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Objective: The aim of the present cross-sectional study was to compare the interocclusal contact records obtained by three different digital methods (intra- and extraoral digital scanners and T-Scan III system) with the conventional method (articulating paper). Materials and methods: Twenty-five healthy volunteers were selected. As a control group, maximum intercuspation occlusal contacts were registered and photographed from the patients with an 8 µm articulating paper. Then, intraoral conventional elastomer impressions were taken and after obtaining the corresponding plaster models of every patient they were scanned with an extraoral scanner (Zfx Evolution, Zimmer Biomet Dental) (group 1). Moreover, digital impressions were made with an intraoral scanner (Trios Color POD, Phibo, 3Shape) and contacts were also registered (group 2). Finally, T-Scan III records were made and stored for further analysis (group 3). Two previously calibrated examiners independently evaluated the interocclusal contacts from every group. Data was analyzed by using Kappa index test and Pearson's chi-square test. Diagnostic tests and ROC curve were also performed. Results: Kappa interoperator index was 70.6% (better agreement). In Kappa intraoperator index, the best value was obtained in the intraoral scanner group (moderate agreement) and the worst with T-Scan III group (low agreement). ROC curve showed highest values in the intraoral scanner group (0.817) and lowest values in the T-Scan III group (0.613). Conclusion: Results suggest greater reliability to record occlusal contacts with the intraoral scanner. Clinical relevance: Intraoral scanners seem to be reliable in registering intermaxillary occlusal contacts when compared with the current gold standard. [ABSTRACT FROM AUTHOR]

This systematic review aims to give an overview of the diversity of research areas related to human biometeorology in Brazil. The main focus of this paper addresses research trends, represented by published papers with national and international authorship, main contributions and shortcomings, as well as challenges and prospects of research in this area of study. An extensive literature search was conducted in the Scopus, Web of Science, and Science Direct databases so as to identify relevant publication output up to July 2021 related to the research area. The screening resulted in 96 studies chosen for full-text reading. Overall, results indicated a reduced amount of articles on the subject matter published internationally, with noticeable gaps in research in some regions of the country, such as the Amazon region and in the Brazilian Midwest region. Research gaps in relevant areas have been identified with limited output in the climate dimensions of tourism, vector-borne diseases, mortality and morbidity in urban centers. Such gaps should further encourage researchers to engage in research focused on those areas. [ABSTRACT FROM AUTHOR]

Background: Involvement in research activities is complex in pediatric nursing and allied health professionals (AHPs). It is important to understand which individual factors are associated with it to inform policy makers in promoting research. Methods: A cross-sectional observational study was conducted to describe the level of participation in research activities over the last ten years of nurses and AHPs working in a tertiary pediatric hospital. A large sample of nurses and AHPs working in an Italian academic tertiary pediatric hospital completed an online self-report questionnaire between June and December 2018. Three multivariate logistic regression analyses were performed to predict participation in research projects, speaking at conferences, and writing scientific articles. Results: Overall, data from 921 health professionals were analyzed (response rate = 66%), of which about 21% (n = 196) reported participating in a research project, while 33% (n = 297) had attended a scientific conference as a speaker, and 11% (n = 94) had written at least one scientific paper. Having a Master or a Regional Advanced Course, working as an AHP or a ward manager, as well as regularly reading scientific journals and participation in an internal hospital research group or attendance in a specific course about research in the hospital, significantly predicted participation in research projects, speaking at conferences and writing scientific papers. It is important to foster research interest and competencies among health professionals to improve participation in research projects, speaking at conferences, and writing scientific papers. Conclusions: Overall, we found a good level of attendance at conferences as speakers (33%), a moderate level of participation in research (21%), and low levels for writing scientific papers (11%). Our study highlighted the need to support participation in research activities among nurses and AHPs. Policymakers should identify strategies to promote research among nurses and AHPs, such as protected rewarded time for research, specific education, strengthened collaboration with academics, and financial support. Moreover, hospital managers should promote the development of research culture among health professionals, to improve their research competencies and evidence-based practice. [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]

Background: There is growing evidence that sex and onset age are important factors of clinical features in Parkinson's disease. Aim: The study aimed to identify nonmotor symptoms based on sex and onset age in people with Parkinson's disease. Design: This is a cross‐sectional descriptive study. Methods: A total of 210 participants were recruited from the university hospital and the Parkinson's disease association. This study measured the Korean version of the nonmotor symptoms questionnaire which includes gastrointestinal, urinary, apathy/attention/memory, hallucination/delusions, depression/anxiety, sexual function, cardiovascular, sleep disorder, and miscellaneous domains. Results: All participants reported at least one nonmotor symptom. The most commonly reported symptoms were nocturia (65.7%) and constipation (61.9%). The male participants reported more dribbling of saliva, constipation, and impaired sexual function, whereas the female reported more weight change. Young‐onset people with Parkinson's disease reported more depression than late‐onset people with Parkinson's disease. Conclusion: This study contributes to the understanding of symptom experience beyond motor‐related symptomatology for those with Parkinson's disease and adds to the current literature. Individualized symptom assessment and management should be provided by prioritizing prevalent sex or onset age‐specific symptoms, rather than addressing with all nonmotor symptoms. Summary statement: What is already known about this topic? Most people with Parkinson's disease experience nonmotor symptoms including autonomic nervous symptoms as the disease progresses.Nonmotor symptoms can affect quality of life of people with Parkinson's disease, but related factors are not fully understood. What this paper adds? This paper identified the presentations of nonmotor symptoms in people with Parkinson's disease based on sex and onset age. The implications of this paper: Nurses enable people with Parkinson's disease to actively engage in self‐care of their own symptoms by educating Parkinson's disease related and how to cope with the symptoms in advance.Individualized nursing care reflecting the disease characteristics is needed to improve patient engagement in symptom management. [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]

Purpose: The purpose of this paper is to conceptualise a research study to examine leadership as a relational concept between leaders and followers. The context is within surgical practice examining how motivated consultant surgeons are to lead junior doctors and which type of leadership style they use. From a follower perspective, the motivation of junior doctors will be explored, and their leadership preferences will be correlated with those of the actual style of consultant surgeons. Design/methodology/approach: In this paper, the authors provide a detailed description of the methods for an international quantitative research study, exploring sequentially how motivated consultant surgeons are to lead and how leadership styles impact on the motivation of junior doctors. The objectives, method and data collection of this study are explained, and the justification for each method is described. Findings: The findings for this outline study illustrate how critical it is to redefine leadership as a relational concept of leader and follower to ensure adequate support is provided to the next generation of consultant surgeons. Without consideration of the relational model of leadership, attrition will continue to be a critical issue in the medical workforce. Research limitations/implications: The research limitations are that this is a proposed quantitative study due to the need to collect a large sample of data from surgeons across the UK, Egypt and Germany. This research will have immense implications in developing new knowledge of leadership as a relational concept in medicine and healthcare. This study additionally will impact on how leadership is conceptualised in the curriculum for specialist surgical practice. Practical implications: The practical implications are that relational leadership is supportive of generating a supportive leadership culture in the workplace and generating more effective teamwork. Originality/value: To the best of the authors' knowledge, this is the first study of its kind to look at a relational model of leadership in surgical practice between consultant surgeons and surgical trainees. This study will also identify any specific country differences between the UK, Germany and Egypt. [ABSTRACT FROM AUTHOR]

Objective: Clinician's experiences of providing care are identified as a key outcome associated with value-based healthcare (VBHC). In contrast to patient-reported experience measures, measurement tools to capture clinician's experiences in relation to VBHC initiatives have received limited attention to date. Progressing from an initial 18-item clinician experience measure (CEM), we sought to develop and evaluate the reliability of a set of 10 core clinician experience measure items in the CEM-10. Methods: A multi-method project was conducted using a consensus workshop with clinicians from a range of NSW Health local health districts to reduce the 18-item CEM to a short form 10-item core clinician experience measure (CEM-10). The CEM-10 was deployed with clinicians providing diabetes care, care for older adults and virtual care across all districts and care settings of New South Wales, Australia. Psychometric analysis was used to determine the internal consistency of the tool and its suitability for diverse clinical contexts. Results: Consensus building sessions led to a rationalised 10-item tool, retaining the four domains of psychological safety (two items), quality of care (three items), clinician engagement (three items) and interprofessional collaboration (two items). Data from four clinician cohorts (n = 1029) demonstrated that the CEM-10 four-factor model produced a good fit to the data and high levels of reliability, with factor loadings ranging from 0.77 to 0.92, with Cronbach's alpha (range: 0.79–0.90) and composite reliability (range: 0.80–0.92). Conclusions: The CEM-10 provides a core set of common clinician experience measurement items that can be used to compare clinician's experiences of providing care between and within cohorts. The CEM-10 may be supported by additional items relevant to particular initiatives when evaluating VBHC outcomes. What is known about the topic? Clinician experience of providing care is an outcome of interest for health systems and services internationally who are implementing value-based care initiatives. Review evidence indicates that measurement of clinician's experience of providing care should address experiences of being able to deliver quality care, collaborate with colleagues, experience psychological safety and engagement in decision-making in the workplace. What does this paper add? The paper reports the development of the short form clinician experience measure (CEM-10) and its initial validation in four value-based healthcare initiatives of NSW Health. What are the practical implications for practitioners? The CEM-10 can be used as a core set of items embedded within evaluations of value-based care initiatives to benchmark and examine experiences across clinician cohorts. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Due to demographic changes and structural developments in the healthcare system, an increasing number of patients receive home care nursing in Denmark. Little is known about the complexity of home care. The aim of this paper was to investigate the challenges that home care nurses experience in their clinical practice by studying factors related to home care nurses' experiences of encounters with patients as burdensome. A population-based survey was undertaken involving all nurses in homecare services in one municipality in Denmark. The participating nurses registered all home care contacts by the patients during the daytime for 1 week. A registration form was used including a series of items designed to identify factors related to the perceived burden of each visit. Statistical frequency analyses were used to examine factors related to the home care nurses' experiences of encounters with patients as burdensome, and to investigate the challenges that home care nurses meet in their clinical practice. Home care nurses estimated 7.6% of 941 representative homecare visits as burdensome. Assessment of burden was associated with patients being below 60 years of age, time consumption and unexpected problems during the visit, especially of a psychosocial nature. Even though <10% of the encounters were considered burdensome, there is reason to believe that an increase can be expected due to ongoing emphasis on achieving greater efficiency in the healthcare system. [ABSTRACT FROM AUTHOR]

Aim: To evaluate midwives' level of stress and burnout during the COVID‐19 Omicron phase in Italy. Secondary aims were to explore the impact of the pandemic on midwives' personal dimensions and professional activities and potential supporting strategies. Design: A mixed‐methods study was undertaken from July to December 2022. Methods: Data were collected using a national online observational survey. Descriptive and inferential analyses were performed to evaluate stress, burnout and the impact of the pandemic on personal and professional dimensions. A deductive qualitative approach was used to analyse open‐ended responses, that were merged with quantitative data following a convergent mixed‐methods approach. Results: A total of 1944 midwives participated in the survey. The stress summary score mean was 10.34, and 562 midwives (28.91%) experienced burnout. The intention to reduce working hours was reported by 202 midwives (10.39%), with 60.40% (n = 122) of them experiencing burnout. The intention to leave clinical practice within the following 2 years was reported by 239 (12.29%), with 68.20% (n = 163) of them experiencing burnout. All the personal dimensions and professional activities considered were defined by more than half of midwives as being impacted 'Moderately' or 'To a great extent' by pandemic. Stress and burnout frequencies increased when the midwives' perception of the pandemic effects was higher. Potential supporting strategies described by midwives as the most important in increasing their ability to cope with the pandemic were 'Women's awareness of the midwives' role' (n = 1072; 55.14%) and 'Family and friends' emotional support' (n = 746; 38.38%). Conclusion: Our findings suggested strategies to support a positive and safe working environment for midwives during a pandemic emergency, with potential transferability to similar contexts when human resources are lacking. It is recommended that maternity services provide the necessary resources for a safe and supportive working environment to prevent high stress levels and chronic burnout. Impact: Studies conducted during the first COVID‐19 pandemic wave showed an increased level of stress, anxiety, burnout, post‐traumatic stress disorder and depression experienced by healthcare professionals; moreover, midwives experienced drastic changes in care pathways and policies with struggles identified when providing high‐quality woman‐centred care following pandemic restrictions. Although it is recommended, there is lack of knowledge about long‐term psychological effects of COVID‐19 for midwives. Our study highlights that during the Omicron wave midwives experienced a high level of stress and burnout with an impact on individual dimensions and professional activities. Their stress and burnout were influenced by several factors, including restrictions in place, lack of organizational acknowledgement, work overload and need for extra childcare cover. Maternity services should provide the necessary resources for a safe and supportive working environment to prevent high stress levels and chronic burnout. Recommendations on how to facilitate this are suggested. Reporting Method: During the writing process, we referred to 'The Strengthening the Reporting of Observational Studies Epidemiology Statement', the guidelines for reporting observational studies from the Equator network. Patient or Public Contribution: No patient or public contribution. What does this paper contribute to the wider global clinical community?: Work overload conditions negatively impacted on the quality of maternity services. Improving organizational aspects, reducing working hours, promoting family and friends' emotional support and improving women's awareness of midwife's role were the main strategies reported by midwives. These suggestions for ensuring a positive and safe working environment for midwives during a pandemic emergency could potentially be applied to similar situations where human resources are lacking. [ABSTRACT FROM AUTHOR]

Background: Screen-based simulation is a cost-effective educational modality that allows nursing students to comfortably acquire new skills as they become accustomed to digital environments. The aim of this study is to evaluate the effectiveness of a screen-based simulation tool in enhancing knowledge and skills related to medication administration and dosage calculation in nursing students. Methods: This multicenter, single-blind, stratified, randomized controlled trial initially enrolled 480 nursing students. The 351 students eligibles were randomly allocated to two groups. Using a screen-based simulation tool (SIMDOSE®), the intervention group was trained in drug administration and dosage calculation through four perfusion clinical cases. The control group underwent the same training content using the paper-and-pencil method. knowledge and skills acquisition, Students' satisfaction, self-confidence and anxiety were analyzed using Jamovi software (version 2.3.18). Results: 4 out of 5 main variables examined were significantly different, specifically in dosage calculation, where the simulation group excelled both in the knowledge post-test (post – pre = 1.00 (20%); p = 0.004) and in the objective structured clinical examination (p = 0.013). The intervention group reported higher levels of satisfaction and self-confidence than the control group (p < 0.001). Their moderate anxiety levels didn't differ significantly (0.161). Conclusion: The SIMDOSE® platform can be used as a supplementary teaching method of dosage calculation for nursing students. Screen-based simulation has benefits that nurse educators should be aware of, such as being a key to more satisfied and confident students. Trial registration: This Moroccan clinical trial was prospectively registered (16/05/2023) in the Pan African Clinical Trial Registry (pactr.samrc.ac.za) with trial registration number PACTR202305505743210. [ABSTRACT FROM AUTHOR]

Background: The social culture, gender stereotypes, and social status of nursing in China impact the professional commitment of male nursing students. Increasing the professional commitment of male nursing students is critical for alleviating the shortage of nurses and addressing the gender gap. The outbreak of the COVID-19 pandemic has caused widespread public concern about the nursing profession and may have changed people's perception of the profession, which in turn may have a positive impact on the professional commitment of male nursing students in China. Objective: This research aimed to assess how the COVID-19 pandemic affected the professional commitment of male nursing students in China and to analyze the impact of the COVID-19 pandemic on potential factors that might affect their professional commitment. Methods: A descriptive comparative study was conducted. This study involved total 368 male nursing students from five 4-year universities in Henan Province, China. 190 male nursing students were included before the COVID-19 pandemic (October to November 2019) and 178 were included after the COVID-19 pandemic (April to May 2023). The data, such as the sociodemographic characteristics and professional commitment of the two samples, were collected using a paper-and-pencil questionnaire. The research instruments used included the Professional Commitment Scale, the Multidimensional Scale of Perceived Social Support and the General Self-efficacy Scale. The data analysis employed χ2-tests, t-tests and hierarchical regression models. Results: The proportion of Chinese male nursing students who are interested in nursing and do not intend to leave the major has increased after the pandemic (65.17% vs. 29.47%, 61.80% vs. 39.47%, respectively). Male nursing students exhibited greater professional commitment (3.30 ± 0.63) after the pandemic compared to before the pandemic (2.77 ± 0.43). The various factors, such as grade, intend to leave the major, interest in nursing, social support, and general self-efficacy, were linked to professional commitment of male nursing students in China. Conclusions: Male nursing students in China exhibited greater professional commitment after the pandemic. This phenomenon may be attributed to the public's increased recognition of the significance of nursing work during the pandemic, and the social status and image of nursing profession have been improved. Given the changes brought about by the COVID-19, strategies should be considered by nursing decision makers and schools to strengthen the professional commitment of male nursing students and increase the number of male nurses in the post-pandemic era. [ABSTRACT FROM AUTHOR]

Purpose: On average, about 50% of cancer patients use complementary and alternative medicine (CAM) in addition to conventional cancer treatment. Since there is a high need for information, patients often search for information about CAM and share experiences with peers, especially in self-help groups. In this study, we tested and evaluated an educational concept developed for group leaders of cancer self-help groups on how to approach the topic of CAM in their peer groups. Methods: The educational concept has been developed and piloted with health care professionals and representatives from different self-help organizations in Germany. It aims to inform and discuss the possibilities and limitations of CAM in terms of scientific evidence, to reflect user behavior, and to provide a guide on how to find and evaluate reliable and evidence-based information sources. First, self-help group leaders took part in an on-site training where they were educated on various CAM topics with the goal of being able to conduct the educational concept in their respective self-help groups. Then, the educated group leaders performed this concept in their groups. The educational concept was evaluated by both the group leaders and participants with respect to acceptance, usefulness, and satisfaction using paper-pencil questionnaires. The study was conducted in Germany based on an observational study design with a six-month follow-up. For the analyses, descriptive and univariate statistics for dependent samples were used. Results: A total of n = 50 interested group leaders conducted the educational program in their groups. The most common implementation barriers were organizational or structural problems, as well as the feeling of being overwhelmed with managing the program in their groups. A total of n = 423 participants were educated with this program by their respective group leaders. The majority felt satisfied with the educational program and improved their knowledge about CAM. At the six months follow-up (T2), significantly more participants had consulted their physicians to inform themselves about CAM and felt more confident in finding reliable information about CAM. Conclusions: In this observational study, we have managed to successfully implement an educational concept with respect to the topic of CAM in cancer self-help groups. Based on the results, the concept approach will be modified to include both a CAM- professional and group leader to train the self-help groups. In the future, the effects of the program should be tested by a randomized trial. [ABSTRACT FROM AUTHOR]

This paper discusses estimation and limited‐information goodness‐of‐fit test statistics in factor models for binary data using pairwise likelihood estimation and sampling weights. The paper extends the applicability of pairwise likelihood estimation for factor models with binary data to accommodate complex sampling designs. Additionally, it introduces two key limited‐information test statistics: the Pearson chi‐squared test and the Wald test. To enhance computational efficiency, the paper introduces modifications to both test statistics. The performance of the estimation and the proposed test statistics under simple random sampling and unequal probability sampling is evaluated using simulated data. [ABSTRACT FROM AUTHOR]

Introduction: Globally, one in every six people will be elderly by 2030. In Nepal, there has been a notable rise in the aging and elderly. Addressing the healthcare needs of them is crucial. Despite the different efforts to advocate for healthy aging, various factors continue to limit this process. This paper aims to explore the utilization of healthcare services among the elderly population and uncover influences on the ability to access these services. Method: A mixed-method community-based study was conducted in Bihadi Rural Municipality of Parbat, Nepal. The quantitative segment involved interviews with 355 individuals aged ≥60 years, while 18 respondents were enlisted for in-depth interviews. We used descriptive statistics, chi-square test, and logistic regression in quantitative analysis. Similarly, content and thematic analysis were performed in the qualitative component. Results: This study reported that health service utilization among the respondents was 65.4%. Among the factors ethnicity (OR 3.728, 95% CI 1.062–15.887), not good health status (OR 2.943, 95% CI 1.15–8.046), bus as means of transportation (OR 8.397, 95% CI 1.587–55.091) had higher odds whereas government hospital (OR 0.046, 95% CI 0.009–0.193), not always available health staffs (OR 0.375, 95% CI 0.147–0.931), not sufficient medicine (OR 0.372, 95% CI 0.143–0.924), not available medicine (OR 0.014, 95% CI 0.002–0.068) had lower odds for health service utilization. Other factors identified from qualitative components include long waiting times, insufficient medicine, lack of trained health personnel, financial capacity, low utilization of health insurance, distance, and support from family members. Conclusions: Nonetheless, a portion of the elderly remained excluded from mainstream of healthcare services. A combination of social, healthcare-related, and individual factors influences the utilization of healthcare services. To ensure elderly-friendly services, prioritize geriatric care training, secure medication availability, and establish a dedicated health insurance program for them. In the current federal context, localizing evidence-based, innovative strategies to address the healthcare needs of the elderly is crucial. [ABSTRACT FROM AUTHOR]

Background: As the number of large-scale outbreaks continues to rise worldwide, clinical trials are increasingly engaging disease-affected peoples within the Minority World (nations with over 80% poverty rates). Yet global health research inadequately addresses potential ethical issues of including impoverished, disease-affected populations and their contextual vulnerabilities in medical research. Objective: This paper presents a mixed-method analysis from our 2022 semi-structured survey capturing the experiences of Liberian Ebola Virus Disease (EVD) survivors serving as study participants in the Partnership for Research on Ebola Virus in Liberia (PREVAIL) clinical trials. Methods: Firstly, we conducted an extensive literature review of the scholarship related to biomedical research and ethical standards protecting study participants to inform our survey method and design. Applying a theoretical framework on vulnerability, we then qualitatively explored the survey responses of 19 EVD survivors' perceptions and experiences taking part in PREVAIL, including their expectations, treatment, delivered benefits, and quality of care. We further quantitatively codified their statements for underlying themes of reported negative experiences against standard ethical regulations in biomedical research, conducting a statistical analysis to inform generalizability. Most of the 19 survivors reported facing extreme ongoing vulnerabilities related to their disease status, including physical impairments, psychosocial stress, and socio-economic inequity. Results: Initially, the survivors tended to experience a sense of hope and pride in volunteering for PREVAIL. One in five participants reported benefiting from PREVAIL's regular medical diagnoses. However, most of their survey responses indicated prevalent negative shared experiences, including continually being confused or misinformed of their study participant rights, roles, and benefits; being burdened by heavy participation transaction costs; and repeated incidents of poor treatment and discrimination by PREVAIL staff after initial recruitment. PREVAIL participant satisfaction ranking is negatively correlated with receiving insufficient financial compensation (r = −0.51), extensive time requirements for each medical visit (−0.40), and being poorly treated by clinical staff (−0.67). [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the relative physical recovery and symptoms after SARS-CoV-2 infection between groups confirmed positive or negative to early strains of COVID-19. Methods: A prospective, longitudinal cohort study compared outcomes of metropolitan adults polymerase chain reaction-tested for COVID-19 between March and November 2020 in Western Australia. Control matching was attempted: inpatients (gender, age) and ambulatory clinic (gender, age, asthma, chronic pulmonary disease). One-year follow-up involved three repeated measures: physical function (grip strength and 1-min sit-to-stand) and patient-reported outcomes (Fatigue Severity Scale, modified Medical Research Council dyspnoea scale and Euroqol-5D-5L). Results: Three hundred and forty-four participants were recruited (154 COVID+, age 54 ± 18 years, 75 females [49%]); 190 COVID−, age 52 ± 16 years, 67 females [35%]) prior to national vaccination roll-out. No between-group differences in physical function measures were evident at any time point. Fatigue (OR 6.62, 95% CI 2.74–15.97) and dyspnoea (OR 2.21, 95% CI 1.14–4.30) were higher in the COVID+ group at second assessment (T2). On Euroqol-5D-5L, no between-group differences were evident in the physical function domains of self-care, mobility or usual activities at any time point. However, COVID+ participants were less likely to report an absence of anxiety or depression symptoms at T2 (OR 0.41, 95% CI 0.19–0.89). Conclusions: Neither statistical nor clinically meaningful differences in physical function were evident between COVID+ and COVID− participants to 12-months after acute illness. Symptoms of fatigue, dyspnoea, anxiety or depression were more prevalent in the COVID+ group til ~8 months after illness with between-group differences no longer evident at 1 year. What is known about the topic? COVID-19 evokes multi-system sequelae including persistent physical and mental health symptoms, functional impairments and poorer quality of life. What does this paper add? A COVID+ group had equivalent physical recovery over 12 months; but higher prevalence of fatigue, dyspnoea and anxiety/depression symptoms at ~8 months compared to a COVID− group. What are the implications for practitioners? Health authorities and employers should know that while adequate physical function may return within months, post-acute sequelae of COVID-19 impair sufferers for over 6 months, likely necessitating healthcare support and workplace adjustments to optimise timely return to participation. [ABSTRACT FROM AUTHOR]

Background and aims: A substantial minority of autistic individuals score within typical ranges on standard language tests, suggesting that autism does not necessarily affect language acquisition. This idea is reflected in current diagnostic criteria for autism, wherein language impairment is no longer included. However, some work has suggested that probing autistic speakers' language carefully may reveal subtle differences between autistic and nonautistic people's language that cannot be captured by standardized language testing. The current study aims to test this idea, by determining whether a group of autistic and nonautistic individuals who score similarly on a standardized test show differences in the number of unconventional and erroneous language features they produce in a spontaneous language sample. Methods: Thirty-eight older children and adolescents (19 autistic; 19 nonautistic), between the ages of 10 and 18, were recruited. Both participant groups scored within normal ranges on standardized language and IQ tests. Participants engaged in a "double interview" with an experimenter, during which they were first asked questions by the experimenter about themselves, and then they switched roles, so that it was the participant's turn to ask the experimenter questions. Participants' language during the interview was transcribed and analyzed for linguistic irregularities, including both semantic anomalies and morphosyntactic errors. Results: Group membership accounted for significant variance in irregularity frequency; autistic participants produced more linguistic irregularities than nonautistic participants. Scores on a standardized language test did not improve model fit. Secondary analyses involving irregularity type (semantic vs. morphosyntactic) showed that group differences were primarily driven by relatively high numbers of semantic unconventionalities produced by the autistic group. While the autistic group made more morphosyntactic errors than the nonautistic group, differences in these numbers were only marginally significant. Conclusions and implications: These findings suggest that a commonly used standardized language test does not adequately predict the number and perhaps type of language irregularities produced by some older autistic children and adolescents during spontaneous discourse. Results also suggest that differences in language use, especially semantic differences, may characterize autistic language, even the language produced by people who score within normal ranges on standardized language tests. It is debatable whether differences reflect underlying language impairments and/or a linguistic style adopted/preferred by autistic speakers. In this paper, we discuss both possibilities and offer suggestions to future research for teasing these possibilities apart. [ABSTRACT FROM AUTHOR]

Simple Summary: Uveal melanoma (UM) is a rare type of cancer of the eye that develops from a cell type called melanocytes, which are present in the uveal tract. These patients have a high risk of liver metastasis, usually many years after the initial diagnosis, which is life threatening. We discovered a population of cells in the primary tumor called dual-nature hybrid cells (DNCs) similar to previously discovered cells in the blood (i.e., circulating hybrid cells, CHCs) with shared characteristics of both cancer cells and white blood cells. In this paper, we determined the types of white blood cells capable of participating in the formation of a hybrid cell with a cancer cell, and we re-created these DNCs in a cell culture. The study of the cells of this tumor, particularly DNCs, is crucial to better understanding dissemination and uncovering a possible target for treatment of this systemic disease. Background: Metastasis, occurring years after primary diagnosis, represents a poor prognosis in uveal melanoma (UM)-affected individuals. The nature of cells involved in this process is under debate. Circulating hybrid cells that have combined tumor and immune cell features found in blood were predictive of metastasis and may correspond to dual-nature cells (DNC) in the primary tumor. Herein, we sought to determine the presence of DNCs in primary UM tumors, the cell types involved in their genesis, and their ability to be formed in vitro. Methods: UM lesions (n = 38) were immunolabeled with HMB45 in combination with immune-cell-specific antibodies. In parallel, we co-cultured UM cells and peripheral blood mononuclear cells (PBMCs) to analyze DNC formation. Results: HMB45+/CD45+ DNCs were present in 90% (26/29) of the tumors, HMB45+/CD8+ DNCs were present in 93% (26/28), and HMB45+/CD68+ DNCs were present in 71% (17/24). DNCs formed with CD8+ and CD68+ cells were positively correlated to the infiltration of their respective immune cells. Notably, UM cells were prone to hybridize with PBMCs in vitro. Conclusions: This phenotypical characterization of DNCs in UM demonstrates that CD8+ T-cells and macrophages are capable of DNC formation, and they are important for better understanding metastatic dissemination, thus paving the path towards novel therapeutic avenues. [ABSTRACT FROM AUTHOR]

While undisputedly important, and part of any systematic review (SR) by definition, evaluation of the risk of bias within the included studies is one of the most time-consuming parts of performing an SR. In this paper, we describe a case study comprising an extensive analysis of risk of bias (RoB) and reporting quality (RQ) assessment from a previously published review (CRD42021236047). It included both animal and human studies, and the included studies compared baseline diseased subjects with controls, assessed the effects of investigational treatments, or both. We compared RoB and RQ between the different types of included primary studies. We also assessed the "informative value" of each of the separate elements for meta-researchers, based on the notion that variation in reporting may be more interesting for the meta-researcher than consistently high/low or reported/non-reported scores. In general, reporting of experimental details was low. This resulted in frequent unclear risk-of-bias scores. We observed this both for animal and for human studies and both for disease-control comparisons and investigations of experimental treatments. Plots and explorative chi-square tests showed that reporting was slightly better for human studies of investigational treatments than for the other study types. With the evidence reported as is, risk-of-bias assessments for systematic reviews have low informative value other than repeatedly showing that reporting of experimental details needs to improve in all kinds of in vivo research. Particularly for reviews that do not directly inform treatment decisions, it could be efficient to perform a thorough but partial assessment of the quality of the included studies, either of a random subset of the included publications or of a subset of relatively informative elements, comprising, e.g. ethics evaluation, conflicts of interest statements, study limitations, baseline characteristics, and the unit of analysis. This publication suggests several potential procedures. [ABSTRACT FROM AUTHOR]

Thousands of dental students and prospective applicants participate in dental MATCH each year. This paper aimed to briefly overview the MATCH process and analyze trends in applicants, program and summary statistics from 2012 to 2023 for specialty programs. The aggregated MATCH data from 2012 to 2023 for all residencies were obtained from the Dental MATCH website and by contacting the Dental MATCH organization. The variables used in this study included applicants matched, number of positions offered, number of programs filled and unfilled, same-year graduates and previous-year graduates matched, US and non-US graduates that matched into a program for each year of analysis. The data was analyzed statistically using the Chi-squared test for proportions to estimate if the proportions deviated from expectations across the years using R 4.2.2. The results showed that Orthodontic programs had a distinct dip in ratio of applicants to total positions offered between 2017 and 2020 followed by a rise after 2020. The Orthodontic residency programs had a lower number of unfilled positions relative to total positions offered for 2015–2016 and a higher number of unfilled positions in 2018 and 2023 (p < 0.05). Dental Anesthesiology had a higher number of unfilled positions in 2015 and Pediatric Dentistry programs had a lower number of unfilled positions in 2015 and higher in 2023 while Periodontics had a higher number of unfilled positions in 2018. The Periodontics residency programs had higher non-US graduates matched in 2018 and lower in 2021 (p < 0.05). Orthodontic programs had higher number of same year graduates matched to total graduates among all other residencies. An overview of the dental MATCH process was detailed in the paper. Additionally, important trends observed in the applicant and program statistics outlines the dynamic and changing landscape of advanced dental education. [ABSTRACT FROM AUTHOR]

Objectives. Associations between shift-work, musculoskeletal symptoms and absenteeism are poorly investigated in the manufacturing industry. This study aimed to investigate associations between working schedule, musculoskeletal symptoms and days of absenteeism among pulp and paper industry workers. Methods. Musculoskeletal symptoms of 904 workers were assessed through the Nordic Musculoskeletal Questionnaire. χ2 tests assessed associations between being a day-worker or shift-worker, the prevalence of musculoskeletal symptoms and days of absenteeism. Results. A significant association was found between working schedule and symptoms in the lower back in the last 12 months, with shift-workers presenting higher prevalence than day-workers (p = 0.022). Significant associations were also found between days of absenteeism and symptoms in the shoulders (p = 0.002), which mostly led to absenteeism of 100–365 days; elbows (p < 0.001), wrists/hands (p = 0.045) and ankles/feet (p = 0.042), which produced absenteeism mostly of 25–99 days; and dorsal region (p = 0.001), which mainly led to absenteeism of 10–24 days. No associations were found between working schedule and days of absenteeism (p = 0.265). Conclusion. Shift-work is associated with increased prevalence of lower back symptoms, but seems not to influence days of absenteeism. Shoulders seem to be the region leading to higher days of absenteeism, followed by elbows, wrists/hands, ankles/feet and the dorsal region. [ABSTRACT FROM AUTHOR]

Chelating gels may initially assist in root canal preparations to help establish a glide path. While irrigation surveys have investigated liquid chelators and gels to a minor extent, no endodontic survey has focused on EDTA gels and why clinicians use them. All 395 members of the Australian Society of Endodontology (ASE) were emailed an 11-question survey concerning chelation gel usage via Qualtrics. Paper copies were also distributed at ASE events. Descriptive statistics were performed for practitioner and chelating gel data. Cross-tabulations of the practitioner type with the case percentage usage of gels were analyzed with the chi square test (adjusted p value < 0.0083). The overall response rate was 181/395 (46%). For 174 eligible responses, those who never/rarely used a gel were as follows: endodontic residents 12/14 (86%), endodontists 53/71 (75%), general dentists 39/86 (45%), and other members 0% (0/3). Most gel users said that gels helped establish a glide path. Those who never/rarely used chelating gels commented that they held no benefits over liquid EDTA. Endodontists were less likely to use a chelation gel than general dentists (p < 0.0083). Older clinicians had higher gel usage than younger ASE members (p < 0.0083), indicating a possible trend to diminished gel usage over time amongst ASE members. In conclusion, most ASE members find no need for a chelating gel, raising questions about their clinical effectiveness. Studies would therefore be warranted to investigate gel efficacy and improved clinical outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The perception of a clinical condition or disorder can vary across patients from different cultural-linguistic backgrounds. There is insufficient evidence to inspect this potential impact on the perception of vocal fatigue (VF) as a common condition perceived by patients with voice disorders. In order to more comprehensively explore this phenomenon, a systematic review was carried out to investigate the differences in perceived VF in a variety of cultural-linguistic contexts, based on a standard self-assessment instrument--the Vocal Fatigue Index (VFI), as translated in different languages. Method: A thorough search was done in MEDLINE, CENTRAL, Web of Science, and Google Scholar by March 2024. Cross-sectional studies investigating the accuracy of the VFI to detect perceived VF in all available languages were considered. The VFI has three distinct parts or factors assessing: (a) tiredness of voice, (b) physical discomfort associated with voicing, and (c) improvement of symptoms with rest. The cutoff points and sensitivity and specificity of each factor were submitted to meta-analysis, and the summary receiver operating characteristic curves were used to determine pooled sensitivity and specificity of each factor of the VFI. Results: Eight papers that examined the diagnostic accuracy of the VFI in English, Malayalam, Turkish, German, Mandarin Chinese, Polish, Cantonese, and Finnish languages were identified as being eligible for this meta-analysis. The pooled sensitivity and specificity along with their confidence intervals (CIs) were as follows: 0.91 CI [0.80, 0.96] and 0.88 CI [0.78, 0.94] for Factor 1, 0.83 CI [0.69, 0.91] and 0.84 CI [0.76, 0.89] for Factor 2, and 0.75 CI [0.67, 0.82] and 0.77 CI [0.59, 0.89] for Factor 3. Conclusions: The present research demonstrates medium to high but heterogeneous accuracy of the VFI for detecting perceived VF across cultural-linguistic contexts. Given the promising results, future studies should focus on (a) further investigating the underlying factors for the observed heterogeneity in diagnostic accuracy and (b) adapting and validating the VFI in more languages toward establishing its validity as a cross-linguistic diagnostic tool for the perception of VF. [ABSTRACT FROM AUTHOR]

Background: A gap in vancomycin therapeutic drug monitoring (TDM) electronic documentation, management, and related clinical pharmacist activities was identified by our clinical pharmacy team. In response, an electronic TDM (eTDM) template was planned, designed, and implemented by the pharmacy department team in collaboration with the electronic medical records team (EMR) and documentation committee. Aim: To assess the impact of an electronic therapeutic drug monitoring (eTDM) template to measure the impact of adherence to vancomycin guidelines. Guideline adherence indicators include the number of vancomycin levels within the therapeutic range and the number of appropriate concentrations taken. Method: An interventional, single‐centre study of vancomycin therapy in adult patients was performed from 2019–2021. Data were extracted from the electronic medical records and TDM paper‐based forms completed by clinical pharmacists. The number of concentrations within the therapeutic range and the number of appropriately taken levels were analysed by the chi‐square test. This study received an exemption from the Peninsula Health Human Research Ethics Commitee (QA/60523/PH‐2019/197291). Results: There was a total of 198 concentrations collected in the 'before' period and 125 concentrations collected in the 'after' period. The number of concentrations in therapeutic range increased from 34.8% to 43.2% (p = 0.132), not statistically significant. The number of concentrations taken appropriately increased from 33.8% to 55.2% (p < 0.001). The proportion of patients with pharmacist involvement increased from 43.0% to 57.0% (p = 0.868). Conclusion: The study shows that implementation of an electronic vancomycin monitoring template improved the proportion of appropriate levels taken and is the preferred method of documentation by clinical pharmacists. Future projects may benefit from analysing the cost associated with unnecessary vancomycin serum levels ordered or inclusion of pharmacists in the TDM of other narrow therapeutic medications. [ABSTRACT FROM AUTHOR]

Background: Adolescent girls face numerous challenges which hinder their ability to manage menstruation in a healthy and dignified manner. Objectives: To examine the menstrual hygiene practices of adolescent girls schooling in rural Anambra communities. Study design: Cross-sectional descriptive study. Method: Participants were selected using multistage stratified random sampling technique and interviewed using self-administered semi-structured questionnaire. Data were analysed using Statistical Package for Social Sciences version 22.0. Results: Mean age of all, pre-menarche and post-menarche girls were 14.7 ± 1.84, 12.8 ± 1.09 and 15.1 ± 1.73 years, respectively. About 46% of the pre-menarche girls had not received any information on menstruation. Common sources of initial menstruation information were mother (87.3%), school (52.2%) and peers (20.0%). Among the 1091 (85.0% (1091/1283)) post-menarche girls, last menstrual period, last menstrual period duration and cycle length could not be recalled by 53.9%, 34.4% and 39.3%, respectively. Majority (98.3%) who could recall last menstrual period had a cycle length of ⩽30 days and the mean duration of menses was 4.4 ± 0.84 days. Disposable sanitary pad was mostly (60%) cited as recommended product, but cloth/rags (40.6%) or tissue paper (32. 3%) were predominantly used. Majority (88.6%) took their bath ⩾twice/day, 50.9% changed sanitary product ⩽twice/day while 72.5% exhibited poor hand washing. Sanitary products were mostly discarded by burning (45.4%). Fifty-one percent could not change in school predominantly due to lack of functional toilets/changing rooms (84.2%) while 72.5% of those who changed did so in bushes or unused spaces. Challenges faced during menstruation include restriction from holy places (38.9%), waist pain (74.9%), blood stains (36.1%) and lack of money to buy pad (27.0%). Factors significantly associated with using commercial pads were age (p = 0.047), class (p = 0.006), mother's educational status (p < 0.001), social class (p < 0.001), ability to recall last menstrual period date (p = 0.029) or duration (p = 0.001). Conclusion: Menstrual hygiene management was unsatisfactory among studied adolescents. Continuous education of adolescent girls on menstrual hygiene management and advocacy for adequate menstrual hygiene management support are imperative. [ABSTRACT FROM AUTHOR]

Drawing on the framework of Ideological Square Model, this paper carries out a corpus-based analysis of the ways in which group relations and the image of China are re-shaped in the English translation (ET) and the Chinese translation (CT) of Korean news discourse about China with intensifiers as an entry of inquiry. The results show that (1) There is a statistically significant difference regarding faithfulness between the ET and the CT of intensifiers (χ2 = 38.11>3.84, p<0.05), with the ET having more translation shifts. Additionally, the Chi-square test of a 3x3 contingency table (T = 49.77>5.99, P<0.05) indicates that there is a difference between the distribution of translation shifts at the 3 levels between ET and CT. (2) The ET of Korean news about China aligns more closely with van Dijk's ideological square model, while CT violates. It is argued that South Korean media have ideological factors to consider when it comes to Chinese readers accepting CT. (3) There is an alteration of the ideological square model in the target texts. The results indicate that in the translation of a target language, the translation propensity for relevant topics of the target country in which the language is spoken obeys the rules of "Us", the ingroup, but not "them", the outgroup. [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]

Aims: This study aimed to present national data for children and adolescents requiring hospitalization in Thailand. Background: Feeding and eating disorders can cause life‐threatening and negative health impacts. In Asia, the prevalence is rising. Data from children and adolescents in Thailand are limited. Design: This study is a retrospective study of the national database. Methods: Data from the National Health Security Office database on Universal Health Insurance Coverage (2015–2019) of 0–17‐year‐olds were analysed by diagnosis (anorexia nervosa, bulimia nervosa, vomiting associated with psychological disturbances, other eating disorders and unspecified eating disorders). Descriptive statistics, chi‐square test and multinomial logistic regression were used. Results: There were 163 patients, averaging 9.4 ± 5.2 years old, requiring 205 admissions. Most diagnoses showed stable trends, except for a slight decrease in anorexia and unspecified eating disorders. Most admissions were due to unspecified eating disorders and psychogenic vomiting, followed by anorexia nervosa. The overall prevalence was 3.86 per 100 000 admissions. Anorexia had the highest hospital costs and re‐admission rates. Anorexia nervosa was most prevalent in early adolescence and females, while bulimia nervosa was most prominent in middle adolescence and had a male predominance. Conclusion: Early recognition in clinical practice could increase early detection and improve outcomes. Summary statement: What is already known about this topic? Eating disorders are serious mental health conditions that involve unhealthy eating habits and cause fatal medical complications.Most studies have been reported from Western or developed countries; recently, more data are emerging from the East, particularly in developing countries including the Southeast Asia.Underdiagnoses and underdetection can cause delayed treatment and prognosis. What this paper adds? Some types of eating disorders such as anorexia nervosa and bulimia nervosa have specific characteristics. ○Anorexia nervosa was mostly prominent among early adolescents but was also found in younger children. Patients with anorexia nervosa required a longer length of stay, had the highest re‐admission rate and had the highest treatment cost per admission.○Bulimia nervosa was more prominent during middle adolescence. Contrasting to previous literature, we found that Thai males were diagnosed with bulimia nervosa 2.5 times higher than females.○Psychogenic vomiting was prominent in children of both sexes. The implications of this paper: We present the prevalence of national data on feeding and eating disorders among children and adolescents, but we believe that there are more patients with eating disorders outside the health care system, who remain underdetected and underdiagnosed.For early detection, minimizing admissions and complications, clinicians, nurses and health care providers who are at the front line are encouraged to recognize eating disorders, particularly in this era where body image is a concern for adolescents.This study portrays feeding and eating disorders among children and adolescents in Thailand, and the trends may represent counties that have similar socioeconomic backgrounds and health care systems. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to develop a model to help parents cope with decisional conflict. Background: Parents of children with congenital heart defect experience decisional conflict when they are uncertain about treatment decisions for their child, which may lead to delay in seeking care or distress over the decision made. Design: Correlational design with model building and data triangulation was used. Methods: Data were collected through surveys and interviews with a consecutive sample of 221 parent respondents from June to December 2018. Structural equation modelling and qualitative data analysis were used. Results: Lower decisional conflict was seen in parents with higher income, more nurse support and physician risk communication. Time delay for surgery was correlated with the child's age, social service coverage, and social support. Decisional conflict mediated the influence of income, nurse support and physician risk communication on satisfaction with decision. Based on model fit parameters, the emerging model is a good and parsimonious model of decisional conflict. The overall theme, 'Deciding for Surgery: What Matters Most', described the processes parents went through in making treatment decisions. Conclusion: Nurses may help parents feel more certain, less conflicted, and more satisfied with their decision by addressing factors including knowledge gaps, personal values, available support, and resource access. Summary statement: What is already known about this topic? Decisional conflict occurs when parents are uncertain of the best action for their child because treatment options entail risks for undesirable outcomes, value compromise, unclear prognosis, or anticipated regret over the decision.Professional support, information, and communication are vital to parents' decision‐making process.Child, parent, and support factors may influence parent treatment decisions in varied paediatric conditions. What this paper adds? Child's age at the time of decision‐making had an effect on the delay in surgery. However, assisting parents to weigh their options and focus on personal values allowed them to make their treatment decision.Low income, costly health services, and bureaucratic processes impeded the timely availment of surgery. Healthcare reforms that provide a system of government funding, streamlined health structure, and social insurance may be looked into.Family support weighed in on the parents' decision to delay surgery for fear of blame or guilt. Providing relevant information enabled parents to make a choice and stand by their decision regardless of the outcome. The implications of this paper: Modelling provides a framework to identify which factors are more important and how they interact to affect decision‐making. It may be used as an approach to find solutions to clinical problems for groups with different diagnoses.Though nursing support, information, and communication are essential, a more holistic family nursing care approach may be considered to assist parents to make appropriate treatment decisions for their child.Familiarity with the healthcare system may equip nurses to aid parents in processing available healthcare funding and dealing with financial uncertainty affecting decisions for their child's treatment. [ABSTRACT FROM AUTHOR]

Background: Text-based digital media platforms have revolutionized communication and information sharing, providing valuable access to knowledge and understanding in the fields of mental health and suicide prevention. Objective: This systematic review aimed to determine how machine learning and data analysis can be applied to text-based digital media data to understand mental health and aid suicide prevention. Methods: A systematic review of research papers from the following major electronic databases was conducted: Web of Science, MEDLINE, Embase (via MEDLINE), and PsycINFO (via MEDLINE). The database search was supplemented by a hand search using Google Scholar. Results: Overall, 19 studies were included, with five major themes as to how data analysis and machine learning techniques could be applied: (1) as predictors of personal mental health, (2) to understand how personal mental health and suicidal behavior are communicated, (3) to detect mental disorders and suicidal risk, (4) to identify help seeking for mental health difficulties, and (5) to determine the efficacy of interventions to support mental well-being. Conclusions: Our findings show that data analysis and machine learning can be used to gain valuable insights, such as the following: web-based conversations relating to depression vary among different ethnic groups, teenagers engage in a web-based conversation about suicide more often than adults, and people seeking support in web-based mental health communities feel better after receiving online support. Digital tools and mental health apps are being used successfully to manage mental health, particularly through the COVID-19 epidemic, during which analysis has revealed that there was increased anxiety and depression, and web-based communities played a part in reducing isolation during the pandemic. Predictive analytics were also shown to have potential, and virtual reality shows promising results in the delivery of preventive or curative care. Future research efforts could center on optimizing algorithms to enhance the potential of text-based digital media analysis in mental health and suicide prevention. In addressing depression, a crucial step involves identifying the factors that contribute to happiness and using machine learning to forecast these sources of happiness. This could extend to understanding how various activities result in improved happiness across different socioeconomic groups. Using insights gathered from such data analysis and machine learning, there is an opportunity to craft digital interventions, such as chatbots, designed to provide support and address mental health challenges and suicide prevention. [ABSTRACT FROM AUTHOR]

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Aims: The study aimed to develop and evaluate the effects of a self‐determination theory‐based, nurse‐led, physical activity programme for postmenopausal women with rheumatoid arthritis. Methods: Between December 2019 and April 2020, this randomized controlled trial recruited 62 postmenopausal women with rheumatoid arthritis from a university‐affiliated hospital in South Korea. The intervention group participated in a self‐determination theory‐based, nurse‐led, physical activity programme that consisted of Tai Chi‐based physical activity, a supportive psychosocial strategy, and interactive counselling for 16 weeks, and the control group continued to undergo their usual care. Results: There were statistically significant group‐by‐time interactions in physical activity and perceived sarcopenia, which favoured the intervention group. Additionally, the intervention group showed significant improvements in the perceived therapeutic efficacy of physical activity, grip strength, walking speed, disease activity score, and health‐related quality of life. Conclusions: The programme developed in this study can be an effective and feasible approach for postmenopausal women with rheumatoid arthritis in improving physical activity, selected osteosarcopenic outcomes, and health‐related quality of life. Further research is required to investigate the long‐term effects of this theory‐based programme for postmenopausal women in diverse settings. Summary statement: What is already known about this topic? Tai Chi‐based physical activity has been known to be a component of self‐management for rheumatoid arthritis. What this paper adds? It highlights the efficacy of a theory‐based, nurse‐led, physical activity programme to improve the quality of life of postmenopausal women with rheumatoid arthritis.The evidenced‐based programme could be transferred to postmenopausal women with rheumatoid arthritis in clinical settings. The implications of this paper: The self‐determination theory‐based, nurse‐led, physical activity programme can improve physical and psychosocial outcomes in postmenopausal women with rheumatoid arthritis.Importantly, this nurse‐led and theory‐based programme is expected to be applicable to postmenopausal women with rheumatoid arthritis in clinical settings, including both hospitals and communities. [ABSTRACT FROM AUTHOR]

Aim: This study aims to identify and synthesize available research reporting parental mental health outcomes related to contact with a stillborn baby. Background: Stillbirth is devastating events for parents. The effects of contact with the stillborn baby on parental mental health are uncertain. Methods: This was a systematic review and meta‐analysis carried out by searching six international electronic databases including PubMed, EMBASE, Cochrane, Web of Science, PsycINFO and CNKI databases from inception to 15 January 2023. Review Manager software was used for data analysis. Results: Ten studies were included (n = 3974). Contact with a stillborn baby increased the risks of anxiety, depression and post‐traumatic stress disorder in the short term and increased the risks of anxiety and post‐traumatic stress disorder in the long term. Parents who had contact with a stillborn baby were more satisfied with their decision. Subgroup analysis showed that seeing a stillborn baby had no significant effect on anxiety or depression, but holding a stillborn baby increased the risks of anxiety. Conclusions: Caregivers should respect the parents' decision on whether to have contact with the stillborn baby and provide parents with continuous information, emotional and behavioural support after they have contact with stillborn babies. Summary statement: What is already known about this topic? Stillbirth is a tragic event for parents and the extended families and can trigger intense grief and devastating psychosocial symptoms.Although some studies have been conducted to investigate the effect of contact with the stillborn baby on parental mental health, there is no consensus on the effectiveness of contact with the stillborn baby. What this paper adds? Contact with stillborn baby, particularly holding a stillborn baby, may increase the risk of harm to parental mental health.Parents were more satisfied with their decision to have contact with a stillborn baby rather than no contact with their stillborn baby. The implications of this paper: This study may provide evidence for managers and caregivers about the development of guidelines for contact with a stillborn baby and promote parental mental health. [ABSTRACT FROM AUTHOR]

Background: There are many controversies over the necessity of monitoring gastric residual volume in the nursing care of enteral nutrition. We aimed to conduct an updated meta‐analysis to evaluate the effects of monitoring or not monitoring gastric residual volume on patients' outcomes and complications. Methods: We searched the Cochrane Library database to 15 April 2021 for randomized controlled trials (RCTs) on the effects of gastric residual volume and no gastric residual volume monitoring. Review Manager software was used for data analysis. Results: A total of seven RCTs involving 1240 enteral nutrition patients were included. Gastric residual volume monitoring was associated with reduced incidence of vomiting (OR2.33, 95% CI:1.68–3.24), whereas no gastric residual volume monitoring was associated with reduced incidence of unnecessary interruptions of enteral nutrition (OR0.38,95% CI:0.26–0.55). There were no significant differences on the incidence of abdominal distention (OR1.87, 95% CI:0.82–4.28), diarrhoea (OR1.03,95% CI:0.74–1.43), VAP (OR0.83, 95%CI:0.37–1.89), duration of mechanical ventilation (MD −0.06,95% CI:−1.22–1.10), length of ICU stay (MD −1.33, 95% CI:−3.58–0.91) and mortality (OR0.90,95% CI:0.61–1.34). Conclusions: Not monitoring gastric residual volume is associated with reduced unnecessary interruptions of enteral nutrition related to inadequate feeding and increased risk of vomiting. Summary statement: What is already known about this topic? Enteral nutrition is vital to the prognosis of critically ill patients.Monitoring the gastric residual volume has been used for the safety of enteral nutrition.The role of gastric residual volume monitoring in critically ill patients remains unclear. What this paper adds? Monitoring gastric residual volume is associated with reduced incidence of vomiting.Not monitoring gastric residual volumes may reduce unnecessary interruptions of enteral nutrition.There are no significant differences on the incidence of abdominal distention, diarrhoea, VAP, duration of mechanical ventilation, length of ICU stay and mortality between patients with or without gastric residual volume monitoring. The implications of this paper: Omission of gastric residual volume monitoring may result in more complete delivery of prescribed enteral nutrition and hence of better nutritional support / status for these patients.The role of gastric residual volume monitoring on enteral safety and nutritional intake of ICU patient needs further investigation. [ABSTRACT FROM AUTHOR]

Aim: To assess if experimental warming interventions are superior to routine warming interventions in preventing perioperative hypothermia. Background: Perioperative hypothermia is a critical issue for the complications of surgery. There are various kinds of perioperative warming interventions, including experimental and routine warming interventions. Methods: We performed a systematic literature review and meta‐analysis for the randomized clinical trials of experimental warming interventions vs. routine warming interventions in the perioperative period. Findings: A total of 15 studies were included with 983 participants allocated to experimental warming interventions and 939 controls with routine warming interventions, who were receiving a variety of surgeries. The focused outcome was the intraoperative and postoperative body temperature. All included studies were randomized clinical trials. Among the participants receiving operations, the meta‐analysis showed that routine warming intervention groups experienced lower intraoperative and postoperative body temperatures compared to the experimental warming groups. The meta‐analysis results included positive mean differences, significant tests for overall effect and significant heterogeneity in the random‐effects model. Conclusions: In spite of significant heterogeneity, experimental warming interventions are likely to demonstrate superior warming effects when compared to routine warming interventions, as shown by the current meta‐analysis results of randomized clinical trials. Summary statement: What is already known about this topic? Perioperative hypothermia is a significant factor for prognosis within and after surgery.The difference between experimental and routine nursing interventions for maintaining intraoperative and postoperative body temperature was unknown. What this paper adds? The meta‐analysis showed that routine warming intervention groups experienced significantly lower intraoperative and postoperative body temperatures when compared to experimental warming groups. The implications of this paper: Experimental warming interventions might be associated with superior warming effects.The heterogeneity of surgery type and experimental warming methods might limit the interpretation of findings. [ABSTRACT FROM AUTHOR]

Copyright of Polish Journal of Management Studies is the property of Czestochowa University of Technology, Faculty of Management and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Nausea is one of the most important symptoms of patients undergoing chemotherapy. This study aims to determine the effects of aromatherapy with sour lemon on nausea in patients undergoing chemotherapy. Methods: A total of 50 patients undergoing chemotherapy were randomly assigned to experimental and placebo (control) groups. The two groups completed the visual analogue scale for nausea before and the first to the fourth week after starting the intervention. The intervention was performed during chemotherapy. Using a dropper, a paper towel was saturated with 3 drops of sour lemon essential oil; however, for the control group, 3 mL of water as a placebo was spread on a paper towel. The intervention in the experimental and control groups was performed once a week for 4 weeks during weekly chemotherapy sessions. Results: At the beginning of the study, no significant difference was observed between the mean score of nausea in the two groups (P>0.05). The first to the fourth week after starting the intervention, significant differences were observed between the mean score of nausea in the two groups (P<0.05). The results of the repeated measures analysis of variance indicated that the mean score of nausea changed over time in the experimental group, indicating a gradual decrease in the mean score of nausea (P<0.05). Discussion: Our findings indicated that aromatherapy with sour lemon can be effective in reducing nausea in patients undergoing chemotherapy. [ABSTRACT FROM AUTHOR]

Copyright of Polish Journal of Management Studies is the property of Czestochowa University of Technology, Faculty of Management and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Although green training has been shown in past research to promote environmentally responsible behaviors at work, scholars have paid less attention to its influence on employees' eco‐friendly behaviors outside of work. This omission is critical because confining green training research to the work domain obscures its benefits in promoting employees' pro‐environmental behaviors beyond the workplace, and thus its role in supporting organizational efforts to conserve the natural environment. To address this gap, we examine the direct and indirect (via connectedness to nature) relationships between green training and employees' eco‐friendly behaviors outside of work, including consumption of eco‐friendly products, reuse of items and materials, and reduced consumption of resources such as water, electricity, and paper. We also examine the moderating influence of intrinsic spirituality on the direct link between green training and connectedness to nature, as well as the indirect link between green training and eco‐friendly behaviors beyond the workplace. Using time‐lagged, multisource data, we find support for our hypotheses. Our findings advance knowledge on the important yet largely overlooked role of green training in shaping employees' environmentally responsible behaviors outside of the workplace. [ABSTRACT FROM AUTHOR]

Background: Dietary supplement (DS) use is common and increasing among older adults, though much data available on use frequencies are from surveys and performed cross-sectionally. This paper sought to assess the frequency and pattern of dietary supplement use among older adults over time. Methods: A secondary analysis of data from the AAA LongROAD study, a longitudinal prospective cohort study of older adult drivers, using data from baseline and the first two years of follow up included a total of 2990 drivers aged 65–79 years recruited at five study sites across the US from July 2015 to March 2017. Participants underwent baseline and annual evaluations, which included a "brown bag" medication review. DS were identified and categorized according to type and key components. Prevalence and pattern of DS use over time and relationship to demographics were measured with frequency and Chi squared analyses. Results: 84% of participants took at least one dietary supplement during the 2-year study period, and 55% of participants continually reported use. DS accounted for approximately 30% of the total pharmacologic-pill burden in all years. Participants who were White non-Hispanic, female, 75–79 years of age at baseline, and on more non-supplement medications took significantly more dietary supplements (P < 0.05). Vitamin D, multivitamins, calcium, and omega-3 formulations were the most common supplements, with stable use over time. Use of individual herbal supplements and cannabis products was uncommon (< 1% participants per year). Conclusions: DS use among older adults is common and relatively stable over time and contributes to polypharmacy. In clinical settings, providers should consider the influence of DS formulations on polypharmacy, and the associated cost, risk of medication interactions, and effect on medication compliance. [ABSTRACT FROM AUTHOR]

Parenting with a physical disability often brings with it a range of challenges. Occupational therapists are well positioned to support parents to address these challenges, yet occupational therapy research and practice around parenting is relatively scarce. This paper addresses the questions: (1) How should occupational therapists support parenting occupations for people with physical disability? (2) How do parents with physical disability experience occupational therapy? An anonymous survey of 62 parents, primarily mothers, with physical disability about their experiences with parenting challenges and occupational therapy was analysed using both quantitative and qualitative techniques. Parents experienced challenges in engaging in a range of parenting tasks with children over a range of age groups. Parents reported that support was often needed and indicated that occupational therapy could assist them directly with specific parenting goals as well as the more usual biomechanical goals that influence parenting. Yet less than half of participants who received occupational therapy services reported that parenting tasks were addressed, and only one‐fifth reported that their goals had been fully met. The data also indicated that the knowledge, skills, and attitudes of occupational therapists with regard to working with parents with disability can be improved. Findings suggest a need to better incorporate parenting occupations in standard occupational therapy training to increase occupational therapists' comfort and competence in working with clients on parenting issues. [ABSTRACT FROM AUTHOR]

Aims: Glioma patients are at high risk for postoperative delirium (POD), yet studies focusing on this population in general neurosurgical ward settings are limited. This paper investigates the incidence of POD and related risk factors in glioma patients hospitalized in general wards. Design: Prospective observational study. Methods: This prospective study included 133 adult glioma patients hospitalized in the general neurosurgery ward. In addition to collecting routine perioperative general clinical data, patients' psychological status was assessed preoperatively using the Hospital Anxiety and Depression Scale (HADS). POD was assessed within 3 days postoperatively using the Confusion of Consciousness Assessment method, twice daily. The incidence of POD was calculated, and risk factors were identified using logistic regression analysis. Results: The incidence of POD in glioma patients admitted to the general ward was 31.6% (40/133). Multivariate regression revealed advanced age (age > 50 years), frontal lobe tumour, presence of preoperative anxiety or depression, retention of a luminal drain, postoperative pain, indwelling catheter these six factors were independent risk factors for the development of delirium in patients after surgery. Conclusion: In general ward settings, supratentorial glioma patients exhibit a high risk of POD. Critical risk factors include preoperative psychological conditions, as well as postoperative pain, drainage and catheterization. Rigorous preoperative evaluations, effective pain management strategies and the integration of humanistic care principles are essential in mitigating the risk of POD for glioma patients. Relevance to Clinical Practice: In general ward settings, this study reveals the high occurrence of POD in glioma patients and identifies preoperative psychological states, age, tumour location and several postoperative factors as significant risk factors for POD, which provides a framework for targeted interventions. By integrating these insights into clinical practice, healthcare teams can better identify glioma patients at risk for POD and implement preventive measures, thereby enhancing recovery and overall care quality for glioma patients in general neurosurgical wards. Reporting Method: This study adheres to the STROBE guidelines, ensuring a transparent and comprehensive reporting of the observational research methodology and results. Patient or Public Contribution: Patients involvement was limited to the provision of data through their participation in the study's assessments and the collection of clinical information. The study did not involve a direct patient or public contribution in the design, conduct, analysis, or interpretation of the data, nor in the preparation of the manuscript. [ABSTRACT FROM AUTHOR]

Introduction: Smartphone applications (apps) for pharmacovigilance present an opportunity for integration as cost-effective healthcare service intervention into basic healthcare services in low-resource settings. This study aimed to (i) evaluate the implementation of the Med Safety app in Burkina Faso, and (ii) compare the characteristics of the reports sent by the Med Safety app with those sent on paper form. Methods: The study had two components: (i) a cross-sectional online survey assessing the Med Safety app, and (ii) a retrospective analysis comparing the characteristics of the Med Safety reports with those of the paper form, received by the National Pharmacovigilance Centre of Burkina Faso (CNVPS), from January 1, 2021 to December 31, 2022. We evaluated the success of the implementation of the Med Safety intervention using measures of acceptability, usefulness and feasibility. This assessment involved a set of 14 items rated on a 4-point Likert scale. Acceptability, feasibility, and usefulness were determined based on achieving a total score higher than the mean. Subsequently, we computed the proportion of participants whose overall score for all items exceeded the mean. Continuous and categorical variables were compared using the Wilcoxon rank-sum test and the Chi2 test, respectively. The significance level of the statistical test was set at 5%. Results: The survey participation rate was 51.9% (160/308). Half of the respondents were in the 35-44 age group (50.6%), and participants were predominantly male (71.9%). The Med Safety app was acceptable, feasible, and useful to 58.1% of respondents. The most useful features of the app were "reporting" (53.1%), "news" (13.6%) and "watch list" (12.4%). During the period, a total of 1,472 reports were received, including 357 (24.3%) through Med Safety and 1,115 (75.7%) through the paper form. The reports of adverse events following immunization received at the CNVPS numbered 974 (66.2%), these were related to COVID-19 vaccines, with 256 (26.3%) through the Med Safety and 718 (73.7%) through the paper form. The median time to submit the reports to the CNVPS was 159 (IQR 59–187) days for the Med Safety and 166 (IQR 107–281) days for the paper form (p < 0.001). Conclusion: In Burkina Faso, the Med Safety was found to be acceptable, useful, and feasible by users surveyed. In addition, and compared to the paper form, the app reduces the time to submit a report, and with increase in use, the reporting timeframe could be further improved. [ABSTRACT FROM AUTHOR]

Background: Instructional videos constitute a pivotal component in flipped learning. Despite their significance, there is a dearth of research specifically dedicated to instructional videos within the context of flipped classrooms. This paucity has led to an empirical void in verifying the efficacy of instructional videos in flipped learning environments. Objectives: The present study endeavours to contribute to the extant literature on flipped pedagogical practices by providing empirical evidence regarding the effectiveness of instructional videos in flipped learning environments. Methods: This study employs a convergent mixed‐methods design. Forty‐five instructional videos in three subtypes were administered in two classes over a 15‐week semester. Data, both quantitative (log data from the learning management system) and qualitative (from focus group discussions at two time points), were concurrently collected from a flipped class (n = 25) and a blended class (n = 28) with the aim of gauging student engagement and learning outcomes in the flipped class and understanding video‐viewing features typical of the flipped class. Results: Both datasets corroborated that participants in the flipped class outperformed their counterparts in the blended class in terms of video‐watching, peer interaction, knowledge retention, and transfer skills. Conclusions: The instructional videos within the flipped classroom setting serve to enhance student engagement in the learning process and improve learning outcomes. The efficacy of these instructional videos in flipped learning can be further augmented through strategic approaches in both their design and implementation. Lay Description: What is currently known about this topic: The flipping pedagogy is conducive to learning.Videos play a crucial role in flipped learning.Videos prepared students for classroom activities.However, engaging students with pre‐class videos presents a challenge. What this paper adds: This paper furnishes direct empirical evidence supporting the effectiveness of instructional videos in flipped learning.It uncovers factors affecting student engagement with videos in flipped learning.It offers insights into the design and implementation of videos in flipped learning. Implications for practice: Considering facilitating conditions and affective factors when creating videos.Acknowledging learner characteristics when designing videos.Utilizing instructional strategies when implementing videos. [ABSTRACT FROM AUTHOR]

Aims: The present study aimed to explore the effects of a guided self‐help mindfulness intervention on psychological resilience and job burnout among psychiatric nurses. Background: Psychiatric nurses work in challenging and potentially high stress settings. Mindfulness interventions can improve psychological resilience and reduce job burnout of nurses. However, face‐to‐face delivery of mindfulness interventions may be inconvenient for individuals. Guided self‐help interventions may be more accessible. Methods: This randomized controlled trial was conducted from January to August 2022. One hundred and eighteen psychiatric nurses were randomized into the intervention and control groups. The individuals in the intervention group received an 8‐week guided self‐help mindfulness intervention, while the individuals in the control group received a psycho‐educational brochure. The Five Facet Mindfulness Questionnaire, the Connor‐Davidson Resilience Scale and the Maslach Burnout Inventory‐Human Services Survey were used to evaluate the levels of mindfulness, psychological resilience and job burnout, respectively. Results: After an 8‐week intervention, compared with the control group, the levels of mindfulness and psychological resilience were higher, while the level of job burnout was lower in the intervention group. Conclusions: The guided self‐help mindfulness intervention can improve psychological resilience and reduce job burnout among psychiatric nurses. Summary statement: What is already known about the topic? Mindfulness‐based interventions can improve psychological resilience and reduce job burnout of nurses.A growing body of studies has begun incorporating self‐help strategies with mindfulness‐based interventions.There are few studies exploring the use of the guided self‐help mindfulness interventions for Chinese psychiatric nurses and the associated effects on psychological resilience and job burnout. What this paper adds? The guided self‐help mindfulness intervention reduced job burnout and improved psychological resilience compared with psycho‐education intervention. Implications of this research Self‐guided mindfulness interventions can be used to improve psychological resilience and reduce job burnout among psychiatric nurses.In the future, the impact of self‐help mindfulness interventions on the mental health of nurses in other specialties can be trialled. [ABSTRACT FROM AUTHOR]

Background: This study examines the perceptions of the Australian public canvassed in 2021 during the COVID‐19 pandemic about their health system compared to four previous surveys (2008, 2010, 2012 and 2018). Methods: In 2021, a nationwide online survey was conducted with a representative sample of Australians (N = 5100) recruited via market research panels. The results were compared to previous nationwide Australian survey samples from 2018 (N = 1024), 2012 (N = 1200), 2010 (N = 1201) and 2008 (N = 1146). The survey included questions consistent with previous polls regarding self‐reported health status and overall opinions of, and confidence in, the Australian health system. Results: There was an increase in the proportion of respondents reporting positive perceptions at each survey between 2008 and 2021, with a significantly higher proportion of respondents expressing a more positive view of the Australian healthcare system in 2021 compared to previous years (χ2(8, N = 9645) = 487.63, p < 0.001). In 2021, over two‐thirds of respondents (n = 3949/5100, 77.4%) reported that following the COVID‐19 pandemic, their confidence in the Australian healthcare system had either remained the same (n = 2433/5100, 47.7%) or increased (n = 1516/5100, 29.7%). Overall, respondents living in regional or remote regions, younger Australians (< 45 years) and women held less positive views in relation to the system. In 2021, the most frequently identified area for urgent improvement was the need for more healthcare workers (n = 1350/3576, 37.8%), an area of concern particularly for Australians residing in regional or remote areas (n = 590/1385, 42.6%). Conclusions: Irrespective of disruptions to the Australian healthcare system caused by the COVID‐19 pandemic, Australians' perceptions of their healthcare system were positive in 2021. However, concerns were raised about inadequate workforce capacity and the cost of healthcare, with differences identified by age groups and geographical location. Patient or Public Contribution: Health consumer representatives from the Consumers Health Forum of Australia contributed to the co‐design, deployment, analysis and interpretation of the results of this survey. J.A. and L.W. from the Consumers Health Forum of Australia contributed to the development of the paper. [ABSTRACT FROM AUTHOR]

The paper examined how dissociation is experienced and manifested in the drawings and narratives of female survivors of childhood sexual abuse (CSA) diagnosed with dissociative identity disorder. Fifteen Israeli women filled out a self-report questionnaire consisting of demographics, traumatic events, and dissociation severity. Then, they were asked to draw a dissociation experience and provide a narrative. The results indicated that experiencing CSA was highly correlated with indicators such as the level of fragmentation, the figurative style, as well as with the narrative. Two main themes emerged: a constant movement between internal and external worlds, and distorted perceptions of time and space. [ABSTRACT FROM AUTHOR]

Aim: To determine the prevalence and clustering of NANDA‐International nursing diagnoses in patients assisted by pre‐hospital emergency teams. Design: Retrospective descriptive study of electronic record review. Methods: Episodes recorded during 2019, including at least a nursing diagnosis, were recovered from the electronic health records of a Spanish public emergency agency (N = 28,847). Descriptive statistics were used to characterize the sample and determine prevalence. A two‐step cluster analysis was used to group nursing diagnoses. A comparison between clusters in sociodemographic and medical problems was performed. Data were accessed in November 2020. Results: Risk for falls (00155) (27.3%), Anxiety (00146) (23.2%), Acute pain (00132), Fear (00148) and Ineffective breathing pattern (00032) represented 96.1% of all recorded diagnoses. A six‐cluster solution (n = 26.788) was found. Five clusters had a single high‐prevalence diagnosis predominance: Risk for falls (00155) in cluster 1, Anxiety (00146) in cluster 2, Fear (00148) in cluster 3, Acute pain (00132) in cluster 4 and Ineffective breathing pattern (00032) in cluster 6. Cluster 5 had several high prevalence diagnoses which co‐occurred: Risk for unstable blood glucose level (00179), Ineffective coping (00069), Ineffective health management (00078), Impaired comfort (00214) and Impaired verbal communication (00051). Conclusion: Five nursing diagnoses accounted for almost the entire prevalence. The identified clusters showed that pre‐hospital patients present six patterns of nursing diagnoses. Five clusters were predominated by a predominant nursing diagnosis related to patient safety, coping, comfort, and activity/rest, respectively. The sixth cluster grouped several nursing diagnoses applicable to exacerbations of chronic diseases. Implications for the profession and/or patient care: Knowing the prevalence and clustering of nursing diagnoses allows a better understanding of the human responses of patients attended by pre‐hospital emergency teams and increases the evidence of individualized/standardized care plans in the pre‐hospital clinical setting. Impact: What problem did the study address? There are different models of pre‐hospital emergency care services.The use of standardized nursing languages in the pre‐hospital setting is not homogeneous.Studies on NANDA‐I nursing diagnoses in the pre‐hospital context are scarce, and those available are conducted on small samples. What were the main findings? This paper reports the study with the largest sample among the few published on NANDA‐I nursing diagnoses in the pre‐hospital care setting.Five nursing diagnoses represented 96.1% of all recorded. These diagnoses were related to patients' safety/protection and coping/stress tolerance.Patients attended by pre‐hospital care teams are grouped into six clusters based on the nursing diagnoses, and this classification is independent of the medical conditions the patient suffers. Where and on whom will the research have an impact? Knowing the prevalence of nursing diagnoses allows a better understanding of the human responses of patients treated in the pre‐hospital setting, increasing the evidence of individualized and standardized care plans for pre‐hospital care. Reporting method: STROBE checklist has been used as a reporting method. No Patient or Public Contribution: Only patients' records were reviewed without further involvement. [ABSTRACT FROM AUTHOR]