized controlled trial. The planned execution time was from August 2021 to December 2022, in the rehabilitation ward of a medical university hospital. Methods: A total of 82 dyads were included in this analysis. Dyads randomized to the intervention group received nurse‐led therapeutic conversations intervention one at four weeks after the patient's hospitalization for a stroke. The family caregiver dyads of stroke survivors in the control group received routine care. An effectiveness analysis that included patients' resilience, self‐efficacy, and patient–family caregiver dyads' family function and QoL was conducted at one month. We used the CONSORT Checklist for reporting parallel group randomized trials in this study. Results: The patients in the intervention group showed improvement in resilience and self‐efficacy after one month. Furthermore, the effects on resilience (Cohen's d = 0.49) and self‐efficacy (Cohen's d = 0.46) were significantly higher than in the control group. Family functioning was significantly higher in patient–family caregiver dyads in the intervention group than in the control group (Cohen's d = 0.55; Cohen's d = 0.50). However, no significant difference in QoL was found between patients and caregivers in either group. Conclusions: The intervention was effective in promoting family functioning and can also promote patient resilience and self‐efficacy in disease management. However, the intervention did not have a significant effect on the QoL of patient–family caregiver dyads. Summary statement: What is already known about this topic? Many interventional care treatments ignore the important psychological factors involved in caring for patients with stroke.Family nursing actions through conversations between nurses and patients/families are helpful for families dealing with the challenges and complex experiences of a patient's illness. What this paper adds? The present study demonstrated that a nurse‐led therapeutic conversation intervention could promote family functioning among patients and family caregivers.Nurse‐led therapeutic interventions can also promote patients' resilience and self‐efficacy in managing the disease.However, the therapeutic conversation intervention did not have a significant effect on the quality of life of the patient–family caregiver dyads. Implications of this study It is recommended to corroborate a nurse‐led therapeutic conversation intervention as a strength‐oriented family intervention in stroke rehabilitation practice.Nurses can identify the care requirements of patients and their family caregivers through therapeutic conversations and offer personalized care solutions.Nurse‐led therapeutic conversation interventions can be implemented in patient empowerment strategies, emphasizing its effectiveness in boosting patient resilience and self‐efficacy in disease management. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: The Health of the Nation Outcome Scales (HoNOS) is a widely used clinical measure designed to rate and monitor the outcomes of service users accessing specialist mental healthcare.Since its development (in 1996), numerous research studies have confirmed the HoNOS captures the aspects of care that it purports to (validity), and that clinicians' ratings are consistent both over time, and between different raters (reliability). What the paper adds to existing knowledge: In 2018, the HoNOS was reviewed with updates made to some terminology and other revisions intended to remove ambiguity in the guidance for raters. However, although the new version (HoNOS 2018) was accompanied by a recommendation that its validity and reliability be re‐tested this was not undertaken.To our knowledge, this is the first study to re‐assess the updated tool's reliability by measuring the level of agreement between different raters. Our findings confirm that there is an acceptable level of consistency between student mental health nurses that have been trained to use the (new) HoNOS 2018. What are the implications for practice: The HoNOS is nationally mandated for use by all specialist mental healthcare providers in the UK.Our findings provide some assurance that, with appropriate update training and monitoring of organisational‐level data sets, the original HoNOS glossary can safely be replaced with the HoNOS 2018 to ensure more contemporary routine outcome measurement can occur. Introduction: The Health of the Nation Outcome Scales (HoNOS) is a well‐established clinician rated outcome measure for use in mental health services. Following an international review, an updated version (HoNOS 2018) was published with a recommendation that its psychometric properties be re‐tested prior to widespread implementation. To date, only one such study has been published. Aims: To test the inter‐rater agreement levels for HoNOS 2018. Method: Third‐year student mental health nurses received training to complete the HoNOS 2018. Following this timetabled session, they were each invited to independently rate two, randomly selected, videos of (simulated) patient interviews. The resulting data were then analysed to calculate the tool's internal consistency and inter‐rater agreement levels. Results: The 55 participants provided 106 ratings from four vignettes. Cronbach's alphas and McDonalds omegas confirmed the revised tool's internal consistency was acceptable. Average measure intraclass correlation coefficients for the four patient vignettes indicated excellent reliability. Implications for practice: This study provides initial assurance that the HoNOS 2018 is a reliable clinician rated outcome measure suitable for use in routine clinical practice by relatively inexperienced mental health practitioners with limited training. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Mental health nursing is generally viewed as the least attractive career choice among nursing students. What the paper adds to existing knowledge?: Studying in the generic nursing program influence higher desire for a career in mental health nursing.Nursing students who have prior experience working in mental health and have provided care to psychiatric patients are more inclined to express a desire to pursue a career in this field What are the implications for practice?: Nursing students enrolled in the generic program, who have previous work experience in mental health or experience caring for a person with a mental illness, and who have a lower level of stigmatizing attitudes, may constitute the future workforce in mental health nursing. Introduction: Mental health nursing is often perceived as an unattractive career choice among nursing students, and it remains unclear whether the type of nursing program influences this view. Aim: This cross‐sectional study aimed to explore the association between stigmatizing attitudes in nursing students and their desire for a career in mental health nursing, comparing students in generic and accelerated programs. Method: A total of 220 nursing students from generic and accelerated programs in North‐Center Israel participated in this cross‐sectional study, completing a questionnaire on stigmatizing attitudes and their interest in a mental health nursing career. Results: Nursing students displayed a generally low desire for mental health nursing, influenced by factors such as enrollment in the generic program, previous mental health work experience and stigmatizing attitudes. Discussion: Students in the generic program, with lower stigmatizing attitudes and prior mental health experience, exhibited a higher inclination towards mental health nursing. Implications for Practice: Prospective mental health nursing professionals may be identified in the generic program, particularly those with prior mental health experience and lower stigmatizing attitudes. Additional studies are required to confirm and broaden their applicability to other contexts. [ABSTRACT FROM AUTHOR]

In this paper, we obtain the asymptotic form of the joint distribution of maxima and minima of independent observations, when the sample size is a random variable. We also discuss the asymptotic distribution of the Range. [ABSTRACT FROM AUTHOR]

The study of longest increasing subsequences (LIS) in permutations led to that of Young diagrams via Robinson–Schensted's (RS) correspondence. In a celebrated paper, Vershik and Kerov obtained a limit theorem for such diagrams and found that the LIS of a uniform permutation of size n$$ n $$ behaves as 2n$$ 2\sqrt{n} $$. Independently and much later, Hoppen et al. introduced the theory of permutons as a scaling limit of permutations. In this paper, we extend in some sense the RS correspondence of permutations to the space of permutons. When the "RS‐tableaux" of a permuton are non‐trivial, we show that the RS‐tableaux of random permutations sampled from this permuton exhibit a linear behavior, in the sense that their first rows and columns have lengths of linear order. In particular, the LIS of such permutations behaves as a multiple of n$$ n $$. We also prove some large deviation results for these convergences. Finally, by studying asymptotic properties of Fomin's algorithm for permutations, we show that the RS‐tableaux of a permuton satisfy a partial differential equation. [ABSTRACT FROM AUTHOR]

To estimate the finite population variance of the study variable, this paper proposes an improved class of efficient estimators using different transformations. When both the minimum and maximum values of the auxiliary variable are known and the ranks of the auxiliary variable are associated with the study variable, these estimators are particularly useful. Therefore, the precision of the estimators can be effectively improved through the utilization of these rankings. We examine the properties of the proposed class of estimators, including bias and mean squared error (MSE), using a first-order approximation through a stratified random sampling method. To determine the performances and validate the findings mathematically, a simulation study is carried out. Based on the results, the proposed class of estimators performs better in terms of the mean squared error (M S E) and percent relative efficiency (P R E) as compared to other estimators in all scenarios. Furthermore, in order to prove that the performances of the improved class of estimators are better than those of the existing estimators, three data sets are examined in the application section. [ABSTRACT FROM AUTHOR]

Social work in the German rehabilitation sector is practiced with great variation and its interventions lack research evidence. The SWIMMER project aims to develop a program theory of social work in rehabilitation to explain this variation and to discuss possible conditions. The dealing with ethical dilemmas by social workers is one possible influence and the focus of this paper. The social workers' practice was analyzed using the triple mandate, a German-Swiss concept that describes three possible, sometimes simultaneous directives without a concrete call to action from society, the client or the profession. This qualitative, case-comparative research project collected data from interviews with social workers and managers, participant observation and counseling sessions in ten German rehabilitation facilities. Social workers were confronted with all three mandates. They prioritized either the societal mandate or the client mandate. A consequence for social work practice was the limitation of options under social law (mandate by society). Social workers relied on their professional experience to reflect on the mandates. They used a variety of strategies when faced with conflicting mandates. The research project has succeeded in systematizing the orientations of social workers in goal conflicts. Further investigation on this topic on a broader basis would be beneficial. [ABSTRACT FROM AUTHOR]

This paper reports the results of a hybrid effectiveness-implementation randomized trial that systematically varied levels of human oversight required to support the implementation of a digital medicine intervention for persons with mild-to-moderate alcohol use disorder (AUD). Participants were randomly assigned to three groups representing possible digital health support models within a health system: self-monitored use (SM; n = 185), peer-supported use (PS; n = 186), or a clinically integrated model CI; (n = 187). Across all three groups, the percentage of self-reported heavy drinking days dropped from 38.4% at baseline (95% CI [35.8%, 41%]) to 22.5% (19.5%, 25.5%) at 12 months. The clinically integrated group showed significant improvements in mental health and quality of life compared to the self-monitoring group (p = 0.011). However, higher attrition rates in the clinically integrated group warrant consideration in interpreting this result. Results suggest that making a self-guided digital intervention available to patients may be a viable option for health systems looking to promote alcohol risk reduction. This study was prospectively registered at clinicaltrials.gov on 7/03/2019 (NCT04011644). [ABSTRACT FROM AUTHOR]

This paper offers a novel approach to formulate efficient ratio estimator of the population variance using a transformed auxiliary variable. The impact of transformation on auxiliary information has also been discussed. It is observed that incorporating a transformed auxiliary variable result in a high gain in efficiency. Theoretical properties of the newly developed estimators have been derived. The empirical and simulation studies show that the suggested estimators outperformed the existing estimators. [ABSTRACT FROM AUTHOR]

The assessment of mutagenicity is essential in drug discovery, as it may lead to cancer and germ cells damage. Although in silico methods have been proposed for mutagenicity prediction, their performance is hindered by the scarcity of labeled molecules. However, experimental mutagenicity testing can be time-consuming and costly. One solution to reduce the annotation cost is active learning, where the algorithm actively selects the most valuable molecules from a vast chemical space and presents them to the oracle (e.g., a human expert) for annotation, thereby rapidly improving the model's predictive performance with a smaller annotation cost. In this paper, we propose muTOX-AL, a deep active learning framework, which can actively explore the chemical space and identify the most valuable molecules, resulting in competitive performance with a small number of labeled samples. The experimental results show that, compared to the random sampling strategy, muTOX-AL can reduce the number of training molecules by about 57%. Additionally, muTOX-AL exhibits outstanding molecular structural discriminability, allowing it to pick molecules with high structural similarity but opposite properties. An active learning model, muTOX-AL, has been proposed for the task of molecular mutagenicity prediction. muTOX-AL is capable of rapidly enhancing its performance with a small number of labeled samples, thereby reducing experimental costs. [ABSTRACT FROM AUTHOR]

One of the major impacts of hearing disability that hinders the individual's effective participation in society and full enjoyment of human rights and fundamental freedoms is his/her ability to communicate with others. Sign language is one of the main methods of communication used by people with hearing disability. Therefore, improving access to sign language services and increasing the availability of interpreters contribute to better inclusion and integration of people with hearing disability into society. This paper explores the experience of a Jordanian university that launched a pioneering initiative by offering a sign language course for its students. It reports the findings of a study that evaluated this initiative from the perspective of students. Feedback was recorded during unstructured interviews with 23 student participants who had taken the course. The paper concludes that universities can play a significant role in integrating people with disabilities into the education system and promoting their participation in society. [ABSTRACT FROM AUTHOR]

Aims: To identify the influence of teamwork, communication skills, and structural empowerment on providing patient‐centered care among nurses in Eswatini. Design: A quantitative, cross‐sectional survey was used. Methods: This survey conducted in Eswatini selected registered nurses working as full‐time nurses with more than 3 months of working experience using convenience sampling. Different measures were adopted and used to collect data among 130 eligible nurses from February to March 2022. Data were analyzed using Statistical Program for Social Sciences version 26.0. Results: A total of 123 nurses responded in the study and the mean age was 31.05 years with a standard deviation of 5.49. The overall response rate was 94.6% in this study. Hierarchical multiple regression analysis revealed that teamwork (β = 0.236, p < 0.05) and communication skills (β = 0.328, p < 0.05) were significant predictors of the provision of patient‐centered care among nurses. Conclusion: Team‐building exercises and management interventions to empower nurses should be established to improve the provision of patient‐centered care among nurses. Nurses should be empowered to provide patient‐centered care in health facilities by encouraging them to provide their input in management procedures and planning programs. Impact: Clinical practice requires nurses to use effective communication skills and work as a team. Nursing care established on teamwork, respect, empathy, and communication skills allows patients to express their concerns and views in health facilities as they feel involved in care. Patient or public contribution: No patient or public contribution in this paper. This study only involved registered nurses as health professionals. Summary Statement: What is already known? : Patient‐centered care gives patients the chance to participate actively in discussions and consultations.Patient‐centered care requires nurses to work as a team, use effective communication skills, and feel empowered during the execution of their work.Nurses who are empowered are less likely to make medical errors, and collaborative nurses provide better patient‐centered care. What does this paper add? : Highlights that teamwork and communication skills influence nurses' ability to provide patient‐centered care.Add to the growing evidence‐based support that there is a need for teamwork and communication education programs for registered nurses in the workplace.Empowering nurses to participate in management processes and program planning will enable them to deliver patient‐centered care in healthcare facilities. Implications for practice/policy : Education programs focusing on teamwork and communication skills should be provided to nurses working in the clinical setting to enhance the quality of patient care and improve collaboration.All hospitals should adopt a tailored intervention designed to enhance the delivery of patient‐centered care to raise the standard of care.It is imperative that nurses prioritize the development of their teamwork, respect, empathy, and communication skills. [ABSTRACT FROM AUTHOR]

Accurate risk assessment is crucial for predicting potential financial losses. This paper introduces an innovative approach by employing expected risk models that utilize risk samples to capture comprehensive risk characteristics. The innovation lies in the integration of classical credibility theory with expected risk models, enhancing their stability and precision. In this study, two distinct expected risk models were developed, referred to as Model Type I and Model Type II. The Type I model involves independent and identically distributed random samples, while the Type II model incorporates time-varying stochastic processes, including heteroscedastic models like GARCH(p,q). However, these models often exhibit high variability and instability, which can undermine their effectiveness. To mitigate these issues, we applied classical credibility theory, resulting in credible expected risk models. These enhanced models aim to improve the accuracy of Value-at-Risk (VaR) forecasts, a key risk measure defined as the maximum potential loss over a specified period at a given confidence level. The credible expected risk models, referred to as CreVaR, provide more stable and precise VaR forecasts by incorporating credibility adjustments. The effectiveness of these models is evaluated through two complementary approaches: coverage probability, which assesses the accuracy of risk predictions; and scoring functions, which offer a more nuanced evaluation of prediction accuracy by comparing predicted risks with actual observed outcomes. Scoring functions are essential in further assessing the reliability of CreVaR forecasts by quantifying how closely the forecasts align with the actual data, thereby providing a more comprehensive measure of predictive performance. Our findings demonstrate that the CreVaR risk measure delivers more reliable and stable risk forecasts compared to conventional methods. This research contributes to quantitative risk management by offering a robust approach to financial risk prediction, thereby supporting better decision making for companies and financial institutions. [ABSTRACT FROM AUTHOR]

This paper reports on a service evaluation of PeerTalk, a nationwide charity that organises and facilitates peer support groups for individuals with depression. Therefore, the aim was to gather and synthesise benefits perceived by support group attendees. Thematic analysis was undertaken following the collection of data from two group interviews comprising PeerTalk support group attendees. Once those data were analysed, five key themes emerged: (1) talking/listening, (2) socialising, (3) contrast with other services, (4) personal benefits, and (5) structure and accessibility. Two further minor themes were also identified: (6) wider benefits and (7) areas for development that could lead to overall improvements to the service. PeerTalk's support groups provide multiple opportunities for attendees to meet others who have similar experiences within an environment that does not require formal engagement or commitment. Those that attend find benefit from supporting others and socialising within the group. These benefits are complementary to mainstream services that they may concurrently be involved with, rather than replacing or hindering them. Peer support groups can therefore provide a resource for healthcare professionals to which they can direct individuals who may feel benefit from engaging with other individuals with similar experiences. Sheffield Hallam University granted ethics approval for the study (ER:59716880) prior to its commencement (16 February 2024). [ABSTRACT FROM AUTHOR]

Introduction. Pacific peoples experience inequity in accessing hearing health care and are disproportionately exposed to the underlying determinants impacting ear and hearing health in Aotearoa New Zealand. Understanding community members’ worldviews, including perspectives, beliefs and values, is essential in developing appropriate and responsive hearing healthcare services to meet the needs of Pacific peoples. Aim. The purpose of this paper is to understand the worldviews, knowledge and beliefs held by Pacific peoples regarding hearing health in Aotearoa New Zealand. Methods. A mixed-methods approach was used. Twelve semistructured face-to-face interviews were conducted with Pacific community members. Twentyfive participants completed an online questionnaire. A simultaneous, integrated mixed-methods approach was used to analyse the qualitative and quantitative data. Results. Five main themes were established, which were: The Meaning of Hearing; Causes of hearing loss; Consequences of hearing loss and Disability; and Improving health care for ear disease and hearing loss. Discussion. Pacific peoples value hearing health to communicate and connect with their families and communities. Participants highlighted the importance of hearing health across the life course. Although the study findings revealed there is potentially less stigma and shame around hearing loss in New Zealand, denial and fatalistic attitudes towards hearing loss may delay some people from seeking healthcare services. Participants expressed key ways in which the health system can be more responsive to the hearing health needs of Pacific peoples in Aotearoa New Zealand. [ABSTRACT FROM AUTHOR]

Objectives: This paper explores parent coaching experiences supporting parents of young children newly diagnosed with type 1 diabetes in a clinical trial. Methods: In a trial for 157 parents, those in the intervention arm (n = 116) were paired with a parent coach (n = 37; Mage = 37.9 years, SD = 3.9; 94.6% mothers, 81.1% White non-Hispanic). Parent coaches provided diabetes-specific social support. Parent coaches completed monthly surveys and satisfaction/feasibility surveys, with a subset (n = 7) undergoing qualitative interviews at the end of this study. Results: There were 2262 contacts between participants and their parent coaches, averaging 14.4 (SD = 9.3) per participant. Parent coaches reported that the most commonly used methods were text messages (67.9%) and emails (18.7%), with 33.6% having in-person visits. Coaches reported high satisfaction and belief in their usefulness to participants during the first 9 months after T1D diagnosis. Themes discussed by parent coaches about their experience in mentoring included relationship building, expertise sharing, personal growth, gratification, and intervention optimization suggestions. Conclusions: Parent coaching post T1D diagnosis involves regular, multi-method contacts. It is highly acceptable and valuable for parent coaches to mentor other parents of young children newly diagnosed with T1D. [ABSTRACT FROM AUTHOR]

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Why you should read this article: • UK care homes are an important example of a complex environment where research is essential but faces multiple challenges in terms of rigour and methodology • This paper offers a variety of important methodological strategies to identify and address challenges that could impact findings and the ability to carry out research • It highlights the importance of taking a critical stance with all elements of the research process and illustrates the need to identify and mitigate challenges when conducting research in complex environments. Background: The evidence base for hydration practice in care homes is underdeveloped. High-quality research is therefore needed to determine what practices support older people with dementia in drinking sufficient fluid. However, methodological developments are needed to be able to do this. Aim: To highlight the methodological issues researchers encountered during a feasibility cluster, randomised controlled trial of ThinkDrink, a hydration care guide for people with dementia living in UK care homes. Discussion: This is a challenging area because of the complexity of recruitment, participation and data collection in care homes. Researchers must pay extra attention to rigour and quality in the design of their studies. There may be multiple challenges, so various strategies may be required. Conclusion: It is important that researchers continue to reflect on rigorous approaches to develop evidence in a crucial area of care, despite these challenges. Implications for practice: Researchers working in complex environments face a variety of challenges to complete methodologically rigorous research. It is important for researchers to be critical of research processes and data, to mitigate and overcome these challenges. [ABSTRACT FROM AUTHOR]

This paper explores perceptions of threat and the subjective ability to cope with belligerency in conflict zones using the diversity of Israel's security arenas. Three research populations were defined, all adult residents in Jewish or mixed localities with a high probability of involvement in a security conflict or in which confrontations occurred between 2002 and 2014: residents of the northern border area (n = 385), residents of the Gaza area (n = 262), and residents of Judea and Samaria (n = 496). Stratified sampling was conducted in each population to generate representative samples. The fourth research population served as the control group for this study: a representative random sample of all Israeli residents aged 18 and over living in Jewish localities (n = 493). The main insight that arises from this study is that residents' attitudes and understanding of the security situation, their perceptions of threat, and their ability to cope with threat are not exclusively shaped by concrete security incidents. Instead, their attitudes and perceptions are the product of multiple formative factors acting concurrently. In each region and population group, it is possible to identify a "cumulative context" that crystallizes from four key factors that shape residents' perceptions: (a) the socio-economic background of the population and the community, (b) factors related to community organization, (c) geographic proximity to the source of threat, and (d) experience and memories of past events. [ABSTRACT FROM AUTHOR]